The Pros and Cons of Attending a PT Residency Program as a New Grad

To residency or not to residency, that is the question.

Okay, no, it’s not exactly Shakespeare’s original question, but it’s closer to the source material than you might think! Even though old Bill’s most famous soliloquy ponders a different sort of choice, the basic premise stands: How can you make a good choice when faced with the unknown? If you’re looking into attending a physical therapy residency program, it may feel like you’re facing a whole hoard of unknowns—or at least a whole hoard of questions. Are PT residencies worth it? Will a residency benefit my career? How will a PT residency affect my finances? 

And while new experiences always come with some measure of unknowns, they certainly shouldn’t come with a hoard of them—which is why we’ve done our best to whip up some information about the pros and cons of physical therapy residency.

Pros 

PT residency alums start their career with some extra clinical experience (and schooling) under their belts. 

Getting a DPT degree is time-consuming. Not only does it require seven years of schooling, CAPTE-accredited DPT programs also require students to rack up hundreds of hours of clinical experience. (Though to be fair, this requirement helps new grads enter the field with a practical understanding of how to work with and treat different patients.)

There’s so much to learn during this time that it can be difficult for new grads to absorb everything they need to know, so for students who live by the mantra “practice makes perfect,” a residency program could be the ideal place to continue practicing those freshly internalized clinical skills. Residencies operate under the assumption that their residents are still learning, and therefore offer additional support and mentorship to help residents master clinical care—far more than a new grad would find in the average PT clinic. Some residencies also fold classes, research projects, and traditional testing into their programs, giving students time to drill down on additional practical skills they may not have refined in school. 

It’s also worth noting that many residencies are hosted in specialized environments (e.g., women’s health or geriatric PT), allowing their attendees to work with patients that ignite their passion. 

Accredited residency programs offer mentorship. 

As with college programs, residencies can obtain accreditation: a status awarded by the American Board of Physical Therapy that ensures a residency meets specific quality standards. One of the criteria of accreditation is that the program hones in on its mentorship opportunities. 

Mentorship can enrich and develop mentees in a host of ways. Studies say that mentorship can: 

• Improve productivity,
• Improve career satisfaction,
• Prepare mentees for career moves, 
• Facilitate networking opportunities, and
• Reduce anxiety and stress.

It makes sense: a PT new grad’s first foray into clinical work is a stressful time filled with uncertainty and doubt. There’s no better moment for a new grad to have someone by their side who’s willing to offer advice and direction (and answer their limitless questions!). 

Conversely, new grad PTs who are hired directly out of school shouldn’t expect to get a dedicated mentor. They may luck into connecting with a colleague or two who they can lean on for help, but that’s a far cry from having an experienced mentor who’s willing to help guide their career development. 

Residency alums often have a leg up during the hiring process. 

Even though residencies are not necessary to have a successful and rewarding career, they can help PTs who’re on the job hunt. Whether it’s because residents are more motivated than their peers or because of internalized academic elitism (or both), some managers and employers have a slightly higher opinion of former residents. This small study revealed that, on average, employers rated residency-trained employees higher than their non-residency-trained colleagues who have similar work experience. This positive perception could help former residents snag a job at a competitive clinic or in a PT-saturated city. 

Additionally, some residencies offer permanent positions to PTs who excel during the program. In these cases, residency can be a great way to get a foot in the door in a competitive environment.  

Residents may be able to negotiate for a higher starting salary—or vie for a position with better pay.

New grad DPTs enter the PT workforce, more often than not, burdened by a veritable mountain of debt. That’s why it’s important to look for higher-paying physical therapy jobs from the get-go—or negotiate for a better salary (among other benefits). 

Because PT residency is viewed so favorably (see above section), a completed residency can help boost a PT’s negotiation power—even as a fledgling member of the workforce. Former residents can present a well-documented track record of patient outcomes and personal growth, and they may even be able to tack on a couple letters of recommendations from mentors or peers. While this may not be enough to secure every single job opportunity, this could easily give a resident an edge over a fresh new grad when vying for a competitive job. 

As for salary negotiation, if a resident can demonstrate how their residency improved their care and their outcomes, they may be able to petition for a better salary. After all, better care means better outcomes, which means happier patients, which means loyal customers, referrals, and PT advocates.    

Cons

Residents may have to relocate. 

While there are hundreds of accredited PT residency programs scattered across the country (350 per this ABPTRFE directory), prospective residents may still not have the luxury of finding a residency program that’s in their home city—or their state for that matter. To put it in perspective, 10,000 new PTs graduate each and every year; there are only a few hundred residency spots; and residencies are open to all PTs—not just new grads.

In other words, prospective residents, and especially those who are laser-focused on pursuing a particular specialty, will likely have to apply to programs in different corners of the country in order to find a residency that both meets their needs and is willing to take them on. Relocating (even for only a year-long program) is a big ask for anyone, but that is often the price of attending a PT residency.   

Residents may have to pay tuition. 

Another serious barrier to consider is that some residency programs have a tuition requirement for their residents. The actual cost of these tuitions vary vastly from program to program; take a look at how the cost ranges between these Arizona programs. Some programs (like the Mayo Clinic’s geriatric program) are tuition-free, whereas others (like the programs hosted by A.T. Still University) cost a little more than $8,000. 

If a resident hopeful has their sights set on a particular program or specialty, then tuition costs must be part of the conversation. Just know that some organizations (like Rizing Tide) offer scholarships to help offset these costs so students have the freedom to develop their careers as they best see fit. 

PT residents are paid less than staff physical therapists. 

Despite the fact that PT residency programs are typically a full-time commitment that involve a heap of clinical work, residents are paid fractionally less than a staff PT. In fact, this source tells PT residents to expect to take home only 80–95% of a staff PT’s salary. Though this source reports PT resident salaries coming out to 70% of a staff PT’s wage. For some context, here’s what that looks like using the national mean annual wage for PTs. 

And that’s assuming the program pays its residents at all. Many, often the ones that require tuition, do not offer salaries to their residents. 

The big takeaway is this: If you’re considering applying for a PT residency, but you’re worried about managing your debt from DPT school, then it may be worthwhile to rethink the path of the PT resident—or to at least seek out scholarships and fiscal aid that’ll help you pursue your educational dream. 

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No matter how hard you try, any new experience will be riddled with uncertainty (at least partially). At a certain point you need to take a leap of faith: decide whether to be or not to be. After all, isn’t that the question?