Homepage | Duke Doctor of Physical Therapy



Episode 13 Lauren Bauer and Zach Tally Residency.mp3Dr. Derek Clewley [00:00:00] So today on the Duke DPT podcast we are joined by two very special guests Lauren Bauer and Zach Tally. Lauren Bauer received her Doctorate of physical therapy from Creighton University in Omaha Nebraska in 2018 and her Bachelor of Science in kinesiology from the University of Minnesota in Minneapolis Minnesota in 2014. She is the current women's health physical therapy resident at Duke University practicing in an outpatient interdisciplinary setting. Lauren is a certified lymphedema therapist and her specialized interests include breast and gynecological cancer rehabilitation and Transgender Health. Zach Talley is a doctor of physical therapy graduate from Duke University in Durham North Carolina and an alumnus of the University of South Carolina with a Bachelor of Science in exercise science with an emphasis in early motor development. He is the inaugural and current on oncological physical therapy resident at Duke University Health System practicing in both acute care and outpatient interdisciplinary settings Dr. Tally is a certified lymphedema therapist. And while in school Zach was a graduate assistant and assisted in the development of the Duke Durham's stroke camp. His specialized interests include bone metastasis management and hematological conditions including sickle cell disease as a fun fact. He did rekindle a friendship and is now engaged to be married to a former classmate of his from Duke DPT. So we'd like to welcome them to the show. computer [00:01:35] WELCOME TO THE DUKE DPT podcast a show designed to bridge academics and researchers with health care professionals. Now here's your host Derek Clewley a faculty member and a budding academician at Duke University in the doctor physical therapy division. Dr. Derek Clewley [00:01:51] OK. So today on the show we have two very special guests. Today we have two residents who are actually part of the Duke University Health System residency programs and I'll have them introduce a little bit more about what their residency is and such. But today we have Lauren Bauer who is a graduate of Creighton University and is here at Duke. And Zach Tally who is a Duke University alumnus and is also here doing his residency and we wanted to bring them on the show today really to kind of talk about the whole process of residency their experiences and such. I think today is going to be a really lively show so. So given that we have our two guests give a little bit more of an introduction of themselves a little bit background that kind of thing right now we'll do and rock paper scissors because they don't know who wants to go first. So we'll just let us take it off first here. Dr. Zach Tally [00:02:41] Go for it. Dr. Lauren Bauer [00:02:42] All right. So I'm Lauren and I'm originally from Minnesota. I played soccer at the University of Minnesota in undergrad and then I decide to go to Creighton University as he said for PT school experiences that I've had in PT school include I was a research assistant under Dr. Jenny Bagwell she did a lot of research on the hip and then I was a tech at a local PT clinic under a women's health certified specialist. So that's kind of where I got my start. And then I was also involved in just the government student government at Creighton University. Dr. Zach Tally [00:03:17] Awesome thanks Dr. Clewley for having me. I'm a Duke DPT alum. I'm originally from South Carolina. I went to the University of South Carolina and studied exercise science but ended up chasing a dream and going to duke for PT school. PT school was an incredible experience for me personally. I was a graduate assistant with the program so I got to work with a lot of the faculty up close and personal and did some research in stroke rehab helped work with the stroke camp that the PT program helped build and clinical experience wise I think had a lot of Pediatrics experience orthopedics and some general ICU stuff which kind of led to some of my interests. Now on the oncology PTresident at Duke in kind of a developing programs on the first one going through that so we'll talk about that as we go on leave. Dr. Derek Clewley [00:04:13] Absolutely. It's actually really cool that we bring in folks in residency background. Obviously there's a certain residency programs and certain specialty areas or academies even within the APTA that are probably seen to be larger and some things like ortho and neuro and things like that. So I think it's really a cool thing on today that we have two residents that are in dare I say a little bit more niche sort of specialized areas of PT practice very also areas that are deserving and need some of that specialized training given that so it's really cool to have you guys on the show today. So I'll fire back and forth questions to each of you. And so feel free to keep playing rock paper scissors whoever wants to keep going first we can alternate how we want to do this is fine. And so in terms of the whole residency process he has already mentioned that you're really kind of recent and at maybe it seems like PT school was a long time ago maybe it seems like P.T. school was just yesterday I don't know but if you could think back and reflect back to the process what inspired you to take on the leap of thought that postgraduate training of residency. Can you speak a little bit to that part. Dr. Zach Tally [00:05:30] I'll take that one. I think I came about a very unique way I believe that I was completely and this is just me being honest I think completely anti specialization early on throughout my entire career. I was I think more scared that I wasn't going to be able to use all of the skills that I was learning and I really just enjoyed learning everything especially at Duke with all the resources and things we have going on. I could have gone in so many different directions and so I didn't really want to pigeon hole or kind of silo myself in that education. But what I kind of slowly started to learn through just my interactions with other residents and other faculty members is that really in a specialty you're kind of able to hone your skills and just dive significantly deeper than you ever would. And so within that kind of boundary there is a lot more freedom per say. So like I said I did not want to do a residency but one kind of fell into my lap a little bit. I actually just shadowed one of our one of our instructors one day shadowed her after class and was kind of expressing my interest in things and how I really wanted to be able to use all of the skills I was learning whether it was neuro or orthopedic cardio pulm integ wound care you name it. I wanted to be able to use all of that in one specific field and I stumbled upon oncology that kind of made that happen. So. With that fast forward a little bit. The national kind of the APTA were creating this or the ABPTS Ended up leading to the specialisation and so we were able to kind of get the residency up and going in time for the specialisation and going through that whole process. And so I kind of fell into it by happenstance but I don't think I would change it at all. Dr. Derek Clewley [00:07:22] Very nice. And before we go to Lauren you're your process there. Can you just remind us is this the first oncology residency Do you know. Dr. Zach Tally [00:07:30] So there is one in Michigan already accredited and there's a couple more kind of coming down the pipeline right. But I say we're we're pretty much on the first wave of all this. Dr. Derek Clewley [00:07:38] So very nice. So Lauren you're your process the stuff that inspired you and maybe even speak a little bit to you know coming from and you're kind of forming a triangle of Minnesota Nebraska down in North Carolina speak to that to a little bit kind of fun. Dr. Lauren Bauer [00:07:53] Yeah. So I guess I chose Creighton because I didn't want to stay in Minnesota anymore. So I was like I wanted to be a little like close enough that I could drive but far enough that my parents couldn't visit me every weekend. So creighton was a great. Dr. Derek Clewley [00:08:10] Mom and dad listening to this too. Dr. Lauren Bauer [00:08:12] Yeah. So Creighton really was a great fit. And the unfortunate part is we did not have much in terms of our curriculum for women's health. So we had one lecture on urinary incontinence and then one lecture on lymphedema. And it was probably a 45 minute. Talk or a lecture. So we're in anatomy class and we're learning about the pelvic floor and I. Happen to be the only person that was somewhat interested in that lecture. So I had a supportive anatomy professor who spoke really highly of the pelvic floor and when I was learning about it I was like Oh I actually really understand these muscles pretty well. Maybe I should go seek out some additional resources. So that's what I did. I was fortunate enough to have one of my PT school classmates her mom is a WCS so I she was right in Omaha. So I went to go shadow her and one shadowing experience turned into another and another and eventually she asked if I wanted to just be a physical therapy tech at the clinic and get paid for most my shadowing experience. So it worked out really well for me. She saw a lot of breast cancer related patients. So that's where my first interest in breast cancer came about. She did not do the lymphedema therapy. So in all honesty I had no idea that the women's health team would be doing lymphedema therapy so that was interesting. So based on those experiences I decide to do a rotation in women's health so I decide to go out to Portland Oregon at OHSU and I had a lot of great experiences there. I was really happy that I chose that they do a lot of rehab post and pre and post lobotomy surgery for transgender individuals. And that was my first time experiencing that. So now I have like a really big passion and I write when I was in that I just started that rotation and then I went to my interview at Duke. So I didn't have much experience in terms of like real time experience. So I was a little bit worried about that. But I am so happy that I chose to do a residency. I just wanted to make sure that I was providing the highest quality of care and knowing that I didn't have much resources from PT school. I really had to make my own experience and then figure out if this is what I want to do in the future I need to. I needed to make sure that I knew what I was doing especially if I wanted to work with individuals with breast cancer or individuals who are transgender. I think they need a little bit more specialized care than just the average person treating urinary incontinence. Dr. Derek Clewley [00:10:59] Very nice. Thanks guys for both providing that process and everybody's process is gonna be a little bit different. I think it's nice to know the backstory. Before we go into some of these things you know one of the probably are a bulk of our guests are obviously going to be students especially those that are going to be listening to this podcast. I think one of the things that I think students are always interested in at least being a previous Residency Program Director is they're always concerned about the whole application process and all the things that go into it. And Lauren you already even spoke to some of the concerns that you even had for yourself going into these things. Can you. Can you speak to that process. Can you maybe maybe even do a little bit of myth busting and maybe a little bit of myth truths and such if you will maybe to put it that way you whenever you want to do. Dr. Lauren Bauer [00:11:53] So I guess applying to the residency I tried to set myself up I guess with all my experiences inPT school I want to make sure that I would really standing out. So it is true that I think they are looking for a well-rounded individual somebody that is just so focused on their like sports ortho women's health even if that's your only experience that's not really creating the well-rounded individual like Zach was talking about. So I think they do want somebody that has a lot of different experiences and I at least had that. They only had one rotation of women's health and I was I think two weeks in. So I get to this. So I get to the. Actual interview. And we have a we have a practical portion. So I'm sitting there I'm like oh my gosh I've had two weeks of actual clinical experience in womens myself and what am I going to do. So I guess if you were to apply be prepared that there will be a practical and it wasn't difficult at all I was actually more of a musculoskeletal which made me feel better about it because I felt good with my musculoskeletal skills. But yeah what about you Zach. Dr. Zach Tally [00:13:09] I think there's a lot of students now who were kind of cringing on the inside thinking back to their practicals. I think I think that I go all of that and I think a lot of times some of the questions that I've heard are kind of well if I want to do this residency I need to have this experience to kind of support that this is my interests and I think it's I think it's cool that we're both kind of talking about this because with oncology or even women's health you said you had half a lecture oncology wise, I think we had two. But they were very general and kind of sandwiched in your first year when you're trying to survive with neuroscience and anatomy and stuff and so I think well we didn't have the experience that I know are clinical or clinical didn't necessarily prepare me personally for going into oncology and so I think part of that is kind of understanding like you are doing the research. We're choosing to do the residency to expand the knowledge that we haven't gained or even to just kind of refine the knowledge that we have gained and so from that standpoint I think exactly what Lauren said as far as being well-rounded showing an interest in learning things whether it is your chosen specialty or not but pursuing different opportunities that show your leadership that show your initiative I think are huge especially going into the residencies where a lot of times it is kind of a Choose Your Own Adventure thing. But as far as the application process goes I think it's relatively straightforward. I would say definitely not like the panic of PT school. Maybe maybe it could be but I know there's always there's always the writing responses and sometimes there's some practical. But I think that interview the same thing they say for PT school it's really your chance to learn about the residency programs and learn about the faculty that you'll be working with. And I think that kind of that's a huge gift that you have because you will be very close and personal with your faculty and with your mentors for the duration of the time you're there. So I think that's a pretty a pretty neat thing that they have. Dr. Lauren Bauer [00:15:17] I will say if you are researching residency programs really look it up online and see what they are recommending in terms of different courses to take or different levels of experience. I know that when I was applying there were some programs that were very direct that they wanted somebody with at least two years of experience and I know I didn't have that. So obviously I was not going to apply to those residencies I wanted to make sure that I was applying to a residency that had at least taken a residence. I mean Zach I mean I'm patting you on the back right now. I don't know how you're doing and doing the first oncology residency. I myself just wanted to be involved in a program that I knew was well developed and that I knew that their residents were successful successful during the residency as well as after and that I would be provided the knowledge to actually pass the specialty board exam. So that's really important to me. I guess at the end of this. So yeah just different things to look out for. Dr. Derek Clewley [00:16:16] But yeah that's great. And I really love that you both said that you know everybody can take a different path essentially to get to their residency and I think that that's one of the big myths that PT students have is that oh my gosh if I don't get this clinical rotation My life is over. I say that's sort of tongue in cheek but it's actually sort of the impression I think that some people get if I don't get these experiences or if I don't get this course or whatever it might be that I love that you both mentioned that the what you can take from every experience that you have can actually influence your potential to secure a residency spot and it doesn't have to necessarily be what you think it is necessarily. So that's great. Thank you very much for that information. So now that you're in residency and such. Can you give us a little bit of what you're working on right now and I know that you're working on a lot. I'm working on trying to keep your head above the water might be one of them. But beyond that is anything specifically that you're working on right now. Dr. Lauren Bauer [00:17:27] I think I can speak for myself and Zach we are both working on our case reflections so we both pick specialties that require a case reflection in order to apply to the specialty for example. So we are working on that and making sure that we pass that in order to take this exam. We are also working on a project a sickle cell and a sickle cell project. So Zach's usually doing the musculoskeletal piece and I'm more helping out in terms of the sexual health. Like if there's any sexual health concerns and we're creating a PowerPoint just for different individuals working with the sexual health patients. And then Zach is really going to be taking on that challenge of working with those patients individually. The. Other than that it is just finishing up projects in terms of finishing your binders very random projects kind of. Be prepared by any project anybody wants to work on is really your project to work on. Dr. Zach Tally [00:18:31] Yeah. So I think you're I think you're right. As far as survival is a big thing. But you kind of do that and just really working and treating your patients is kind of their priority now. And we still have didactic curriculums and modules and journal articles to read to keep to keep us going on things. Yeah like Lauren mentioned we're working on this is actually kind of a post residency bridge but working on some kind of program development things down the pipeline which kind of helps us secure our jobs in the future in a way. But right now the I didn't think I was going to specialize in getting more and more into niche PT which is hilarious but working with creating this kind of more rehab program for patients with sickle cell disease and transitioning that into you. I think the end goal is really going to be kind of a comprehensive rehab program for a lot of medically complex patients. And so it's really neat that we can both kind of come to the table and in our residencies we get to do research and get to do all those things and so we're going to use a lot of the lit reviews and using stuff that we've done so far to create a program. So it's really cool to kind of throw that evidence into practice which is really funny that you were in my evidence based practice instructor. But it's really cool to be able to kind of like translate that directly into our jobs in the future. So it's been it's been pretty pretty awesome to do that. Dr. Derek Clewley [00:19:57] Awesome. So. You've already kind of mentioned a little bit and it's been it's been awesome it's impactful already and I think if I'm not mistaken you guys spent two months away from completion of residency right. So if you could speak to a little bit as well about the impact that it has had so far on you and however you want to take down give me freedom to take that in terms of professionally personally whatever you want to talk about because impact is such a sort of a generic we're not going to much of that taken as that. So whoever wants to take that one first. Dr. Zach Tally [00:20:33] I'll take that one. i think I was pondering this question for a very long time and there was so many just memories and things that came to my mind I really couldn't choose. But professionally I think the biggest thing that I've gained through this is the ability that we've had as we go to different conferences or go speak different things or go work with patients to brush shoulders with kind of the movers and shakers in our specific field especially oncology where it is pretty new and small. It has been really awesome to go to some national conferences. We went to Texas for the ACRM conference and CSM obviously but to get to see the people who. Their names are on all the articles that you've been reading for the last year but to have candid conversations with them about where the profession's going and things like that. I think that has been one of the most. Kind of unforeseen gifts of the residency. Personally. This is super cheesy but honestly the biggest the biggest thing that I've gained this year has been to get to work with patients with extremely complex conditions especially here at Duke. But the biggest impact on me was being able to discharge those patients and significantly better condition than when they came to me initially which is no testament to me but really a testament to the education that I received whether at Duke DPT school or here in the residency. But knowing that this residency is to prepare me to be a specialist and to be in clinical expert in the specific field and to kind of look back over the year and see patients that if they would have just walked in off the street into my new grad position at a random P.T. clinic I think I would have been a little lost. But having the experience and the knowledge and the opportunities that I've had it has been an incredible honor to be able to kind of take those patients through their episode of care and to actually. For lack of better words know what I'm doing. But I think that has been one of the most memorable experiences of the year. Dr. Derek Clewley [00:22:40] Yeah I figure that's it. It's not cheesy. I think that's fantastic. That's why we do. That's what we're attracted to this profession right. I think like you said and I hear that from other residents and such that when you come out of PT school you really don't know a whole lot. And even at this point the more you know the less you know kind of thing. But at least you're having some of that that confidence to be able to walk somebody through that that process there or at least the confidence in knowing the limitations to you sometimes so I think that that's fantastic. Lauren what about you. Dr. Lauren Bauer [00:23:18] well said by Zach's but professionally I think it's night and day just similar to Zach. I felt like going into the residency at first I thought Yeah I know what I'm doing. And then I slowly started realizing that I have no idea what I was doing and now I walk into a patient's room and I have so much confidence in the skills and know that I'm going to provide the highest quality of care. So that's great. I'm. I have so much more confidence and my ability to clinically reason has improved tremendously so I am very grateful for that. I think an impactful situation that I encountered and it was I don't even know why I was impactful but it made me proud to be at Duke. I think it was it's kind of a weird story. I wanted to observe a surgery and it was a prostate surgery and I go. Put on my suit toobserve and I am standing in front of the OR and I'm just standing there minding my own business and I'm looking around and I really see anybody that I really know. And then this physician comes up and he's like What are you doing here. And I'm like well I'm just waiting to observe with so-and-so doctor and he's like he's not here. And I was like Oh what do you mean he's not. He's like he's not doing surgery today. I think you have the wrong day. So I'm like freaking out I'm looking at my phone I'm like oh my gosh what am I going to do. Like I completely like canceled every one of my patients for this experience I want if this was the whole day experience and he was like You know what. He's like Just come into the OR he's like I'm going to teach you all this stuff. And it was like one of the best experiences. So knowing that somebody else at Duke or just different physicians anybody is willing to help you out and give you that learning opportunity it was really really cool to experience. And I'm really grateful that I am at Duke so I've had a I had a great time so it was really a part of being in a teaching institution where everyone wants to teach. That's awesome no matter what your area of specialty your practices and such. So you. Actually haven't alluded to this too much and I'm really interested in it. It's always love seeing people's careers grow and that sort of thing and I'm sure that you guys like to see your careers grow too but. So you know two months left in the residency experience where do you see your self you know kind of going after the residency program maybe even shooting off some long term goals which as we all know things don't always necessarily come to fruition but maybe at this point where you kind of see that and how do you see this residency experience getting you to those what are now going to be sort of these really short term career goals and maybe long term goals. Dr. Lauren Bauer [00:26:07] So I guess going into the residency they did ask me what my goals were and my goals were related to the pelvic floor and sports. So I wanted in five years I wanted to be able to provide just educational talks to various sports teams whether that just be high school or middle school and just bridge the gap between what is the pelvic floor and what is incontinence. And yes it is very very common in individuals especially girls that play high impact sports. So that was the goal I still have that goal. But now I've kind of switched focus I guess. So I am still interested in the sports realm but now I'm more interested in the breast cancer and the transgender medicine. So I guess what I want to take from that is. Staying at Duke still continuing to work with the breast cancer related patients. And as well as gyn patients I am really interested in pelvic radiation right now. So getting the opportunity to work with that and really developing more of a program I think working with Lisa and working with some of those those doctors to get more referrals in because we're not seeing as much referrals out for pelvic radiation and then hopefully helping Lisa start developing this transgender protocol for rehab would be great. We're thinking it's going to happen in the next year or two so nice. I want to be involved Dr. Derek Clewley [00:27:39] Very cool. Dr. Zach Tally [00:27:40] Goals man crazy. So in the next two months we'll be kind of closing down the residency. I'm getting married and then starting a new job so survival of the next two months is the biggest goal in front of my head. But other than that long term goals I really really get the residency because I knew that there was a gap in the information that I wanted and so I pursued the residency to get a ton of oncology specific knowledge that I couldn't get otherwise. But my real passion is with pediatrics adolescents and young adults and childhood cancer survivors in that respect too and so my big kind of ambition is to take the knowledge and skills that I've gathered from this residency to be able to adapt that to this kind of underserved population in a rehab sense whether that's through program development or whether it's through potentially creating another residency somewhere. I think the sky's the limit. I think when you kind of start and you just finish your residency because you do have so much knowledge and so much experience in such a short time that it's really kind of how do you and make it super applicable for us long term goal. I feel like I'm just like buttering you up Dr. Clewley But really like I do want to go into to. -Ha yeah I knwo there's no school work attached to this- I really do want to go into academics I think there is a huge place for oncology in P.T. curriculums. We know that the goal of PT school is a kind of help to create this generalist practitioner per say but to give every student this well-rounded wealth of knowledge and I think know where more can be applied in an oncology and with sixteen point nine million cancer survivors people are gonna be seeing these survivors in clinics. And so I would love to kind of make that information super palatable for students and to kind of open up that gate to them too. Dr. Derek Clewley [00:29:35] That's fantastic. So closing down the show here. If you could. Now that you are older wiser and such. What advice. Maybe last words of wisdom would you have for our listeners who are at this point you are considering residency or maybe even I think we get a wealth of listeners maybe even folks that are interested in developing residencies like that but just your own personal words of wisdom something you want to share. Dr. Zach Tally [00:30:06] I think first the biggest thing is just be willing be willing initially to admit that you don't know everything. And that's really a humbling position to be in. After graduating with a doctoral degree in physical therapy is that you feel like so empowered and so confident which we should. But being willing to admit that there are plenty of people out there that know way more than we do and it's up to us to seek that information out whether it's the residency whether it's through mentoring in clinical settings. Just be willing to learn and to be exposed to that. I think the second thing is be willing to be uncomfortable especially from time to time. As a new grad and a fresh PT. The biggest thing is that you can do is to kind of break out of that comfort zone that you have or whether it's your specific manual skills you developed or your specific patient population that you know. I think it's really important to kind of branch out and take the expand your skills. It's sort of like being in the crucible for lack of better words but to help refine kind of where you're at and where your skill set is. And then lastly just be willing to be kind of shaped by the things around you you're not necessarily only going to grow at a residency you'll grow in a clinical setting you'll grow in your first job for sure but even the years to come you're gonna continue to grow if you're willing to use that clinical experience and use the resources around you to kind of help shape your practice. Dr. Derek Clewley [00:31:28] Words of wisdom Alright Lauren,. Dr. Lauren Bauer [00:31:32] I think I have two. One is don't be afraid to fail. We got pretty lucky and when we applied we got in right away. But that's not the case for everyone. And if this is truly your passion I would recommend trying again or at least trying to work with these patients in the clinic and getting enough experience and maybe not even having to do a residency but just getting enough hours and taking the board exam. So don't be afraid to fail everybody fails. We just haven't had we just come to get really lucky. And then similar to Zach. Just be open to new experiences. I think going into this I thought it was gonna be very structured and it turned out to not be as structured as what I thought it was gonna be but they really allowed me to make it my own experience. So being open to different experiences regarding different niches within my niche like regarding male pelvic health pediatric pelvic health women's public health athletic pelvic health like all of that I didn't realize until I came here. So just being open to all experiences. Dr. Derek Clewley [00:32:39] That's awesome. Well I want to thank both Lauren and Zach for being on the show today and being a part of the new DVT podcast. I think this will be one that a lot of individuals will be really interested in hearing about and really thank you both for sharing your experiences and your wisdom and your advice and all of that with our listeners. Thank you very much. Thanks for having us. computer [00:33:02] Thank you for listening to the Duke DPT podcast if you like what you just heard. We hope you'll pass it along to your friends and colleagues. For more information about all that is happening at Duke DPT please check out our Web site. Otherwise we hope you join us next time in our pursuit to bridge research and clinical practice. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download