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Oct 05, 2022

All Things Sports PT Residencies
with Dr Tim Machan

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Read the conversation below

Dr. Yoni Rosenblatt: Welcome back to the True Sports PT Podcast. We got Dr. Tim Machan with us today. He is going to tell us all about the residency life in the residency world, the sports residency world. Gonna break here just for a second and say to Tim Machan, I want you to introduce yourself to the sports physical therapists that are listening to us. Tell us about... A little bit about your career path, and then see if you can hone in on some of your residency experience.

Dr. Tim Machan: Yeah, absolutely. Thanks, Dr. Yoni Rosenblatt. Excited to be on today. My career has been fortunate in that I've had a lot of opportunities to work with a lot of different high-level athletes. I started as a resident myself coming out of PT school, and I did the sports residency at the University of Cincinnati. I was full-time in the training room. I worked primarily with football and then a little bit with the baseball team there. After that, I moved to Baltimore and was able to work with our illustrious podcast host at True Sports for a couple of years, where I got to experience some really good, high-quality outpatient care as well as dabble a little bit in working in the training room at Morgan State University. And then from True Sports, I moved down to North Carolina, where I was a contractor for Exos with Special Forces, Psychological Operations at Fort Bragg. Part of a really cool multi-disciplinary program. We had PT. We had strength and conditioning. We had nutrition, dietitian, all in one facility with a great performance gym, great resources, really cool program, working with armed forces... Members of the armed forces, which is great.

Dr. Tim Machan: I left from there, stayed with the program but moved to Fort Campbell, which is kind of on the Tennessee-Kentucky border just outside of Nashville, really cool position there with third group. That unit was... Or that program was a little bit bigger, so we also had a sports psych and an athletic trainer that we worked with, and as well as I was one of four PTs. And then I, from there, moved back to Cincinnati, where I kinda revived the residency that had gone away, restarted that and had the opportunity to work with all of the sports teams at the University of Cincinnati. And then the most recent move, I left Cincinnati in March of 2021 and moved out here to the East Coast, back to the east, where I took a job with Rutgers... Rutgers University working with the football team specifically. So, been around a lot.

Dr. Yoni Rosenblatt: That's awesome. Yeah, and it's been so cool to see you grow and to see all the athletes that you've come in touched with and that you've really helped. I wanted to hone in on that residency piece, because that's a question that I get a tremendous amount, just being in the high-level sports world that we are. I'll have a lot of new grads come in and say, "You know, I'd love to work, but I really wanna do residency." And I'm not a residency graduate, although I refer to myself as a sports PT, 'cause I'm treating high-level athletes all day and everyday. The first person who ever mentioned this concept of residency to me was Tim Machan. And so, when I met you coming out of that residency at Cincinnati and I interviewed you, I was just amazed. I was amazed at what you know. I figured it was from that residency. And I'm just like, holy cow, every residency, just... That's just your ticket to quickstart... To jumpstart your career. And then I started coming to contact with other residencies and other residents, and I'm like, "Wait a minute, maybe it was more Tim than it was Cincy." So, maybe I was wrong, but... But having run a residency program, tell me about who is the perfect person to go into a sports residency, and who maybe is it not perfect for and should really just stay the course and find a different route?

Dr. Tim Machan: Yeah, I mean, I think that's a fantastic question and something that it's really important to consider, 'cause it's not something that you should just do. It's not like medicine, where residency is just what you do after you graduate, like, PT is unique in that sense. So I'll kinda start with the perspective that I had as a... In PT school at the time, about to be new grad. And then I can kind of pivot to the other side where I spent more time recently. So for me, I really, really wanted to work with high-level sports. And I knew, coming out, I had really good clinical affiliations, but nobody was gonna hire me to be a sports PT with the experience I had. So residency was a no-brainer for me to get that experience and learn how to work with those athletes. So at the time, and I think these numbers are accurate, there were 21 sports residencies. I applied to nine of 'em. I got interviews at seven, and I was ultimately offered a spot at two, and I had a choice to make. And the decision for me came down to what... Which program was gonna offer me the opportunity to get the most experience with high-level athletes? How was I gonna get, and I refer to this now, all the data points? How was I gonna develop my collection of patients and cases...

Dr. Tim Machan: To learn how to do that? And so the University of Cincinnati program provided me with that by being full-time in the athletic training room. I had a great opportunity to learn how to do it and a great faculty to learn from, and Bob Mangene and Joe Roush... I learned a ton of things from two amazing sports physical therapists.

Dr. Yoni Rosenblatt: So... That's awesome to know that that's what you were looking for. I give similar advice on the grad school side, when people say, "Which grad school do I need to go to?" I say, "Look at the faculty and see who they are. Are they mostly neuro? Well, that's probably more of a neuro school, and if you're interested in sports, maybe that's not the best for you."

Dr. Yoni Rosenblatt: It seems like you did something similar in terms of looking at the faculty, looking at the opportunity... Is it easy to see the... As you look through sports residency programs, how much interaction you're gonna have with the athlete? How would you say... Is it easy to see? One. And two, how can you tell if you're gonna get great tutelage?

Dr. Tim Machan: So that's a great question and a perfect point to pivot to the other side of it, 'cause this is something that I found myself answering a lot for people. So one, the benefits now, like the PTCAS or PVPRV, whatever the alphabet soup is, has a centralized location for all the programs. So it's a lot easier to find them now and go to their websites. Most of the programs have pretty good informative websites with a mock schedule of, "This is the type of patient you will be working with. This is when in your day you'll be doing it." And then the thing that I did, and I strongly still recommend to potential applicants is reach out to the director. Go on the website, figure out who the director is, and send them an email, you introduce yourself, say you're interested in the program. "Can we set up a phone call?" And I found that that was very beneficial for me as an applicant, and it absolutely gave the applicants I was reviewing a leg up because it showed a couple of things. It showed that you were serious about... It wasn't just a one-off like, "Oh yeah, I guess I'll apply to residency."

Dr. Tim Machan: 'cause that's what you do. It was, This is something that's important to me. It was an opportunity, essentially, it's an interview, that you call it what it is, it's an interview. It's your opportunity to interact with the person who's gonna be making the decision about who they're gonna hire. So use it to your advantage, sell yourself, but also show interest in what that program offers. And the last piece, and arguably the most important is to make sure that that program offers what you're looking for, and if... I said blatantly to applicants all the time, "I wanna be transparent with you, this is what my program is gonna be, this is what we're gonna offer for you." If your career goals don't need that, you should probably look at a different program because in the dog days of camp or in the middle of the season, if you don't really wanna do this, you're not gonna be happy, you're not gonna do a good job, so we're not gonna be happy. And if you leave, everything goes bad because you've wasted your time, we don't have anyone to do the job. I wanna make sure I'm as transparent as possible about what the expectations are for my program. With an applicant, you need to understand what the program offers. It's as much an interview of that program and that's...

Dr. Tim Machan: To your original question, I think I've tied it back in, how you really find out because they'll sell you with a flashy website and they'll say, "We work with X team" or "We provide coverage", but standing there and watching someone provide coverage is different, and maybe that's what you're looking for or working with a high school is different from working with a college or... There's all sorts of different levels of involvement, and make sure that the residency has what you want for your career, where you're looking to go.

Dr. Yoni Rosenblatt: Yeah, I think that is... That's awesome advice. And it works for residencies, it works for... 'cause that's what I look for too when I hire, someone who's just dying to be there. That's the number one predictor of success at True sports is, "How excited are you to be there?" So I'm sure it's the same thing with residency. How many residency directors are responding to that? Like, how do you respond to that email? You think that...

Dr. Tim Machan: And this was a while back when I was looking for it. I heard back from everybody, and I know when I was in that position as a director, that was a priority for me, you talk about... You're supposed to respond to an email within 24 hours or whatever, if I got something about the residency, didn't matter what time, I pulled it up on my phone and I saw it, I was gonna respond to that person right away, and I learned this from being in a fraternity. But recruitment is the life blood of anything... Like, you need to always be selling what you have to bring in the top talent, to bring in the most qualified, the highest achievers, you've gotta put on a good face, so if you take a week to get back to them, they don't get a warm and fuzzy about you. They don't feel confident in your interaction, whereas if I'm out for a walk at 8 o'clock and you're sending me an email, I'm gonna send you an email. And I'm gonna say, "Hey, I'd love to talk to you. What's your schedule like? When can we get a phone call?" Because we were very successful in the time I was at Cincinnati, our residents... The first one is essentially running a practice in Texas where he's doing NBA draft training, and NFL Draft training, and all sorts of cool things.

Dr. Tim Machan: The second one followed me up and is in the training room at Cincinnati. The third one is starting kind of a relationship at the University of Alabama, Birmingham, and all of the people that we brought in were very motivated, very talented, and are doing good things in the sports PT world, which I think is a direct reflection of how appealing we were able to make the program.

Dr. Yoni Rosenblatt: That's really... Yeah, that's really awesome and it speaks volumes. It's one of the reasons I love talking about how successful you are because it means we did something right at True sports. And that's really the hallmark of an outstanding program. So kudos to you for creating that. Now, when... What is it that... 'Cause you get paid as a part of residency, right?

Dr. Tim Machan: Yeah.

Dr. Yoni Rosenblatt: About what percentage is that of an expected starting salary in an outpatient clinic?

Dr. Tim Machan: So that's a great question and, unfortunately, I'm a little out of touch with those numbers. So I'll kind of speak generally...

Dr. Yoni Rosenblatt: Sure.

Dr. Tim Machan: From what I remember from a couple of years ago when I was really in the nitty-gritty with this. Typically, it varies. You'll see some programs as low as 50% of a salary, and in some programs as high as 100%. This is what they would be paying a new grad in their facility.

Dr. Yoni Rosenblatt: Oh, wow.

Dr. Tim Machan: And then you'll see all sorts of different commitments. Some it's, when you're done, you're done. You can walk away. Some it's, you're kind of incentivized to stay, and some, you're in a contract. It's like, "Yeah, we're gonna commit this to you. You'll get a full salary, but you're then gonna work for us for two years afterwards, so we're gonna kind of recoup some of the cost on that side of things." I would say majority of the programs, again, at least a couple of years ago when I was really in tune with this, we're in the 60-80 percent of a clinician salary.

Dr. Yoni Rosenblatt: Okay, and what is your ideal applicant? I think you told us how they stand out, but who's perfect for Rutgers or Cincinnati at the time?

Dr. Tim Machan: Yeah. So fortunately, I should give a little bit of a plug. I'm currently on faculty with the NovaCare Philadelphia Sports Residency, which I'm really excited about. It's a program in its infancy, kind of like the Cincinnati program was when I started, but our resident gets to do all sorts of cool things. They spend a month with me in the training room at Rutgers.

Dr. Yoni Rosenblatt: What could be cooler?

Dr. Tim Machan: They spend... I know, right? They spend time with the Philadelphia 76ers, they spend time with the Philadelphia Phillies down in Florida.

Dr. Yoni Rosenblatt: So cool.

Dr. Tim Machan: They spend time with Temple University in their athletic training room. So it's a great program to see a big variety of really high-level athletes. But when I'm evaluating a candidate, what I'm looking for... Everyone... Like, if you submitted an application, you probably have checked the boxes in terms of what you need on paper, you know, good clinical experience, a broad exposure to different types of sports, observation experience, volunteer experience, potentially, you had mentioned strength and conditioning things, the CSCS, continuing education things. And I don't think there's one recipe for that, and there's not a make or break thing. People ask all the time about the CSCS. It's not like an absolute yes or an absolute no, but it adds to the picture of who you are, how you have approached your learning and what you've done up to that point. But like I started with, most people have... They hit the minimum with that, I'll say. It's not like I'm gonna make a decision on this person because they took 10 Con Ed courses while they were in PT school. You gotta hit the minimum threshold, but it's not like you get bonus points after that. So the next piece for me is the dedication, the desire.

Dr. Tim Machan: And you nailed it. I've always felt that when interviewing, I need to show them how excited I am about the opportunity. So if I'm interviewing someone and they're not showing me how excited they are to be with me... One of the big things, I have the fortune of working for Coach Shaun O'Hara at Rutgers and I've learned a ton from him, but he's been saying recently, "Don't ignore the signs. If they're not excited to be part of the interview, what makes you think they're gonna be excited to show up to work?"

Dr. Yoni Rosenblatt: I love it. I'm gonna even ask you to break it down further. How do I show you, Tim, that I'm excited to be there?

Dr. Tim Machan: So, well, I think the big thing is, what did you have on paper? Because, that's gonna show me how dedicated you are to learning. So if you're excited about getting better, then you're excited about what you do, you're gonna be a good fit. I think in passion and engagement and the ability to express excitement. And one of the best people I've ever interviewed was super nervous, but in that, I saw in him the excitement. He was nervous because of how excited he was for the opportunity. Now, sometimes there's nervousness, which can be a bad thing. So I'm not trying to advocate to be nervous in an interview or anything, but you can see the... If you can come across genuine and you truly care, people will see that.

Dr. Yoni Rosenblatt: I love it. I think that's totally true. It's... I would... I look at body language. Like, are they coming forward or are they sitting here? Are they smiling and engaging or are they stone-faced and reserved? It was very hard for me to interview during COVID. To have that mask on, I think, made it very hard, but it's...

Dr. Tim Machan: And you couldn't take them to Birds of a Feather.

Dr. Yoni Rosenblatt: That's exactly right. Great Scotch bar at Fells Point. I don't even know if it's still there. Also, I started drinking a lot more vodka. Don't hate me, Tim.

Dr. Tim Machan: I was actually... You're gonna kill me. I was in Baltimore back in March, maybe, I came down.

Dr. Yoni Rosenblatt: Just hang out with Tyler? What were you doing?

Dr. Tim Machan: No, I stayed the Admiral Fell Inn. Right there in...

Dr. Yoni Rosenblatt: Yes, I know where it is.

Dr. Tim Machan: No, it was Emily and I went. Then we just did a weekend and I showed her True Sports. I did...

Dr. Yoni Rosenblatt: Well, that's a reason. Why else you coming to Baltimore? [laughter] I love it. So that, to come back to the excitement thing, it's unbelievable how important it is. You touched on this previously, which is, it doesn't matter as much what kind of load you're giving them or what kind of manipulation you're giving 'em, it's like... Can you show them you care? And you can show them you care, that's what it's about. Your description of who you're looking for for residency, I think is... It's the same thing we... We're looking for the same candidates but just from a standard business operation is what we're looking for, is how excited are you to be there? And then one other thing I would add is, I look for an email follow-up, like, "Hey, thanks for your time. Can't wait to hear from you." Do you put any stock in that?

Dr. Tim Machan: Absolutely.

Dr. Yoni Rosenblatt: Oh, I thought you were gonna say absolutely not. Don't email...

Dr. Tim Machan: It's a little thing but it shows, again, it shows that you care and you're committed. So yeah, I think that's good. And then the last piece, kind of like the three things that I look for, is personality. You know, especially in the setting I work in, you're gonna spend a ton of time together, so you've gotta have that connection, that fit, that could... Could we hang out? Some people call it the "get a beer" test or whatever. Could we hang out in a setting like that?

Dr. Yoni Rosenblatt: Yeah, I love it. One last softball for you. What should they wear to that interview?

Dr. Tim Machan: Oh, a suit.

Dr. Yoni Rosenblatt: A suit. Hold on. You're walking them... What are you gonna be wearing? That quarter-zip.

Dr. Tim Machan: Yeah, I wear my Polo and my quarter-zip. It's a very professional look.

Dr. Yoni Rosenblatt: It is a very professional look. We won't talk about your shoes from earlier today, but the... So you want them in a suit. Did you wear a suit to True Sports when you interviewed.

Dr. Tim Machan: A hundred percent I did.

Dr. Yoni Rosenblatt: You did?

Dr. Tim Machan: I showed up in a boot and crutches in a suit.

Dr. Yoni Rosenblatt: You did.

Dr. Tim Machan: How was that not memorable?

Dr. Yoni Rosenblatt: Damn it. You stud. That's right, you did do that. Okay, you want them wearing a suit. I want... I am totally fine them wearing a suit to a job interview at True Sports. Just make sure that whatever you're wearing fits you, that you're put together. Don't wear the khakis and Polo, please. We're past that as a profession. So I think it's suit or I think it's button-down and slacks. I think you can't go wrong because after all, we're talking to a diverse audience and we want them... We gotta give them the whole picture... You gotta give them the whole picture.

Dr. Yoni Rosenblatt: Tim, this is super valuable information. Like I said, you were really eye-opening to me as a residency grad. I think your advice helps protect some of what I see, which is people who have graduated residencies that sometimes weren't great residents or they didn't choose the right residency for them, and I think you can really clarify that. And I think when you put that go-getter personality that you were and that you just described with a residency that matches you. And you gotta do that due diligence, that's what I just took away from listening to you, you can jump start your career really rapidly, so I think that's all really well said. I wanna thank you tremendously for your time, I think you were super valuable to our audience and I think there's plenty more to come. I would love to bring you back on, talk a little bit more clinically because I think it's such a wealth of knowledge that you have. Anything you wanna share with future residents or future sports PTs before we say adios?

Dr. Tim Machan: Well, I think you touched on it there, is what residency can provide for you. And I think a well-run residency that's focused on the resident and not on what can I get from an employee, I don't have to pay as much and try to do it that way, but if you're really focused on developing them in the mentorship model. Developing your data points, all of your cases and learning how to recognize patterns. That's the stuff that normal clinicians, it takes you years to develop that, but in a well-run, structured program with the right opportunities, you can really accelerate that pattern recognition, kind of expert level of thought process.

Dr. Yoni Rosenblatt: I love it, I love it. And it's no wonder that your students speak so highly of you. I did have to tell one of them how athletic you are. I don't know why that was... They question that. But you remember what you were most known for in the True Sports therapeutic exercise folklore?

Dr. Tim Machan: Oh, the B-Skip.

Dr. Yoni Rosenblatt: It's the best B-Skip. It's the best B-Skip in the world. So thanks for sharing your B-Skip, thanks for sharing your knowledge. This is a podcast that is all about the sports PT. You wanna hear more about something, you wanna hear less about something, let us know. Pod, We also have a lot of continuing education from True Sports Physical Therapy. About to be launched so, Tim, look out for that, but if you wanna get on our email list, just shoot us a quick email. You can find out everything that's going on at Tim, thanks again so much. We look forward to hearing from you soon.

Dr. Tim Machan: Alright, thanks, Dr. Yoni Rosenblatt.


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