Insights, Advice, and Cautions for O&P PhD Seekers

As more O&P clinicians consider forging a path to their doctoral degree, PhDs who have preceded them on the journey offer helpful insights born of their experiences. Determine Your Direction “I have not come across a list that specifically identifies O&P-related PhD programs, but I started my research toward a PhD by searching for ‘PhDs for physical therapists’ because that was an adjacent, parallel health field. I was able to see what programs physical therapists are interested in, and that allowed me to find different areas of focus, like rehabilitation science and kinesiology programs,” says Ciera A. Price, MSPO, CPO/L, FAAOP, a first-year doctoral student at the University of Texas at Austin. “If you’re more interested in going into biomechanics, those programs aren’t going to come up; you’d have to key in a similar search for ‘biomechanics PhD programs.’ “Talking to people who have experience in pursuing a CPO PhD is likely to be more helpful than consulting a list, because O&P is a very niche field. And while a program could look interesting, there may not be faculty conducting O&P-related research, so they may not be able to advise you and support you through your program. For example, a rehabilitation science program may have interesting curriculum, but if the faculty all have [occupational therapy] backgrounds, that program may not be the best fit for you.” Connect With a Mentor “I would encourage O&P clinicians interested in pursuing a doctorate to reach out to PhD CPOs in the field who have gone through this process and ask them about their experiences,” says Samantha Stauffer, CPO, MSOP, FAAOP, director of research, Independence Prosthetics-Orthotics, Delaware, and a doctoral candidate at the University of Delaware Limb Loss Studies Lab. “I believe that connecting with the right advisor is so important that you should be willing to prioritize that above all else,” says Sally A. Kenworthy, PhD, CPO, assistant professor, Baylor College of Medicine Orthotics & Prosthetics. I honestly think that if I had not found an advisor that I clicked with or had similar interests with, I may not have pursued the PhD. You can get into a great program at an institution, but if you don’t get along with your advisor, or they’re not a great teacher themselves, you’re not going to have a good experience.” Personalize Your Planning Kyle R. Leister, PhD, CPO, program director and assistant professor, Master of Science in Orthotics and Prosthetics Program, College of Health Sciences, East Tennessee State University, says, “By the time you accomplish an undergraduate degree and then a master’s degree, you’re into that phase of your life where you need to start thinking about what you want your personal life to look like as well. It’s very hard to make those decisions when you’re not getting paid very much as a research assistant, expected to produce research independently, and produce research for your advisor and team. “Be aware that a PhD pursuit amounts to an incredible time commitment that lasts for between four and seven years. It’s not only the PhD, but also everything else that’s happening in your life during that time period that needs to be considered—like raising a family.” “There are a couple of different avenues that people can take toward their PhD,” says Stauffer. “If they do not stay in clinical practice during their PhD, they can wrap up faster, with less to juggle. There may be pathways where they can be a full-time PhD student and be in the clinic maybe one day a week, if the university that they’re going to has their own prosthetic clinic—for example, the University of Michigan—or if they have a close affiliation with a related clinic.” To PhD or not PhD? “A PhD is definitely not something to just explore,” Kenworthy says. “You should explore a lot of things and then decide that a PhD is definitely something to pursue. “I think the benefit of being a more seasoned clinician before going back to school was that I had probably a broader perspective on the issues that we addressed, because I had experienced them, and I had talked to other people who had experienced them. I was also just 100 percent sure that this PhD study was what I wanted to do; it definitely wasn’t a whim. I didn’t do it because I didn’t know what else I wanted to do.” “There are multiple reasons that one might pursue a PhD, and that can include the desire to be the principal investigator for your driving ideation and design and research—all those good things—as well as the internal drive to push yourself further,” says Shane Wurdeman, PhD, chief clinical officer, Hanger. “If your goal is to become a doctor, and for people to call you doctor professionally—just know that this need wears off in about two weeks. It is understandable when you consider all that these people have sacrificed and all they went through to get to that point. However, in some ways it is rather humbling as to just how obsessive you must be to achieve it, that you really don’t need people to call you that. I still appreciate the acknowledgement, but certainly don’t require it,” says Gerald Stark, PhD, MSEM, CPO/L, FAAOP(D), director of clinical operations and technical support, BionIT Labs, and adjunct instructor, University of Tennessee, Chattanooga. “A PhD is not for everyone. You can do research without doing a PhD,” Leister says. “There are avenues that allow you to be a scientist and ask questions without this advanced level of training. “If you’re looking at some of the bigger foundational grants, like Department of Defense, National Institutes of Health, or the Bill Gates Foundation—you really have to have someone on your authorship that has that PhD level of training. “That said, there are a lot of smaller foundational grants: The O&P Foundation for Research & Education, for example, that will award microgrants, or smaller grants; those are great opportunities for someone who’s trained at a master’s level to go after funding to support their research. “However, I’ve taken two or three classes during my PhD that have specifically just focused on how to write a grant, and you may not get that sort of guidance in grant writing at the master’s level. Those nuances can make a grant more competitive.” “I don’t think researchers are less likely to get published because there’s not a PhD on their paper; they’re less likely to get published because they don’t have the knowledge or haven’t been trained on how to present their research in a way that is consistent with journal expectations,” says W. Lee Childers, PhD, CP, senior scientist, Extremity Trauma and Amputation Center of Excellence, Military Performance Lab, Center for the Intrepid, Brooke Army Medical Center. “If those who have no research experience are curious and want to get involved, they should look at the universities in their area and see if anyone is doing research related to O&P,” says Stauffer. “If so, they may be able to start getting involved that way, to gain experience. If they don’t know if they like research because they’ve never done it before, going straight into a PhD program might be very jarring. “If they do have experience with and enjoy research, but just aren’t sure about whether a PhD is right for them, I would encourage them to reflect on what role they would want to take in doing research: If they want to be active in interpretation of the data, data collection, participant recruitment, and having more of that hands-on role with making research happen, but are comfortable with others heading the project, then being a research prosthetist or a research orthotist but not pursuing their PhD might be better for them.” She continues, “If there’s a specific problem that they want to try to address, or feel really passionate about, or questions that they really feel need to be answered, and they want to be the ones driving those initiatives, that’s when they would want to pursue a PhD. The PhD enables them to assume the leadership role when they complete their PhD and start their own research lab.” Aside from clinical practice, there are a number of professional avenues where no PhD is required. “I don’t know if a PhD is necessarily required. You certainly can be a director and administrator at any of the O&P education programs or organizations without a PhD,” Stark says. “There is no assurance that your educational level will assure you a higher status within O&P. “For the most part, it’s still more about your skillset and alignment with the organization than necessarily your educational level. In general, I don’t advise approaching a PhD program with the thought of an assured transactional improvement like a promotion or a pay raise. “However, it does carry some level of achievement for outside evaluators if you’re applying for a grant, providing consultations, or starting your own business. Perhaps the PhD does give you a little bit more cachet, but really that’s only a side benefit. The main benefit is that you think differently, your approach is more thoughtful, and you act more systemically.” Commit to Your Pathway “I think to be successful at getting your PhD you have to be very internally driven to do it. You’re making a lifelong commitment: ‘I’m going to do research as my career!’ “Yes, there are other jobs you can do with a PhD,” says Childers. “But the primary reason to get one is to do research; so if you have that commitment, and this is what you want to do, a PhD is the tool that you need to eventually get the research funded that what you want to do.” “It boils down to that itch that you just have to scratch. You must have that burning desire and be fully committed to do it—otherwise it makes something that’s already very hard essentially impossible,” says Leister. “If you don’t have a deep, deep sense of why you’re doing this, and the conviction to do it regardless of the outcome, I don’t recommend that you do it,” Kenworthy says. Obstacles and Sacrifices “It’s sometimes difficult for PhDs in O&P because for the most part we have a terminal education with direct clinical applications,” says Stark. “You may not be able to develop that academic record of grants and publications because you’re still trying to see patients or running a school program. Many PhDs in O&P must be able to provide clinical support and leadership so it still depends on whether or not the market actually sees value in your PhD and if your organization wants to promote it as a benefit. “There is a shadow side to getting your PhD, with things I had to miss, like my children’s awards banquet,” Stark says. “I remember asking if I could miss class, but my chair was emphatic: ‘No, no—we only meet in class two days a week—you’ve got to be there—it’s not an option for you.’ “My family made sacrifices, and I made career sacrifices for me to pursue this interest. I could be traveling, at a professional dinner, but then I had to excuse myself to be on a message board for two hours until midnight—that was a lot sometimes. Kenworthy agrees. “I don’t think people understand that you’re going to miss birthday parties, weddings, all that stuff. There is no PhD without sacrifice—and it’s a different level of sacrifice than undergrad or even getting an O&P degree. It’s so much independent learning that you have to be self-motivated.” “Your PhD time commitment is Monday through Monday, and you’re taking as long as it needs to take to get it done,” Leister says. “You can take your weekends off, and you have a lot of autonomy to make your schedule, but the workload is so profound that oftentimes the only times you’re not working or writing, you’re catching a minimal amount of sleep. “I don’t want to discourage anyone from doing this—but I do want to make it clear that pursuing a PhD is not for the faint of heart. You really have to be passionate about it in order to do it at a high level and be successful with it.” When It’s All Over “Folks ask me, ‘What are you going to do now that you have your PhD?’ Well, I want to do more of what I’m doing now, just in a better way—as a better researcher. Because I’ve been doing research the whole time at my job,” says Kenworthy. “There is this ‘doctoral blues’ thing,” Stark says. “[It] is a real issue, because once you get done with it, your life is a little bit empty, because you’re geared to do one thing, and your brain architecture has actually changed to do it. “There are studies that show that when you do something long enough, your brain changes physiologically—so it’s made to do something you’re not doing anymore. Just like an amputee in some ways—you are permanently changed.” The PhD is a life-changing experience that affects awareness and perception. “Normally I just listened to lectures, and they sounded fine to me, but all of a sudden, when I’d gotten through my core courses, I would hear things in lectures that just didn’t seem like they made sense,” he says. “I became aware that any discussion—even ones that I provided—has limitations and weaknesses, like any kind of thought. “You become more aware critically of what works and what doesn’t, and you read things differently and question leaps of logic. I realized that as an engineer, I wasn’t much of a critical thinker; engineers read things like the stress-strain diagram for metals, and we believe it, and we go with it. Why would it be wrong? But after a doctoral program, with any reference you really consider who wrote it, when did they write it, why did they write it? Would there be any motivation for them to alter that? You’re a little bit suspicious of everyone and everything.” Advice to Potential PhDs “I would strongly encourage anybody who intends to do clinically relevant research to find a way to maintain some form of clinical contact during their PhD, even if it’s just shadowing or spending time at a local prosthetic clinic for a few hours a week” Stauffer advises. “It’s important to be connected to the population that you intend to impact with your research. “The doctoral path takes a lot of drive and a lot of passion. You don’t want to arbitrarily pick a lab; you want to have a problem that you’re actively trying to solve. Additionally, if you don’t enjoy reading or critically evaluating research, it may not be for you. If you don’t like writing, it may not be for you. “But, if you’re just not a strong writer, there are a lot of opportunities to get additional assistance and training while you’re in your PhD, so that shouldn’t stop you if it’s something that you feel really strongly about,” she says. “It’s a lot of cognitive work. I spend a lot of time in front of the computer on my research days; so if you struggle with sitting still for long periods of time, or you want a really active vocation, you may not fare well with a PhD.” Stark says, “My advice is what I was told: That you should really enjoy the journey rather than the destination because the journey is the most important. “I always thought that was just a line to keep people from getting so anxious, but it’s pretty true. You get the doctorate because you love the journey, and how it transforms you. If you’re doing it because of a certain cause and effect result, you might be disappointed.” Judith Philipps Otto is a freelance writer who has assisted with marketing and public relations for various clients in the O&P profession. She has been a newspaper writer and editor and has won national and international awards as a broadcast writer-producer.

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