BACKGROUND AND PURPOSE
In the past decade, the physical therapy profession has placed increasing emphasis on the importance of evidence-based practice. Many professional (entry-level) physical therapy degree programs now offer a clinical doctorate in physical therapy in an effort to provide clinicians with the tools they need to effectively use available evidence. At the same time, more physical therapists are pursuing nonclinical doctoral degrees, such as PhDs, in an effort to obtain the skills necessary to conduct original research and add to the foundation of literature upon which we base our practice. In 2002, the number of American Physical Therapy Association (APTA) members reporting a nonclinical doctorate as their highest earned degree was 30% higher than in 1996 (APTA Archives, oral communication, March 2003). Despite this increasing trend toward and emphasis on nonclinical doctoral training of physical therapist researchers, there has not been a concomitant statement from the profession regarding the importance of postdoctoral study for these individuals. The purpose of this paper is to advocate for placing increased importance on postdoctoral studies in the training of independent, funded researchers in the profession of physical therapy. Additionally, we recommend ways that the physical therapy profession can encourage individuals to pursue study beyond the PhD.
Postdoctoral Fellowships: History and Current Status
What is a postdoctoral fellowship and why is it important? The first part of this question has been answered by the Federation of American Societies for Experimental Biology (FASEB),1 which defines a postdoctoral fellowship as noted in Table 1.
The concept of a postdoctoral fellowship first emerged in Europe in the 1870s, was adopted by Johns Hopkins University in 1876, and became formalized at the Rockefeller University in the 1920s. Since that time, the most rapid increase in the total number of postdoctoral fellows (postdocs) in all fields in the United States has occurred in the past 15 to 20 years. In fact, the number of postdocs in the US more than doubled between 1981 and 1998, and was estimated to total 52,000 in the year 2000.2
Current Status of Postdoctoral Training in Physical Therapy
There is currently no information available on the percentage of PTs with nonclinical doctorates who actually pursue postdoctoral training (Sarah Miller, APTA Archives, oral communication, March 2005), as postdoctoral study is not included as a category on PT surveys used by APTA and CAPTE.3,4 Postdoctoral training appears not to be recognized as essential by most institutions seeking new faculty members. In a recent review of job postings in PT Bulletin Online, there were 11 positions available for tenure track faculty members who were expected to conduct research as part of their job responsibilities.5 Of those 11 listings, only 1 required postdoctoral experience, and 2 noted that postdoctoral experience was preferable. The other 8 made no mention of postdoctoral training, despite the fact that applicants were expected to conduct independent research and obtain funding to support their work.
It is difficult to assess the availability of postdoctoral positions for physical therapists, as this will depend on each individual's area of interest, and the pool of available positions is constantly changing. Postdoctoral positions come and go as investigators' grants are funded and expire. Potential applicants often learn of postdoctoral positions by word of mouth. Many positions are filled before they are ever formally advertised. Despite these issues with assessing postdoctoral availability, there seem to be ample opportunities for PTs to pursue postdoctoral study. This is evidenced by the total of 16 advertisements for postdoctoral positions posted in the first 6 months of 2005 on the biomech-l and neuromusc listservs.6,7
POSITION AND RATIONALE
Physical therapists with nonclinical doctoral training should, as a rule, pursue postdoctoral training prior to accepting a faculty position. This period of postdoctoral training is an essential step in the process of becoming an independent, funded investigator who will ultimately contribute to the knowledge base used to support clinical decision making. Just as the number of postdocs has increased, so has the importance of postdocs. Much of the research conducted in the US today is done by postdocs. For example, 43% of the articles in two 1999 issues of Science had postdocs as first authors.8 Postdoctoral fellowships are important not only for the progress of science as a whole, but for the progress of individual researchers as well. In fact, the Committee for Science, Engineering, and Public Policy stated that “a postdoctoral appointment is a virtual prerequisite for those wishing to carry out long-term, independent research in the life sciences, physics, chemistry, and a growing number of other fields.”2 Physical therapy is certainly among these “other fields.” Postdoctorally trained physical therapists will be the major contributors to the development of the body of evidence we have available to guide and support professional practice. However, the importance of the postdoc in physical therapy has yet to be fully recognized. The following paragraphs outline the reasons why postdoctoral work is so important.
Reasons to Pursue Postdoctoral Training
Encouraging, or even requiring, postdoctoral training for physical therapists pursuing research will ultimately benefit the physical therapy profession. As more physical therapists with research doctorates pursue postdoctoral training, the pool of individuals with outstanding credentials and the necessary skills to pursue independent, funded lines of research will grow. With training that is comparable to other scientific disciplines, physical therapist researchers will play an increasingly important role in the greater scientific research community through development of their own lines of research and through collaboration across disciplines. Each generation of physical therapist researchers will be better prepared than previous generations to pursue research agendas and to collaborate more widely with scientists in other fields. The result will be an increase in the number and quality of publications produced by physical therapists and a resultant growth in the foundation of knowledge upon which our clinical practice is based.
Without postdoctoral training, many new PhD graduates may be ill prepared to fulfill the duties of a tenure track faculty member, including developing their own line of research and competing for federal funding to support this work. This is of great concern because having a job and funding support are prerequisites for conducting research that will add to the available evidence to support physical therapist practice. The postdoctoral period provides the trainee with the following items critical to his or her success: greater flexibility and a competitive edge when seeking jobs in a variety of settings9; scientific knowledge and technical skills; protected time for early career development experiences, including the establishment of a record of publication7; mentoring from an experienced colleague; and financial support and exposure to grant writing. Without these vital experiences and opportunities it would be much more difficult for a junior faculty member to succeed in developing his or her own line of funded research. Postdoctoral study places the PT with a research doctorate on a level playing field with PhDs in other disciplines where postdocs are the norm. This is essential because PTs will be competing with these PhDs for federal funding.
Encouragement for postdoctoral work can be achieved in multiple ways. First, as a profession, we need to change expectations in the job market by insisting that institutions require, or at least recommend, postdoctoral training among applicants for faculty positions for which those with nonclinical doctoral training are sought. By changing job market expectations, graduates from nonclinical doctoral programs will be strongly encouraged and perhaps even driven to pursue postdoctoral studies prior to accepting an academic position. The result will be a pool of junior faculty that are better prepared to meet the demands of an academic career by virtue of their enhanced skills, experience, and competitiveness for funding.
Second, postdoctoral training should be acknowledged by professional organizations through the addition of postdoctoral training as a level of education in member surveys used by APTA and in accreditation surveys used by CAPTE. Acknowledging postdoctoral training as a level of education will serve several functions. It will represent an acknowledgement of the importance of postdoctoral studies by our professional leadership organizations, familiarize all PTs being surveyed with the term postdoctoral fellowship and make them aware that there is a step that can be taken beyond traditional doctorallevel training, gather vital baseline statistics on the number of PTs who currently have pursued postdoctoral studies, and enable the profession to track how this number changes in coming years.
Last, we should also make efforts to enhance graduate student access to information on how and why to pursue postdoctoral training and suggest pursuit of postdoctoral studies from the start of doctoral training. Enhancing graduate student access to information on postdoctoral fellowships will help them to build postdoctoral studies into their career plans from an early stage. Planning to pursue a postdoctoral fellowship from the outset rather than considering it late in the education process will likely result in greater numbers of students actually completing postdocs before accepting faculty positions.
All of these efforts will help to bring the importance of postdoctoral training to the forefront, a move that is critical to our success in developing a strong foundation of knowledge to drive evidence-based practice in the future. Recommendations numbers one and two are beyond the control of the authors, but in an effort to address recommendation number three, the following section provides information and resources for those interested in pursuing postdoctoral research.
Characteristics of a Desirable Postdoctoral Experience
The following characteristics are essential to a postdoctoral experience that will provide the most benefit to the individual and therefore, ultimately, to the profession. A postdoc should have opportunity and encouragement to publish results in peer-reviewed journals. A postdoc should have opportunities to participate in grant writing with mentor support for the fellow to obtain external funding to support his or her own work. The experience should also allow for networking with colleagues in the same field and other disciplines, fostered by the mentor and enhanced by presenting results at scientific meetings on the local, national, and international levels. Finally, during the postdoc years, the fellow should develop new skills, techniques, a command of the literature, and ideally a line of research that they can take with them into their first faculty position.
Postdoctoral training for PTs is currently undervalued, as evidenced by the lack of attention postdoctoral training receives from institutions seeking faculty members and from professional organizations surveying PTs with respect to highest level of education. Postdoctoral work has multiple benefits to postdoctoral trainees, mentors, institutions, and, perhaps most importantly, to the physical therapy profession. By encouraging postdoctoral training, these benefits can be reaped with the ultimate result: the creation of a pool of independent, funded scientists working to advance the knowledge base we use for evidence-based practice.
Additional Resources/Recommended Readings
There are a number of Web sites that offer useful information regarding the postdoctoral experience and career development. A partial list of these is provided in Table 2, along with information about content of each site and addresses that can be used to subscribe to listservs that regularly advertise postdoctoral positions as well as more senior academic, industrial, and government positions. Table 2 also includes a list of recommended readings.
1. FASEB Postdoctoral Fellow
Definition. Available at: http://opa.faseb.org/pdf/pstdocdef.pdf
2. Committee on Science, Engineering, and Public Policy. Enhancing the Postdoctoral Experience for Scientists and Engineers
. Washington, DC: National Academies Press; 2000.
3. Physical Therapist Member Demographic Profile 1994-2004. American Physical Therapy Association. Available at: http://www.apta.org/AM/Template.cfm?Section=Demographics&Template=/MembersOnly.cfm&ContentID=25286
. Accessed August 2006.
4. 2005 Fact Sheet Physical Therapist Education Programs. American Physical Therapy Association. Available at: http://www.apta.org/AM/Template.cfm?Section=Demographics&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=23836
. Accessed August 2006.
5. PT Bulletin Online
[serial online]. Available at: http://www.apta.org/AM/Template.cfm?Section=Jobs1&Template=/JobBank/SearchJobForm.cfm
. Volume 6, Issue 10, Accessed March 15, 2005.
6. Biomech-l listserv. Available at: http://www.isbweb.org
7. Neuromusc listserv: [email protected]
8. Vogel G. A day in the life of a topflight lab. Science
9. Jensen MA. A beginner's guide to finding and choosing postdoc positions, part I. Available at: http://nextwave.sciencemag.org/cgi/content/full/1998/03/29/271
. Accessed January 2002.