By Alyssa Troutner, DC
Editor’s Note: This week, the VA opened its yearly application process for the chiropractic residency program. For application materials, visit the VA website. Learn more about what it’s like to be a VA resident below and in our ongoing series.
As a resident at the VA Finger Lakes Healthcare System, students and new graduates alike frequently ask me about my experience as a resident and how it varied from my time as a student clerk at the St. Louis VA Medical Center. To help provide a better perspective on the two types of positions, I’ve invited three New York Chiropractic College (NYCC) students who are currently finishing their clerkships at the VA Finger Lakes Healthcare System to reflect on their experience. In addition, I have provided a brief description of the two positions.
What is a VA clerkship?
The clerkship is an honors-level opportunity that students apply for as they enter their school’s clinic system. While this post is written primarily from the perspective of an NYCC student clerk, know that the application process varies slightly between VA healthcare centers and their academic affiliates. The VA clerkship opportunity is a competitive process that requires an up-to-date CV, a personal statement describing why you want to do a clerkship, how you will benefit from a clerkship, and what you can provide to benefit the clinic. Students are also required to provide two letters of recommendation, with one typically from a faculty member at their chiropractic college and another from a non-faculty member.
The application is then submitted and reviewed by a board consisting of clinical educators and administrators who will score the application and compile a list of the top candidates for each available clerkship location. Those candidates’ applications are then forwarded to the onsite VA chiropractor(s) for review and an interview will be conducted either in person or via telephone. Clerkships vary in duration and can last anywhere from eight weeks to two trimesters, with shifts lasting 8-40 hours per week. Students accepted for clerkships are typically in their last year of chiropractic college and have already entered their school’s clinic system. There are currently 63 different clerkship opportunities available across the nation, and clerk responsibilities vary based on location. For example, there are several locations that allow their clerks to shadow various specialty clinics whereas others are more focused on direct student-patient clinical care. It is important to thoroughly research the clerkship that you are applying for to gain a better understanding of what you can expect as well as what you can contribute to these teams. I also recommend reaching out to the attending clinicians or previous clerks if you have any specific questions or concerns regarding time commitment and what your day-to-day would look like if selected.
Clerkship opportunities, grouped by the affiliated academic institution, are listed below. Please note that there are often several students rotating through each location per year and that some opportunities may have been unintentionally left off this list. Reach out to your academic affiliate’s clinical directors for more information about specific opportunities that you can apply for.
|Academic Affiliate||Program Location|
|University of Bridgeport School of Chiropractic||
|New York Chiropractic College||
|Logan College of Chiropractic||
|Palmer College of Chiropractic||
|University of Western States||
|National University of Health Sciences||
|Southern California University of Health Sciences||
|Northwestern Health Sciences University||
|Cleveland University-Kansas City||
|Keiser University College of Chiropractic||
Brooke Morphet (clerk at Rochester VA Community Based Outpatient Clinic), Andrew Sorensen (clerk at Canandaigua VA Medical Center and Michael Cole (clerk at Bay Pines VA Medical Center) discuss the application process for their VA clerkship opportunities and their reasons for applying.
Why apply for a VA clerkship?
Michael Cole: I chose to do a VA clerkship to treat our nation’s veterans and to challenge myself clinically. Our nation is currently in an opioid epidemic and looking for non-opioid treatment methods for chronic pain. I believe that chiropractic is a big part of the solution to the chronic pain and opioid epidemic as we shift towards a multi-modal integrative approach to treating chronic pain. The clerkship gives students the unique opportunity to work with complex cases they would likely not be exposed to in their traditional clinic system. The patients at the VA often suffer from an extensive list of co-morbidities and many also suffer from mental health disorders such as PTSD. As a student, I believe the clerkship is the best opportunity to challenge yourself both as a person and as a young aspiring clinician. In addition, the clerkship offers the unique opportunity for chiropractic students to work as a member of a multidisciplinary team alongside physical therapists, pain psychologists, anesthesiologists, etc.
Brooke Morphet: I chose to apply for a VA clerkship after I had already experienced a required three-month rotation through the Rochester VA, as one of the required rotations for students at NYCC’s Seneca Falls Health Clinic. During my short three-month rotation, I found myself consistently challenged in the clinical aspect, and working with some of the most complex cases I have seen during my graduate education. I found myself willing and wanting to learn more following each patient visit, and this really sparked a further interest in what chiropractic care is all about. Being able to give back to those who so unselfishly served our country was one of the easiest decisions I have ever had to make. These patients recognize that we at the Rochester VA are a learning clinic, and are not afraid to challenge me and make me the best doctor I can be. I believe that they enjoy getting this care as much as they enjoy being part of my educational experience and truly have the student’s best interest in mind.
Each day I have a more complicated and interesting patient that furthers my education and requires me to continue researching the best options for treatment. The most common patients that I come across in this clinical setting are those in chronic pain who have exhausted all other medical options, had multiple failed surgeries, and are just trying to make their lives more than their pain. Most of the time, these patients have realistic expectations and understand that we as chiropractors will not be able to completely eliminate their pain, but rather find ways to work around it and restore their favorite activities that they so deeply miss. Working at the VA has truly given me the understanding of how important human interaction is during the treatment process, and the lessons I have learned from my patients will stay with me throughout the remainder of my chiropractic career.
Andrew Sorensen: I chose to apply for a VA clerkship because I’m able to give back to the veterans that have served our country and help them with their musculoskeletal complaints using conservative, nonpharmacological care. I applied so I can sharpen my clinical skills with patients by becoming more efficient and effective with histories, physical exams and treatments. The opportunity to work in an integrated healthcare environment enables me to communicate and collaborate with other healthcare professionals, ultimately creating an environment for optimal patient-centered care.
What is the VA chiropractic residency program?
While the clerkship is available to chiropractic students, the residency position is a post-doctorate training program for licensed graduates. The majority of the selected residents apply within the first two years after graduation, but any qualified applicant is encouraged to apply regardless of length of time since graduating from chiropractic college. It is highly recommended that any student interested in applying for residency complete a VA clerkship during their academic career. Applicants go through a competitive application process that begins on the second Monday of January each year. College transcripts, letters of recommendation, previous professional experiences and/or on-site interviews are all factors that are considered during this process.
The residency program has strict learning objectives and is more intensive than a clerkship. The curriculum is created to provide a supervised clinical educational experience that allows you to develop your skills as a competent, autonomous healthcare provider while under the guidance of VA chiropractors. There are three main categories of the program: clinical training/patient care, interprofessional education and scholarly activities. I spend the majority of my time taking part in direct patient care, diagnosis and co-managing a myriad of neuromusculoskeletal presentations. The interprofessional education component includes rotations through various medical specialties including primary care, orthopedic surgery, neurology, the emergency department and behavioral health, just to name a few. Additionally, residents have the opportunity to participate in research, give lectures/presentations to other departments and the VHA journal club, and complete two online courses in experimental analysis and integrated geriatrics.
All VA chiropractic residencies meet the same national standards, but each program is unique, with different experiences and opportunities available at each location site. For more specific information from each program, click here. You can learn about the experiences of other VA residents in previous posts on ACA Blogs.
This blog post was written to provide a general overview of the key differences between a clerkship and residency position. Keep an eye out for an upcoming blog posts from the current resident class as we describe the differences in our individual programs.
Dr. Troutner is a chiropractic resident at the VA Finger Lakes Healthcare System. She graduated in 2015 from Cornell University with a Bachelor of Science in Human Biology, Health and Society and then went on in December 2018 to receive a Doctor of Chiropractic and Master of Science in Sports Science and Rehabilitation from Logan University in Chesterfield, Mo. While at Logan, she completed a clerkship at the St. Louis VA Medical Center as well as the Affinia Healthcare System, an integrated Federally Qualified Health Center.