By Emily Dorn, PT, DPT

Physical Therapist, New Jersey

During APTA’s NEXT conference in 2017, I attended a lecture about being a “generalist versus specialist”. I was still a PT student at the time and I could honestly say I really didn’t grasp what they were talking about or why it was so important.

Fast forward to a few years later when I had to decide between a generalist versus a specialist for my own health. I started seeing a gastroenterologist for digestive problems. And it made sense. I specifically wanted someone who specializes in digestion. I wasn’t interested in a dermatologist, cardiologist, or endocrinologist, not even my primary care doctor. I wanted the person who had the most knowledge with the best current research to help me. That’s exactly what I want to provide to my patients.

What is a Geriatric Clinical Specialist in Physical Therapy?

A Geriatric Clinical Specialist (GCS) is a physical therapist who has extensive knowledge of older adult patients. The APTA description of specialty practice describes this clinician as having “advanced level tasks and the knowledge, skills, and attributes” to work with the older adult population. When I think of how complex the older adult is, it really emphasizes how important this specialty practice is.

Consider the difference between these two patients: a 34-year-old who has a fractured ankle status from a pick-up basketball game with no significant past medical history or medication use versus an 84-year-old who has a fractured hip status post fall, congestive heart failure, high blood pressure, urinary incontinence, venous wound, depression, hyperlipidemia, chronic kidney disease and takes 12 medications. The past medical history and medications alone will challenge the rate of recovery, not even yet considering the normal effects of aging and healing.

How much fear or difficulty will the basketball player have when returning to their first game? How much fear or difficulty will the older adult have when returning to a family dinner or a doctor’s appointment? Understanding multiple body systems and the appropriate progression of interventions for this population is imperative to provide the best care.

How Does a PT Get Certified as a GCS?

Studying for the exam as well as maintaining certification requires clinicians to have up-to-date knowledge of this complex patient population. The exam itself is a 200-question, seven-hour computer-based, multiple-choice test. It sounds daunting and difficult, but it’s definitely doable. The most difficult aspect is balancing studying, working, family, friends… and the rest of your life.

There is some sacrifice, as there is with anything challenging, but that’s what makes a GCS different than any physical therapist. Some therapists choose to go through a residency program before sitting for the exam, or those who have 2,000 hours of direct geriatric patient care can self-study. The APTA’s description of specialty practice provides a content outline, however gives no guidance on the method of studying or the recommended amount of preparation.

How to Prepare for the GCS Exam

I would not have known what to do for my self-study or even where to start, but fortunately, FOX has provided the outline and support I needed to prepare for the exam. As a FOX Rehabilitation clinician, I have access to the Medbridge prep course which consists of over 100 courses, 3 practice exams, and a pre-prepared 20-week study schedule.

I followed the content outline of the APTA description of specialty practice in conjunction with the Medbridge 20-week study schedule. I knew I wouldn’t be able to study for an hour and a half every day of the week (it is recommended to study 10-12 hours a week) and didn’t want to burn myself out with working and studying (and life). So I expanded my 20 weeks into about 30 weeks so that I could take some days off and enjoy the holidays.

How FOX Rehabilitation Supported My GCS Certification

Beyond the prep materials, I was able to access other content offered including FOX clinical training, research articles, and reference guides through Medbridge. The FOX Board Certified Specialist Program also hosted designed group study and review sessions scheduled at different times of the day to reduce interference with treatment schedules.

All of the review sessions were recorded in case you weren’t able to attend, so they were accommodating to our busy lives. I found these study groups very helpful. We talked about study habits, sample questions, exam day preparation, and more. It was great to know that other FOX clinicians were working full-time and going through the same process. The APTA Geriatrics also offered study groups and had specific prep courses that you could pay for. FOX provided similar content at no cost to colleagues.

How Much Does the Geriatric Clinical Specialist Exam Cost?

I spent a little over $1,000 (being an APTA member makes it cheaper) for the application and exam fee. And I’m sure you want to know if it’s all worth it, right? After all, that’s money you could spend on vacation, mortgage, gifts, children, loans, retirement, or hundreds of other things.

That price tag can feel pretty steep, but let’s put it in perspective. Certification lasts 10 years and during years three, six, and nine you must provide evidence of direct patient hours, professional development, and a portfolio submission. (In year ten you must sit for a recertification exam which is about half the questions). So, thinking of a cost/benefit ratio, you’d pay about $130 per year for your specialist certification. To put that in perspective, I spend more than double that on groceries per month. That is to say, it is well worth it! Another benefit is that as a FOX clinician, you’ll be reimbursed after you pass the exam.

With Hard Work and the Right Support, You Can Become GCS Certified!

If you are considering sitting for the GCS exam, go for it! It will take some time and sacrifice. There will be plenty of time spent studying when you’d rather be sitting on the couch relaxing. But it will be well worth it when you know how to better assist your older adult patients.

FOX provides wonderful support and many clinicians have already received their certification while working full-time, raising a family, and everything else in between! There are so many resources and strategies that make the process a little bit easier and I’m happy to say I have taken the exam, a 5+ year goal of mine!

Enrich Your Career with FOX Rehabilitation

FOX clinicians accounted for more than 10% of all GCS certifications in 2020. And with over 140 GCS-certified clinicians, you’ll have plenty of support as you prepare for the exam. If you’re interested in learning more about how becoming a FOX clinician can help you advance your career, explore available openings in your area!