@TheOncoPT (00:19)
Hey, Onco PT, welcome back to this episode of the Onco PT podcast. I’m really excited to be talking with you today because as I look outside my office right now, now I’m in Texas, I know your weather might be a little different where you’re at, but spring is firmly here. Like the sky is blue, the leaves are green, the flowers are starting to bloom. We did some gardening this weekend. I mean, just spring is in the air. And what that also means, whether or not that’s necessarily your backyard view at the moment,

is that this is a changing of seasons. And specifically in OncopT world, this means changing of the seasons from the end of last year’s ABPTS oncology exam cycle to the beginning of this year’s cycle. So the 2026, 2027 cycle of the ABPTS oncology process.

Now we’re going to stick to specifically talking about the oncology stuff, because that’s why you’re here with the OncoPT. We’re going to save the other sections. They can talk about it on their own podcasts. But what I want to talk to you about today is what really kind of starts off this whole process. So let me give you the 30 second rundown of how we got to this point. So if you are interested in potentially ever pursuing your oncology specialty certification,

This is kind of the cycle timeline that we’re working with. So in the spring is when the last exam takers have taken their specialty certification exam. They are finishing up. It’ll be a few months before they get the grade. It is now time for the next cohort to start working on their application. Now the application isn’t actually as scary as what it sounds. The case report requirement of the application is where most PTs spend the most time because it is the most

time-consuming aspect of the application, it’s also the most challenging. And unfortunately, a lot of oncology physical therapists make this process even more challenging than it needs to be. And it’s not on purpose. It’s not because they want to make more work for themselves. It’s just something that happens very, very naturally. I see this happen all the time where an oncology physical therapist will sit down to write their case report. They specifically go in with the mindset of,

Okay, I’m going to write this case report. I’m going to crank it out. I’m going to be done with it. And pretty quickly into the writing process, this case report stuff starts to feel way harder than what they expected it to. And pretty quickly they start to think, I’m just a bad writer. I’m not a very good writer. I haven’t done any writing since I was in PT school or since I was in college or whatever that is. I’m just bad at writing. And if I get better at writing,

my case report will improve. And my friend, is almost never the actual problem making this case report stuff harder than it needs to be. The writing part is rarely the actual problem behind the case report because what happens is most people assume that it’s a writing problem. I’m just bad at writing. If I were to get better, then things would be easier. But what usually ends up happening here is that a physical therapist

selects a case that does not give them enough to work with. So when we’re talking about case reports here, we’re talking specifically for your AB PTS oncology specialty certification application, this is a really specific kind of case report. This is not something that you are submitting to your typical academic journal that is like very structured and very rigorous and very, I don’t even know the, I’m doing the chopping motion with my hand right now, like just very strict.

on how a case report is written. When we’re talking about this kind of case report, this case report that you write for your AB PTS oncology specialty certification application, say that five times fast, is specifically designed to pull out your clinical reasoning and your clinical decision-making skills that demonstrate that backup, that exemplify your specialist level

thinking. That’s the whole purpose behind it. It’s not because the readers want to just read a whole bunch of case reports every year. In fact, I’m sure they would prefer to do the opposite. This is the best way that I think we in cancer rehab have at this time to really discern is someone ready to pursue specialization or not. And so in order to do this, you write a case report and a lot of PTs tend to do this. They pick

a case report that maybe is like super rare or it’s super exotic or it was just really kind of out there from a point of like, wow, I’ve never seen this before. This was so crazy. I bet it’s going to make me look like a real like like a real specialist right now. And oftentimes that doesn’t give you enough to actually work with to write a full case report about this. And so how this manifests when you’re writing your case report.

is that you start to try to basically put words into your case report’s mouth to make it seem more cool and frankly, longer, bigger, more impactful than what it actually is. So this can look like you are trying to explain decisions that you made that don’t come through clearly. Maybe it’s convoluted, maybe it’s really hard to understand or even follow.

why you made these kinds of decisions in this particular case. As you’re writing, you are trying to support things that frankly feel a little thin, that maybe don’t have that same level of evidence that other parts of cancer rehab, other parts of oncopathy have. Or even as you’re trying to find literature for your case report, because that is part of the requirement,

It’s hard to find evidence that supports your decision making or even supports the kind of interventions that you implemented with this patient case. And these adding up start to make this case report feel way harder than what it should be. The writing of this case report is way more difficult, way more challenging than maybe you went into this process thinking. And at this point, it’s not that you don’t know what you’re doing.

If you’re even considering this process, it’s because you are a really competent physical therapist. You are an emerging specialist in oncology physical therapy, and you’re ready to take that knowledge and that understanding you have to the next level. And that’s amazing. That’s incredible. You are not the problem in all of this. It is the case that you have chosen for your case report that isn’t supporting you and supporting your writing through this process. I like to think of it like this.

If you are trying to build a house, my dad built houses for many years. We previously lived in a house that had a lot of foundation problems. So I’ve heard a bit about foundation problems over the years. If you have a house that has crummy crumbly foundation, right? It’s not aligned.

It’s not done well or maybe over the years, like maybe it was done really well, but over the years it’s kind of broken down and it hasn’t been kept up with. If you’re trying to build a house on a foundation that isn’t solid, that isn’t strong, that isn’t going to hold up against this weight that you’re putting on it, everything is going to take more effort to basically keep together.

There’s going to be more patches that are required to keep things working as they should. Let me give an example. In our previous house, like I mentioned, our foundation was not good. Maybe it started fine. It wasn’t kept up with properly over the years. And so we would have doors that would not close properly. Like we would close them and they would, we would think latch.

and then they would end up opening on their own because the foundation wasn’t unaligned, wouldn’t actually keep the doors in their proper place. We have the opposite problem too. We had doors that we could not open. At one point, our front door was so jammed into the like door frame, we physically could not open our front door. ⁓ That’s a fire hazard if I’ve ever heard one. Like that is a significant safety concern here. Everything about that house,

took so much more effort because the foundation was a problem. Like I mentioned, doors were an issue, windows were an issue. We had cracks galore all over this house that were frankly really unsightly. just all this to say, big, big problem. And at the core of this, the reason all of this was happening is that the foundation was not there adequately supporting this house. And we see a very similar thing.

with your case report. If that foundation is not there, if this is not a strong, solid foundation upon which you can build that case report, your case report is going to crumble. It is going to take so much more effort to do every single part of this case report and everything about writing this case is going to feel less clear. Even though you may have a really good memory of what you did, how you proceeded in this particular case, the bringing it together,

and the justifying your decisions and really demonstrating your clinical expertise feels so much harder. So much more work is put into really bringing this out instead of having a case that really supports you and your decision making and your specialist level thinking in all of this. Now, why this happens is not because you go out there and you say, I’m going to pick the craziest.

hardest case to possibly write about, like I am a glutton for punishment kind of situation. That is not what happens. Most PTs choose their case for their case report based on a couple different things, which is this was an interesting patient. I really had a lot of thinking that went into this. I’ve never seen this before. Or this was a really ⁓ unique diagnosis that I’ve never encountered previously.

That’s not a bad reason to pick a case. It’s not the reason you should be taking a case for your case report though. ⁓ Second reason or second kind of problem area I see here is that I remember this case really well. That is a good thing. We do want a case that you remember what the heck you did. If you can’t remember what you did in the case, you have no business writing about it. You have no business writing a case report on it. I think that makes sense.

But just because that case is really, really fresh in your mind does not always equate to a really strong case report. And then number three here, which is this case, this patient interaction felt meaningful to me, felt impactful to me. Again, at face value, that’s a cool thing. That can be in fact a good thing when it comes to considering your case report options. But if this is the

only reason why you’re selecting a case for your oncology case report, everything that you do in the writing process is going to be that much harder because while meaningful and impactful can be really wonderful things for us to reflect on as oncology physical therapists, that does not translate to I am an emerging specialist in oncology physical therapy and I have the thinking

the planning, the decision-making skills and the execution skills to really show that in my day-to-day practice with my oncology patients. All these to say, the picking a case because it’s interesting, picking a case because you remember it, picking a case because it was meaningful to you. These are not bad things, but you cannot rely solely on these reasons to pick a case. They’re not bad. They’re just not strategic in the grand scheme.

of you picking a case to actually write your case report. So what I need you to think of, what I need you to consider in all of this, because sometimes PTs that I talk to through coaching them on their case reports, they kind of want to rush past the picking a case, picking a patient case for their case report and just get down to the writing. Because in their minds, they think that, the writing is the biggest, the hardest part in all of this.

Yes, the writing takes up a significant amount of time, but if you don’t pick the right case and end up having to choose a different case down the road, you have doubled or even tripled your writing time in all of this. It is worth slowing down and really considering what patient case is best for my case report, because this is not just choosing your patient case is not just the starting step.

in your case report, like, get it done, move past it, and then move on to other things. This is the decision that truly determines how everything else in your case report goes, even to the point of, you finish your case report by the deadline or do you not? And I have seen both happen across all ends of the spectrum here. This is the single most important decision that you can make when it comes to writing your case report.

Selecting a strong patient case is going to help you make your reasoning clearer in your writing. It’s going to make the writing process itself easier and much more streamlined. And it’s also going to make the evidence that you have to gather to support your decision making with much, much easier to connect between what you did, what’s available in the literature, and even to talk about the gaps in there.

One thing I want to make sure that before we move on to the next part of this episode, I don’t want you picking a case just because there’s a lot of literature on it. Yes, you need literature, you know, support evidence for your case report. Yes, it is better to have some than none with like a really, really rare case, for example. But part of your case report, you are going to be identifying gaps in the literature. And so it’s OK for there to be gaps.

And in fact, the readers at ABPTS wants you to make those kinds of connections. And a good, solid, strategic patient case that you select intentionally for your case report is going to enable you to connect the dots between what you chose to do in your case report, in that patient case management, connect that to the available evidence, but also talk comfortably about the gaps that still remain between the two of those.

So all that to say, do not pick a case just because there’s a lot of evidence on it in lieu of considering some of these other criteria that we’re talking about too. A strong case is going to make your reasoning clearer. It’s gonna make your writing easier and it’s going to make the evidence easier to connect to the decisions that you made in this case. A weak patient case for your case report is going to do the opposite. It’s going to make writing harder.

it’s going to make it more challenging to really justify what you did in this case. And a lot of times it’s going to make finding evidence that truly supports what you chose to do, how you chose to implement care in this case, much more difficult and sometimes even muddy, if not impossible to find in some situations. So if you are early on in your case report writing process,

this is where I would really pause. Maybe not pause, this is where I would really sit with your decision and really spend time thinking and discerning which is the best patient case for me, for my case report, which is going to ultimately make my case the strongest it can be and also ease the writing process a little bit.

I’m not saying that writing is gonna be a breeze. It’s gonna be completely easy. There’s tough challenges awaiting you, 100%. But don’t let the picking of your patient case for your case report dictate how difficult your patient, like your case report is going to be. It does not have to be as hard as what you’re making it if you choose the best patient case from the get-go. It is so much easier to slow down now.

really think and discern on this decision so that you get it right now instead of having to try and fix it later.

Going back to our house foundation example previously, it would have been so much easier.

especially when it came to the doors, the windows, the cracks, et cetera, it would have been so much easier to have a house that had a strong foundation that was taken care of from the get-go and just made little tweaks here and there instead of the major foundation repair that our previous house had to have, I think three times in the time that we lived in that house.

That was huge. That was major. That was major construction. was time consuming and it was expensive.

Imagine the work that could have been avoided, right? That unnecessary work that could have been avoided by taking care of it from the get-go. And going back to our case report example here, you know, going from house foundation to case reports, this case report writing process will be so much easier and so much more straightforward if you

really spend the time now to make the best decision for your case report rather than having to fix problems that manifest down the road because of the case that you chose. My friend, you do not have to have the double, the triple, the quadrupled amount of case report writing time that I have seen other oncology physical therapists have to do for this. You can pick a case.

and breeze through that writing process and come out on the other side, say, that was a really beneficial experience. I’m glad I did that. And now I’m done and I can move on to other things like enjoying my life, like getting ready for the oncology specialty certification exam. Instead of spending all this time on your application, on your case report, redoing it over and over and over again because of this one simple decision at the very, very beginning of all of it. Now,

This is something that you’re in the middle of right now, right? You have maybe picked a patient case. you’re maybe questioning or second guessing this. I am also going to break this down a little bit more concretely in a video that I released later this week on my YouTube channel. So you can actually see how to approach this very, very important decision step by step early at this point in your case report before you start doing too much writing. So.

I will have that posted, like I said, later this week on YouTube. When this episode comes out, it will not be there yet, but it will be just a little bit later. If you want a notification for whenever that does release, you can subscribe to the Onco PT on YouTube and you will get that notification in your inbox saying, Hey, that new video is there ready for you. So you can walk through this process with me. I look forward to seeing you over there, but until next time, this is Elise with the Onco PT and remember.

You are exactly the physical therapist that your patients with cancer need. So let’s get to work.