Chapter 1: Introduction

Group five's roundtable discussion, Professor Pacharo is unavailable due to prior commitments.
Introduction of group members: Fritz Sarah Nakila, Shaira Dean Castro, Rosie Espinosa, Ayona Ang, Ryan Joshua Romeo, and Janice Salinas.
Speaker: Dr. Gaya Rosales, a clinical director in an early intervention pediatric clinic in California (near San Francisco).
Alumna of Silliman University (batch of 2018), took board exams in the Philippines (February 2019) and the US (July 2019).
Previously worked in an orthopedic and sports setting with various populations, including professional baseball athletes.

Initially, Dr. Rosales did not plan to work in the US and preferred the Philippines.
During her physical therapy internship, she assisted in surgeries under Dr. Oligario, which influenced her career path.
She realized her calling was adding life to years, aligning with the role of physical therapists, who focus on improving quality of life rather than just extending it.
Physical therapy in the US offers more autonomy compared to the Philippines due to direct access, allowing clinical decisions and patient referrals.
In the Philippines, physical therapists are often under the direction of medical professionals, limiting their autonomy.

In the Philippines, review centers are common and offer structured study plans.
Students typically take the board exam within a few months of graduating.
In contrast, US board exam preparation often involves self-study using resources like TheraPed and online modules.
Dr. Rosales studied for the NPTE in ten days, which she does not recommend, due to her recent experience with the Philippine board exam.
During the first four months of board exam preparation in the Philippines, Dr. Rosales focused on having fun but dedicated the last month to strict study, leading to topping the board exam.
Rest and relaxation are crucial during study periods to aid in absorption and learning.

A significant challenge is gathering the necessary requirements for the NPTE, including credentialing and visa processing.
The credentialing process involves taking specific classes, and approval can change yearly, requiring careful planning to avoid delays and additional costs.
It's important to find the right timeline for taking classes to avoid a large gap before the board exam.
For those in the Philippines, balancing work with NPTE preparation is a challenge.
During the NPTE, maintaining focus and avoiding panic are key.
In California, foreign-trained professionals must complete a nine-month supervisory internship at an APTA-accredited clinic before obtaining a permanent license.
During the internship, they are paid as physical therapists but must work under supervision.
Job availability is high in the US due to greater demand for physical therapy services, unlike in the Philippines, where awareness and demand are lacking.

The passing score for the US NPTE is at least 600, with a maximum score of 800.
The structure and content of the Philippine board exam are more categorized, with sections like APK, MedSurg, and PT apps.
The US exam is comprehensive, presenting patient scenarios with lab values, MMT results, and other relevant information.
The Philippine exam is academe-based and relies on memory and understanding of systems and processes.
The US exam is more focused on practical PT applications.

The level of difficulty varies for individuals based on their learning style.
The Philippine board exam favors those good at memorization, while the US exam suits those with analytical skills.
It's important not to underestimate either exam, as both Philippine and US-trained physical therapists can perform well in the US.

Philippine physical therapists taking the NPTE should focus on understanding concepts rather than just memorizing facts.
Analyze questions from multiple angles to avoid being caught off guard.
Having a license in multiple places can provide a backup plan.
Working in America may be financially rewarding, but it's essential to have a plan and realistic expectations about the American dream.
The Philippines does not provide sufficient salaries for its medical workers, despite their specialization and clinical understanding.
If financial gain is the primary motivation, consider the decision carefully, as America may not provide everything one desires.

Dr. Rosales learned about Rehab 2030 through the dean of Silliman University's physical therapy program.
Her experience in both inpatient (internship) and outpatient settings has prepared her to contribute to health system strengthening by addressing a wide range of demographics.
She can educate various groups and refer patients to primary physicians for primary prevention.
Working with the early intervention population allows her to fill gaps in under-advocated areas.
She can raise awareness about government funding for special needs children from zero to three years old.
Providing physical therapy in a pediatric setting includes secondary and tertiary care, even for babies in hospice.
The goal is to provide function, purpose, and meaning to their lives, as well as provide equipment and accessibility through government-provided services like Uber rides and equipment recommendations.

Her clinic works as an extension of the regional center in the US, providing services for kids with special needs regardless of social status.
They are expanding to other counties to address the population in specific areas.
In the Philippines, she is working with Silliman University to provide free clinics and educate therapists to address that population.
She hopes to hold seminars for PTs all over the country because in general, the country does not know much about early intervention.
Most patients addressed at a young age can crawl, stand, or walk before the age of three, which is often not seen in the Philippines, where interventions are delayed.

In third-world countries, lack of awareness and prioritization due to financial constraints are major challenges.
People making limited income prioritize basic needs over physical therapy.
Funding is not readily available, leading to high prices.
The government should provide stipends or cover continuing education costs to alleviate financial burdens on physical therapists and patients.
Accessibility is limited, especially in remote areas.
The workforce is insufficient due to many professionals leaving the country, creating a cycle of underfunding and lack of awareness.
Even with a large number of physical therapists, very few specialize in pediatrics and special needs.
North California has very few clinics specializing in that, leading to a huge waiting list and delayed services for children.

Being a great physical therapist is not solely about academics or graduating on time.
The first person in Dr. Rosales's batch to own a clinic failed and was on probation but still succeeded in America.
Dr. Rosales topped the board exam but does not own a clinic.