Georgetown University Hospital
Department of Physical Medicine & Rehabilitation
Women’s Health
Physical Therapy Residency Program
Resident Application
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Resident Application 
Page 2
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
CONTENTS
Page
Mission Statement
3
Residency Program Goals
3
General Information
4
Didactic Curriculum
5
Faculty
6
Admissions Requirements
7
Application Process
8
Further Information
9
Application
10
Resident Application 
Page 3
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Residency Mission Statement
The primary purpose of the Georgetown University Hospital Women’s Health Physical Therapy
Residency program is to prepare physical therapists with advanced knowledge in women’s health
physical therapy integrated with a foundation in basic and applied sciences and scientific inquiry.
The program will also prepare residents for independent advanced practice in the area of women’s
health physical therapy and prepare them for their role as a clinical specialist.
Graduates will demonstrate their education through excellence in evidence based practice, the pursuit
of clinical research and leadership in Women’s Health physical therapy.
They will make a strong contribution to their profession and to their community.
The program will graduate physical therapists that support and uphold the mission, vision and values
held by Georgetown University Hospital.
Residency Goals

Support the Mission, Vision and Values of Georgetown University Hospital by meeting the needs
of our patients, physicians and co-workers through provision of women’s health physical
therapy services.

Contribute to the profession of physical therapy through writing, teaching, leadership in
consultative activities in the area of women’s health.

Be critical consumers of scientific literature and be proficient in incorporating new techniques
and knowledge into clinical practice.

Exhibit the highest standards of professionalism.
Resident Application 
Page 4
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
General Information

Credentialing: Accreditation is currently being sought from the APTA for the Residency
Program; the Program is currently not accredited by the APTA and accreditation is not
guaranteed and is not a condition of acceptance or completion. The American Board of Physical
Therapy Residency and Fellowship Education states the following: Residents or fellows are
considered graduates from a credentialed Program that had submitted a complete application
while the residents or fellows were actively enrolled in the Program, and the credentialing was
based on that application.

Length of Study:

Program Entrance Date:

Tuition:

Salary: Residents will receive a salary as an employee of Georgetown University Hospital.
Salaries are somewhat lower than those for new gradate physical therapists. (Residents do not
carry a full-time case load in order to allow time for didactic coursework, research, mentoring,
presentations and projects.)

Benefits:
Residents are eligible for benefits as an employee of Georgetown University
Hospital. This includes employer supported health and dental insurance, employer paid time-off
(vacation/sick time, six holidays, educational days, two floating personal holidays). This is not an
all-inclusive list. Applicants are directed to the GUH Department of Human Resources for a full
description of benefits.

Overview:
The program is designed to provide residents with a minimum 12 month
intensive study in the area of Women’s Health Physical Therapy, preparing the resident to sit
and pass the Women’s Health Specialty Exam administered by the American Board of Physical
Therapy Specialties (ABPTS). The program curriculum includes direct patient care, mentoring
time, didactic education, projects and presentations.
12 months (minimum); 36 months (maximum)
Rolling dates
While enrolled as a resident in the GUH WH Program, there is no fee for tuition.
Resident Application 
Page 5
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Didactic Curriculum
Residents receive didactic training on topics related to women’s health physical therapy which are
expected knowledge areas published in the current Description of Specialty Practice for Women’s Health
Physical Therapy. The content is taught by faculty of the GUH Women’s Health Physical Therapy
Residency Program and additional continuing education coursework. Residents will also participate in
Grand Rounds, Case Presentations, Journal Club and other educational experiences.
Learning Unit (Examples)
Overview of Women’s Health
Pelvic Floor Dysfunction
 Pelvic Pain
 Continence Issues (Urinary/Fecal)
Pre-Natal & Post-Partum Orthopaedic Dysfunction
Lymphedema
Musculoskeletal Dysfunction
 Female Athlete
Osteoporosis
Fibromyalgia/Chronic Pain
Post-Surgical Dysfunction
Additional didactic coursework opportunities include (but are not limited to):
 Continuing Education ($2500 per year continuing education credit as GUH employee)
o APTA Section on Women’s Health
o Pelvic Rehabilitation Institute
o APTA Orthopaedic Section
o Real Time Ultrasound (Scott Epsley, PT, Post Grad Certification Sports
o
o
o
o
o
Physiotherapy)
International Spine & Pain Institute/NOI Group (David Butler)
Institute of Physical Art
University of St. Augustine for Health Sciences
North American Seminars
Kinetacore (Intramuscular Physical Therapy/Dry Needling)
Resident Application 
Page 6
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program

Faculty
Clinical Faculty:
Carrie James Pagliano, PT, DPT, OCS, WCS, MTC
Scott Epsley, PT, Post Grad Certification Sports Physiotherapy
Kendra Harrington, PT, DPT, WCS
Lisa Ebb, PT, MSPT, NCS
Johanna Murphy, PT, MS
Jennifer Thoren, MS, OTR/L
Core Academic Faculty:
Carrie James Pagliano, PT, DPT, OCS, WCS, MTC
Michael Uttecht, PT, MS, ATC, CFMT, OCS, CSCS
Scott Epsley, PT, Post Grad Certification Sports Physiotherapy
Johanna Murphy, PT, MS
Jennifer Thoren, MS, OTR/L
Adjunct Physical Therapy Faculty:
Michael Uttecht, PT, MS, ATC, CFMT, OCS, CSCS
Scott Epsley, PT, Post Grad Certification Sports Physiotherapy
Aaron Keil, PT, OCS
Patricia Alomar, PT
Kurt Van der Schalie, PT, MS, OCS, ATC
Scott Juzwak, PT, DPT
Sameer Mehta, PT, DPT
Blair Watson, PT, DPT
Ann Nicholson, PT, DPT, MTC
Andy Novick, PT
Glenn Thomas, PTA
Resident Application 
Page 7
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Admission Requirements
1. Applicants must show proof of graduation from a CAPTE (Commission for Accreditation in
Physical Therapy Education) accredited physical therapy program and hold (in good standing) a
current license to practice physical therapy in the District of Columbia. Completion of a Pelvic
Floor Rehabilitation Course (Level 1 at minimum) is required upon initiation of program (or
proof of registration). If applicant is currently a student, the applicant will identify anticipated
date of graduation from CAPTE program.
2. A completed application received by the program director
3. Acceptance is based upon interest, ability and aptitude for a career as a women’s health physical
therapist. The strongest applicants will demonstrate the following:
a. Strong academic education and background
b. Advanced verbal and written communication skills
c. Clinical education, internships and mentoring experiences in women’s health physical
therapy supervised by a Clinical Specialist in Women’s Health
d. Strong fundamentals in clinical reasoning/problem solving and the application of
examination and treatment procedures related to the practice of women’s health
physical therapy
e. Research experience and interest
4. Residents are selected by the Residency Admissions Committee and their decision is final.
Superior candidates will be given an interview, conducted by the members of the Application
Committee. Candidates are assessed in the areas of commitment, knowledge of the purpose of
the program, interests and personality. Good candidates will possess qualities of flexibility,
team building, leadership and a desire to learn.
Applicants requesting disability accommodations must do so by filing a request detailing necessary
accommodations in writing to the program office.
Resident Application 
Page 8
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Application Process
1. To obtain an application:
a. Online: available 12/2010
b. E-mail: Send an e-mail to Carrie.J.Pagliano@gunet.georgetown.edu requesting an
application. Type “Women’s Health Residency Application Request” in the subject line.
c. Mail: Write to the Program Coordinator Carrie James Pagliano and request an
application by mail
 Carrie J. Pagliano, PT, DPT, OCS, WCS, MTC
Women’s Health Residency Director
Georgetown University Hospital
Department of Physical Medicine & Rehabilitation
Bles Building, CG-12
3800 Reservoir Road, NW
Washington, DC 20007
2. In applying for admission the following materials must be submitted:
a. Application form with essays (see application packet)
b. Three (3) letters of recommendation (see application packet)
c. Current resume or summary of career goals, employment history and extracurricular
activities
d. Official academic transcripts
e. Copy of DC Physical Therapy license or proof of application
f. Proof of completion of a Pelvic Floor Rehabilitation Course (Level 1 at minimum) is
required upon initiation of program (or proof of registration).
g. Non-refundable application processing fee of $50.00 payable to Georgetown University
Hospital Department of Physical Medicine & Rehabilitation
3. GUH WH Residency Program reserves the right NOT to process any application that is
incomplete
4. Within 2-4 weeks after the application is received, applications meeting admission requirements
will be invited for a personal interview or phone interview.
5. Acceptance into the program is provisional pending the candidate meeting all conditions of
employment of Georgetown University Hospital. Applicants will be notified of their status in the
program in writing within 45 days of an interview or within 60 days of receipt of the completed
application.
Resident Application 
Page 9
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Details regarding submission of these materials are provided with the application materials.
Further Information
For further information or an application packet, please visit our website: (12/2010)
Or contact:
Carrie James Pagliano, PT, DPT, OCS, WCS, MTC
Women’s Health Residency Director
Georgetown University Hospital
Department of Physical Medicine & Rehabilitation
Bles Building, CG-12
3800 Reservoir Road, NW
Washington, DC 20007
Telephone: 202-444-4180
E-mail: Carrie.J.Pagliano@gunet.georgetown.edu
This information represents what is current at the time of printing of this publication and is subject to
change. Applicants should contact the Women’s Health Residency Program at Georgetown University
Hospital to verify the requirements for the year in which the application will be submitted.
It is the policy of the Women’s Health Residency Program to recruit, admit and retain participants on a
nondiscriminatory basis. Specifically, the program does not discriminate on the basis of race, creed,
color, gender, age, national or ethnic origin, sexual orientation and disability or health status.
Resident Application 
Page 10
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Application Checklist
Application materials must be submitted directly to the Program Coordinator.
 Application Form with essays
 Three (3) letters of recommendation. If you are a recent graduate, please include on
recommendation from a clinical instructor.
 A current resume or CV
 Official academic transcripts
 Copy of DC Physical Therapy License
 Proof of completion of a Pelvic Floor Rehabilitation Course (Level 1 at minimum) is required
upon initiation of program (or proof of registration).
 Non-refundable application processing fee of $50.00 payable to Georgetown University Hospital
Department of Physical Medicine & Rehabilitation
An interview will be arranged as appropriate after all application materials have been obtained.
Interviews are conducted in person when feasible. Phone interviews will be considered if necessary.
It is the responsibility of the applicant to insure that all materials (including letters of recommendation)
are received by the program director/coordinator in a timely fashion.
Applicants lacking materials will not be considered. Applicants will be notified by mail of the Program’s
decision within 30 days of receipt of the entire application packet.
SEND ALL APPLICATION MATERIALS, LETTERS OF RECOMMENDATION AND CORRESPONDENCE TO:
o
Carrie J. Pagliano, PT, DPT, OCS, WCS, MTC
Women’s Health Residency Director
Georgetown University Hospital
Department of Physical Medicine & Rehabilitation
Bles Building, CG-12
3800 Reservoir Road, NW
Washington, DC 20007
Carrie.J.Pagliano@gunet.georgetown.edu
Resident Application 
Page 11
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
PERSONAL INFORMATION:
Name (Last, First, Middle):
Mailing Address:
City, State & Zip:
Until:
Permanent Address:
City, State & Zip:
E-mail:
Social Security Number:
Day Phone:
Evening Phone:
Are you a United States citizen?
Yes
No
If NO, do you have US Permanent
Resident Status?
Yes
No
Date of Birth:
If NO, what country?
RACE/NATIONAL ORIGIN:
White (non-Hispanic)
African American, African Caribbean or Black
Alaskan Native or American Indian
Asian or Pacific Islander
Mexican American
Cuban American
Puerto Rican
Latino/a or other Hispanic
Other
Do not choose to indicate
EMERGENCY CONTACT INFORMATION:
Name:
Relationship to applicant:
Day phone:
Address:
Evening phone:
E-mail:
Have you ever applied to this program before:
Yes
No
When?
Have you ever been place on probation or dismissed from a college or university?
If yes, please provide details in attached statement.
Have you ever been convicted of a crime (other than a minor traffic violation)?
If yes, please provide details in attached statement.
Resident Application 
Page 12
Yes
No
Yes
No
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Last Name, First Name
ACADEMIC BACKGROUND:
List all colleges and universities attended. Please enclose official transcripts from all of these
institutions.
Institution City/State
From
Mo/Yr
To
Mo/Yr
Major
Does your academic record accurately reflect your capabilities?
Describe why or why not.
Have you been certified in any health profession (?)
Yes
Credits
Earned
Yes
No
Profession:
Profession:
Degree
Date
No
If yes, please indicate:
Date:
Date:
Please list other residency programs to which you are applying this year:


PROFESSIONAL LICENSURE:
Please indicate the state(s) in which you currently are licensed to practice as a physical therapist.
Resident Application 
Page 13
GPA
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program

Submit a photocopy of your licensure certificate(s).
Last Name, First Name
RECOMMENDATIONS:
Please list three (3) individuals you have asked to send letters of recommendation on your behalf:
1.
Name
Title/Organization
Address
2.
Name
Title/Organization
Address
3.
Name
Title/Organization
Address
WORK/VOLUNTEER EXPERIENCE:
Please attach your resume. Please describe below your healthcare experience beginning with the most
recent.
Institution:
Position/Title:
City, State:
Volunteer
Dates:
Description of Responsibilities:
Total Hours:
Institution:
City, State:
Position/Title:
Volunteer
Dates:
Description of Responsibilities:
Total Hours:
Institution:
City, State:
Position/Title:
Dates:
Volunteer
Total Hours:
Resident Application 
Page 14
Paid
Paid
Paid
Georgetown University Hospital Department of Physical Medicine & Rehabilitation Women’s
Health Physical Therapy Residency Program
Description of Responsibilities:
Last Name, First Name
APPLICATION ESSAYS:
1) Please describe the motivating factors influencing your decision to apply for a Women’s Health
Residency at Georgetown University Hospital. Please include in detail your experiences in
physical therapy that may have an effect on successful completion of the program. Indicate any
strengths/weaknesses that might influence your pursuit of the program. Include educational,
clinical, business administration, marketing and research experiences. Limit: 1000 words.
2) Discuss your experiences with and knowledge of autonomous practice and how this may shape
your experience as a Women’s Health Resident. Limit: 750 words.
3) Please write any additional statement you wish to include supporting your application. This
question is optional and intended only to give each candidate full opportunity for selfexpression. Limit: 500 words.
ADDITIONAL INFORMATION:
How did you learn about the Georgetown University Hospital Women’s Health Physical Therapy
Residency Program: Check all that apply:
Ad in
Bulletin (Posting) /Website
Conference
Referral by physical therapist/student
Other:
What factors contributed to your decision to apply for admission to our Residency Program?
_____________________________________________________________________________________
REQUIRED SIGNATURE:
To the best of my knowledge, the information on this application is true and accurate.
_______________________________________________________________
Applicant Signature
Resident Application 
Page 15
___________________
Date