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“Congratulations! You have passed the Hand Therapy Certification Examination.”

By Kate Silverman, MOT, OTR/L, CHT

Writing this first blog post, I can barely believe my own bio: full-time mother of two young girls, the sole caregiver for an ailing family member, a hand-therapist with a rapidly expanding private practice in LA, and – as of two weeks ago – a newly minted CHT. Six months ago, when I first set out to study for the CHT, I could not see a way forward to achieving this professional milestone for myself. The mountain of materials I found when I set out to study seemed insurmountable, and there was no clear pathway through it. Well, actually, there was, but it took me a minute to find it.

You see, with 12 years of experience as an OT in Chicago and Boston, I had of course been using modalities for my whole career. But when I moved with my young children to California mid-Covid and obtained my CA license, I realized that I would not be allowed to use these same modalities in CA without a “modalities certification,” requiring 240 hours of safe utilization of modalities to be signed off by a supervisor, along with course work. This requirement, however, becomes obsolete when you are a CHT. I figured I might as well aim as high as possible, and make this the year that I became a CHT.

I had 6 months until the test. And not having worked for almost 3 years I was a bit, well, rusty. I tried to make a study plan by looking up the recommended books and courses on the HTCC website, but I was totally overwhelmed. There are over 50 resources listed on the website! I joined a Facebook group and was told to try the “purple book.” But with the length of time passed without hands on clinical work (I’d been at home full time with my kids during the pandemic), I knew this wouldn’t be enough to create a sturdy foundation of anatomy/ kinesiology/physiology review for me. I needed and wanted to learn, and relearn, concepts to allow for real clinical problem solving as well as the ability to answer test questions.

With no well-trodden path to follow, I ventured out on my own, piecing together chapters from various texts and trying to follow my own outline. I was able to achieve a bit of an anatomy review this way, but I often felt that I was spending too much time trying to get to the “meat” of each chapter – that is, the most important points and concepts that essentially carry over into exam questions. I became increasingly frustrated without any sort of structured guide.

So, I ordered the ASHT prep book. It offered a solid outline and I utilized various texts to supplement. But I had questions. There were concepts I was unsure of, typos in various texts, and I was spending so much time trying to reinvent the wheel on my own. A lawyer friend kept comparing the CHT to when she took “the Bar” – but where was my well-established, time-tested “Bar review” course that I could trust to lead me to a passing a grade??

I started to look for CHT prep courses. What I found fell into two, very limited categories: either completely independent learning via a website or programs that required attendance at scheduled meetings. With two young children in a pandemic, my life is far too unpredictable to spend significant money on classes I would certainly have to miss.

And then a course sparked my curiosity: the Virtual Hand to Shoulder Fellowship. It appeared to be a new course with an ideal set up: a syllabus with selected readings from the required textbook and weekly lectures that I could access asynchronously (between bedtime and my toddler’s first middle-of-the-night wake up, for example!).

The course was designed to be taken over one year. I did not have a year but figured I would double the pace. I went for it. I initially paid for the first month to see if it was what I thought it was. It wasn’t. It was so much more! The power-points were beautifully done by the founder, a highly experienced therapist and instructor. As I read the required textbook alongside the power-points I realized I had found what every clinician studying for the CHT needs, a guide along with personalized mentorship, that would not only help me pass the exam, but also help me become a better therapist. And isn’t that ultimately what we all want?

I looked at the calendar alongside the syllabus and mapped out exactly what I would need to do to get through 1 year of readings, lectures and associated exams in 6 months. I stuck to it. My consistent study time became 4 to 6 am (my only guaranteed time alone). Two months prior to the exam, major health issues hit my family. I had every reason to abandon the plan, but I decided I had come too far to give up. So I kept at it, exhausted beyond measure, but with the VHSF to hold my hand all the way. I made it through the entire syllabus, read close to 50 chapters, took notes, listened to the lectures, and took the quizzes and quarterly exams created by the Fellowship.

In the final week before the exam, I paid to sit for two exam-length, 4-hour practice tests from two different companies. They were not cheap! One was $135, the other was $200, and I was disappointed with both. One exam I scored in the high 80s but I didn’t feel that the questions were sufficiently difficult. The other exam I failed and received no feedback whatsoever – no percentage score and no idea which questions I had answered wrong. I retook the second test open book, double-checking each answer. Sure enough I did pass, but I had only changed 1 or 2 answers! I was beyond frustrated at this point.

The need for a concise, high-quality CHT-prep program, with assigned text, lectures, mentorship, and up-to-date associated exams, was glaringly obvious. I had been so lucky to have happened upon the Virtual Hand to Shoulder Fellowship and wished I had known all along that it was all I needed to get climb the CHT test-prep mountain.

Two days prior to the exam, I was fried. I decided to just go through basic anatomy and my cheat sheet (Brachial Plexus, Semmes-Weinstein etc.) at this point and rest as best as I could. I took the leap of getting a hotel room close to the testing center and handed the kids over to their dad and grandparents.

The day before the exam I was a complete wreck, stressed and full of doubt. I lay awake all night, trying to remember this origin, that insertion, and generally making myself crazy. Finally around 4 am, my usual time, I got out of bed and went down to the hotel gym to move my body before having to sit for the 4 hour exam.

I sat down in my seat at the run-down test center, mask on. I tried to remember that my first instinct was usually right. And I could bookmark questions I was unsure of and return to them. I thought I would have plenty of time for the 200 questions, but soon my time was up and I had just finished my last bookmarked question. I felt confident in around half the questions; the other half I had to really think and problem solve through more closely.

None of the books or paid tests I had bought compared in style and content to the actual exam. Yet I could problem-solve though all of the questions because the Fellowship had given me such a solid anatomy/ kinesiology/physiology foundation through the clinical applications. When I left that exam I burst into tears in complete shock that it was over.

When I got home, I grabbed my kids and hugged them. This test had taken so much “mom-time” from them, but I knew they were proud of me. And I was proud. I had powered through despite so many personal challenges. That night I finally slept for more than 3 hours in a row. My body knew it was done.

Each day thereafter was spent with an underlying mild agitation and fear as I waited for the verdict. Just about two weeks after the testing period ended the results were up. My hands shook and my heart raced as I opened my online results. I could barely see straight. And there it was: I had passed! I screamed out in joy and my kids and dog looked at me like: “well she’s finally lost it.” I shouted that I had passed! My older daughter burst into tears, full of pride and relief. I finally felt the weight of it all lift.

It took a few days to truly sink in, and then the fun part began as I told colleagues, family, friends, and mentors that I had pulled it off! There was one person, in particular, I couldn’t wait to tell: Mirella, the founder of the VHSF program! The hard work she put forth to create the fellowship and my unwavering commitment to complete it had paid off. The formula for success had indeed taken shape.

It has now been about two weeks since I was given the results. And looking back at it all, I realize it shouldn’t have been this stressful. Should it be challenging, yes? Should the exam ensure that you are an expert, yes? But the feeling of having no compass in an endless sea of information? No. This process can be different. There should be a go-to program for everyone in the field that takes you from start to finish and is manageable for even the busiest parent and professional. Fortunately, Virtual Hand to Shoulder Fellowship, just a newcomer to the field, has begun to fill this critical need as it develops what I consider to be the first clear pathway to success on the CHT exam.

After many discussions along the way with Mirella, and analyses of what worked and what didn’t, Mirella asked me to join the Fellowship team. I would now have the opportunity to use my first-hand experience to help others find their way to success! I am honored to be a part of the Fellowship, to be a support and guide so others may achieve this milestone: to become better therapists and achieve the recognition they deserve through CHT credentialing.



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