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What I’d Wish I Would Have Known as A New Grad Physical Therapist

I can remember back to this time four years ago when I was finishing up the 3rd of my four student clinical affiliations. What a challenge it was to have my acute care clinical at Memorial Sloan Kettering Cancer Center in New York City. To be honest, throughout my entire time in PT school, I was dreading when the time came for me to begin my acute care affiliation. After all, I entered PT school knowing that I was going to graduate and become a sports medicine Physical Therapist (sound familiar?). I was going to work with athletes, help return them to sport, and support them in fulfilling their athletic ambitions. Unbeknownst to me, I never imagined that I might find myself in a hospital bed and on the operating table for something non-athletic-related early on in my PT school journey. This experience didn’t immediately cause me to change my focus from becoming a sports medicine PT, but it opened my eyes to broader opportunities. It’s amazing how a scary life experience can broaden our horizons in more ways than we could ever imagine. It was after this experience, that I became more open-minded. While I still thought I would likely end up in a sports medicine orthopedic clinic upon graduation, I took every new opportunity as a clean slate and an opportunity to learn.

Thank goodness I hadn’t accepted that job offer from my second clinical affiliation when I still had two more to go! While I loved every minute of my second clinical affiliation which was an orthopedic private-practice clinic that saw a diverse patient population ranging from pediatrics to student athletes to geriatrics, I had yet to experience a few more settings. It was a tough proposition to turn down, knowing that I loved going to that clinical every day, loved the people I worked with, and my patients. It also wouldn’t have hurt knowing that I’d have a job lined up no problem upon graduation. Luckily, I had some amazing professors, who offered great advice. “It wouldn’t be fair to myself to accept a conditional offer of employment prior to graduating having more than a year of school left and two more clinical affiliations to complete”.

In February of my 3rd year, I was nearing the end of my clinical rotation at Memorial Sloan Kettering Cancer Center. My initial impression of acute care consisted of getting patients up out of bed, into a chair, and perhaps walking a little. I couldn’t have been more wrong! In this acute care setting, the therapists worked tirelessly to give critically ill patients their mobility and independence back. Wow! It was more like an acute rehabilitation hospital than what I had imagined the acute care setting to be like! So, what did a typical acute care hospital look like in terms of physical medicine & rehabilitation? This clinical was by far the most intellectually and emotionally challenging clinical experience I could have asked for. It made me second guess my desire to solely focus on sports medicine and orthopedics. After all, when you are treating oncology patients, you are treating the whole body (orthopedic, neurological, cardiovascular, pulmonary, integumentary, etc). Maybe, just maybe, I didn’t want to close the door on acute Physical Therapy job opportunities post-graduation. What further solidified this intuition was the fact that professors in our program consistently told us, “If you don’t get acute care experience within your first few years out of school, you can say goodbye to working in that setting”. While I wasn’t sure I wanted to spend my whole career in acute care, I certainly didn’t want to close that door. There are so many opportunities to learn and grow in that setting, not to mention that it can be a very rewarding setting.

In March of 2015, I began my 4th and final clinical rotation. Too bad we had already set it up far in advance or I would have chosen to do a pediatric focused clinical. While pediatrics wasn’t anywhere on my radar when I began PT school, I was lucky to work in my 2nd clinical with a pediatric therapist. When anyone under the age of six came into the clinic, they got placed with us… and boy did I love it! Heading into my 3rd clinical at Memorial Sloan Kettering Cancer Center, I was told that students didn’t typically work with the pediatric oncology patients. Surprise, my clinical instructor was assigned to three floors with one of them being the pediatric floor. I never realized how children undergoing cancer treatment could be so resilient and what physical therapy could not only do for the children, but for their families! If I would have known this, I would have certainly opted for my 4th and final clinical to be in pediatrics.

Such is life, right? We can’t predict the future! How would I have known that I would have been so interested in pediatrics? The only choice I had left was to go into my fourth and final clinical with an open mind. It turned out to be a very busy small private-practice outpatient clinic. The owner was a graduate of my program and he was fantastic! By that point in my student career, I was independent at treating patients and was considered “entry level”. Instead of reviewing skills, his mission for me by the end of the clinical rotation was to KNOW MEDICARE BILLING INSIDE AND OUT. Sounds boring right? Yes – but I couldn’t have been more grateful to him when I graduated and was out in the real-world. He put an exclamation mark on the end of my PT school career and gave me the confidence I needed to enter the job market.

But now what???..... I’ve graduated and passed boards! Woohoo! I thought for sure I’d go into sports medicine. I still liked sports medicine, but there were other areas I enjoyed as well. What do I do? I didn’t want to close any doors! Couldn’t I have it all?

I applied for an 18-month residency that I knew would be a longshot. After all, they only accepted ONE applicant. Why this residency? It was unlike any residency I had seen before. In this residency, I would have spent 9 months in acute care treating pediatrics to geriatrics across all services. Then I would have spent 9 months in outpatient treating pediatrics to geriatrics! Wow, that 18 months could have helped me decide where my niche was! Fast forward two months…. I interviewed and received a letter stating that I was a strong candidate, however, they felt I would benefit more from the program with a few years of experience in acute care under my belt.

I had been looking into travel therapy opportunities at the same time as permanent opportunities. My permanent options were two outpatient private-practice clinics in New York City, an acute care hospital in New York City, or a hospital-based oncology clinic in Columbus, OH. I had no idea. My father urged me to “just take something!”. I didn’t want to lock myself into one setting, and let’s be honest, I didn’t know exactly what I wanted, so I decided to travel.

And guess what???? BEST DECISION EVER!!!

What I didn’t know that I know now (almost 4 years later!!!):

  1. You don’t really know what you want as a new graduate and you shouldn’t have to (at least for 99% of new graduates don’t)

  • Do you really want to work in an outpatient clinic forever?

  • o What if there’s only a few other therapists in your clinic or you’re by yourself? Where are the opportunities for learning and skill development? (Side note: in my first year as a travel PT, I worked with 26 different PTs!!!)

  • o What if you get tired of that patient population?

  • § As a student you don’t get to work in more than one or two different clinics. Do you like chronic pain, occupational medicine, manual therapy, neuro-based clinics, community clinics, aquatic therapy clinics, clinics owned by physicians or chiropractors, private-practice chain clinics, hospital-run clinics (see what I’m getting at? Do you need/want to explore?)

  • o What if the clinic you sign on permanently with is nothing like your clinic as a student? Like I’ve said before, no two clinics are truly the same.

2. You don’t know which questions to ask in a permanent job interview to determine if the job will be a good fit for you.

  • o There are different management styles (some that will mesh great with you and others that will cause you to pull your hair out on a weekly basis)

  • o No hospital or outpatient clinic is the same, even if they see the same patient population

3. The people you work with matter! You spend a lot of time with your co-workers. You want to make sure you fit the mold so to speak?

4. Always follow your gut! If you have an interview for either permanent or travel positions and your gut isn’t feeling quite right, move on!

5. Travel offers more flexibility than a permanent job with regards to time off, location, setting, patient population, and salary

Take-Home Message….

After traveling for nearly four years, I can honestly say that I didn’t know what to look for in terms of a permanent job. What kind of management style was I looking for? What kind of organizational structure meshed well with me? What is my ideal patient population? What is my ideal schedule? What I do I need in terms of salary, time off, scheduling, continuing education? These are all things that a few years of traveling have helped me to figure out. Traveling has given me an advantage that I would have never dreamt about 4 years ago. Not only have I worked in multiple settings and in multiple states, I’ve started to truly discover my niche as a Physical Therapist. There’s a lot left to discover, but I am so far ahead compared to where I started. I was lucky enough to have worked with some incredible recruiters who valued both my professional development and personal happiness along the journey. In a non-pushy way, they helped me to build a resume I can say I am proud of me and picked me up when something went awry while on assignment. To be connected to two of the best, click here!

I hope this helps any current students or new graduates trying to find their path in this crazy healthcare world! Congratulations on your achievements and happy soul searching!

Questions or comments? Leave them below!

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