As a new grad fresh out of Physiotherapy School I was both excited, to be making a difference, and petrified that I wouldn’t be able to help anyone. After nearly 7 years of post-secondary schooling, an undergraduate degree and a Masters degree in Physical Therapy, I felt very ill-prepared for the real world.
Now, reflecting back on that time in physiotherapy school, my training more than prepared me for what was ahead in the real world. I just didn’t know it at that time. To be completely honest, I wish someone had told me that.
I thought maybe I needed to take more post-grad courses, I thought I needed more mentoring and hand holding, and I thought every one of my clients knew that I was a newbie and thought that I was an idiot (which they probably did anyways). But, for the most part, I was wrong. I didn’t need more courses right away, I didn’t need someone to hold my hand through everything, and most surprisingly my clients didn’t think I was an idiot!
So if I could go back in time, here are 10 things I would tell myself as a new grad:
Physiotherapy school does prepare you for the real world
The biggest fear for most new grads is that we won’t be competent and able to properly rehab our clients. Although we are given a wide array of tools, techniques and treatment principles, part of us (a big part) doesn’t trust the fact that we actually know what we are doing. As physiotherapists we are always touted as the movement experts. Yet, as we finish school, we usually feel far from expert. But if we take a step back, or a step into the clinical realm, we actually are the expert in the room. Sure we may not have as much, or at that point any clinical experience, and we may not have as many tools as a more experienced practitioner, but we are still the expert and we do have enough knowledge and tools to be able to effectively treat and rehab any injury or condition that comes through the door. We just need to trust ourselves that we will be able to apply that knowledge in a practical setting.
You don’t need post-grad courses (yet)
Once I had completed my program and started working, I was convinced that I needed more skills and tools to be able to treat and rehab my clients effectively. Be it soft tissue skills, manual therapy or needling techniques, I thought I needed to learn these things before I could be a good physiotherapist. Boy was I wrong!
I didn’t need more courses. I needed to get my hands dirty and get more clinical experience. I didn’t need to take a course about “how to best treat a shoulder” but rather, I needed to treat more shoulders to get a sense of what type of presentation I was seeing, what was working and what wasn’t working. Post-grad courses play a key role in an evolving the industry such as rehab and physiotherapy, but I’m a firm believer that as a new grad it is better to understand and cement the concepts and tools I have already been taught rather than to keep adding new skills and not really having a good grasp on anything.
You won’t be able to “fix” everything in the first treatment
The moment I had my first appointment as a physiotherapist I was on a mission to “fix” my client right away. I was going to get rid of all his pain, fix his biomechanics, give him some good quality exercises and do it all within a 40 minute assessment and treatment on top. Yeah right! I wasn’t even able to get through my entire assessment as I mumbled, fumbled and bumbled my way through awkward questions, poor patient handing and just overall being overwhelmed by the whole thing. And guess what? That’s OK. Especially as a new grad, I found the less you try to do, the better you do. If you try to do multiple things at once, you will lose focus of what you are actually trying to do and in the end you do nothing. Keep it simple, keep it focused, and don’t try to “fix” everything. In the end it will end up “fixing” itself.
There is more than one way of doing things
This one is from two perspectives. First, as a therapist and rehab professional, if a treatment approach works well once for a certain condition, lets say lateral epicondylitis, that doesn’t always mean it will work again. Every client is different, every tissue and structure responds differently and heck even the way you apply the technique will differ from day-to-day. So again, in the lateral epicondylitis example, the mobilization with movement may work for you once, twice, or even three times, but when you get a patient that doesn’t respond to it, don’t keep doing it, try something different and see if that works.
Secondly, as a new grad you get a lot of unsolicited advice from colleagues, other physiotherapists and even other new grads. Each have their way of doing things and techniques they always use. Just because it’s the way they do it, it doesn’t mean it’s THE ONLY WAY of doing it. Take that clinical tidbit and find whatever way you see best to apply it. In some cases just smile and nod as you think ” TENS and heat won’t fix everything jackass”.
Don’t do something just because everyone else is
More and more it seems as if the world we live in is full of imitators. There is constantly new trends arising whether it be in fashion, economics or social media and everyone is trying to mimic or copy them (who thought a man bun was a good hair style?). The world of rehab is no exception. I would always take courses because well other people were taking courses. Everyone was signing up for acupuncture or dry needling, so what did I do? Signed up for acupuncture. At the clinic I was working at, everyone treated with a very similar approach, so what did I do, treated the way they treated, even thought I didn’t buy into the treatment style fully. But in retrospect, I should have done those things with 2 people in mind, first myself and secondly my clients. Just because everyone else was doing something didn’t mean I had to as well.
Plus growing up didn’t everyone’s mother have the same line of “If Johnny jumped off a bridge would you?” Johnny always did seem like a cool guy though…..
Be Confident
As a new grad I think the biggest thing I was lacking was confidence. I wasn’t confident in my skills and hands on abilities, my treatment plans were shaky and muddled, my subjective interview was convoluted and all over the place and most of all I wasn’t confident in front of my clients and my colleagues. More experienced therapists would either ask questions or give me ideas for treatment plans and I would be timid and worried they were just judging me as a therapist. Patients would ask the dreaded question of “how long have you been doing this?” and every time I would give a run around answer and not really instill any confidence in my client.
Even if you don’t know the answer to a question, or unsure about something a colleague was trying to explain to you, you have two choice; admit that you are unsure about it or sometimes you just have to fake it until you make it. Clients rarely are ever testing you or even know what the right answer is, as a therapist be confident and don’t be afraid to say I don’t know but I will find out and let you know. If colleagues are questioning something you do, chin up and answer with some confidence, they might just be genuinely curious and not really judging you.
The more confident you come across the more client buy-in you will get, and the more confident you are the more confident you will feel. If all day you are worried about screwing up and walking on egg shells, well guess what you will probably screw up. But if you are confident in what you do, you will most likely succeed.
Don’t just limit yourself to one clinical setting
This is one of the biggest pieces of advice I could give any new grad in any rehab profession. Don’t just stick to one clinical setting, try to work, volunteer or even job shadow in multiple clinical settings. It can be in different clinics, locums, gyms, hospitals or with various local teams. The more exposure you can get to different work environments the better. The more you see the more you can decide what best suits your style or ideals, or in other cases what doesn’t. What I find is if you stick to one clinic setting, you get set in those ways, if they only book clients a certain way, you get used to that.
So get out there and get exposure to as many different clinical settings as you can.
Get out in the community
Trying to build a caseload from scratch is always difficult. As a new grad it’s even harder. No one knows who you are, you will have little to none direct referrals, everyone who comes to your clinic usually will have a therapist they usually see and so on. Which can make building a caseload a difficult task.
So what’s the best thing to do, get out in the community. Working with local teams, running short seminars for teams, schools or other groups, anything to get your name and face out in the community. As your name gets more familiar in the community, so will the names and faces of people coming in the clinic to see you. I can’t count the number of times I’ve had people come see me because they know I work with a local sports team, or they saw me at a local event.
Have a group of people to network and mentor with
Just like starting any new job it is always nice to have a group of like minded people to be able to bounce ideas off of, brainstorm ways out of a difficult situation, or just have a few drinks and rant on about how your day was. But the key to this is to try to find those like minded people. If you yourself are more of an exercise based therapist and you surround yourself with manual therapists, as great as it is to have that differing opinion, they might not be as insightful to help with your specific area of need.
When looking for mentoring, don’t look solely on a person’s business card or how prestigious the clinic they work at is. Both of those things won’t matter if the mentor isn’t a good teacher, doesn’t want to mentor or might just be too busy to take the time to offer you something meaningful. I’ve worked with great therapists who may just be too busy to take the time to explain and teach, and I’ve worked with good therapists that are great mentors because they know how to teach and explain. Find the fit (similar to finding the right clinical setting) that works best for you.
Also mentoring shouldn’t be limited to just the Rehab or Physiotherapy profession, seek out individuals in different fields of work. It can be people in business, other areas of healthcare, or something that has nothing to do with Physiotherapy!
Don’t burn out too quick
Coming out of school with students loans and every other cost imaginable is a very daunting scenario. And with most rehab professionals being in a setting where their income and earning potential is directly linked to how much they work, it is very easy to find yourself working 6 days across multiple clinics and pushing 50 if not 60 hour work weeks. This was my exact scenario for the first couple years of my working life. It was all about how many clients did I see, how much of a dent did I put in my students loans, was I able to pay off my car, and in the end I was just stretching myself too thin. I was burning myself out and I had only been working a couple of short years.
So if I could redo it I would ease my way into working, yes everyone has financial restraints, expenses and student loans, but in the grand scheme of things if I get it all paid off at 6 months vs 12 months, or 2 years vs. 3 years is it really a big difference? For most people the difference in working 5 days and adding that 6th day of work doesn’t really change anything in their lifestyle. They will live in the same house, drive the same car, go on the same vacation. Albeit they may have a marginally lower income, but guess what you won’t be as tired, you will have more time to enjoy the things in life that you are working toward and you will probably be a better therapist in the end.
So there it is, I didn’t have this list when I was a new grad to help reassure me or to give some guidance, so if you are a new grad or student in any rehab profession I hope this gives some guidance that helps shape your first few years as a rehab professional.
Are there other things you would add to the list? Feel free to add them in the comments.
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