All the Things I Don't Want to Do...

I am getting ready to graduate from PT school in May, and find myself in the same difficult situation as you. Before starting PT school, and throughout most of it, I had my mind made up, I was going to practice in an outpatient orthopedic setting. My research is based in this setting, I have had the opportunity to complete two clinical rotations in this setting, and enjoy every aspect of this type of practice. Ah yes the decision seemed easy, until recently.

My last clinical rotation was in an inpatient neuro setting. Going into this rotation I was sure I would stick with outpatient for my career. This rotation threw a wrench in my plans. I very much enjoyed working in the neuro setting. Being able to work with the same patients daily for an extensive time period was awesome. It challenged me to come up with new treatment ideas and helped me to improve my repertoire of interventions. It also allowed me to address everything I wanted to with the patients as time constraints were not an issue in most situations.

So now I have a decision to make. I think what I'll do is apply for a job in both settings to keep my options open. I'm sure I'll be happy in either setting in the long run.

Lauren,

First thank you for starting this blog, it’s comforting to know that many DPT students have the same concerns as I do and it’s helpful to learn from each other’s experiences. This past week I have had the highest of highs and lowest of lows when considering different PT settings.

Before starting PT school I fell in love with inpatient rehab but last week, during a wound care lab, I felt like a rug was pulled out from under me. I was told that in this setting I would be required to do dressing changes and other wound management. I can barely keep my lunch down during some of our wound care lectures so I began to panic. What if I couldn’t be the type PT I always wanted to be because I can’t stomach wounds? I immediately met with my mentor who works in inpatient rehab to ask how she adjusted to wound care. She started laughing when I told her my concerns; the most wound care she had done in the past two years was putting on a band aide.

This experience showed me how diverse a PT’s job can be, even within the same type of PT. Depending on the hospital an inpatient rehab PT might do wound care everyday or almost never!

As a first year PT student, I can completely relate to this post.  Before entering PT school, I tried to shadow in a wide variety of settings so that I would have a better idea of where I wanted to focus while in school.  This hasn't helped as much as I had hoped, because in school I am constantly learning of new settings I had never even considered before!  I know that wound care is not the setting for me as I can barely stand looking at the pictures shown in the powerpoints in class.  I also share your feelings about pediatrics.  Before school I shadowed in an outpatient pediatrics clinic which I found to be very rewarding.  Recently I shadowed my PT mentor who works in the acute and inpatient pediatric wards at the local hospital.  Seeing the huge changes trauma (some of them "not accidental") can cause in a child's life was too much, I know I would be crying everyday at work as well.  

Good luck with deciding where you want to work, and remember if you don't like your initial setting you can always find somewhere new to work later!

Michael- we seem like we're in similar places.  I have loved all of my rotations as well, so as I near the point where I'll have a career I am trying to narrow down the exact place where I want to end up.  I will say, however, that I have been advised against travel PT right out of school.  I have heard that because you're so transient, you don't have much guidance and you often get put into less-than-ideal situations.  Just a thought!  I'm sure that it works for some people, but just wanted to throw it out there.  

Tamara-  even though I'm a year ahead of you, I feel your pain.  I am still figuring out all of the options available to us as future PTs.  As for wound care, I have never personally been involved, however I feel like you'll learn absolutely invaluable information on that clinical rotation.  Skin integrity is something that is stressed in so many areas of PT- geriatrics, neuro, or anyone on prolonged bedrest.  I imagine that it will be one of those things that will serve as a valuable reference down the line.  And you never know what opportunities it will open up!  Your first rotation will be overwhelming no matter what the setting, so take it in stride.  Do the best you can and try to keep track of things that you're learning.  It will help you in the long run!  If you have any other specific questions, feel free to ask.  Good luck!!

I am a first year student in our program and about to embark on my first clinical rotation.  I know this is very early on still, but I cannot help but wonder about this same problem.  What do I inevitably want to do as a PT?  We have so many options, which to be completely honest, I did not realize how many there were before I started school. While I know that I will learn a lot and enjoy my clinical rotations, I am also hoping they will help me to rule out what I do not want to do.  My second rotation is in wound care.  We are covering the material in class right now and I am concerned that I may not be able to stomach it.  Did you do a rotation in wound care?  Is there any advice you can share with me as I go out on my first rotation?  Best of luck finishing up your degree!  

I feel like I'm in a big predicament, just like you are. I'll be graduating PT school in May, and it's starting to get real.  "Real life" is coming sooner than expected, and I have no idea what specific setting I want to work in. I'm a guy that can be happy pretty much anywhere, which is a blessing AND a curse. I've loved all my rotations (for the most part), which makes it very difficult to choose what I want to do for my first job out of PT school. I've enjoyed working with geriatrics in a SNF, and the 'younger' crowd of those active military on a base. Acute care, SNF, and outpatient settings all are appealing to me. I think ideally I'd like to rotate between all of them!

I tried to start by thinking of the things I don't want to do, like Lauren did.  Pediatrics is honestly the only thing I feel that I have no interest in. I love kids, but not in the rehab setting.

Since my interests are so wide open, I'm now considering doing a couple travel assignments to better my understanding of what I want and don't want for a permanent position. Maybe travel to a few different states and see what else is out there. Hope it works!

I too always said I would never work acute care full time but ended up working in acute care for 21 months right out of P.T. School and I am very glad I did. I had the opportunity to work with ortho, neuro, and cardiac patients on a daily basis which helped me expand my skills as a new grad. I worked in the ICU and learned how to monitor critically ill patients. All of these skills and experiences have been invaluable now that I work full time in a school setting with medically fragile kids who have multiple disabilities. In addition, I am better able to manage situations that may arise at the nursing homes I work at PRN. I knew acute care wouldn't be a career long placement but it's a wonderful learning environment for new grads to expand their knowledge and skills. When I have P.T. students on clinical rotations in the school system, I always discuss the benefits of having a first job in the acute care setting. Good luck on your journey and don't stress. One of the perks of our profession is if you find a setting isn't for you, there are options to work in a different setting. You don't have to know where you want to spend your entire career before you graduate.