Choosing a Specialty

First, I'm appalled at the typos in my previous comment...sorry!  I'll try to edit this one before I post!  

I wanted to talk about the "wounds is for nursing" comment.  I do think there are some aspects of wound care that can be carried out by nursing, but I don't think this is a lost area to PTs.  

When I did wound care I thought much of what I did should be done by nursing, but the truth is when we turned it over to nursing, the patient got worse.  The nurses hadn't had the in depth training that I'd had.  They didn't know when to change course or what adjustments to make.  And neither did the doctors, so it isn't like they could write orders for the nurses to follow.  I undervalued my own knowledge and skill until I saw what happened to the patient in the hands of someone who didn't have that same training.  

If you truly "specialize" in wound care, you will have a level of expertise the vast majority of nurses and doctors don't have.  You will be able to provide a level of care unavailable by nursing.  You'll come to appreciate that there is an art to wound care.  

My uncle, who lives in KY, had an ulcer for months, extending past a year, that wouldn't heal.  He finally ended up in a free standing wound care clinic staffed with PTs.  And the wound healed.  My cousin is a podiatrist in California.  He sends his patients with wounds to PTs...not nurses.  

I'm not disagreeing with Christie.  In her part of Illinois, wound care is going to the nurses.  But I also know first hand that PTs are still a first-best-line of defense for wound care in various parts of the US.  So if this is your chosen passion, you may have to be willing to relocate.  That is a very helpful thing to know moving forward.

Veronica,

I second Jason's comment.  Acute care was very beneficial for me.  I'd take it one step further...if you can get on at an acute facility that is a teaching facility that is ideal.  You'll see things there that you won't see in a regular acute hospital setting.  

What I was sure I was going to specialize in, while I still enjoyed turned out not to be my first love.  My first love was something I thought I would hate...maybe because how I was taught?  Or maybe because what was in the books didn't translate accurately into real life...no matter how it was taught.

Finally, after a time in an acute teaching hospital, there were two other experiences that helped grow my wings...home health and traveling PT.  Home health gives you a different appreciation for patients...helps you relate to them on a different level.  You carry that with you no matter what venue you choose next and it makes you a better clinician.

Traveling PT helps you to experience different sites for a short period of time.  I wouldn't recommend this for a new graduate.  But after two years in an acute setting it would be a great experience.  It is like extending your clinical experience as a seasoned professional...except you get paid really well and all of your living expenses covered!  You can work in different settings to see what you specialities you like and don't like.  You also get to see how different facilities operate and that allows you to find out management styles you can comfortably live with and those that will make you miserable.  You may even get to try your hand at management.  If you enjoy travel, it lets you experience different parts of the US and you may find you enjoy living somewhere you never expected.  You may also find you like to visit a city more than you'd like to live there.  All invaluable learning experiences!

Just like you don't have to choose your college major when you are a senior in high school, you don't have to choose your specialty before you graduate from PT school.  It is okay to enjoy the variety that is out there.  The last thing you want to do is choose to soon and choose wrong.  Relax and enjoy the journey.

I think you will never go wrong with anything related to biomechanics and kinesiology...understanding movement is what we need to know...no matter what your setting.

As far as wounds, I find it interesting, but I am finding that much wound care is going back to nursing. Gone are the days of whirlpool (thank goodness) and any wound care tech can be taught how to do ultraviolet, US or e-stim.  With the advances in enzymatic debridement, I personally see no reason for wound care to be done by PTs anymore. Even though I loved it, from a functional point, I really feel it's a nurses job unless you are doing lymphedema management.  

One of the best advises my CI told me was to work acute care for a couple of years.  True I hated to hear that and wanted to hear I would make a great therapist in Peds.

I did do acute and loved it for four years.  The knowledge and skills learned are invaluable.  From there I was able to position myself and volunteer for wounds, peds, etc.  

If unsure, do acute for awhile and keep your eyes and ears open for oportunities.  It is also the best way to know the docs and directly communicate with them.