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How to survive new grad

Tips For New Grad Physical Therapists – A Survival Guide

Congratulations! You did it! You finally made it through school. You passed the boards! No more long lectures to sit through! No more papers to write! You finally know it all and are ready to venture out into the world of clinical practice and fix everyone!…..Or are you?….. This article will provide tips for new graduated physical therapists to help get you started in your career.

The Beginning of your Physical Therapy Career as a New Graduate

The reality is that school gives you a good broad knowledge base on a large breadth of information and allows you to succeed in hopefully not killing anyone. You will have a fair chance of figuring out what may be causing a patient pain or dysfunction, but you are a jack of all trades and nowhere near a king of any.Graduate Lego

You were likely taught a variety of evaluation techniques that the newest research shows to be outdated or have very poor clinical utilization. In addition, you were likely taught a variety of treatment interventions that have poor reasoning behind them (METs to correct innominate torsion, cross friction massage to stimulate healing, mobilizations to relocate a fibro-adipose meniscoid in the cervical facet joints, etc, etc) or lack of any research to support their effectiveness (ultrasound, laser, spray and stretch, etc, etc).

Nonetheless, you have graduated and you are a freshly minted Doctor of Physical Therapy. You enter the next phase of you career feeling confident and hungry to fix the world. You get in the clinic and begin to treat patients for a few weeks and all the sudden you start to have the sinking realization that you feel a little lost and maybe aren’t as good of a clinician as you thought (we’ve all been there…. all of us).

Patients are so much more complex in the real world. They have a presentation that doesn’t seem to follow a pattern. They have several comorbid conditions that didn’t come up in class. All 17 special tests you are doing seem to be positive; or even worse they are all negative. You begin to miss school and how much simpler the days and patients were.

The common path new physical therapists’ take (and the mistakes they make)

You will have the tendency to treat physical therapy as a PRODUCT and not as a PROCESS; attempting to do something to “fix” people’s dysfunctions. The next step new grads usually take is to find the first continuing education course they can register for in order to teach them the magic trick to fix all the patients they have been struggling with. I’m sorry to let you know the new functional needlecupstymio taping course (note- needlecupstymio taping is now a common language word)  isn’t going to be quite what its marketer’s claim. This is the step that leads me to where I wanted to go with this post. I want to stress the importance of understanding that physical therapy and treatment should be a PROCESS not a PRODUCT.

There is no magic bullet that will be the secret ingredient you’ve been missing in treatment. Manual therapy (of any sort) can be helpful and a good adjunct to treatment as part of the entire process. However, it’s the confidence with which the practitioner applies the treatment and the patient’s perception of the treatment that makes it valuable as opposed to the inherent power of the super-secret tool box treatment itself. Interactions will always carry more power than specific techniques.

Physical therapy techniques are about confidence and patient perception for achieving results

There isn’t a fancy movement screen that can pick up on the risk of injuries and dysfunctions in all of your patients. Again, a movement screen could possibly be a helpful addition to a comprehensive evaluation PROCESS for the purposes of giving the clinician a standardized way to look at global movement capacity of the patient and the presence of pain with certain movements. As a stand-alone our screens tend to fall short when tested for injury prediction in controlled trials. In fact, the founders of the FMS openly state this here on their website, but that doesn’t keep people from bastardizing their approach and claiming to be able to predict all sorts of injuries in virtually everyone they can get to complete the screen.

So at this point I’ve basically shot down approximately 96.54% of continuing education classes and you’re wondering what you’re supposed to do. I want to strongly encourage you to develop a plan for self-growth and education that revolves around building your critical thinking skills, gives you well-rounded and thorough examination skills, and improves your PROCESS. Seek an approach that helps you to coach patients through their rehabilitation by leading them down the path of the best evidence, providing realistic expectations, building relationships, and encourages patients.

Tips for new grad physical therapists – The 3 Biggest things you can do to succeed

Mentorship: Find a GOOD mentor. However, by mentor I don’t mean someone that can hold your hand through treating patients daily. Instead, a mentor should be a clinician that you can go to with your more difficult patients and someone that poses questions to you that encourage clinical thinking and growth. Mentors can be in person, on the phone, on skype, or even through Facebook. There are a plethora of outstanding clinicians that are putting out top notch content free for consumption. I consume loads of information from several different people and try to pick what makes the most sense from each one to build my own unique approach and identity as a clinician.

Read…as much as you can: Read both physical therapy and personal growth materials. Plug yourself into as much easy access info as possible. Social media can be an extremely powerful for this. There are groups and people who post good solid info on a daily basis. Find these people and follow them like a fly on the wall for a little while. Then jump in and ask questions. Get into discussions about why they do what they do and what caused them to say what they said. Read about leadership, interpersonal relationships, what makes someone successful. Self-reflect on what you’ve read. Are you blowing through information but not applying it?

Consuming new information without reflection is like breathing air when you’re thirsty. Just because it has hydrogen and oxygen in it doesn’t mean it is going to quench the thirst you had. You need to convert the ingredients into a viable product before it will become useful and nourish the deficiency you had.

Finally, remember that you are human: You aren’t going to be the best clinician in your clinic, company, town, county, state, or region over night. Don’t get discouraged. Learning and becoming a master at your craft takes time and consistency; reading a little regularly; talking with people smarter than you regularly; going outside your comfort zone regularly. In fact, you will likely end up with far more questions than you started your journey with.

Trust the Process

Enter into the PROCESS of growing yourself. There is no PRODUCT you can buy to make yourself successful and no PRODUCT you can throw at your patients to fix them. Become comfortable with the processes and stay consistent. Develop critical thinking and a knowledge base in place of a “tool belt”. Grow your user manual not your list of tools.

Thanks for reading,

Jarod Hall, PT, DPT, CSCS

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About Jarod Hall

Jarod Hall
Jarod Hall is an outpatient orthopedic physical therapist in Fort Worth, TX. He directs Greater Therapy Centers Southwest Fort Worth. He is an adjunct instructor at University of North Texas Health Science Center in orthopedic and musculoskeletal examination and intervention. Jarod is also an Orthopedic Clinical Specialist (OCS) and Certified Strength and Conditioning Specialists CSCS). He runs his evidence based physical therapy blog at www.DrJarodHallDPT.blogspot.com.

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