Your grad year as a Physio is a very exciting as well as nerve racking time. It's a time of incredible learning, fun and development, as well being at times quite challenging mentally, emotionally and physically. You are very well equipped with some of the latest and greatest information and knowledge of research, as you have come straight from uni. You will be keen to learn, develop and start seeing real clients and helping them recover from their pain and injury issues and get on a path to a healthier, happier life! Having been a graduate myself (slowly becoming more of a distant memory! 🤣) and having spoken with many recent graduates over the years, I’ve put together a list which I think will help you get the most out of your first year (or two) as a graduate physiotherapist, no matter where you choose to work (public or private).
It’s important to note, regardless of where you work, there will be ups and downs, good times and bad times, easier days and harder days - that’s just life! A specific challenge a lot of physio graduates will face, will be working in a private practice environment - 60% of graduates will get jobs in this sector, with only 3% of placements being offered in private practice. A key factor if choosing to go into private practice is choose your employer carefully. Make sure you have adequate support and guidance around you so that you can develop and thrive and not end up on the burnout pile (which is unfortunately common) - see the link here for tips on what to look for in a private practice.
Here are the 10 key things to consider going into your graduate year so that you get the most out of it:
1) Choose the area which you are most passionate about
Don’t just go for the safe option - if you love MSK go for it! Just do your checks and balances to make sure the private practice supports you really well. You need to read and learn a lot in the first few years, therefore you’re more likely to do it and thrive, if you’re reading things you’re interested about and not doing rotations that you have no interest in.
If you’re mostly interested in MSK but are not closing the door on neuro, cardio or paeds etc, are there opportunity to try some neuro, cardio or paeds in the private practice you're looking at?
2) Be an active learner
Structured learning, mentoring and support is great (and necessary), but you will get the most out of it if you drive it. If you are a passive recipient, then your progress will be much slower. Make sure you chat to your employer about the topics you want to learn about and discuss. Other things to do here are:
Listen to a podcast weekly
Read a journal a week (or a summary - Physio Network subscription!)
Follow some reputable (and intelligent) sources on social media (Knowledge Exchange, iMoveU etc)
Informal learning is a big thing (just ask a clinician that has worked as a solo practitioner and not had anyone to bounce ideas off!). If you run into a client and aren't exactly sure of a plan of action, do a quick search of your own resources and then make sure you ask questions and discuss it further with more senior clinicians. Other considerations here:
Can you knock on the door of your seniors if required?
Who is around at the lunch break?
3) Understand yourself
Understand your learning style - how do you learn best?
Auditory, visuo-spatial, kinaesthetic or linguistic?
Understand your personality type
How do you best engage and work with others. Try a test like the 16 personalities quiz to find out more about yourself
What’s your communication preferences? Knowing how you like to give and receive feedback can be an important learning tool too
> Try a work love languages quiz
Discuss and/or share these with your employer so that you can understand each other better and develop a strong working relationship
4) Don’t expect that you’ll know everything
You will likely learn 3+ times as much in your graduate year, compared to what you learnt over your entire uni degree. This is normal. You’re now seeing real people and developing neural networks in your own brain linking all the theory with practical examples - you are gaining real life experience!
Expect the unexpected - keep an open mind and be ready to challenge your own biases!
Very importantly, have self awareness and know when you need to ask someone for help - don’t be too proud! Research the question yourself first then go ask your senior some questions.
Try new things - when you read an article/podcast/video/do a course - try it. See what works for you. Keep doing what works and keep adjusting what doesn’t!
5) Don’t assume you know nothing
You know a lot, you’ve done 4 years of uni. Have confidence in your ability!
Present confidently and assertively to clients (but not arrogantly!) - they need to have confidence that you’re the right person to get them better!
Confidence with verbal and non-verbal communication
Confidence with handling and ‘hands on interactions’ (not necessarily 'hands on' treatments!)
6) Build the fundamentals of your practice
Don’t go looking for the next big thing, or the most obscure condition you can find. If it looks like a horse and sounds like a horse, it probably is a horse, not a zebra
At a very reductionist level, in MSK practice, once you’re confident it’s not a serious pathology (no red flags), it’s very likely a MSK problem - so treat it! If progress plateaus, then look for further investigations then +/- chat to your senior therapist about the plan
Build great communication skills as well as rock solid subjective, objective and basic treatments - you don’t need to reinvent the wheel! The best practitioners just do the basics really, really, really well. It isn’t sexy (like IASTM or a shiny electric gadget), but it’s the most effective!
7) Did I mention your communication?
Your ability to build rapport with people will likely be the biggest factor in your success or failure as a physio (wherever you work and in whatever field!)
‘People don’t care about what you know, until they know how much you care’
‘Soft’ skills, emotional intelligence and exceptional communication skills are all things that you can learn and develop
Make this a priority!!!
8) Choose your workplace carefully
Do the values of the business align with yours?
The workplace culture will go a long way to either helping or detracting from your experience
What’s the plan with structured support?
Get very clear on this
How much and for how long?
Ask what their treatment philosophy is and what you’ll learn about (ie what is their guiding clinical philosophy and how do they go about treating their clients)? eg's include:
Exercise vs manual therapy focus
Patho-anatomical focus vs health promoting language
Movement ‘control’ bias vs progressive loading philosophy
Clinical reasoning vs pre-determined ‘pathways’ models
Outcome focused incorporating motivational interviewing, therapeutic alliance, great communication and clear planning vs session by session ‘see how we go approach’
Career progression
Will you be pushed down a ‘certain path’ or niche area from the word go or are there clear defined pathways that you can grow into your career
Are you able to work with your employer to market to your ideal client as your practice evolves?
For more info on questions to consider whether a workplace is going to be right for you, click on this link.
9) Find a balance with focus on earning big $ vs learning
In the first few years look to consolidate your skill set before you focus on trying to earn big dollars.
This doesn’t mean don’t try and gradually increase your income, but those who get sucked in to practices suggesting you can earn big dollars straight away, or set high patient numbers that are associated with higher pay packets will often lead to the therapist ending up being another one of the physio ‘burnout’ statistics.
Get the foundations of your career right and you can build anything you want form there!
10) Work-life balance/harmony
Don’t neglect your downtime
The first year or two out can be intense learning and you need to dedicate a significant amount of time to upskilling yourself. However make sure you also schedule in time for doing the things you love - catching up with family/friends, going out for coffee, reading books, watching movies, playing sport etc. It’s a big change in lifestyle from uni life to full time work, so investing in yourself can be as simple and important as regularly taking time out to do the things you love (and not just read every journal article under the sun!)
Use skills like time blocking and/or a diary, calendar or task list app like Asana to increase your efficiency
Being in a good habit of having things written down stops you from having to remember everything, so you can enjoy your downtime and not have things ‘hanging over your head’. This makes sure your downtime, truly is downtime, and can reduce a lot of stress
These are well worn tips gathered by many people over many years. Good luck with the start of your career and I hope your first years as a physio are full of enjoyment, success and growth. If you have any questions or would like further advice feel free to contact me at ben@proactive.physio
Yours in health,
Ben