Educational Background and Training

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You will learn a great deal about the history, the philosophy, and the duties involved in physical therapy by reading; but seeing a physical therapist in action in a typical setting will teach you more than all the books can offer.

You can begin by calling your local hospital and making an appointment with the director of the physical therapy department for an interview and a tour of the department. After this first introduction, try to get some work experience in the field. Ask the director of the department if there is an opening available as a vacation replacement aide or orderly. If there is a job, apply for it, but if there is none, contact the director of volunteers to inquire about serving on Saturday mornings or one day a week as a volunteer.

If you land the job, report for work every day, be on time, and don't skip out early when the boss is attending a meeting. Value the job, and show it in your attitude toward the job's requirements.



If you accept a job as a temporary employee, you must work as long as you specified on the application. Don't decide halfway through the summer that a canoe trip is more fun than a job and quit with a day's notice. Leaving will cause a great deal of difficulty for the department; it will be impractical to hire someone for a few weeks, and working short-staffed puts an added strain on all the people you leave. Besides the difficulties you cause, it points out to the director of the department that you lack the maturity and depth for a service career in the health field. The director may never give you another opportunity to work for her or him, nor will that director ever give you a recommendation to work for anyone else, much less a recommendation for enrollment in a physical therapy course.

As an aide or orderly, you will transport patients from their rooms to the physical therapy department in wheelchairs or on carts. You will make up treatment tables with fresh linen, empty laundry hampers and sort fresh linen, clean hydrotherapy equipment, and occasionally clean other machines. You may help with clerical work. You will have an opportunity to help the therapists "transfer" patients, that is, move them from one place to another, but there will be little more you will be able to do in direct patient care. The therapists in the department will know you are interested in the field as a possible career, and they will invite you to watch interesting procedures when the work schedule allows it. You will be able to see the chain of command in a department, you will learn to talk with patients, and you will become familiar with the types of disabilities that physical therapists handle.

You may prefer to work outdoors as a counselor in a summer camps for handicapped children. Spending a summer as a camp counselor can be a rich and rewarding experience as well as fun. It is, however, not a typical physical therapy situation. A better investment of your time would be to spend a summer working in a hospital.

While you are working or volunteering, or just considering a career in physical therapy, it would be beneficial to read several books about the work. One description of the working life of a physical therapist can be found in Your Career in “Physical Therapy” by Patricia and Ray Darby. Patricia Darby is a physical therapist; Ray Darby is a professional writer. Two novels, Laurie, “Physical Therapist” by Lois Habart, and Janet Moore, “Physical Therapist” by Alice Colvert, are also good reading. (There is as yet no known book with a male central character.) Another book that opens the horizons of a foreign work experience is “Erica and the King”, by Erica Leuchtag. This is an account of Ms. Leuchtag's experiences in Nepal, when she rehabilitated the queen and participated in the overthrow of the Rana regime and the re-establishment of the monarchy.
Ask your department director to notify you when the local chapter will be showing several of the recruitment films made by the American Physical Therapy Association.

Physical therapy is a popular career choice, and competition for admission into physical therapy programs is intense. By 2001 all programs for physical therapy will be at the master's degree level and above. To gain admission to these programs, students will need good undergraduate grades and volunteer experience in physical therapy.

FORMAL EDUCATION

Your education for a career in physical therapy must include a balanced combination of courses that will teach you how to live as well as how to earn a living. You must develop an understanding of humanity's spiritual and social needs as well as our physical requirements. You must learn to think logically, to analyze, and to interpret. You must be able to write and speak effectively. You must learn how to establish good interpersonal relationships. After you have built this foundation, you can begin planning for your professional courses. Today's requirements for admission into a physical therapy course are higher than ever before, because scholarship makes the difference between a craft and a profession.

HIGH SCHOOL


Your education should include a college preparatory course in high school. In general, this should consist of four years of English, with both speech and journalism courses, if possible. Take two years of a foreign language, two years of mathematics, and one year each of biology, chemistry, physics, history, social science, first aid, health, business, and computer science.

COLLEGE OR UNIVERSITY


According to the American Physical Therapy Association, 173 physical therapy programs were operating as of July 1997. Forty-six of these offer bachelor's degrees. One hundred and sixteen offer a master’s degree in physical therapy. By 2001, according to the Occupational Outlook Handbook, all accredited programs will be at the master's degree level and above.
In addition to requiring work in the basic sciences, bachelor's programs now include courses in biomechanics, neuroanatomy, human growth and development, manifestations of disease, examining techniques, and therapeutic procedures. Those who major in a related field may choose to pursue a master's in physical therapy.
A list of programs appears in the appendix to this book.

PHYSICAL THERAPIST ASSISTANT

Because the need and demand for physical therapy increased so rapidly after World War II, in 1967 the American Physical Therapy Association established the Physical Therapist Assistant program. The APTA, which had established the educational requirements for physical therapists, decided upon a two-year associate degree program that gives students both theoretical and practical knowledge, but that stresses the practical application- how ? Rather than, why?
If you decide upon this two-year program, the freshman year curriculum will include many liberal arts courses to provide you with a foundation for intellectual, social, and cultural growth. This background differs from that in a vocational or skill-oriented field. Some schools introduce physical therapy in the freshman year, but others do not offer physical therapy courses until the sophomore year. During the latter part of the course you will spend some time in hospitals, nursing homes, and children's centers to apply what you learned in your classes.

Every job and every level of physical therapy has advantages and disadvantages. That of the physical therapist assistant is no exception.

The two-year course is less expensive than the four-year baccalaureate program. If you are hesitant to   take on a sizable loan to finance your education, you can begin working in two years, and you continue your education by attending evening courses at a nearby college or university. This would enable you to enroll later in a baccalaureate program.

Many hospitals give employees the fringe benefit of certain professional courses or college credit hours. Also, most universities give free credit hours to members of physical therapy departments where their students are assigned for clinical experience. Depending upon many circumstances, it might be possible for you to receive part of your education free. Remember, these fringe benefits are not routine, nor are they inherent in every job, but they do exist in some places.
One great advantage in working as an assistant is having constant association with patients. Your time is not diverted into administrative details or teaching.

The salary of the assistant varies from $5.15 to $15.00 per hour.

One major disadvantage is that an assistant cannot advance up the professional ladder into the other positions open to the physical therapist with a baccalaureate or master's degree.

Very few junior colleges have open-end programs with universities that would allow a graduate with an associate degree to continue in the junior year in a baccalaureate program.

Usually, associate degree graduates must take several courses to enter the baccalaureate program and then may have to repeat some of the junior college work, depending upon the requirements of the university they enter.

The assistant may not evaluate or assess a patient, nor make judgments pertaining to therapy, except in simple, routine situations. In some states, the assistant may not work unless a therapist is on duty to give direct supervision. In other areas, it is possible for the assistant to treat a patient after the therapist has performed the initial evaluation, even though the therapist may not be present. The latter approach will probably become the custom and the law in a very short time.
The potential of job definitions is very speculative at this time. Some authorities are forecasting that in a very short time physical therapists will be acting as department directors- supervising, evaluating, teaching, and administering-while the assistant will perform all the more routine duties related to direct patient care. Other leaders point out that many hospitals with limited budgets prefer to employ therapists whose broader educational bases qualify them for a wider scope of activity, authority, and responsibility. In 1985, Medicare and Blue Cross began an intensive cost-cutting campaign in hospitals. The lower salary of the physical therapist assistant may increase the job potential for this group of employees.
A physical therapist can perform all the treatments that an assistant can perform, but an assistant cannot perform all the treatments that a physical therapist can give.

The role of the assistant is neither subservient nor demeaning. The assistant offers an extension to the arms of the therapist to ensure that all patients' needs will be met as often as they arise.

In the next chapter, you will read the details of all the physical therapy treatment procedures. Those treatments that the assistant gives are whirlpool and Hubbard tank therapy, diathermy, infrared light therapy, paraffin therapy, ultraviolet light therapy, Jobs intermittent pressure, ultrasound, massage, cervical and lumbar traction, training in exercises and ambulation, teaching Activities of Daily Living (ADL), and assisting the physical therapist in some of the more complicated treatments. If you become an assistant, you will have the opportunity to instruct patients in situations where the information is standardized. You will treat patients when rapid or unexpected adjustments are unlikely and where certain vital signs are readily identifiable and easily interpreted. This level of the profession requires some decision making and use of judgment, but does not deal with crucial or demanding situations.

Is this the role for you?

PHYSICAL THERAPIST

Most of the people working in the field today are physical therapists with baccalaureate degrees. Today's students must eventually earn a master's degree, but as they begin as physical therapists they always have; the general liberal arts courses required during the first two years of most undergraduate degrees. Liberal arts courses include English composition and literature, a foreign language, philosophy, psychology, speech, history, sociology, anthropology, biology, zoology, bacteriology, embryology, chemistry, physics, and mathematics. Be certain that your general courses include the prerequisites for admission to the physical therapy curriculum. During the final two years, you will be taking courses in professional education.

Physical therapy courses will include human anatomy with cadaver dissection, physiology, biophysics, physics, kinesiology, abnormal psychology, child development, medical lectures in many of the specialties, physical therapy procedures, and professional ethics. While you are in college, take all the physical education courses you can in folk dancing, modern dance, and aerobics. Corrective exercise courses and gymnastics, swimming, and life saving are also helpful.

If you may choose electives, enroll in courses in educational psychology and methods, because you will be teaching people of all levels of education achievement throughout your professional life. You may also be teaching in formal classroom situations. Other electives that might be helpful are public speaking, journalism or business English, behavioral science, organizational behavior, administration, interpersonal behavior, and labor relations. If your computer skills need work, develop them now. Computer science is becoming increasingly important also because computers are used for billing, statistics, and for recording patient progress.

Both physical therapy and physical therapy assistant pro-grams include clinical experience. This begins with a half day per week observation, and expands to working full time, in the final quarter or semester. Students work under the supervision of a therapist. They apply what they have learned in the academic courses. The clinical rotations include acute hospitals, rehabilitation centers, pediatric and geriatric centers, private practice offices, and homebound work.

Some programs assign students to institutions close to the home university. Others, because of their location, or the large number of students, must arrange for clinical facilities farther away. Some programs are very strict about the placement of students, while others are more fluid and will attempt to arrange an affiliation in the student's hometown, even though this may not be one of the usual clinical facilities.

Lodging is provided by most hospitals, usually without charge, to the students, although some may charge a nominal fee. Some give the students free meals, but most do not. Some provide laundry or other personal services. A few give the students a stipend, but this is rare and is becoming rarer with spiraling inflation and increasing governmental surveillance of hospital finances.

Colleges and universities charge a credit hour fee for the period of clinical experience, and the students must pay their own transportation from the school to each of two or three facilities and back to the University for Graduation. In considering the total cost of your education, you must plan for these necessary and inevitable expenses during your senior year. You will also need two or three uniforms and duty shoes. Good quality uniforms are rather expensive, but they hold their shape longer and are usually more durable. Some schools have their own uniforms.

In choosing the school for your professional training, you must consider several facts. In most state university programs, competition for seats in the program is very keen. Many of those turned down are qualified applicants. Some state universities accept only students who have had their freshman and sophomore years at that institution, but they may accept one or two transfer students. If the state university in your state does not accept you into the program, it would be wiser, easier, and probably no more expensive to enroll in a private college than to attempt to enroll in a state university in another state, where competition is great and your chances for acceptance are greatly diminished. Rates for nonresident students are usually high. Universities offering programs are listed in the appendix at the back of the book.

There are many advantages for the physical therapist who has a master's degree. When you have had adequate experience, your opportunities for advancement from staff therapist to responsible and interesting positions are numerous. You may be appointed physical therapy educational supervisor in your institution. In this position, you would supervise the clinical students in your institution. You would also arrange and conduct all the in-service programs. You might teach classes of students in the school of nursing or classes of patients. You might even teach interns and residents. You would have the opportunity to advance to the position of assistant director of the department. After this experience, you would be qualified to become the director of a small department, and, later, you would be qualified to assume responsibility for a large department. An increasing number of physical therapists are taking on supervisory roles.
Even as a staff therapist, you would have the authority to evaluate and assess patients. (Physical therapists may not diagnose, so we never use the word "examine"; instead, we use the words "evaluate" or "assess.") After the evaluation, you would plan the treatment program. You should also consider that as a therapist you would treat patients whose medical problems are more interesting than are those assigned to the assistant. Also, the treatment program is more challenging to your initiative and ingenuity.

The same or greater possibilities for tuition assistance exist for therapists as those that were previously described for the assistant.

Recent salary surveys conducted by the American Physical Therapy Association suggest that earnings also vary according to work setting. Physical therapists working in home health and long-term care report the highest earnings; both groups average $60,000. Those employed in clinics earn slightly less, with average annual income of $56,000. In hospitals physical therapists have salaries of $46,500, and in schools they earn $43,500.

The same survey reported that earnings for physical therapy assistants varied similarly according to setting. Physical therapy assistants in home health reported salaries of $38,000. In long-term care they earned $36,000. PTAs working in clinics averaged $32,000 per year, while those in hospitals averaged $30,500. The lowest annual salaries, $28,500 on average, were reported by physical therapy assistants working in school settings.

Federal statistics for 1996 were reported in the Occupational Outlook Handbook. They indicate weekly salaries for physical therapists. For 1996, those median salaries were $757 per week. Therapists in the top 10 percent of earnings had weekly income of $1,294. The middle 50 percent had median earnings of $577 to $1,055. The bottom 10 percent reported median income of less than $400 per week.
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