Discouraged in PT School & Learning Nothing

[A.C]

TL; Don’t Wanna Read; here are the highlights.

• Felt like I was sold a bill of goods by PT school reps who make the field sound better than it is.
• Not really learning anything in PT school. After 2 years I have almost no ability to treat patients. Learned more from PT youtube videos in my off time than from school.
• Where should a PT student be as far as overall understanding after each year?
• Does working as a PT suck as much as PT school does?

I’m a bit discouraged about my choice to go into Physical therapy school and wanted to see if my experience is normal.

First, I feel like I am not learning anything. I’m in my second year of PT school in a 4 year program. Sure, like everyone else I am “learning'' massive amounts of facts, concepts etc. but I do not seem to be able to apply them. Maybe I understand the mechanism of injury for a rotator cuff tear, the steps of healing, what healing should look like etc., but at the end of the day I have no idea where to start with treatment. The way we learn is so segmented that I am having difficulty putting everything together in one cohesive picture of understanding.

In my off hours, I watch PT videos from physiotutors/Bob & Brad etc. to get intervention ideas and to learn better techniques. I feel like I have learned more from youtube than I have from PT school.

I’m not sure where I should expect to be with my overall understanding. Everyone else in my cohort seems to be in the same boat but I do not find that very comforting. Occasionally we have a patient experience where patients are brought in from the community to act as patients. I always end up doing fairly well with them but never feel like it (i.e. the professor will say it went well but I will leave with the impression that it went poorly). Then I will get hammered by the documentation both because it is not very intuitive to me and because the nature of documentation makes it a tad bit annoying.

At my program, our clinical rotations do not start until the very end. So I do not get to spend weeks in the clinic throughout my program to see if I actually even enjoy PT. This leads me to my second frustration: the bill of goods PT school recruiters sell undergraduate students. Every time a PT rep would visit my school they would highlight all the best parts of the job: helping people, training impairments, flexible schedules, and so forth. Every rep just so happens to leave out the massive amount of the workday that is spent doing documentation/paperwork, wrestling with insurance, and the constant threat of losing your license due to some malpractice suit or other mistake.

I’m so frustrated with the program that most days I do not even want to sit for the boards. Some days I think that the only regret I would have from quitting PT is over the ridiculous amount of debt that I went into to get this far.

What are the normal experiences of students in PT school? Does this look like your experience? How did you make it through and is working in the clinic any better than the school itself?

Thanks, any help is appreciated!

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[wiseOldPT]

I think the thought of "I don't know how to actually treat a patient" is quite common, at least with good PT education. Yes, that might sound like a contradiction. But think, anyone could go watch those youtube videos and copy them, right? Anyone could google exercises online. That is not what your expertise is or what makes you a PT (especially not the higher level of reasoning though for a DPT). A good PT program should never teach you set protocols of "do x, y, and z for a patient like A", but rather, they are teaching you all the underlying knowledge. You can then reason through a patient case from examination (and importantly, identifying red flags that need referral out) to crafting a treatment plan, and the easy part, actually doing the intervention. You will learn the day to day how to treat when you are in the clinic. When I was faculty in a DPT program, we'd often have students complain that they felt they didn't know how to treat patients before a clinical. When they'd come back, they'd be glad we had the approach we did as they saw it come together on their clinical experience. That said, I do not like the approach of all clinicals at the end, but doesn't seem there is anything you can do about that now.

As for documentation, yep, everyone hates it. Sorry you didn't feel properly warned about it, but remember every job has parts we don't like. Heck, adulthood has lots of parts we don't like! You will get faster at documentation so it becomes less of a drag, but insurance and all that is part of the medical system here unfortunately. You can choose different practice areas that have different emphasis on that- ex. cash based but where you might have higher liability, vs. working for schools vs. working in hospitals, etc.

While PT school can be hard and frustrating, please don't play the victim. It was your job to go into this informed- that means shadowing and understanding what the profession is. It means researching schools to decide how that works for you. No one conned you into anything. If you really don't think you want to be a PT, leave school now. Yes, you'll have debt, but it isn't like the payout of becoming a PT is going to make facing (more) debt better than it is now. But be informed in any decision you make and thoroughly research other careers.

 

[kdubz7w7]

TL; Don’t Wanna Read; here are the highlights.

• Felt like I was sold a bill of goods by PT school reps who make the field sound better than it is.
• Not really learning anything in PT school. After 2 years I have almost no ability to treat patients. Learned more from PT youtube videos in my off time than from school.
• Where should a PT student be as far as overall understanding after each year?
• Does working as a PT suck as much as PT school does?

I’m a bit discouraged about my choice to go into Physical therapy school and wanted to see if my experience is normal.

First, I feel like I am not learning anything. I’m in my second year of PT school in a 4 year program. Sure, like everyone else I am “learning'' massive amounts of facts, concepts etc. but I do not seem to be able to apply them. Maybe I understand the mechanism of injury for a rotator cuff tear, the steps of healing, what healing should look like etc., but at the end of the day I have no idea where to start with treatment. The way we learn is so segmented that I am having difficulty putting everything together in one cohesive picture of understanding.

In my off hours, I watch PT videos from physiotutors/Bob & Brad etc. to get intervention ideas and to learn better techniques. I feel like I have learned more from youtube than I have from PT school.

I’m not sure where I should expect to be with my overall understanding. Everyone else in my cohort seems to be in the same boat but I do not find that very comforting. Occasionally we have a patient experience where patients are brought in from the community to act as patients. I always end up doing fairly well with them but never feel like it (i.e. the professor will say it went well but I will leave with the impression that it went poorly). Then I will get hammered by the documentation both because it is not very intuitive to me and because the nature of documentation makes it a tad bit annoying.

At my program, our clinical rotations do not start until the very end. So I do not get to spend weeks in the clinic throughout my program to see if I actually even enjoy PT. This leads me to my second frustration: the bill of goods PT school recruiters sell undergraduate students. Every time a PT rep would visit my school they would highlight all the best parts of the job: helping people, training impairments, flexible schedules, and so forth. Every rep just so happens to leave out the massive amount of the workday that is spent doing documentation/paperwork, wrestling with insurance, and the constant threat of losing your license due to some malpractice suit or other mistake.

I’m so frustrated with the program that most days I do not even want to sit for the boards. Some days I think that the only regret I would have from quitting PT is over the ridiculous amount of debt that I went into to get this far.

What are the normal experiences of students in PT school? Does this look like your experience? How did you make it through and is working in the clinic any better than the school itself?

Thanks, any help is appreciated!

- well yeah, obviously they are going to advertise the field and try to make it sound fantastic. It's up to you to do your own unbiased research.

- I think that's normal. All the pieces and loose ends don't really get pulled together until you go to clinic. It's really unfortunate that you do all didactic before clinic. Ours was throughout school and it really helped, but there isn't anything you can do about it now. As said above, school teaches you the underpinnings of what goes on with treatment - in clinic you learn how to put it all together. It is not formulaic and would be impossible to teach in a classroom/lab setting. You will be surprised how much random crap you learned in the classroom that didn't seem important or significant at the time will suddenly be very relevant when evaluating or educating a patient.

- Short answer, there is no "should"......It's hard to say and does not have an answer. Every program has different material per year, so at the end of school everyone will have learned the same stuff but the order varies wildly. We did our first two clinics during our second year and still had didactic in our third year so how we felt at the end of each year will obviously be different than how you feel - comparing year to year, we probably felt more confident than you PURELY because we went to clinic much earlier. Doesn't mean we learned more or better, we just learned in a different order. But, I think what you are describing is normal. You're still in school. You haven't graduated yet. You haven't even gone to clinic yet. So yes, very normal. Try to trust the process. Wherever you are, is where you "should" be because you shouldn't really be anywhere in particular.

- It's an opinion question, not a factual question, but my answer is no. I hated PT school passionately. I hated all things PT by the end of my first year. Clinic really helped me to refocus and remember why I decided to go to school, but it didn't change how much I hated PT school itself (and I loved undergrad and my master's program so I am not normally a school-hater). Now, I love my job and am so glad I stuck it out and didn't change my mind and drop out.

"Everyone just happened to leave out..." - again, it is on you to do your own research, including talking to practicing PTs. And also, not every field and not every job is like that. I did a rotation in a cash based clinic and it was magical - minimal documentation and no dealing with insurance. My final rotation was heavy on documentation and insurance wars. It is not your school's fault that documentation is a thing. It's a necessary evil we all had to learn.
I personally did not understand documentation AT ALL until my final rotation. My classmates were still explaining SOAP notes to me in my final year, despite learning it year 1. Don't worry about it.

 

[CPT2DPT]

Im sorry if this doesn't really answer your question, but what school has a 4 year PT program? That is like paying an extra year of DPT tuition and still getting the same curriculum as others.

 

[ya1]

First, I feel like I am not learning anything.

You may not be learning much because you already know that information. I did not know much when I got to PT school and I was learning a lot.

’m in my second year of PT school in a 4 year program. Sure, like everyone else I am “learning'' massive amounts of facts, concepts etc. but I do not seem to be able to apply them. Maybe I understand the mechanism of injury for a rotator cuff tear, the steps of healing, what healing should look like etc., but at the end of the day I have no idea where to start with treatment. The way we learn is so segmented that I am having difficulty putting everything together in one cohesive picture of understanding.

That is OK! It is a path to the day when you are able to put everything together. I was able to do that only after I started working on my own. You do it 20-ish times and you will be able to put it together. I still cannot put together lots of things, for example, how to diagnose nerves impingement which is OK since I am not working in a setting where those diagnoses are needed.

Then I will get hammered by the documentation both because it is not very intuitive to me and because the nature of documentation makes it a tad bit annoying.

I have never met anyone who would say they ENJOY documenting! You accept it as a part of your job. In some setting, you will have to document a couple of hours a day, in other settings it may take 6h - something to consider when choosing your job setting. Also many PTs use templates when documenting, so the process becomes almost automatic with minor changes.

At my program, our clinical rotations do not start until the very end. So I do not get to spend weeks in the clinic throughout my program to see if I actually even enjoy PT.

Rotations are not necessarily very exciting either . But at least you will get an idea if you like this specific setting or not. I liked only 1 out of 3 and so far my preference has not changed.

is working in the clinic any better than the school itself?

Depends where you are working! Some clinics do suck and work the sh-- out of you. Other places have the nicest bosses and co-workers and your day may be very enjoyable!
School is a great experience for some students, but it is OK if it is not! School is just school. It will be over in 2 more years for you and you will never have to go back. Try to figure out what kind of setting is the best fit for you. You may want to start with thinking how much time you want to spend on documentation vs direct patient care. Then consider if you want to treat 1 patient at a time or you are ok with treating 2 people at a time, or 4 people at a time. If you answer the questions above, it may help you to filter out undesirable settings after you graduate. Good luck!

 

[A.C]

I think the thought of "I don't know how to actually treat a patient" is quite common, at least with good PT education. Yes, that might sound like a contradiction. But think, anyone could go watch those youtube videos and copy them, right? Anyone could google exercises online. That is not what your expertise is or what makes you a PT (especially not the higher level of reasoning though for a DPT). A good PT program should never teach you set protocols of "do x, y, and z for a patient like A", but rather, they are teaching you all the underlying knowledge. You can then reason through a patient case from examination (and importantly, identifying red flags that need referral out) to crafting a treatment plan, and the easy part, actually doing the intervention. You will learn the day to day how to treat when you are in the clinic. When I was faculty in a DPT program, we'd often have students complain that they felt they didn't know how to treat patients before a clinical. When they'd come back, they'd be glad we had the approach we did as they saw it come together on their clinical experience. That said, I do not like the approach of all clinicals at the end, but doesn't seem there is anything you can do about that now.

As for documentation, yep, everyone hates it. Sorry you didn't feel properly warned about it, but remember every job has parts we don't like. Heck, adulthood has lots of parts we don't like! You will get faster at documentation so it becomes less of a drag, but insurance and all that is part of the medical system here unfortunately. You can choose different practice areas that have different emphasis on that- ex. cash based but where you might have higher liability, vs. working for schools vs. working in hospitals, etc.

While PT school can be hard and frustrating, please don't play the victim. It was your job to go into this informed- that means shadowing and understanding what the profession is. It means researching schools to decide how that works for you. No one conned you into anything. If you really don't think you want to be a PT, leave school now. Yes, you'll have debt, but it isn't like the payout of becoming a PT is going to make facing (more) debt better than it is now. But be informed in any decision you make and thoroughly research other careers.

Drop the victim mentality - Got it. Thank you. That was the highest value piece of advice. Didn't even realize I was doing that. Thanks for your insight into the profession.

 

[A.C]

You may not be learning much because you already know that information. I did not know much when I got to PT school and I was learning a lot.

That is OK! It is a path to the day when you are able to put everything together. I was able to do that only after I started working on my own. You do it 20-ish times and you will be able to put it together. I still cannot put together lots of things, for example, how to diagnose nerves impingement which is OK since I am not working in a setting where those diagnoses are needed.


I have never met anyone who would say they ENJOY documenting! You accept it as a part of your job. In some setting, you will have to document a couple of hours a day, in other settings it may take 6h - something to consider when choosing your job setting. Also many PTs use templates when documenting, so the process becomes almost automatic with minor changes.


Rotations are not necessarily very exciting either . But at least you will get an idea if you like this specific setting or not. I liked only 1 out of 3 and so far my preference has not changed.

Depends where you are working! Some clinics do suck and work the sh-- out of you. Other places have the nicest bosses and co-workers and your day may be very enjoyable!
School is a great experience for some students, but it is OK if it is not! School is just school. It will be over in 2 more years for you and you will never have to go back. Try to figure out what kind of setting is the best fit for you. You may want to start with thinking how much time you want to spend on documentation vs direct patient care. Then consider if you want to treat 1 patient at a time or you are ok with treating 2 people at a time, or 4 people at a time. If you answer the questions above, it may help you to filter out undesirable settings after you graduate. Good luck!

Awesome advice, thank you! I appreciate it.

 

[A.C]

- well yeah, obviously they are going to advertise the field and try to make it sound fantastic. It's up to you to do your own unbiased research.

- I think that's normal. All the pieces and loose ends don't really get pulled together until you go to clinic. It's really unfortunate that you do all didactic before clinic. Ours was throughout school and it really helped, but there isn't anything you can do about it now. As said above, school teaches you the underpinnings of what goes on with treatment - in clinic you learn how to put it all together. It is not formulaic and would be impossible to teach in a classroom/lab setting. You will be surprised how much random crap you learned in the classroom that didn't seem important or significant at the time will suddenly be very relevant when evaluating or educating a patient.

- Short answer, there is no "should"......It's hard to say and does not have an answer. Every program has different material per year, so at the end of school everyone will have learned the same stuff but the order varies wildly. We did our first two clinics during our second year and still had didactic in our third year so how we felt at the end of each year will obviously be different than how you feel - comparing year to year, we probably felt more confident than you PURELY because we went to clinic much earlier. Doesn't mean we learned more or better, we just learned in a different order. But, I think what you are describing is normal. You're still in school. You haven't graduated yet. You haven't even gone to clinic yet. So yes, very normal. Try to trust the process. Wherever you are, is where you "should" be because you shouldn't really be anywhere in particular.

- It's an opinion question, not a factual question, but my answer is no. I hated PT school passionately. I hated all things PT by the end of my first year. Clinic really helped me to refocus and remember why I decided to go to school, but it didn't change how much I hated PT school itself (and I loved undergrad and my master's program so I am not normally a school-hater). Now, I love my job and am so glad I stuck it out and didn't change my mind and drop out.

"Everyone just happened to leave out..." - again, it is on you to do your own research, including talking to practicing PTs. And also, not every field and not every job is like that. I did a rotation in a cash based clinic and it was magical - minimal documentation and no dealing with insurance. My final rotation was heavy on documentation and insurance wars. It is not your school's fault that documentation is a thing. It's a necessary evil we all had to learn.
I personally did not understand documentation AT ALL until my final rotation. My classmates were still explaining SOAP notes to me in my final year, despite learning it year 1. Don't worry about it.

Makes sense. Good advice. Thank you for your perspective.

 

[DPTPT]

I felt so lost and scared/nervous right before my first internship. A lot of my friends felt the same way (and Im sure every single student felt this way in my cohort, but don't want to admit it due to feeling insecure about expressing their "weaknesses"). Everything will come together on internship, don't worry. Im sure that at least 1 of your CIs will tell you to forget what you learned in PT school because its not ideal the way they teach. Obviously you need to know all those concepts as a baseline and how to perform exam steps, but PT is not black and white. IF you have good CIs, you will learn so much (especially treatment) and u will be prepared once you are done with PT school/internships. Now, I highly recommend that you don't copy exactly how your CI treats. I used my CI's tactics, and once I felt comfortable doing things his/her way, I found my own groove. You will to. Good luck!

 

[btjack22]

Man just crush it, do the best you can. After clinicals then finishing with studying for boards you'll probably feel much better and confident. It's still a profession where you have to keep learning for a very long time, but if you happen to take boards after graduation you can devote more time to diving into the areas you felt weaker.