Other OT-Related Information I'm a hand therapist AMA

[Aylek12]

Hello,

Once a former lurker here around 2012-13 I have returned as a hand therapist to answer questions you may have about my speciality/career. I graduated in 2017, and I am nearing my CHT exam.

Do you have interest in hands? Considering outpatient? I will do my best to answer whatever questions you may have. I should probably tell you I won't give you specific advice about your hands as an official evaluation should always occur prior to giving medical advice.

Anyways, I am heading to work shortly and will return this evening to reply, if there is interest.

Looking forward to answering questions.

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[OTish20]

Thank you for doing this!!! I apologize that I have so many questions, I'm a very interested incoming student!

1. What is the best way to get into hand therapy? Any particular settings that are beneficial (whether directly related or tangentially) to get fieldworks in or try and get your first job in?
2. I know some have mentioned a waning job market for OT, have you found the same to be the case of hand therapy?
3. Is it true that, on average, the salary is higher for CHTs?
4. What are some traits you think would make a good hand therapist? Whether that's in academics (like excelling in a particular subject) or personal qualities.
5. Was it hard to break into the hand therapy field? How did you do it?
6. What is the most common setting hand therapists work in?
7. Any advice for incoming students?

 

[OThopefully183]

Hi! Very interested in the hand therapy route. So sorry for all the questions and thank you for doing this!

1) During fieldwork how did you make the most of the fieldwork experience? Did you do it in a hand clinic?
2) For Hand therapy, did you have trouble finding a job after graduating? Do most clinics allow for you to get experience as you work towards certification?
3) What made you pursue this field?
4) What courses should we really concentrate on (during our OT education) that will really help with hand therapy.
5) I am interested in various fields was that the case for you? If so how did you decide what path after graduating?

 

[Aylek12]

Thank you for doing this!!! I apologize that I have so many questions, I'm a very interested incoming student!

1. What is the best way to get into hand therapy? Any particular settings that are beneficial (whether directly related or tangentially) to get fieldworks in or try and get your first job in?
2. I know some have mentioned a waning job market for OT, have you found the same to be the case of hand therapy?
3. Is it true that, on average, the salary is higher for CHTs?
4. What are some traits you think would make a good hand therapist? Whether that's in academics (like excelling in a particular subject) or personal qualities.
5. Was it hard to break into the hand therapy field? How did you do it?
6. What is the most common setting hand therapists work in?
7. Any advice for incoming students?

1. By far get a fieldwork. Unfortunately, I was unable to get a hands fieldwork as my school recognizes it as an advanced area of practice and wouldn't send students to hand clinics.

I disagree with this, and was quite frustrated with my school for some time as it made getting into hands difficult. I have two students right now, and they are doing fine.

2. I haven't heard about a waning job market, but it doesn't exist in hands. There are plenty of CHT jobs on the asht website. I sent a relative to a CHT in his area as he needed in person therapy and when they found out I am a hand therapist he was asked if I needed a job.

3. I believe this is this case. While I don't have access to the data they give you when you are a CHT regarding median wages I would be surprised if it wasn't.

4. You need to enjoy anatomy. Everything I do requires an in depth understanding of how each system works. Sometimes clinical testing can be extensive to find which small ligament of the wrist is the problem.

In regards to what kind of person will excel, I would say someone who is compassionate, but someone who can tolerate putting people into pain for the greater good. It's like burn therapy. Sometimes needed treatments can be extremely painful. (Looking at you new flexor tendon repairs). You need to be able to connect with your patient to help them make it through these difficult treatments.

I will make one important statement about who hands is not for: If you cannot tolerate gore, hands is not for you. I once had a pregrad student audibly grimace when undressing a significant wound. Neither I nor the patient appreciated it.

5. If you do not get a level 2 in hands you will struggle. I took continued ed courses as I had no real hand knowledge and found a clinic willing to mentor an eager therapist. This was the hardest step, as most hand therapists want you to have experience before they will give experience. (for good reason, you can hurt someone)

6. Outpatient no doubt.

7. You will have to jump through hoops in graduate school. There is nothing you can do about it. Just ask how high and do it.

Don't take things like theory over the top. It will be taught aggressively in school. It isn't worth the effort. Do you know how many times I have sat with a difficult patient and though "what would I do different with a PEO perspective? How about MOHO?" Never.

Learn how to study effectively.

Hopefully I answered your questions to satisfaction. If you have any followups let me know.

To the person below you. I will answer your questions shortly.

 

[Aylek12]

Hi! Very interested in the hand therapy route. So sorry for all the questions and thank you for doing this!

1) During fieldwork how did you make the most of the fieldwork experience? Did you do it in a hand clinic?
2) For Hand therapy, did you have trouble finding a job after graduating? Do most clinics allow for you to get experience as you work towards certification?
3) What made you pursue this field?
4) What courses should we really concentrate on (during our OT education) that will really help with hand therapy.
5) I am interested in various fields was that the case for you? If so how did you decide what path after graduating?

1 I wish I had a hand clinic rotation. I did outpatient Neuro (awesome) and outpatient peds (not for me, glad there are people who do it.

To make the most of it you really have to push yourself to learn. Ask your CI for resources. Actually study what you are using. It's nice as a CI not to have to teach everything. (I.E. if you in a SNF I shouldn't have to teach hip precautions, in hands I shouldn't have to teach you basic anatomy). Ask your CI what you can do to improve.

2. I didn't search for hands immediately, because I knew I knew nothing and didn't expect to get a job in hands without some experience. While a rare clinic might be willing to hire a new grad that ain't happening without a FW in hands.

Unfortunately, most clinics won't hire you if you don't already have at least a year of hand experience or a FW right out of school. You might find a clinic that will (I did). Look up mentorship programs. They do exist. You will likely need to move to whatever location to break in.

3. Initially I wanted to work with special needs children, but when I was in school I found I liked anatomy much more than anything else I learned. Upper extremity anatomy moreso due to the complexity. In graduate school I found myself spending significant time dissecting the ue to the origins and insertions. Wish I could do it again to do so with the ligaments and the extensor mechanism of the finger.

4. Anatomy. Learn, commit it to long term memory. Neuro can be helpful, but not as much as anatomy. Splinting. At least begin it. Familiarize yourself with patterns. If you have an Ortho class absorb all of that. Peds to an extent. When you are doing hand therapy with kids it's play time. You need to know how to make therapy a game.

5. I had a couple interests, although knew I wanted to do hands in grad school. I knew UE anatomy was complex, and I love feeling that my job is skilled. There is something awesome about being able to say not every therapist can do my job. Specializing is amazing. Additionally, we see results quickly. People get better fast sometimes. It's rewarding to see people you help improve and feel their gratitude.

My other interest would have been outpatient Neuro.

Try to get any fieldwork in those areas, even a level one is helpful. Save your level 2s for your areas of most interest.

If you can't do that, shadow on your own time.


Basically, hands rocks.

If either of you have anymore questions please post them below. I'll check tomorrow for any followup questions.

 

[OTish20]

1. By far get a fieldwork. Unfortunately, I was unable to get a hands fieldwork as my school recognizes it as an advanced area of practice and wouldn't send students to hand clinics.

I disagree with this, and was quite frustrated with my school for some time as it made getting into hands difficult. I have two students right now, and they are doing fine.

2. I haven't heard about a waning job market, but it doesn't exist in hands. There are plenty of CHT jobs on the asht website. I sent a relative to a CHT in his area as he needed in person therapy and when they found out I am a hand therapist he was asked if I needed a job.

3. I believe this is this case. While I don't have access to the data they give you when you are a CHT regarding median wages I would be surprised if it wasn't.

4. You need to enjoy anatomy. Everything I do requires an in depth understanding of how each system works. Sometimes clinical testing can be extensive to find which small ligament of the wrist is the problem.

In regards to what kind of person will excel, I would say someone who is compassionate, but someone who can tolerate putting people into pain for the greater good. It's like burn therapy. Sometimes needed treatments can be extremely painful. (Looking at you new flexor tendon repairs). You need to be able to connect with your patient to help them make it through these difficult treatments.

I will make one important statement about who hands is not for: If you cannot tolerate gore, hands is not for you. I once had a pregrad student audibly grimace when undressing a significant wound. Neither I nor the patient appreciated it.

5. If you do not get a level 2 in hands you will struggle. I took continued ed courses as I had no real hand knowledge and found a clinic willing to mentor an eager therapist. This was the hardest step, as most hand therapists want you to have experience before they will give experience. (for good reason, you can hurt someone)

6. Outpatient no doubt.

7. You will have to jump through hoops in graduate school. There is nothing you can do about it. Just ask how high and do it.

Don't take things like theory over the top. It will be taught aggressively in school. It isn't worth the effort. Do you know how many times I have sat with a difficult patient and though "what would I do different with a PEO perspective? How about MOHO?" Never.

Learn how to study effectively.

Hopefully I answered your questions to satisfaction. If you have any followups let me know.

To the person below you. I will answer your questions shortly.

Thank you for taking the time to answer all of my questions! I do have a follow-up question. With the seemingly limitless options for settings to go into but the extremely limited fieldworks, how do you choose what you want to do them in? I would like to learn about hands (my program offers an elective hand therapy course which I'll likely take) but there are so many other also interesting settings. It's a bit overwhelming!

 

[Aylek12]

Thank you for taking the time to answer all of my questions! I do have a follow-up question. With the seemingly limitless options for settings to go into but the extremely limited fieldworks, how do you choose what you want to do them in? I would like to learn about hands (my program offers an elective hand therapy course which I'll likely take) but there are so many other also interesting settings. It's a bit overwhelming!

I would say consider shadowing areas you aren't sure about. Many of my cohorts (myself included) simply knew areas they didn't want to be in (i.e. I don't want to practice in mental health, or I don't want to practice in peds, etc). If not, as you are going through the program and learning you will likely find areas and treatments you don't think are fit for you.

We had 5 fieldworks. It doesn't cover everything, but it gives you a good taste of areas you might like. The only area I never saw that I had interest in was burns. I'm ok with that.

Look at the areas you are considering this way:Would I enjoy doing this for 40 years? When I considered the SNF I started at, the answer was a hard no. How about where I am now? Yes. You aren't stuck in any area. You can always move if you aren't pleased with your choice of practice.

 

[OTish20]

I would say consider shadowing areas you aren't sure about. Many of my cohorts (myself included) simply knew areas they didn't want to be in (i.e. I don't want to practice in mental health, or I don't want to practice in peds, etc). If not, as you are going through the program and learning you will likely find areas and treatments you don't think are fit for you.

We had 5 fieldworks. It doesn't cover everything, but it gives you a good taste of areas you might like. The only area I never saw that I had interest in was burns. I'm ok with that.

Look at the areas you are considering this way:Would I enjoy doing this for 40 years? When I considered the SNF I started at, the answer was a hard no. How about where I am now? Yes. You aren't stuck in any area. You can always move if you aren't pleased with your choice of practice.

Thank you for the advice! I guess I'm just nervous about not being able to get a fieldwork in an area I'm interested in and then it being extraordinarily difficult to break into later, but I guess it's not impossible.

 

[OThopefully183]

1 I wish I had a hand clinic rotation. I did outpatient Neuro (awesome) and outpatient peds (not for me, glad there are people who do it.

To make the most of it you really have to push yourself to learn. Ask your CI for resources. Actually study what you are using. It's nice as a CI not to have to teach everything. (I.E. if you in a SNF I shouldn't have to teach hip precautions, in hands I shouldn't have to teach you basic anatomy). Ask your CI what you can do to improve.

2. I didn't search for hands immediately, because I knew I knew nothing and didn't expect to get a job in hands without some experience. While a rare clinic might be willing to hire a new grad that ain't happening without a FW in hands.

Unfortunately, most clinics won't hire you if you don't already have at least a year of hand experience or a FW right out of school. You might find a clinic that will (I did). Look up mentorship programs. They do exist. You will likely need to move to whatever location to break in.

3. Initially I wanted to work with special needs children, but when I was in school I found I liked anatomy much more than anything else I learned. Upper extremity anatomy moreso due to the complexity. In graduate school I found myself spending significant time dissecting the ue to the origins and insertions. Wish I could do it again to do so with the ligaments and the extensor mechanism of the finger.

4. Anatomy. Learn, commit it to long term memory. Neuro can be helpful, but not as much as anatomy. Splinting. At least begin it. Familiarize yourself with patterns. If you have an Ortho class absorb all of that. Peds to an extent. When you are doing hand therapy with kids it's play time. You need to know how to make therapy a game.

5. I had a couple interests, although knew I wanted to do hands in grad school. I knew UE anatomy was complex, and I love feeling that my job is skilled. There is something awesome about being able to say not every therapist can do my job. Specializing is amazing. Additionally, we see results quickly. People get better fast sometimes. It's rewarding to see people you help improve and feel their gratitude.

My other interest would have been outpatient Neuro.

Try to get any fieldwork in those areas, even a level one is helpful. Save your level 2s for your areas of most interest.

If you can't do that, shadow on your own time.


Basically, hands rocks.

If either of you have anymore questions please post them below. I'll check tomorrow for any followup questions.

Thank you! Your perspective is quite helpful. If my OT courses are not so hand oriented, what kind of courses after the program can I take? What is it called? It seems so daunting haha I don't know where to start. I love anatomy and I hope to be able to learn more and apply it to my future OT career. I'm about to start my Fieldwork II and just wanted to get some insight.

Fortunately, my school has been really great and said they are most likely able to get me a hand clinic as they have wide network. I will be sure to reach out if I have any more questions. Thanks so much!

 

[Aylek12]

Thank you! Your perspective is quite helpful. If my OT courses are not so hand oriented, what kind of courses after the program can I take? What is it called? It seems so daunting haha I don't know where to start. I love anatomy and I hope to be able to learn more and apply it to my future OT career. I'm about to start my Fieldwork II and just wanted to get some insight.

Fortunately, my school has been really great and said they are most likely able to get me a hand clinic as they have wide network. I will be sure to reach out if I have any more questions. Thanks so much!

You know what would impress me if I was hiring a new student post or w/o a hands FW? If you took the hand therapy review course. It's prep for the CHT and has a ton of good info in it. Right now they have a digital version available, and you get access for a year.

ASHT Virtual Hand Therapy Review Course | American Society of Hand Therapists (ASHT)

Virtual Hand Therapy Review Course The Virtual Hand Therapy Review Course (Virtual HTRC) includes an innovative online format comprised of 21 on-demand sessions, including a cadaver lab.

www.asht.org

 

[OThopefully183]

You know what would impress me if I was hiring a new student post or w/o a hands FW? If you took the hand therapy review course. It's prep for the CHT and has a ton of good info in it. Right now they have a digital version available, and you get access for a year.

ASHT Virtual Hand Therapy Review Course | American Society of Hand Therapists (ASHT)

Virtual Hand Therapy Review Course The Virtual Hand Therapy Review Course (Virtual HTRC) includes an innovative online format comprised of 21 on-demand sessions, including a cadaver lab.

www.asht.org

Wow thank you so much! I'm going to check it out. I think this would also be a good opportunity for me to learn more about hand therapy.