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The Pre-PT Club

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Nov 3, 2022
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If you've been in the Pre-PT game long enough you know that getting a variety of observation hours in a number of settings makes your application look good.

What I've found many Pre-PT's don't know however, is what exactly a different setting means & what to do with this information.

According to PTCAS, a different setting isn't simply a different clinic or outpatient vs inpatient, instead it's the 8 designations listed below.

It's crucial that you get hours in a variety of these settings if you want to give yourself the best shot of getting accepted.

On PTCAS you will select the facility name you shadowed at, the setting it was, and the patient population(s) seen. There is no free-text field to describe the place in more detail. Instead, that's where your interviews and essays come in.

If you are aware of the general algorithm behind admissions, you can see the issue here...

For competitive programs, they aren't capable of analyzing your application holistically right from the start of the admissions process. Instead, they'll use simple data outputs such as # of settings observed to rank students in various categories, ultimately cutting the lowest tiers of applicants and never reviewing the "holistic" part of the application or offering an interview.

If you've only ever shadowed in various types of outpatient ortho facilities, even if they were all super unique and served very different patients, this may look like you only shadowed at 1 setting (depending on if the school uses the PTCAS definition vs simply # of different entries).

So, make sure you're getting a diversity of the settings listed below if you want to give yourself the best chance of getting accepted.

Now that that's covered, here's the list of settings & patient populations with a brief description of what they mean:

Inpatient (meaning the patient stays at the facility overnight):
» Acute Care Hospital: Short-term care for reasons such as illness, surgery, accident, or recovery from a trauma. The goal in this setting is to discharge patients as soon as they are medically stable and have a safe place to go. Average stay may be as little as a few days.
» Rehabilitation Facility: Intense rehab that is often >3 hours per day (between PT, OT, and speech). Think those recovering from a stroke or the geriatric population that needs a lot of help every day, for many weeks, but has the potential to be discharged back home.
» Extended Care Facility/Nursing Home/Skilled Nursing Facility: Long-term care for geriatric patients that often (but not always!) does not have the end goal of discharging the patient.
» Free-standing Physical Therapy/Private Practice or Hospital Outpatient Clinic: People tend to call this "general outpatient". This is where the majority of PT's work.
» School/Preschool: PT done in a school, often focused on kids with disabilities.
» Wellness/Prevention/Fitness: PT focused more on injury prevention and wellness, less on rehabilitating patients. There aren't too many places that do this and only this. It's often part of a general outpatient practice.
» Industrial/Occupational Health: PT done at a person's work. Big factory-based companies often have PT's that help rehab patients right away and help screen people's form.
» Home Health: PT done in the patient's home rather than in a medical facility. Often for those that can't transport themselves (geriatric population and those with severe neurologic disabilities), but not always.

Patient Populations:
» General Orthopedic (musculoskeletal): Probably what you think of when you think of PT. Post-op rehab and addressing pain/functional limitations.
» Neurological (neuromuscular): Patients that had a stroke; those with vestibular/balance impairments
» Cardiovascular / Pulmonary: For patients that had a heart attack, are very cardiovascularly deconditioned, have COPD, etc.
» Integumentary (wound management): Amputees or early in the post-operative stage of general procedures like a knee replacement (helping re-wrap wounds)
» Geriatrics: Those generally > 65 years old. Focus tends to be on activities of daily living, such as standing up from a seated position, balance, walking endurance, etc.
» Pediatrics: Those < 18 years old, but typically < 13. Often focused on those with disabilities.
» Sports: Athletes. Wide range here from high school/recreational athletes to professional.
» Aquatics: PT done in a pool (often for those with weight bearing restrictions or those that need general conditioning)
» Womens Health: PT dealing with the pelvic floor. Most patients are women, but men can have pelvic floor impairments too, so some PT's (myself included) prefer using the term "pelvic health" vs "womens health".

As you can see, a setting is the location where PT is provided. A patient population is generally tied to a patient's impairment and/or demographic. There's often, of course, a correlation (for example, nursing homes have geriatric patients).

If you shadow enough places, getting patient populations won't be an issue - I wouldn't recommend focusing on that at all. Instead, just focus on the settings.

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