Student clinical rotation settings - how will this impact my career in the future?

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Hahill

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Hi all - I am a 2nd year DPT student. I completed the didactic portion of my program and passed comps back in May. In order to graduate, we must complete 3 10 week clinical rotations to finish out the program. Needless to say, with COVID rotations have been a mess. My class' May rotations were all cancelled, so we are scheduled to start our new first rotations this Monday. I was originally supposed to be going to a SNF for these 10 weeks, but due to pandemic-related changes and student restrictions, the parent company cancelled my rotation there last week. My clin ed coordinator scrambled to get me placed somewhere else, and I am now scheduled to start at an OP clinic on Monday. That being said, I am now scheduled to complete 3 outpatient ortho rotations, and no inpatient experience (this was required by my program before COVID, but they are not considering waiving the IP requirement). I love the clinic I will be at for my 2nd rotation, and at the 3rd OP clinic I will be getting the opportunity to get in the pool for aquatic therapy 2 days a week, which I am very excited and passionate about. On the other hand, I am really ambivalent about the clinic I was just placed at to start on Monday. Since it was a last minute placement, it is not an ideal situation (hour commute both ways, on top of 11 hour work days), and I am honestly just not psyched about doing all outpatient ortho. I am passionate about aquatic therapy, the spinal cord injury population, patients with MS and Parkinsons, and adaptive recreation. I am concerned that I will not get enough/any exposure to a neuro or inpatient population now, and I also don't feel confident in an inpatient setting so would really like to get some experience there.

Long story short, I'm debating backing out of this rotation. It would mean graduating even later (our December 2020 grad date is now pushed to March 2021), and with so much uncertainty in the future I can't say for sure I would get the opportunities I would be seeking if I defer doing this rotation to next Spring. But I am really concerned about the hit my experience and education might take from just sticking out the situation I'm in now. I would also really like to know how much weight the settings of your clinical rotations have on your future job prospects. I am concerned I may not have the opportunity to pursue working inpatient, or with any type of neuro population, if all I do is OP ortho. I am looking for some other student and PT perspectives on my situation. Thank you!

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That is a bummer you don't get inpatient, but remember outpatient can be super variable. Some might be more manual based vs. exercise based. Some cater to young athletes, others to older, more joint replacement. Some outpatient clinics to pelvic floor, vestibular, specific protocols. Try to keep an open mind and get all you can out of each experience. I'd be worried to wait and hope you get a different experience as so much is up in the air and all are going to be trying to compete for acute spots.
 
Don't worry about it at all. Most acute/inpatient settings have 1-2 month orientations, even for seasoned clinicians. The reason being is each facility has it's own clinical pathways, EMR setups, standards of care, etc. Even if you had acute care experience during clinical rotations no hospital would stick a new grad or 5 year clinician in the ICU without vetting them and making sure they are comfortable in the setting.

If you are looking at travel therapy contracts this may be more problematic as they want you to hit the ground running, otherwise enjoy your experiences wherever they take you.
 
Hard to tell if they want to hire you with zero inpatient experience.Especially if there is another person who is applying to the same position with some experience... depends on the hiring person I would say. But here is my experience: I had 8 weeks in SNF during rotations and 2 OP ortho. Zero experience in hospital setting. Right after I got my PT license, I applied to hospitals and SNFs. Got interviews in 2 hospitals, 1 in-patient acute rehab, and 1 SNF (all within 3 weeks). I never heard back from the in-patient acute rehab. Both hospitals asked me if I had any experience in acute setting or in hospitals, and the answer was NO. It did sound strange to 1 of the interviewer, but she still gave me a job offer per diem and was willing to train me (I was supposed to follow her for a week or two and they would still be paying me). I ended up rejecting the offer. The 2nd hospital did not express any issues with me having no experience in acute hospital, also told me they would train me, and also gave me a per diem job offer. Had an interview and Got an offer for a full-time job from a SNF and accepted it. I did not need any training in SNF, just started with a low case load which was gradually increasing during the 1st month and I did just fine.
So based on my experience, you do not need inpatient experience to start in an inpatient setting. You will need to be flexible a little: maybe accept per diem jobs first, don't ask for too much money (hospital offered me $38-39/h which is still higher than OP), get 3-6 months of experience that way (which is actually more valuable and sounds as 100% real experience vs internships since they don't know how much you were really doing during your rotations) and then if you want you can look for a better inpatient job.
I was never interested in working in OP setting, just like you. If I had to make a decision like you, i would go through your 3 OP clinicals to graduate sooner.
 
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