Physical Therapy

5 Physical Therapy Settings to Explore Before Applying to PT School

When you’re planning to apply to physical therapy school, you may or may not have an idea of what you’d like to do once you actually become a PT. Sure, there are plenty of articles out there reminding you of what a great profession physical therapy is, and they’re mostly right! But the majority of the media paints the same picture of what a physical therapist is: a smiling, perky young lad or lady, absently stretching a faceless leg.

The reality is that the physical therapy profession is so much more than stretching people’s legs in a generic outpatient orthopedic setting. (Outpatient ortho is what those pictures represent, by the way, but the pics don’t come close to representing the actual excitement of clinic life). A PT can help to improve the functions—and the lives—of everyone from children with developmental disabilities to active older adults. Physical therapists work in schools, adult day care facilities, gyms, and nursing homes, and they treat people with everything from sprained ankles to acute heart conditions.

There’s an enormous variety of practice settings and populations out there, and it’s essential to expose yourself to as many as possible before you apply to school. Not only will you have a better understanding of the clinical settings in which you might practice one day, you’ll have an easier time candidly discussing the PT profession in your school applications, as well as during your interviews. Plus, even if you do want to spend your entire career working with athletes in a gym setting, you’ll be required to work as a student physical therapist in a variety of settings throughout your education. And you might find that the only jobs available in your area are in a hospital, rather than a gym. It’s much better to know what’s out there and enter school with wide-eyed anticipation than to head into school laser-focused on a single setting that may or may not turn out to be what you hope.

Here are 5 settings to explore before applying to PT school:

Skilled Nursing

Also known as a nursing home or a long-term care facility, a skilled nursing facility (SNF) is a building (or group of buildings) with round-the-clock nursing care, as well as rehabilitation services. SNFs are where physical therapists, occupational therapists, and speech-language pathologists can find some of the highest-paying and most in-demand, jobs.

SNFs house patients who are unable to care for themselves for both the short-term and the long-term. PTs who work in SNFs will evaluate and assess these patients, determining whether their functional mobility levels have declined from their baseline levels. If the patients are deemed below their functional baseline, the PTs will work with them to improve their sitting, standing, and walking abilities.

People considering the physical therapy field should definitely spend some time shadowing the rehabilitation team in SNFs if at all possible. Not only are a large percentage of PT jobs located in these facilities, the type of work can be on the physically and emotionally demanding side, so it’s good to shadow as much as possible before investing in the expense of a PT doctorate (DPT).

Acute Care

Acute care is a fancy way of saying “the hospital,” and PTs who work in acute care tend to see all sorts of illnesses and injuries, from a debilitating case of pneumonia that leaves a patient too weak to get out of bed, to a traumatic accident that leaves a patient without a limb. This setting is exciting and collaborative, and by shadowing in acute care, you’ll get to witness PTs working alongside physicians, nurses, occupational therapists, speech language pathologists, respiratory therapists, and other medical professionals. Acute care PTs tend to see patients for only a few days at a time, which is unlike most other practice settings, where patients might be seen for many days or weeks—or even months—on end. Most acute care facilities make students go through a battery of tests in order to hit the floor as volunteers, so be prepared for a TB test, drug screen, and more.

Acute care is a wonderful setting to explore before applying to PT school, as many roles that are open to new graduates are in these facilities.

Inpatient Rehabilitation

Some PTs assert that inpatient rehabilitation is the purest form of physical therapy there is, because patients typically make enormous functional gains in a brief, intensive time period. Most patients spend 2-3 weeks in inpatient rehab, and they’re seen by multiple therapy disciplines.

Inpatient rehab patients have often suffered strokes, traumatic brain injuries, or serious accidents that have impaired their ability to walk, dress themselves, feed themselves, and (sometimes) even speak. The inpatient rehab setting can be very taxing for PTs, and by shadowing therapists in this setting, you’ll get a better understanding of the type of physical and emotional demands your job as a therapist will entail. As with acute care, you’ll likely need a TB test and physical before you’re able to shadow in this setting.

Outpatient Orthopedics

If you like solving problems and working with an active population, you’ll probably love outpatient orthopedics. There are many differences within outpatient ortho, though. Some clinics largely treat active older adults, while others specialize in working with athletes, teens, or even primarily post-operative patient loads.

As a potential PT student, it’s a good idea to shadow in several outpatient ortho settings. Some are extremely fast-paced, and therapists will see as many as 30 plus patients in a single day. This can be physically and mentally taxing. Other clinics are more mellow, and you may see 8-10 patients in a day.

If you’re considering becoming a PT to work with an ortho population, definitely spend a lot of time in multiple outpatient settings, as just shadowing in one or two will not provide representation of the myriad of company cultures and patient populations you’ll find from clinic to clinic.

Home Health

Home health physical therapy is an extremely unique and rewarding setting, and therapists enjoy quite a bit of flexibility and autonomy in this setting. Home health PTs visit patients in their homes and provide extremely functional treatments that utilize patients’ own furniture and equipment. PTs working in this setting also make home safety recommendations, perform caregiver education, and provide training on everything from equipment transfers to conserving energy while cooking or performing hygiene.

Aspiring PTs benefit from exploring this setting; it is growing rapidly as efforts increase to keep the population aging safely at home. Quite a few of the jobs available to physical therapists are anticipated to be in this setting. It can be a bit isolating, though; you’ll spend a good amount of time on the road as a home health PT, and unless you’re provided with a company car (which is rare), you’ll put quite a few miles on your car.

There are plenty of other settings we haven’t covered, including outpatient and inpatient pediatrics, schools, burn units, intensive care units, mobile outpatient therapy (sometimes called “outpatient on wheels”), adult day care, and more. But by spending some time in the primary five settings mentioned above, you’ll get a sampling of the settings where you’ll find the most—and the highest paying—jobs available to a newly minted physical therapist.

M
Meredith Castin, PT, DPT is a physical therapist and co-founder of The Non-Clinical PT, a resource designed to help clinicians leverage their rehab de...