overqualified? (Full Version)

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aph401 -> overqualified? (March 7, 2008 1:03:25 AM)

this question is primarily directed at PTs with a DPT education, but i certainly welcome answers from everyone.

a phrase i've been hearing a lot lately - both on forums and from PTs and PT students - has really stuck in my head.. "overqualified for the job". do you really think that PT education today is producing graduates who are overqualified for the jobs in which they will actually be doing in "the real world", after graduation? how much of what is being taught (or what you learned) is largely not applicable for the average clinician and the settings in which you would most likely be working?

curious to hear your reponses.



T_Thom -> RE: overqualified? (March 7, 2008 1:41:45 AM)

DPT x 4 yrs.
Huh. I haven't noticed anyone posting this (or it's ridiculous enough that I've ignored it.) I feel underqualified, if anything, a.k.a. "Dunning-Kruger effect"



Dr.Wagner -> RE: overqualified? (March 7, 2008 3:13:34 AM)

Perhaps a better phrasing to ask BPT or MPT if they feel underqualified.



orthotherapist -> RE: overqualified? (March 7, 2008 10:25:54 AM)

I have a bachelors degree in PT and have kept up with CEUs, journals etc. I do not feel underqualified in the arena in which I work.



SJBird55 -> RE: overqualified? (March 7, 2008 10:55:48 AM)

There are certain situations that I feel definitely underqualified... then there are the times that I feel way overqualified.... and then there are fleeting moments that I wish I could be patrolling our border between Canada and Michigan OR asking "do you want fries with that?"  LOL

Is there really such a thing as "overqualified?"  I've never read that a recent DPT graduate is overqualified.  If anything, the recent graduate is greener than green.  Book smarts might be there, but the confident ability to communicate with patients isn't going to be apparent nor is the ability to physically handle a patient with ease.  That stuff comes after making mistakes and trial and error.  What will be true is a chunk of debt needing to be paid off.  Granted though, the times are worse than when I graduated and there are some amazing sign on bonuses out there - those will take a chunk outta that debt!  (I can't figure out how the sign on bonuses can be as large as some of them are because reimbursement is dropping annually.)



rwillcott -> RE: overqualified? (March 7, 2008 2:34:49 PM)

I don't think you could ever be overqualified in this profession.  I have heard concerns that the MSc DPT programs are placing a larger emphasis on theory rather than clinical skills.  However, I think having a strong backgraound in the research and education prior to graduating is a great way to begin as a clinician.  This can prevent PT's basing there treatment on anecdotal evidence as described in the wikipedia defintion of physical therapy.



Kaden -> RE: overqualified? (March 7, 2008 3:24:01 PM)

In a profression such as PT where it takes years of practice and making mistakes to improve ones communication, manual and exercise skills I don't ever see a situation in which a graduate of an entry level PT program would enter the work force overqualified. 

I think the question one needs to be asking is whether or not the DPT is overkill?



aph401 -> RE: overqualified? (March 7, 2008 3:50:38 PM)

i guess everyone is kinda missing my point...

maybe i should say this: do any of you DPT grads feel that much of what you learned in the program is never utilized in the clinical setting, ESPECIALLY in the hospital setting? from what i hear, many new grads feel that a lot of their classes were a "waste" (i.e. as kaden said - "overkill") to end up walking patients down a hallway or transfering them from their bed to a chair in the acute care setting. in terms of the orthopedic setting, i've talked with one new grad from my school who feels that all she does is ultrasound, e-stim, go through some exercises, out the door... all day, every day. many feel as though many components of the program were unnecessary - i.e. led to them being overqualified for what they are actually doing on a day-to-day basis.



T_Thom -> overqualified? (March 7, 2008 3:55:31 PM)

Are the overqualified statements coming from 'traditional' acute care or PT mills? We are overqualified if providing non-skilled care & these two clinical settings do have that reputation.
I agree with what rwillcott is saying about putting more emphasis on practice theory than on clinical skills. In school, our program had implemented the Patient Centered Learning (PCL) model rather than the ‘traditional model’. Students graduating from the latter model are said to have a stronger base, seeing things as more black and white, but have more difficulty integrating new ideas under the EBP model. The PCL graduates seem to be contemplative, and less ready for the assembly line. I had forgotten about these two educational paradigms until recently, having always felt shorted by PT school. Now, several years out of school, I am finally thankful.

Addendum: aph401 you posted while I was submitting the above :)



rwillcott -> RE: overqualified? (March 7, 2008 4:02:29 PM)

alph401

I hope you would agree that physiotherapy is a profession that is more than walking people and applying hotpacks.  Your colleagues that you mention have choosen to work in those positions.  If they believe that physiotherapy is more than that (which it is) then they should make an effort to either change how things are done where they work or find somewhere else to work.  There is a reason that the education in the DPT program is so extensive.  It's just a matter of applying your knowledge appropriately.

Rob 



aph401 -> RE: overqualified? (March 7, 2008 4:19:28 PM)

i agree, i just wanted to hear some of your thoughts. the people on this forum are an invaluable resource and i enjoy soliciting them for information. rob - while i DO realize what you're saying, i personally like the hospital setting and acute care patients, and would love to work in this area after i finish my program.. therefore, the comments that i hear are certainly concerning, and i've talked about that often on this board. it discourages me to think that PTs are utilized as techs in the hospital setting. it discourages me to think that i would be overqualified for the setting in which i wish to practice. so i agree that they have chosen to work in these positions, but i guess it's too bad that these positions make PTs feel overqualified.



Kaden -> RE: overqualified? (March 7, 2008 4:30:03 PM)

aph401,

Agree with your above post that it is sad when a position in a particular setting makes one overqualified. 

It is one of the reasons I would like to see PT education become more specialized.  I don't know how it would be done but would be nice.  I know I (being outpatient ortho PT) don't use much of my peds, neuro, wound care education.   I would have loved to have been able to utilize the countless hours I sat in peds and neuro classes to advance my outpatient skills



aph401 -> RE: overqualified? (March 7, 2008 4:44:05 PM)

you touched on something else... wound care, something i'm very interested in. this is another area where i see why new grads feel so overqualified coming from our program - ALL the hospitals in our city have wound care taken on by nursing. in order to ever utilize what we learned in this area, one would have to move. i've also heard about PTs in emergency departments, but these jobs are so hard to come by.. this is one area where i could see really utilizing a lot of what we've learned for acute patients, but again, these jobs are practically non-existant. there are only a couple schools in the country that even allow students to rotate here (i.e. st joseph's in tuscon). we hear and hear about the many settings PTs can practice in, all they can do.. but it seems like, in my city anyway, your options are to be utilized as a tech in a hospital, or do outpatient ortho.

*sigh* i digress..



SJBird55 -> RE: overqualified? (March 7, 2008 5:12:25 PM)

So.. who is putting the gun to the head of physical therapists to only perform ultrasound, electrical stim and some exercises? 

I spend most of my day thinking, problem-solving, talking and documenting.  My hands never hold an ultrasound wand, hardly ever hold a hot pack or a cold pack and only a couple times a year put any electrical stimulation pads on anyone.  My hands hold my pen, my computer, patient's body parts and exercise equipment.

You make your career what you want and you make your own choices.  If you want to perform at the bare minimum, then, yep, you'll be "overqualified."  Technically, the true word is bored... just going through the motions doing the bare minimum is boring and maybe not even reaching mediocre care level.



T_Thom -> RE: overqualified? (March 7, 2008 5:39:16 PM)

aph401,
If you've got the passion for it, do the research and start changing the system. There is a market, especially if "unskilled" therapy is common practice. Instead of moving, find the PT-friendliest hospital in your area, and work from there. Target a few key aspects you could realistically improve and work from there (I'm sure the Acute Care Section will have some of this information.)  I bet you will find there are others in support of this type of practice once you start looking.
 
When it comes to wound care, nursing too is also in short supply, so getting into wound care wouldn't be as hard as you think. You can debride, modify your POC & dressings without an order, whereas nursing does not has this capability without additional training (WOCN), and more stringent supervision. PTs have quite a different approach to wound care than nursing does.
 
Above all else, stand by your work, learn, teambuild, and be patient. Change does happen, but often people quit too early before things catch on and you reap the reward you were after. As PTs, we do have the ability to improve how the system works, not just your immediate surroundings. It just has to be talk and action.



Kaden -> RE: overqualified? (March 7, 2008 6:08:45 PM)

SJ,

Agree with your comments on an outpatient treatment basis , no one is being forced to practice like a robot.  I think this post does bring up the point that if DPT's are significantly overqualified in the acute care setting (feeling like glorified people walkers) then she would be the profession of choice treating in some of these settings.

I can see the value of a PT with an acute CVA or TBI but would question why a far less skilled person could not perfom the services commonly rendered by PT's on an ortho floor in hospital such as with total hips and total knees.



rwillcott -> RE: overqualified? (March 8, 2008 10:38:24 AM)

aph401

Sorry if you interpreted what I said the wrong way.  If you want to work in inpatients then I think that's great.  Like anything in life it's what you make of it.  If you are passionate about inpatient physiotherapy then you will excel.  Nurses and Physicians will see your passion and realize your knowlege and skills.  You and I both know there is more then simply walking the patient.  Think of all the different tests, measures, functional goals, pathologies etc. that you are trained in as a PT.  The staff at the hospital will quickly see this.

Having a DPT like yourself that wants to work in inpatients is great for the profession.  It continues to demonstrate that we are an integral part of the health care team.

Rob



aph401 -> RE: overqualified? (March 8, 2008 1:49:46 PM)

i appreciate all of the great responses, advice, and encouragement i received on this thread. thanks for your input!



blast7 -> RE: overqualified? (March 8, 2008 8:47:32 PM)

I work in the acute care setting and much of what I here from other staff PT's/PTA's is that we are overqualified.  However, many times the therapy they are providing is not skilled and further skews the image that we present to other healthcare professionals. 

In some respects I do feel I have knowledge from PT school that I do not use but I also feel there is a great deal of knowledge I did not know coming into acute care.  This includes a greater knowledge of phyisiology (particularly cardiopulmonary), ventilator function, chest PT, prognosticating physical function and disposition recommendations.



aph401 -> RE: overqualified? (March 8, 2008 9:02:37 PM)

blast - can you tell me what your typical work day is like?



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