Blog #10 - Choose your first job wisely as you only get one chance at being a graduate

Lately in our profession there has been alot of hype and recognition about the 'Choosing Wisely' campaign when it comes to effective treatments offered to patients. I feel we should also be starting a campaign of similar wording for our new graduates entering the workforce for the first time - Choose Wisely.

I say this because, you only get one chance at being a graduate and being offered the intense learning of a 'Graduate Development Program'. You can not apply for a position in your 2nd year when you had a terrible start and request that you be offered the Graduate Development Program........

Your first year of learning is essential in any position you decide to take on whether it be in a private or public model of care. However the training should be clinically orientated to the area you have chosen to work in and encompass all facets of the model of care, for instance in private practice this should include the business skills to succeed in a privatised environment.

What are the follow- on effects of taking on the wrong role for the wrong reasons as a graduate:

1. Wanting big money.

Money is definetly a draw card, especially when you have just completed 4 years as a broke university student. However, taking the job for the money now may not put you in the best learning position for the future. As a private practitioner and business owner, paying a graduate high wages will mean in return there needs to be revenue++ bought into the business to compensate for your wage. The pressure for a graduate to perform at this level to meet wage requirements and with a focus on learning will be a mismatch.

It is always best to take on a role that allows you the time to have non- billable hours to continue learning, have dedicated time with a mentor and professionally develop without the pressure to be seeing patients constantly. Learning is a process and you need time as a graduate to reflect on your practice, discuss new knowledge and skills and this feedback loop can not be achieved when you at always seeing patients. So bottom line, ask what KPI's are expected for that wage and what time will be allowed for non- billable hours for learning and development. A business owner would be more than happy to discuss and negotiate a suitable wage especially if your keen focus is learning in your first year. Your first year sets you up to be the best private practitioner you can be and profitability will come after the ground work has been set.

2. Taking a role because your boss works with an elite sports team.

We have all been that starry eyed new graduate that dreams of one day working as the head physiotherapist for an elite sports team. Being the graduate in a clinic will mean that you are more than likely the least of the team to be next in line to the throne to be the head physiotherapist for your current boss's sports team. You may be lucky enough to see a glimpse of players or athletes as they walk down the corridor or you may score some free game tickets now and then, but to take a job believing that you will automatically be working with sports stars everyday will be a myth. If it is your dream and desire to work in this field then talk to your prospective employer prior to accepting a job offer about what the opportunities may be to learn the ropes, perhaps if you are willing to put in the hard work without pay to learn from the master then this will pay off in the future.

3. Taking a role that does not have a structured Graduate Development Program in place.

These days there are many more graduates going straight into private practice then there ever was a few years ago. In my time, it was tradition to do your first year as a grad in a hospital to do the rounds and gain experience and then maybe venture out into the private practice world. Well things have changed greatly, and not only is there many grads stepping into private practice for their first year, that number is on the increase. Private practices are starting to recognise this trend and in order to cater to this employee market and manage a younger, inexperienced clinician in their clinics, a structured Graduate Development Program (GDP) should be in place. This should be one of the first things you need to discuss with your prospective employer, is what will the GDP include and how much time is dedicated to graduates each week/month and even better ask for a copy of the program for you to peruse. If your prospective employer can not produce a GDP, then be mindful that they might take a very casual approach that will not be enforced for your 12 months of initial learning.

4. Taking a role that does not have a dedicated mentor or clinical educator.

In reality to point number 3 that there is an influx of graduates progressing into private practice there is also a high attrition rate of senior and experienced physiotherapists from the profession. Hence the question lies with, who will train the graduates? Ask your prospective employer who you will be mentored by or who will be in charge of your dedicated learning, will there be one- on- one time?

All of these questions will allude to the fact that if everyone is supposedly involved in your learning than really no one takes responsibility especially if they have their own caseload to attend to. Most senior physiotherapists are on a commission based model, so if they are not seeing an adequate patient load then they are not making their money. It is important in your first year of learning that there is a designated person or persons that are responsible for giving you feedback, spending time with you to discuss caseloads and clinical reasoning and get you up to speed with the processes and business skills of developing into a profitable private practitioner. The sooner you learn these skills the quicker you will build a caseload and perform in private practice, then you have the opening to approach your boss about potential earning capacity based on your exceptional performance and KPI's.

5. Not taking a role in a private practice because there is hospital or aged care work involved.

Not interested in spending any time at a hospital or aged care facility? Only want to be a musculoskeletal physiotherapist? Please keep in mind that as a graduate it is an important part of learning to have a varied caseload and the addition of a hospital round for a few hours a week or an aged care facility will be a welcome reprieve from the chaos of private practice. A few hours a week in each of these facilities gives you an opportunity to see conditions that you may not otherwise see in the clinic but will be of benefit for the future. Being in a private practice seeing patients constantly and being time poor can be a very pressurised environment, it can be a nice change to visit the hospital or aged care setting where you can slow the pace down and potentially utilise another set of skills which may also give your hands a break from manual therapy. Having these rounds will make you a more empathetic and compassionate physiotherapist and that is a skill set that is just as important in this highly competitive field of health professionals. There are some things you learn from Mrs. Jones your 90 year old patient at the residential aged care home that you will remember for a lifetime and it will make you a better physiotherapist and a better person with a much better outlook on life.

Final Tip: in your first year take a job for the learning capacity not the money.