Student placements: the world is your oyster

A myriad of career options across clinical, research or managerial settings can be opened up by a career in physiotherapy. This is because, over the last decade, the profession has expanded and developed apace. And, as a taster, student placements can offer valuable and rewarding insights into choosing a career path. They can also be personally enriching.

CSP accreditation of pre-registration courses ensures that students undertake a minimum of 1,000 hours of practice-based learning, giving them an insight into the breadth of the profession. Placements can be found in the UK, or all over the world. So what are the options? And what is the scope of work, preparation and experience needed?  Here’s some expert advice.

Working in a developing country

Physiotherapists and students alike have many reasons for wanting to work abroad. Motives often include a desire to make a difference, skill development and being immersed in new cultures. Opportunities vary from two weeks of volunteering to several years of paid employment, and incorporate a diverse range of projects. There are so many exciting ways to get involved with international work , but it can often feel daunting when it comes to where to start.  

Opportunities abroad may include seeking a student placement as an official elective through your university or a third party, gaining experience during student holidays or working abroad following graduation – as a  volunteer or paid. 

The first port of call in finding a student placement should be your university which may have established links to hospitals and other organisations. Third-party companies can also be used, but more research is needed if you are sourcing placements this way. Ask to be put in touch with previous students for a genuine account of their experience. Also, ensure you choose a specific placement in a well-established site with supervisors used to taking foreign students. 

Work the World and Projects Abroad are well established agencies that can help secure a placement. 

After graduating, keep your university documentation (transcripts and module handbooks). These are often required for future international work. Stay in touch with your personal tutor who could provide a reference. 

Once qualified, you are able to practice in most developing countries. If you are volunteering independently it’s your own responsibility to check if any registration, in addition to your Health and Care Professions Council registration, is required. 

Build your skills to strengthen your application and help the effectiveness of international work. Often, getting relevant professional experience first is best. Strong team working, adaptability, problem solving, endless patience and training and language skills are invaluable. 

Research the country where you intend to volunteer and consider culture, customs, climate, security and health. Talk to people who have visited before.

ADAPT, the professional network of physiotherapists interested in global health, can advise you and has a buddy system linking experienced clinicians to those embarking on international work in similar contexts. It has contributed to the development of an information pack to help plan your international adventure both safely and effectively. If you would like further information, please email adaptenquiries@gmail.com and join the ADAPT network via the CSP site.

ADAPT’s next annual study day on November 17 focuses on the theme Rehab for Migrant Populations. Follow @ADAPT_CSP on Twitter for tickets. 

• Kate Mattick, PR officer, ADAPT

Respiratory physiotherapy

Respiratory physiotherapy could involve leading a community pulmonary rehabilitation class; assessing a first day post-operative lung resection patient on a thoracic ward; treating someone who is intubated on intensive care; reviewing complex neuromuscular patients in the community; responding to a patient with an acute exacerbation of their chronic obstructuve pulmonary disease (COPD) and setting up non-invasive ventilation; goal setting for a polytrauma patient, or optimising a patient who is awaiting a lung transplant.

A tolerance of phlegm is required, but a love of physiology is a must. We refer to physiology every day, whether it is through analysis of an exercise test, consideration of an airway clearance device, or for the set-up of a ventilator. Respiratory care is challenging, fast paced, sometimes sad, but most of all rewarding. 

Laura Breach, critical care clinical specialist physiotherapist, takes students for placements on the cardiothoracic intensive care unit (ICU) at Glenfield Hospital, near Leicester. This allows students to experience non-routine patient groups, such as those on extracorporeal membrane oxygenation (ECMO). When a patient’s lungs are not working, ECMO removes the patient’s blood to be oxygenated and carbon dioxide removed. Students assist with treating these patients’ complex airway clearance needs, ventilator weaning and mobilisation on the ICU. Yes, patients who are on ECMO can mobilise. These patients require the use of many of our transferable physiotherapy skills, from areas such as neuro and musculoskeletal, as well as good respiratory care, which makes respiratory an ideal placement to develop as a physiotherapist. 

The home ventilation team in Bristol is a great learning opportunity too. The patients have a range of neuromuscular conditions and more complex COPD, and are primarily seen as outpatients or in their homes. Physios provide equipment and treatment to patients to optimise their ventilation (particularly at night) and to help improve their cough strength. The team build good relationships with patients and quite often will know them and their families all the way from diagnosis through to the end of life. 

There is a lot more to respiratory physiotherapy than having a good cough. Placements are a learning opportunity so previous experience is not required. A ‘normal’ day will entail multidisciplinary team working, ward caseload management, even managing an outpatient diary. These are all essential transferable skills that you will be able to use throughout your career, irrespective of the setting.

Thinking ahead, as a qualified physiotherapist there are also opportunities for ongoing development within respiratory. Across the country there are respiratory physiotherapists who take blood gases, prescribe medications and use lung ultrasound. We also have a number of consultant respiratory physiotherapists.

For more information visit the Association of Chartered Physiotherapists in Respiratory Care (ACPRC) website. We offer both student and qualified memberships that provide access to all our online resources, short courses and conference. We are also on Twitter @TheACPRC and host monthly tweet chats.

• Ema Swingwood, vice-chair, ACPRC

Working in a hospice

People often assume that hospices are sad and depressing, and wonder what a physiotherapist might learn there. However, a placement within a palliative care team can provide students with huge opportunities for growth, professionally and personally. 

Every hospice has its own way of working, but most provide inpatient care, day services or outpatient services and community services. Hospices provide palliative care to people with any life limiting illness, including conditions such as COPD, heart failure, motor neurone disease and advanced cancer.  

So, hospices provide opportunities to develop skills in multiple specialities and in multiple settings.  They are mostly run as independent charities, with variable amounts of NHS funding. This can enable students to experience a placement outside traditional NHS structures. There are often volunteering opportunities in hospices, even if you are unable to get a formal placement. Hospice UK has details, which you’ll find at here.  

Approximately 30 per cent of people in hospital are in the last year of life – so palliative care should be everyone’s business. A hospice placement can prepare you to provide appropriate, compassionate and holistic care for patients with palliative care needs throughout your future career. 

It will also help you to reflect upon your own emotions about dealing with people who have advanced disease, in a way you may not have time to do on other placements. This is vital to help you develop as a reflective and resilient practitioner. 

Paul, a student from the University of Essex, who had a hospice placement, said: ‘Physiotherapy in palliative care is different from other settings, because you are focused on what a person wants to achieve . A person might want to get up and walk out into the garden to spend time outside, which is a physical goal, but for a hospice patient it is also a psychological and spiritual goal. And that is really important. 

‘My experience at the hospice has made me want to make sure that every moment I spend with a patient counts and benefits them in some way.’

The Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) supports qualified and student physiotherapists. More information at acpopc.csp.org.uk and on Twitter @ACPOPC. 

ACPOPC has a student representative on its committee, Rozi Kakrida, who supports students in developing knowledge of this speciality.

• Emily Stowe, chair, ACPOPC