Thinking about leaving DPT program for MD

[sbgee]

Hey all - there have been a few posts on this topic but I haven't seen one recently. I'm a rising second-year DPT student and am seriously considering leaving to apply to PA or MD programs. The lack of rigor in I've seen in both PT education and the PT profession has made me doubtful that I'll find the job interesting in 5 years, if ever. After attending two different national conferences, I can't help but feel like PT is the five-year-old who wants a seat at the big kid table because now we have a "D" in front of our PT degree. APTA is pushing for PTs to expand our practice (into nutrition, annual PT checkups, etc.), but we don't even have a handle on our own best practices for treatments of conditions that do fall squarely in our field. A patient could go to 5 different PTs with knee pain and would get 5 different treatment plans. Chances are 4 of them would be successful, but how do we know what really works? There is certainly variability in medicine as well, but I'm afraid that the subjectivity in PT evaluation and treatment is just too much for me. In addition, so many of our treatments are fads that seem to have little effect beyond placebo (dry needling, kinesiotape, core stabilization, etc.) and do not lend themselves well to research, so it feels like we'll never truly get to the bottom of it.

Add to the above all of the other frustrations in PT (relatively low compensation for the cost of education, lack of upward mobility in the profession, high productivity expectations, limited scope of practice) and I'm wanting to run for the hills.

PTs - does it get better? Are you satisfied in your career? Would I be silly to throw away a spot in a DPT program to start all over again?

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[Doc-PT]

I understand some of what you're saying but I disagree with some as well. To be honest I've had the same idea of going back to school (more likely PA school for me) and I , like everyone else in my class, literally just got my degree and passed the NPTE.

Prior to PT school I had narrowed down my career options to MD, PA or DPT. And then narrowed t down even further to Pa or DPT because of the extreme time commitment involved in med school. I narrowed it down to these options after a lot of online research and shadowing opportunities that allowed me to see the jobs first hand. During one of my shadowing experiences of a PA the doctor said "why do PA? If you're smart enough for that just do med school."

Ultimately I went the DPT route mainly for the ability to have a normal M-F schedule, the ability to change specialties as I like and the fact that I could, should I decide to, open my own clinic at some point.

My dilemma now is that I have a LOT of school debt which means I want to go where the money is which is HH, SNF or travel. However, this is in direct conflict with my original reason for choosing DPT: normal hours. It seems harder to find a normal schedule in an inpatient l setting so that leaves outpatient which pays...less.

I love a lot of physical therapy too and to be honest I loved my education and was lucky enough to have wonderful rotations with amazing CIs. However, there are some things that make me think, like you, that burnout isn't going to be too far down the road, especially in certain settings (i.e. Inpatient) given productivity standards, the push for high RUG levels and, thus, long treatment sessions ranging from 45-90 min and of course weekend shifts (no thanks!).

A couple things we're not in agreement about are the rigors of the job/education. DPT school is competetive and the standards are high. I certainly didn't think my education was easily attainable nor do I think the job is easy perform; It takes a great deal of skill.

However, I think the most skilled aspects of the PT profession more often take place in an outpatient setting where they diagnose and treat their own caseload as a fully autonomous practitioner. To be honest, I'm still very proud to have obtained my DPT despite my consideration of returning to school.

I also think most DPTs are happy with their career and dont want a "seat at the big kids table" so to speak. There are people in every profession who have nagging thoughts about wanting to transition to a different career in healthcare, especially those of us who have been considering those other careers all along.

And lastly, I think it's a good thing that the APTA is moving the PT profession in the right direction and I believe the promotion of nutrition and healthy living should of course be addressed by PTs because they are health practitioners. All health practitioners should play a role in encouraging positive healthy behaviors in our patients.

You should get in touch with freddydpt. He is a DPT and an MD and was kind enough to talk to me about my urge to head back to school for my PA.

 

[Fiveoboy11]

Hey all - there have been a few posts on this topic but I haven't seen one recently. I'm a rising second-year DPT student and am seriously considering leaving to apply to PA or MD programs. The lack of rigor in I've seen in both PT education and the PT profession has made me doubtful that I'll find the job interesting in 5 years, if ever. After attending two different national conferences, I can't help but feel like PT is the five-year-old who wants a seat at the big kid table because now we have a "D" in front of our PT degree. APTA is pushing for PTs to expand our practice (into nutrition, annual PT checkups, etc.), but we don't even have a handle on our own best practices for treatments of conditions that do fall squarely in our field. A patient could go to 5 different PTs with knee pain and would get 5 different treatment plans. Chances are 4 of them would be successful, but how do we know what really works? There is certainly variability in medicine as well, but I'm afraid that the subjectivity in PT evaluation and treatment is just too much for me. In addition, so many of our treatments are fads that seem to have little effect beyond placebo (dry needling, kinesiotape, core stabilization, etc.) and do not lend themselves well to research, so it feels like we'll never truly get to the bottom of it.

Add to the above all of the other frustrations in PT (relatively low compensation for the cost of education, lack of upward mobility in the profession, high productivity expectations, limited scope of practice) and I'm wanting to run for the hills.

PTs - does it get better? Are you satisfied in your career? Would I be silly to throw away a spot in a DPT program to start all over again?

How do you know your or all PT schools lack rigor? Speaking of objectivity do you have any way to back that up? Does your subjective opinion re PT school rigor have any studies showing it is valid? Are you comparing it to how difficult you assume med or PA school is? Not sure that makes sense. What were your grades like? I think most would agree PT school lacking rigor because it's not medical school is laughable nonsense. The DPT is a legit degree regardless of what a 1st yr student makes up in their head.

Not sure how rigor of schooling has anything to do with interest in doing the job? Maybe you're confounding a bunch of things. Maybe you don't like physical therapy because it isn't perfect or that it isn't a good fit for you but that says more about you than anything doesn't it? It's a difficult job with lots of unanswered questions and just getting started with evidence based practice but think of how that must make the job difficult not easy. There's expertise in physical therapy to know that far exceeds anything you'll be exposed to in PT school alone. PT school teaches the basics, to enter the workforce with basic entry level skills. There's con ed, experience, residencies and fellowships for a reason.

There is subjectivity and opinions in physical therapy assessment and treatment but that exists in all domains of healthcare. POC differences get a "pass" in medicine because they're special?

 

[sbgee]

Fiveoboy11 - You are correct that my assessment of the difficulty of my program is completely subjective and only based on my experience along with that of my friends in the program. I worked very hard for my undergraduate degree in biochemistry and loved almost every minute of it; PT school has felt very different so far although the grades have been good in both cases. But you are also right that my perceived experience says more about me than the profession I've chosen - maybe my frustration stems from a lack of interest in the subject material. Same goes for subjectivity - it certainly exists in all areas of healthcare, and I need to evaluate for myself why the T&M we use in PT leave me so unsatisfied.

Doc-PT, thank you for thoughts!

I realize I'm at a high risk for throwing the baby out with the bathwater here- just need to figure out how I feel about the baby itself.