International Service Learning: Heshima Children’s Center in Nairobi, Kenya

For the past two weeks, I’ve had the opportunity to work with 3 new grad PTs, a pre-PT student, and an incredible pediatric PT alongside passionate local physiotherapists here in Nairobi, Kenya.  

Heshima translated from Swahili means dignity.  The Heshima Foundation believes that all human beings are made in the image of God, regardless of their outward appearance. Genesis 1:27 says “So God created man in His own image, in the image of God He created him, male and female, He created them.”  This children’s day center for disabilities is a safe haven for about 27 children and their mothers. With about 42 tribes here in Kenya, the majority believe that those with disabilities are cursed and should be left to die.  Some of these tribes dispose of children with disabilities by throwing them into the bushes in “hopes” of being eaten by lions, while other tribes give cattle colostrum which is known to solidify in the GI tract to cause a painful death.  At times, the mother is to blame for the child’s disability and is ostracized by the child’s father and all family members. These women are subjected to feelings of shame and guilt and are forced into isolation. They are left alone to care for a child with special needs. 

By the grace of God, some of these women find Heshima. This fortress provides breakfast and lunch, basic educational instruction depending on the need of the child, as well as occupational, physical and speech therapy. But most importantly, it provides a community where these children can be children and where mothers can lean on each other for support. My mom has always told me, you’ll never understand the extent of a mother’s love until you become a mother. I’m not a mom, but the mothers of Heshima have demonstrated this unconditional love. They have literally fought fiercely to keep their children alive.  I’m in awe of their strength and blessed by their children’s smiles.  As you peruse my pictures, I hope that you see the face of hope through all the joy and laughter they bring this world. 

Heshima is completely funded by donations, so if you should feel inclined to donate to this beautiful organization please check out their website: http://www.heshima.org.

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Joint Blog Post 2 with HoboHealth: Having ONE Recruiter vs. MULTIPLE Recruiters

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James of HoboHealth worked in private practice before going into traveling PT and believes gaining professional experience is the right move to make before traveling. April of The Vagabonding DPT has had professional success and happiness through becoming a traveler immediately as a new grad. These two traveling Doctors of Physical Therapy from different personal and professional backgrounds have connected to provide you diverse perspectives. This is their second blog post together on a series of Travel PT topics.

 

 

Introduction:

 

HoboHealth

  • When I first started traveling, I worked with just one company, I had steady health benefits, I would accumulate PTO, and I even got a free wifi printer as a loyalty bonus. The printer was too big to travel with, but I still use it when I have it with me. The company I worked with initially has big name, and they were always able to find me a job. But, when I started looking around, I realized the deal I was getting might not be as good as I thought. Other companies were offering me as much as $200 more per week for similar jobs and seemed a lot more attentive to my needs. $200, that’s one wifi printer per week! That started me down a path of searching with multiple companies about 7 or 8 years ago.

The Vagabonding DPT:

  • I started traveling about 2 years ago as a new grad. I was fortunate to have a Travel PT mentor who set me up with my current recruiter. Yes, that’s singular. I have one recruiter. I know that the majority have multiple recruiters, but for now, having one recruiter has helped me build my career as a physical therapist. My recruiter is fully aware of my abilities, professional goals, minimum pay rate, and setting preferences. He’s submitted me for positions that I may not “qualify” for (i.e a requirement of 5+ years for a job assignment) because he was confident in my skills and that the position would be a perfect fit for me. Even as a new graduate with my first assignment, I’ve stood firm on negotiation of time off as well as pay rates. I got exactly what I wanted because I had a recruiter who was willing to negotiate those terms on my behalf.

 

What are the advantages of having one recruiter vs. multiple recruiters?

 

HoboHealth:

  • Compare pay rates between companies. It becomes clear very quickly whether what you have been making is competitive with other companies rates or not. Knowing what other companies are able to pay you in a given area can be a great negotiating tool if you do decide to stay with just one company.
  • Different companies have different jobs. You will see many of the same jobs posted across most agencies – the jobs that are the same across agencies are all listed on databases that many facilities contract with to fill their jobs. The databases sell subscriptions to the staffing agencies to have access to their jobs (the databases also charge 3-4% of the total contract price to the recruiters). To beat this system, agencies have gone out of their way to make contracts to exclusively staff particular facilities. So, it is possible that you can’t find a job in a particular area because you aren’t looking with the agency that has an exclusive contract with a facility in the area. Also, some agencies rely solely on what comes across the databases; Other companies are willing to call around for you. All recruiters will say they are willing to canvas an area for you, but less will actually do it (the smaller agencies tend to be more willing to put in the footwork of tracking down novel contracts). Broadening your agencies, may open up additional options.

The Vagabonding DPT:

  • Company Benefits: Each travel company provides different perks the more time you spend with them. The benefits listed below are solely representative of one company:
    • Paid Time Off: My company provides paid time off for 40 hours after working 2,080 hours and 1 year with them. A travel therapist would be free to cash out that PTO to fill any requested time off during an assignment or in between assignments. From that point thereinafter, you accrue some PTO for every hour you work.
    • New Grad Bonus: A new grad who works 3 consecutive contracts with this company will earn a $1,000 bonus.
    • Continuing Education Bonus: When you’ve stayed with this company, you receive $400 of continuing education credit valid also for conferences such as Combined Sections Meeting or NEXT.
  • Less Paperwork: Every company has a set of protocols that they must follow to be compliant with TJC including BLS certificate, licensing, NPI number, vaccinations, physical exams, TB tests, drug screen and physical examination. In addition, each company will have a mound of paperwork in regards to the company’s policies and procedures about expectations, benefits, clinical competency, etc. Staying with one company allows you to focus on what you need: less paperwork and more time to invest in your passions and interests.
  • Health Insurance:  If you choose to go with one company and choose to go with their health insurance, you won’t have to worry about switching health insurance companies. Travel PT companies will typically allow you a 30 day grace period in which you will be covered by the company while you’re between assignments.
  • Consistency: Some larger Travel PT companies will bounce you around with various recruiters who manage a particularly region. If this is the case, then you’ll have to take the time to get to build a relationship with a new recruiter each time you change regions.

 

Do you feel there are any disadvantages to the approach you have taken?

HoboHealth:

  • The obvious downsides to working with multiple agencies are the benefits you don’t get for being loyal to one agency and the extra paperwork you do get – as April mentioned above.
  • If you do work with multiple companies, remember this cardinal rule: “You take a particular job with whichever agency offers it to you first.” Meaning, you can’t take an assignment offered by one agency, and tell a different agency about it to try to get a higher pay rate. Things can get sticky fast.
  • It takes some management to work with multiple companies. At one time, I was searching with 6 or 7 different agencies. One job came up and they had received my resume from multiple different agencies, each claiming I was “their guy”. While I went with the first agency to present the job to me (the only agency who had permission to submit me for the assignment), another agency bullied the facility into only accepting my interview through them. I was unable to go with the agency I liked best and who had presented me the assignment first. It was embarrassing and it’s why I now limit my searches to 2 or 3 agencies. When you are working with multiple agencies, you have to be clear that you need to be contacted before being submitted to a job, otherwise you may end up in my situation with companies bickering over ownership of you with the facility – it’s a good way to blow the interview before you even have it.

The Vagabonding DPT:

  • As James mentioned above, working with one company requires much trust in one person to provide you with the best pay rate, location, and setting. By doing so, you may limit your options for future possibilities. You must trust that your recruiter is negotiating the terms of your contract to the best of his/her ability to provide you with the best overall package. To decrease this, you could also do some research and ask other Travel Therapists about their pay rate for that setting in that specific region.
  • The same facility may be working with several travel recruiting companies to fill a need. So when you work for multiple companies, you may be offered the same position via two different companies which can actually work against you. In the end, you may not end up with the assignment. 

 

Conclusion:

  • We present you with the advantages/disadvantages to assist you in making the best informed decision for your travel career path. We’ve each done our research to negotiate our contracts. Stay informed and ask around.
  • Follow us on Facebook @Hobo Health and @The Vagabonding DPT as well as follow the FB group page, Travel Therapists. Check out our websites: http://www.hobohealth.com and http://www.thevagabondingDPT.org
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What is a Vagabonding DPT?

According to the Mirriam-Webster’s Dictionary, a vagabond is defined as “a person who wanders from place to place without a home” and a DPT is a Doctor of Physical Therapy.  Although this simplified definition implies a wanderer who lacks direction, this couldn’t be further from the truth. Let’s dissect and debunk this definition.

Myth One: Vagabonding DPTs have no home. . Home is where I celebrate milestones and holidays with loved ones.  No matter how far I’ve traveled, home is where my family resides: San Bruno, CA. This suburb is perfectly situated by the ocean and just south of that beautiful city by the bay, San Francisco.  It’s where I learned how to fly a kite despite the fog.  It’s where I learned to drive and navigate through one-way streets and parallel park on hills.  It’s where the only season that exists is spring. The Bay Area is where family and friends from near and far come to visit to see the Golden Gate Bridge, Pier 39, Lombard Street, Chinatown, Palace of Fine Arts, Muir Woods, Napa Valley, Monterey Bay, and Fisherman’s Wharf.  I am incredibly blessed to call the Bay Area, my home.

Myth Two: Vagabonding DPTs are jobless. I am a traveling physical therapist, which means I work with my recruiter to secure short-term contracts.  I always have the option to schedule contracts back-to-back or extend my contracts pending my availability.  I also have the flexibility to take time off at my own discretion.  With the higher pay rate of traveling physical therapists, I can also save money for the time between my contracts to pursue my passion for travel and service. It’s seriously a millenial’s dream come true!

Myth Three: Vagabonding DPTs are wanderers, lacking direction.  Some choose to say wandering, I prefer to say that I’m on a constant journey of exploration and self-discovery.  I am an advocate for unorthodox approaches to employment.  I choose to create experiences that force me out of my comfort zone.  This could be working at a SNF in a small town in Texas with a population of 1,200 residents or co-treating for a week with a Physical Therapist in Peru without an interpreter.  Yes, these stories are true.  With each opportunity, I learned, I made memories, and strengthened relationships.  This embodies the very definition of a Vagabonding DPT.   “If you want something you’ve never had, then you’ve got to do something you’ve never done.”

A Vagabonding DPT is a doctor of physical therapy who is in constant pursuit of learning and manifests the ultimate raw human experience. At the end of the day, there’s nothing more powerful than a smile, a helping hand, and an open heart.

From this blog, you will gain insight into:

  1. Traveling therapy from a new grad’s perspective
  2. International service learning trips,
  3. Global travel for leisure

Embrace the life of a Vagabonding DPT.  Subscribe today and be part of the movement!

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International Service Learning: Heshima Children’s Center in Nairobi, Kenya

For the past two weeks, I’ve had the opportunity to work with 3 new grad PTs, a pre-PT student, and an incredible pediatric PT alongside passionate local physiotherapists here in Nairobi, Kenya.  

Heshima translated from Swahili means dignity.  The Heshima Foundation believes that all human beings are made in the image of God, regardless of their outward appearance. Genesis 1:27 says “So God created man in His own image, in the image of God He created him, male and female, He created them.”  This children’s day center for disabilities is a safe haven for about 27 children and their mothers. With about 42 tribes here in Kenya, the majority believe that those with disabilities are cursed and should be left to die.  Some of these tribes dispose of children with disabilities by throwing them into the bushes in “hopes” of being eaten by lions, while other tribes give cattle colostrum which is known to solidify in the GI tract to cause a painful death.  At times, the mother is to blame for the child’s disability and is ostracized by the child’s father and all family members. These women are subjected to feelings of shame and guilt and are forced into isolation. They are left alone to care for a child with special needs. 

By the grace of God, some of these women find Heshima. This fortress provides breakfast and lunch, basic educational instruction depending on the need of the child, as well as occupational, physical and speech therapy. But most importantly, it provides a community where these children can be children and where mothers can lean on each other for support. My mom has always told me, you’ll never understand the extent of a mother’s love until you become a mother. I’m not a mom, but the mothers of Heshima have demonstrated this unconditional love. They have literally fought fiercely to keep their children alive.  I’m in awe of their strength and blessed by their children’s smiles.  As you peruse my pictures, I hope that you see the face of hope through all the joy and laughter they bring this world. 

Heshima is completely funded by donations, so if you should feel inclined to donate to this beautiful organization please check out their website: http://www.heshima.org.

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Lessons of Global Travel 

I’ve kept much of my Central America trip open to allow fluidity and an opportunity to truly be present in the moment. Even though I’ve traveled to about 12 countries, I learn something new every time I travel.  Here are a few lessons I learned even before I took off:

1.  Chase Sapphire Reserve:  Seriously, what an amazing credit card! Did I mention that there are no foreign transaction fees?  In addition, they also grant you access to 900+ airport lounges all around the world via the Priority Pass.  If you ever have a long layover, you can eat, drink, sleep, or simply hangout in these lounges. Lesson learned: Make more use of this amazing card and make sure to bring the Priority Pass Membership Card everytime I travel. 


2. Flying to Guatemala: So as I mentioned I tried to keep my Central America as open as possible.  I only purchased a flight to Guatemala without an exit trip.  I thought I was being more flexible and spontaneous than my usual Type-A self by leaving it open. However, I learned that there are a few things that actually need planning like an exit trip from Guatemala. I tried checking-in online, but the website stated that I needed to check-in at the counter.  I made an attempt to check-in at the counter only to discover that I couldn’t because I didn’t have an exit plan. Oopsies. If you choose to stay in Guatemala for more than 90 days, you will need a visa.  I never planned on staying that long, but apparently the ticket agent couldn’t read my mind. I jumped on my iPad and used Kayak to help me buy my ticket. Lesson Learned: Purchase a ticket to AND from Guatemala. 

3. Travel Backpacking:  I planned on only bringing my handy dandy Tom Binh 40 L Travel Backpack along with my purse. I’ve had my luggage stolen/lost when traveling abroad, so I thought that this would be the way to go.  When I got to the counter to check-in, not only am I surprised that I have to buy an exit ticket, but now I also found out that I had to check-in my 40 L Tom Binh Travel Backpack because it was over the carry-on weight limit. I may have panicked a little bit as I had the ticket agent assure me about a thousand times that my backpack would make it from SF to Guatemala City. Did I mention I also had a 42 minute layover in Panama City to get on my flight to Guatemala City? To say that I was a little bit nervous about this tight layover was an understatement. I would be gone for about 3 months and if my backpack didn’t make it then what would I do?  I whispered to myself, “Be flexible.”  Lesson learned: For Copa Airlines, your carry-on can weigh no more than 10 kg.

I’m a travel PT by profession; however, in between assignments I integrate my passion for service, learning, and global travel. I just started a YouTube channel to document my travels through Central America. Come join me in my journey. Follow me on IG @TheVagabondingDPT, Twitter @AprilFajardoPT, YouTube @TheVagabondingDPT, and my FB Page @TheVagabondingDPT.  

The little guy, Dino, featured below was gifted to me by my former co-workers at St. Mary’s Hospital.  I promised them that I would bring him along on all my travels, so you’ll be seeing him around. #TheVagabondingDPT 

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The Low Down on Creating Sustainable, Ethical ISL Programs

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I pursued Travel PT as a new grad to afford me the flexibility to continue with international service learning trips in my career.  From my experience, students and clinicians are interested in serving domestically and internationally, but are often unsure on how to start and how to create a sustainable impact in a global community.  In 2015, I had the pleasure of serving as the Global Health Project Committee (GHPC) Co-Chair with Josh Greensweig to create the first International Service Learning (ISL) Manual.  The 2016 Global Outreach Committee further developed this ISL manual to include robust research on the ethical implications of ISL.

 

What is the purpose of the manual?

Christina and Kelsie:

This manual is intended to be a resource for students considering international service trips, with the aim of providing evidence and resources to help students plan and execute the most successful and meaningful trips possible. Prior to the creation of this manual, there were very few resources specifically for PT and PTA students to help them navigate the process of finding and choosing the best international experiences for their needs and skills.

The Global Health Project Committee (GHPC) of 2015 published the first draft of this manual last year, which provided very strong resources about the logistics of planning a trip and provided wonderful resources on where to find opportunities for international service. This year, the re-named Global Outreach Project Committee (GOPC) wanted to expand upon this resource, with advice and guidance from the APTA’s Global Health Special Interest Group leadership, to include even more resources and evidence on ethics, sustainability and community engagement to supplement what was created last year. We wanted students to have the most up-to-date information regarding global health/service opportunities available in one place.

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Why did we personally want to work on the manual? Why did we think it was important to create this type of resource?

Christina:

To be completely honest, before becoming involved in the GHPC last year and becoming chair of the GOPC this year, I did not have a particularly positive view of short-term international service trips.

Prior to beginning PT school, I served as a Peace Corps volunteer in Burkina Faso for 2 years. During that amazing and life-changing experience, I saw many short term service groups from a variety of disciplines come and go from my village and, from my unique vantage point as both a foreigner and a steady member of my community, I saw very mixed results.

Some groups were indeed very successful at providing medical services or helping to develop sustainable programming, but most the groups I experienced had minimal lasting impacts on the community- or worse yet- some of them had negative impacts on the community. I knew that all of the short-term volunteers I met had the best of intentions and it was hard for me to watch them work so hard towards such admirable goals, only to have minimal lasting effects. It was also hard for me to watch members of my community suffer the consequences of poorly executed service trips. Due to all of these experiences, I left Burkina Faso after 2 years feeling jaded about short term service trips and feeling very unsure as to whether it was possible for these negative impacts I had seen to be minimized. I felt as though a long-term commitment- such as the 2 years I spent in Burkina Faso- was a requisite for truly having a positive impact on a community.

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Based on my experience, it may be surprising that I chose to work on this resource at all. However when the opportunity to work on this manual was presented to me, I was thrilled. I suspected that researching, writing and collaborating with the GOPC members on this resource would validate many of my concerns (which it did), but most of all I was hoping that searching and synthesizing the literature would prove my suspicion that these negative impacts could not be mitigated to be wrong! I was hoping that we would be able to find evidence-based strategies to avoid many of the pitfalls I had seen during my time abroad, while ensuring that students had a thorough understanding of the ethical implications of working in a resource-limited international setting. Working on this manual gave me the opportunity to explore and share the literature about community experiences and impacts from international service, and allowed me to collaborate with the committee to find evidence on how to make these experiences more positive and productive for all involved; including students, professionals and, most importantly to me, the host communities. The more I delved into the research and listened to the experiences of my fellow committee members, the more I realized that with proper research, preparation and skills, short-term service trips could indeed be tremendously successful for both students and communities. I believe that having this knowledge is immensely powerful and important in allowing students to make thoughtful choices about how and where to serve in order to prevent other students from making the same mistakes I had seen in the past.

Kelsie:

e0a19e7e-eebd-41f0-aa56-8edaf5f032baI love opportunities that combine the things i’m passionate about – particularly therapy/rehabilitation, international experiences, and education – and with an increased student interest in global health the need for a resource like this was apparent. After spending a year in Indonesia as a Fulbright English Teaching Assistant prior to beginning PT school, I knew I wanted international service to be a part of my future career as a physical therapist, but like many students did not know where to find these opportunities. This led to my involvement in the Global Health Project Committee and the Global Outreach Project Committee, where I had the opportunity to contribute to this resource- an evidenced-based document answering many of the questions I originally had regarding international service experiences while a student and beyond.

Similar to Christina, I really wanted to stress the importance of ethics and sustainability which are often missing in short-term service trips. You will see this theme echoed throughout this blog post and the manual, as we are both passionate about serving and respecting the local communities we have the opportunity to serve. Education is one of the most powerful tools we have to promote mutual respect and cultural understanding, and I believe this manual is our best effort to promote this theme and create meaningful experiences for both volunteers and host communities.

Why did our committee want to expand upon the manual?

Christina and Kelsie:

The members of the 2015 GHPC wrote the first version of this manual in its first year as a committee, which is quite remarkable. In a very short amount of time, they developed a database of available international service opportunities across the country and created a tremendous resource. As we mentioned above, the first version was very robust in terms of providing thorough information on the logistical aspects of planning a trip; these included finding service opportunities, funding, and obtaining travel documents as well as safety precautions including health requirements and resources to help find safety information about the country of interest among many other resources. However, only so much can be accomplished in a year! When Christina took over as chair of the committee this year, April suggested adding more evidence on sections they had not been able to fully expand upon, including sustainability and ethics. When we decided to seek endorsement from the Global Health SIG to get this resource published on their website- the leadership of the GHSIG agreed that these areas should be our areas of focus. Because we are both passionate about sustainability, ethics, and community engagement in global health and service, we were thrilled to have the opportunity to work with our fellow GOPC members to research and expand upon these areas in the manual. We also had several committee members with expertise in various languages, so were able to add to the existing language resources from the first version of the manual, including new language appendices in French, Swahili and Portuguese.

What do we hope students will get from reading the manual?

Christina and Kelsie:

We hope that after reading the International Service Manual for Students, students will have many of their questions about global health and involvement answered and come away with a passion for ethical and sustainable global service. We want students to understand that it is possible to expand their knowledge, practice their clinical skills and fulfill their desire to serve, all while making sure that the experience is as positive as possible for the people in the communities in which they serve. Students should feel empowered with resources and knowledge to find service trips and organizations with ethical, community-based and sustainable models so they can choose the best possible service experiences. Additionally, we hope this manual encourages students to reflect on their experience and to stay involved with global health and community service while a student and a professional.

What did we learn from the experience of working on this manual?

Christina:

As I said above, I started the process feeling less than enthusiastic about short-term international service. I am happy to say that working on this manual changed my views! Throughout this process of researching and writing, my opinions were consistently challenged and I was pleasantly surprised by the amount of research looking at short-term service and how positive the impacts can be.

I learned that with proper planning, research and community partnerships it really is possible to have a mutually beneficial experience for all parties involved in an international service experience.

I feel so fortunate to have had this opportunity to expand my knowledge base, change my biases and develop a more holistic view of international service. I also learned so much from the other contributors to the manual.

As the Chair of the committee, I had the unique privilege of dividing up work tasks and reading/editing everything that other committee members created. I was always amazed with what my colleagues would come up with- whether it was research I hadn’t considered before or a way of writing that communicated their passion for service- it was an amazing experience to see what such a small but dedicated group could come up with together.

Kelsie:

We started this year’s update to the manual with a comprehensive literature review and I was pleasantly surprised to learn how much evidence was available regarding student involvement in international service/global health as well as the impacts on host communities. Thresearch-2is is still a growing area of research, and I look forward to seeing how the manual and international service trips evolve as more evidence becomes available. The experience of writing this manual went hand-in-hand with being apart of the GOPC this year, and I gained so much from collaborating and talking with my other committee members. As anyone who has ever traveled and served abroad, we love to share our experiences and inspire others. Not only did I learn about my fellow students’ international experiences and passion for global health, but I learned about their research interests, the structure of other PT programs, and time management. We bonded over stressful test/project/practical weeks, while working together towards a common goal. This experience expanded my #PTfam and introduced me to an incredible group of people who were supportive both in- and outside of the responsibilities of this project.

What are our future plans?

Christina:

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Working on this manual has made me even more passionate about global health and service- especially now that I feel like I have many of the tools and resources to do it right! I would like to use many of the skills I developed while serving internationally to be more involved in global health and service here at home because serving those in need in our own neighborhoods is so important. But I also still plan to work abroad in some capacity and am taking advantage of every opportunity to gain more experience and expertise in this area. Right now I am completing my DPT practicum project, under the tutelage of some amazing PTs who specialize in women’s health in low-income settings, to develop a group exercise intervention for survivors of conflict-related sexual trauma in Democratic Republic of Congo.

Our goal is to help develop a trauma-sensitive program that will be carried out by local healthcare providers, that can help meet some of the rehabilitative needs of these amazing women without the need for a lot of medical staff (which is unrealistic in this particular setting). I honestly had never considered the role of PT in serving this specific population, but it makes so much sense that we should be involved in treating many of the resultant issues like pelvic pain, pelvic floor dysfunction and functional training. So I hope to continue to have opportunities like this to expand both my clinical and global health skills to develop into a well-rounded PT. But for now- I am just hoping to pass the boards and get a job following my graduation in May!

Kelsie:

Similar to most 3rd year DPT students my immediate future plans are to study for boards, finish clinicals, pass boards, graduate, and get a job. My plans following graduation are to spend the month of June in Africa starting with two weeks in Nairobi, Kenya volunteering 3fab65b7092ba06159de9cc3fecbac8ein a clinic, a few weeks of traveling, and ending in South Africa at the World Confederation of Physical Therapy (WCPT) congress. The idea of a post-graduation service trip to Kenya was brought to me by a classmate early in our 2nd year and we have been working with the organization ever since to make it a reality while best serving the needs of their community. The organization only employs local Kenyans so our role will largely be providing education for families and local PTs. Our secondary goal is to assess the feasibility of leading future trips for students and/or professionals. Since I was already planning to travel in Africa for a few weeks, I decided at the last minute to round-out my post-grad travels at the WCPT congress in South Africa! Whether I end up leading international service trips, working abroad, teaching, or contributing to research, I look forward to seeing where where my love of global health and physical therapy takes me in my professional career.

 

We will both be at CSM in San Antonio along with several other members of the GOPC. Feel free to contact us – we would love to meet you!

 

Click here to read the International Service Learning Manual.

 

Special Thanks to the 2015 & 2016 Global Outreach Project Committee Members:

  • Ashley Alagna, SPT Carroll University
  • Rachel Buckner, PT, DPT University of Southern California
  • Tessa Comstock, SPT The College of St. Scholastica
  • April Fajardo, PT, DPT Southwest Baptist University
  • Randy Kaw, SPTA Oakton Community College
  • Christina Machaby Lee, SPT Boston University
  • Monica Lee, SPT Maryville University of St. Louis
  • Kelsie Miller, SPT Mayo School of Health Sciences
  • Brittney Townsend, SPT Southwest Baptist University
  • Michael Weinand, SPT Northern Arizona University
  • Samantha Weng, SPT California State University Long Beach

 

 

screen-shot-2016-12-16-at-1-37-25-pmChristina Machaby Lee, SPT: Christina Lee is a third year student in the DPT program at Boston University in Boston, MA. Christina’s passion for global health was sparked during her 2 year service as a Peace Corps volunteer in Burkina Faso from 2012-2014. She served in the Education and Health sectors and served as President of the Community Health and AIDS Taskforce, during which time she oversaw country-wide efforts focused on Malaria and HIV/AIDs prevention. Christina was a member the Global Health Project Committee in 2015 and is thrilled to be serving as the Chair of the Global Health Outreach Committee in 2016. She is also a student liaison to HPA the Catalyst’s Global Health Special Interest Group for the APTA. Christina’s passion in global health revolves around helping students and professionals to promote culturally appropriate, sustainable and community-based solutions to health problems around the world. Christina can be reached at cmachaby@gmail.com.

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Kelsie Miller, SPT: Kelsie Miller is a 3rd year DPT student at Mayo Clinic School of Health Sciences in Rochester, Minnesota. She was a Fulbright English Teaching Assistant in Gorontalo, Indonesia during the 2013-2014 academic year and studied abroad at the University of Otago in Dunedin, New Zealand in 2011. She was a local ambassador for Global PT Day of Service in 2015 and 2016, and currently serves as the Mayo DPT Class of 2017 Class President and as a student liaison to HPA the Catalyst’s Global Health Special Interest Group for the APTA. Miller participated in an ISL experience in Honduras in March 2016 on a team with American PT students, physiatrists, physical therapists, and Honduran functional therapy students and residents. Her goal is to provide similar international opportunities for students in the future and to explore rehabilitation concepts and beliefs in other cultures. Kelsie can be reached at millerkelsiem@gmail.com.

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Hobo Health & The Vagabonding DPT Joint Blog Post 1: Gaining Experience before Travel PT vs. Pursuing Travel PT as a New Grad

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James of HoboHealth worked in private practice before going into traveling PT and believes gaining professional experience is the right move to make before traveling.  April of The Vagabonding DPT has had professional success and happiness through becoming a traveler immediately as a new grad. These two traveling Doctors of Physical Therapy from different personal and professional backgrounds have connected to provide you diverse perspectives on travel PT.  This is their first blog post together of a series of topics.

What are the advantages of being a New Grad PT vs. being an Experienced PT then going into Travel PT?

HoboHealth:
Professional Experience – I only worked for six months between graduation and starting as a traveling PT. The brief time I worked in private practice before traveling did a lot to shape who I am as a clinician today. Getting just a little bit of experience as a clinician allowed me to become grounded in a healthy work environment before setting out into the less predictable and less stable world of traveling.

Personal Marketability – I believe the little bit of experience I had in private practice prior to traveling gave me a leg-up on other candidates looking at the same jobs. My first traveling job was (primarily) outpatient in a community hospital outside of Boston with other therapists around to help continue my mentorship and growth. Without a little experience, I don’t believe they would have taken on the risk of hiring a near-new grad. Six months in private practice, followed by 10 months at my first travel assignment with strong mentorship set me up for 10 years of positive traveling assignments. Bottomline, if you get a little experience before travel, better employment opportunities are available to you as a traveler.

Vagabonding DPT:
My life was as compact as possible.  I already had sold all my furniture and everything I owned fit into my Honda Civic. I was as mobile as I ever would be.  If there was any opportunity to travel and explore, now was my moment. I had just spent my 3rd year completing my clinical rotations in Oklahoma City, OK; Salt Lake City, UT; Springfield, MO; and Dallas, TX. I was moving about every couple of months.  In essence, my clinical internships provided me the opportunity to live the life of a travel DPT as a student.  I was used to learning at a rapid rate and had to learn to adjust to a new city and clinic every few months. Because of this, It was quite an easy transition to go from a DPT student on clinical rotations to a DPT on the road for work.

You have “less” responsibility. As one begins to settle into their career and life (in general), the natural progression is to get settled into a specific location, get married, buy a house, have children or furry kids, and/or take care of ill, elderly parents.  Although I think it is absolutely possible to travel with all the aforementioned circumstances, these factors require far more extensive benefit/cost analysis. For myself, I wasn’t married, I didn’t have a house, nor did I have children.  So I made the personal decision to take the plunge straight into travel PT for further domestic exploration and adventures!

Money
Although I believe that this shouldn’t be your primary reason for going into traveling therapy.  It definitely doesn’t hurt. Students are coming out with a tremendous amount of debt and this is definitely a great way to pay down those student loans.

What are the disadvantages of being a New Grad PT vs. being an Experienced PT then going into Travel PT?

HoboHealth:
When I first thought about this question, my gut reaction was, “There’s no disadvantage! What could be wrong with having more experience going into a job?” …but then I thought of the hardest day of my PT career – the day I had to quit my first job. The day I told my mentor and friend that I wouldn’t be able to work for him anymore was a really stressful day. Quitting a job, especially one that you like, is hard. I can see how someone with the intention to travel could go get a steady job and never end up leaving it. While I do believe strongly in getting experience before traveling, I can see how you risk getting “stuck” in a permanent job. I remember the phrase one of my professors told me to make quitting professional and simple, “It’s an opportunity I can’t pass up.” Remember that phrase, it’s a good one.

Also, the traveling lifestyle is only available to those in the right life situations to have the flexibility to take short-term contracts. Sometimes you have to strike while the iron is hot – waiting to take a permanent job, get several months of experience, and then quitting can shift you into a phase of life where the idea of travel isn’t as easy as it once was. New family obligations, meeting a significant other, and simple logistics like year-long rental leases can obstruct your path to the open road.

Vagabonding DPT:
Mentorship:
Off the bat, one’s initial thought may be the lack of mentorship.  There are some travel companies that may market mentorship opportunities.  I challenge you to ask them what exactly this looks like.  Just being in the same clinic as other physical therapists does not constitute as mentorship.  This can be countered by building an army of mentors while being a student.  Based on my interests, I’ve inadvertently built an army of specialists from Neurologic PT to Global Health to Nonprofit Leadership.

Mentorship does not have to be limited to our profession. There is something to learn from everyone.  Quite frankly, our patients become our first mentors.  If you learn to listen intently, they will lead you to the answer.  In addition, a firm understanding of other disciplines such as occupational therapy and speech & language pathology can help us maximize our role with a focus on patient-centered rehabilitative care.

Lack of Experience:
James touched upon this and it is true.  There will be some jobs that will require that you have more experience than what you have had. However, I secured my second job assignment by highlighting my strengths and experiences in that setting.  I applied for a position in inpatient rehabilitation that required 5 years of experience.  So during my phone interview, I discussed my experience.  I worked for two years as a PT aide in outpatient PT, then did an additional two years as a rehab aide prior to even applying for physical therapy. I also completed two clinical rotations in inpatient rehabilitation. I felt I was more than qualified for the position at hand.   I’m glad that the rehabilitation manager was pleased with my response as well because she essentially hired me for the position. I’ve extended my contract since then.

Being a traveler can isolate you from the typical learning and professional development paths that may be available in more traditional PT careers. What have you done or do you plan to do to continue your professional development?

HoboHealth:
Board Specialty
Shortly after completing my transitional-DPT, I soon felt ready to pursue my Orthopaedic Clinical Specialty (OCS). I spent more than a year reading every piece of ortho research I could get my hands on and reading a couple comprehensive ortho books cover-to-cover. The constant studying kept me focused on a fixed goal for quite some time. Specialties through ABPTS are available in variety of practice areas. A couple supervisors on travel assignments have told me they hired me specifically because of my board specialist certification. In total, my tDPT and OCS combined filled the first  4 years of my professional life with a structured, focused learning path.

Some universities are offering post-doctoral learning paths that culminate in sitting for (and hopefully passing) the specialist exams. My alma mater, Northeastern University, offers a Certificate of Advanced Study in Orthopedics. Essentially, you take 5 online classes focused on advanced orthopedic practice, earn college credits, and become more prepared for the OCS exam. Programs like this can help you keep a structured learning schedule that can otherwise so easily fall out of priority while working as a travel PT.

Certifications
Generally, I am skeptical of programs focused on one clinical belief system and the alphabet soup that comes along with them. Courses that all come from a single guru will help you dive deeply into a treatment strategy, but are typically lacking in variety outside of that one strategy. However, as a way to provide a structure for learning towards a final goal, they can be very useful. I currently am about to set out on earning my certification in Dry Needling. Over the next year, I have my learning laid out for me and a fixed goal to be certified in Dry Needling and Cupping by the end of 2017. There are some other great programs available that offer several courses on different topics culminating in a single certification – do be discerning, not all certs are created equal.

Vagabonding DPT:
With the constant change, rapid rate of learning, and high productive expectations expected as a Travel PT, you can get burnt out and/or apathetic as a PT.  It is pivotal that you “Be fearless in the pursuit of what sets your soul on fire.”  Since graduation, I have done exactly that through social media, leadership positions, national PT conferences, and continuing education courses.

Social Media
I didn’t understand Twitter.  I didn’t get the point.  However, a few years ago, I ran for the position of APTA Student Assembly Director of Communications and thought that I should get one in the event I got elected and had to manage one. I’ll be honest.  I had no idea what I was doing.  With the Twitter mentorship of Matt Debole, PT, DPT, OCS and Stephanie Weyrauch, PT, DPT, they opened up a world of passionate students and clinicians from all over the country and the world.  I started utilizing pound signs…I mean hashtags and twitter handles in my tweets.  A few years later, I had the pleasure of engaging with these professionals virtually and in person.

If you don’t have a twitter account, get one.  The best way is to just dive in and follow a few hashtags such as #ChoosePT, #DPTstudent, #SolvePT, #FreshPT, #PTFam and/or #TravelPT, just to name a few.

Still don’t get it? Start one, follow me, then tag me @AprilFajardoPT in your first tweet! Be part of the conversation.

PT Conferences
National Conferences: Have you ever been to National Student Conclave, Combined Sections Meeting (CSM), or NEXT?  It’s how the kids say, “lit?”  Yesss, LIT!!!! Everyone comes to this conference to learn, but one of the most important aspects of these conferences is the opportunity to formulate connections.  If you’ve been active on social media, meet some of those you follow on Twitter at one of these conferences.  You get to attend a multitude of receptions based on your interests and involvement from Alumni events to Section events.  The exhibit hall is equipped with the latest physical therapy gadgets and with recruiters from every corner of the US.  The

International PT Conference: This coming year, I plan on attending the World Congress of Physical Therapy on July 2nd-4th in Capetown, South Africa.  I look forward to the opportunity to learn from and engage with physiotherapists around the world.  Sounds enticing, doesn’t it?  Well, the early registration deadline is November 30th.  Join me and check out their website at http://www.wcpt.org/congress.

Professional Leadership
I’ve been on the go as a traveler; however, I’ve stayed engaged through the pursuit of my passions in professional development, engagement, APTA membership, global health, and service.  I currently serve as The Academy of Neurologic PT’s membership and public relations committee member, an Early Career Team committee member, and the PT Day of Service’s Global Affairs Chair.  My role in all these leadership positions has been location independent.  If I can do it, you can too!  Not sure where to start?  Fill out the APTA Volunteer Interest Pool at http://www.apta.org/VolunteerGroups/ or email the APTA Executive Director of the Section you want to get involved in at http://www.apta.org/Sections/.

Continuing Education Courses
Every state has a different set of requirements for continuing education courses.  However, I’ve found that the most helpful courses have been those developed by a specific section of the APTA.  I’ve taken a continuing education course on Parkinson’s Disease developed by the Academy of the Neurologic PT.  Terry Ellis, PhD, PT, NCS of Boston University  and Lee Dibble, PhD, PT of University of Utah taught the course through the integration of the evidence and its clinical application.  So if there’s a specific topic you want to learn about, check out what courses are provided by the appropriate APTA section.

 

About Dr. James Spencer:

My wife and I been traveling Physical Therapists for 10 years working mostly in New England, Hawaii, and Alaska during the summer and living/working in Aspen, Colorado each winter. I am an Orthopaedic Clinical Specialist who is most at home in outpatient ortho, but have worked in many varied settings. I am involved in APTA leadership, particularly in the Ortho Section and with the Colorado Chapter. My wife and I intermittently live in a camper and would enjoy having a big dog someday. I normally blog about travling physical therapy on my website hobohealth.com which aims to helps new traveling therapists find their way.

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Travel Therapy 111: What to Look for in a Recruiter

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You want a recruiter who will serve as your champion.  What exactly does this mean?  This means you have a recruiter who will:

  • Listen.

    • What exactly are you looking for as a travel therapist?  Are you looking for mentorship? Are you looking for adventure?  Are you looking for experience in a specific setting ?  Are you feeling out different parts of the country for a place to call home?
    • What are your priorities in securing an assignment? Location? Setting? Corporation? Private Practice? Rural? Urban?
    • Whatever your needs are, just make sure that your recruiter is listening.  Is he or she suggesting assignments that have nothing to do with what you want?

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  • Lay out ALL the expectations including the fine print. 

    • The “Release Clause”: Depending on our contract, you will have a clause that states the facility can release you from the contract in the event that they find a permanent employee to fill the position.  This “release clause” varies anywhere from two-to-four weeks. That means that they have to give you a two or four week notice (dependent on your contract) prior to releasing you from the contract.
    • The required minimum number of hours: How many hours are you expected to work?  If you fail to meet those number of hours, is your board/lodging rate prorated?  Do you get penalized by not getting the full board/lodging stipend and just get your hourly rate?
    • It’s pivotal that you understand all the fine print. You don’t want any surprises when taking on this assignment.

Reading the Fine Print

  • Go above-and-beyond.

    • This kind of goes back to listening.  For my first assignment as a new graduate, I was looking for a facility in Texas that was close to a major airport.  Originally, I wanted to be in or around the three major cities: Austin, Dallas, or San Antonio.  You see, my college roommate was getting married and I was a bridesmaid in her wedding.  I didn’t want to spend 4 hours driving to an airport to fly out to Los Angeles just for the weekend for this wedding.  I realized that I ultimately just really needed to be close to an airport.  So my recruiter looked into this assignment around Abilene, TX.  It wasn’t in my list of ideal locations, but it was close to an airport.  Before looking into the assignment, my recruiter sent me a list of ALL possible itineraries in and out of that airport to determine if the cost was within my budget and if the availability of flights were within my time frame. I was impressed and he hasn’t failed to demonstrate his commitment to providing the best Travel PT experience for me yet.

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Travel Therapy 110: Finding Recruiters

I’ve talked with several students interested in pursuing traveling physical therapy and they have asked me which company is best.  Truth be told, I advocate more for finding the right recruiter versus the right company.  One of my friends, Ademola Giwa, PT, DPT, wrote an article as well on this topic: New Grad PT’s Blog: Intro to Traveling Physical Therapy.

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Finding the PERFECT recruiter for you is the most important component in determining your traveling therapy career. This seemingly small decision can make or break your experience. You need a champion. One who will be by your side to fight for what you want and deserve. Where do you start to look?

1. Referral from a Current Traveling Therapist:

  • Utilize your personal connections:
    • This is how I personally found my recruiter.  I asked a friend who had been traveling for 5 years to set me up with a recruiter who would be a great fit for me. My friend knew me well enough to give me the perfect recommendation and after an initial phone interview with him, I knew he’d be perfect!
  • Utilize Social Media:
    • I am currently part of several Facebook groups including Travel Therapists, Doctors of Physical Therapy Students, Physical Therapists, and Doctors of Physical Therapy: New Grads in the Real World. I’ve seen some post questions about recommendations for finding a recruiter. So for these groups, you can find conversation threads about recruiters by using the search engine within the FB group. (You can access this search engine on the top right side of the group page.)
  • Ask Me:
    • If you e-mail me at TheVagabondingDPT@gmail.com, I would be more than happy to share my recruiter’s information with you.
  • Disclaimer:
    • If you choose to go the referral route, know that there is typically a referral bonus for the person who sets you up with the recruiter.

2. Attend a PT Program Career Fair or a State/National Therapy Conference:

  • Recruiters are swarming at these type of events. Typically, they’ll have recruiters and if you’re really lucky, they’ll also have current traveling therapists to share their experience.
  • In this day and age of technology, we’ve lost the art of meeting face-to-face. Events such as these, will give you an opportunity to get a feel for the recruiter and the company.  Look him/her in the eye, give a firm handshake (No floppy fish hands, please!) , and have your questions ready.

3. Utilize the web to find traveling therapy websites.

  • If you put “travel therapy companies” in any website’s search engine, a number of travel companies will come up.  You can conduct your own research and see what they have available.*
  • Although this is a feasible option, this is probably my least favorite avenue for finding a recruiter because it takes away from that personal connection.  However, it can help give you pertinent information quickly.  For instance, if you’re looking for an assignment in a very specific location then this would be a great way to find that information.

Call me old school, but I prefer finding someone via a referral or face-to-face. With referrals, I have a first hand account about the quality of the traveling therapy experience.  With meeting recruiters face-to-face, it affords me the opportunity to know what motivates and drive them to pursue their job as well as their pursuits outside of their career.

* I understand that this is super vague; however, I don’t want to endorse any specific companies and demonstrate bias. However, if you’re really interested in learning about my recruiter, feel free to contact me.

**Beware that if you choose to give your information to a plethora of recruiters prior to researching them, you may get bombarded by email or phone calls.

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TT 100: The Traveling Therapy (TT) Process of Securing an Assignment

Not sure what to expect?  Neither did I.  I was fortunate enough to have a great mentor to help me through the process.

checklist

Based on my experience, here’s a general outline of the Traveling Therapy Process:

  1. Find recruiters.
  2. Interview recruiters.
  3. Recruiter creates a portfolio based on your preferences.
  4. Recruiter discusses assignment options based on your given parameters including location, setting, mentorship, and pay rate.
  5. If you’re interested in a particular assignment, your recruiter submits your portfolio to the facility of your choice.
  6. If the facility is interested in pursuing you, they’ll discuss and set up a phone interview for you with your recruiter.
  7. You’ll have a phone interview with the facility. They’ll inform your recruiter if they’re interested in moving forward or if they don’t think it’ll be a good fit.  At the same time, you’ll decide if you’re interested in pursuing that assignment.
  8. If you both agree, then your recruiter will begin to draft your contract for that assignment. This would be the best time to negotiate terms of the contract and then sign the contract. At this point, make sure that your recruiter has worked out the details including any of your requested time off, the number of guaranteed hours, cost for travel expenses, license reimbursement, pay for orientation or online training, number of hours guaranteed in contract, and the clause that releases you from a contract should the facility find a full-time therapist.
  9. Find housing.
  10. Start traveling to the site.
  11. Explore and make new friends!

I’ll go into each of these steps in more detail with an individual blogpost on each step. Stay Tuned!

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New Grad Traveling Therapy: Is Traveling Therapy (TT) for you?

I took my boards early, passed, then graduated.

DPT graduation

DPT Graduation

With a blink of an eye, I went from graduate student to officially unemployed. Ahhhhhhhh!!!! What do I do next?  It seemed like the possibilities were endless and I wanted to do them all.  I downloaded the Linked-in Jobs app and was hoping to find something that would jump out at me.  Where do I even start?  Should I apply for a Neuro Residency?  Should I work full-time or PRN? Should I live in TX or transfer my license to CA or go into traveling? Should I do this or should I do that? I’m not going to lie: I was overwhelmed.

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I know you’re not supposed to compare yourself to others, but my classmates secured jobs and they didn’t even take the boards yet. I took boards, passed, and had no idea what I was going to do. What if I made the wrong decision? These thoughts hit me like a wall and I froze. I couldn’t and didn’t make a move in any direction.

The day after graduation I sat with my professor, Dr. Beverly McNeal, and she told me exactly what I needed to hear:

“The beauty of our profession is that you can go down one path and if it doesn’t work out, you’ll know and then you can try something else.  None of this is permanent.”

Woah!!!  I mean I knew that, but those words finally sank in and had meaning.  I finally had clarity and vision. I was going to pursue traveling therapy (TT) to allow me the flexibility to serve on international service learning trips and explore the world at my own leisure.  I made a decision and didn’t look back. And I’m L-O-V-I-N-G it!

Don’t get me wrong. TT is not designed for everyone and not everyone is designed for travel therapy.  Ask yourself the following questions to determine where you stand. A self-assessment is necessary before you decide to jump in.  If you’re only after the money, then you may want to check yourself.

Check yourself # 1:  What’s your learning style?

  • Do you learn best from observation or from trial-and-error?
    • It’s no surprise that you may find that those who enjoy TT are the ones who like to dive right in.  With TT, companies are paying you top dollar to fill a void. So they expect results. They’re looking for someone who will maximize their profit for their facility AKA productivity.
  • When you were on clinical rotations, how did you learn?
    • Did you find yourself struggling to learn the new documentation system while treating patients? Were you overwhelmed? If so, then I’d reconsider TT.
    • You will be expected to document, evaluate, treat, and discharge on your first couple of days with minimal orientation. It’s reality.

Check yourself # 2: How do you deal with stress?

  • Do you crack under pressure or do you rise to the occasion?
    • This relates to the information above. The turnaround between orientation and managing a full caseload is quick. Did you blink? Yeah, it’s that fast. Does that thought give you heart palpitations or does it get you excited?
    • Skilled Nursing Facilities have the highest productivity rates and expect 90% to 95%. Did that make your heart stop? Then let’s rethink this. If not, then go ahead and proceed.
      • The majority of Travel Therapy contracts are based on SNF; however, there are opportunities in other settings including home health, acute, outpatient, and inpatient rehab.  I’ve been extremely fortunate to extend my contract in IP Rehab.

Check yourself # 3: How do you deal with CHANGE?

  • Do you think of living in a new place as a new adventure and seek for opportunities to meet new people?  Or are you a homebody? If you demonstrate either of the above characteristics, then traveling therapy may be perfect for you.  You’ll live in a new home away from anything and everything you’ve ever known.
  • It’s important to identify and cater to your social and emotional needs. If you’re an introvert then you’ll have plenty of time to reboot in the solitude of living in a new and unfamiliar place. If you’re an extrovert, you’ll seek opportunities to meet people no matter where you go.
  • If you’ve never left home and have only lived close to home with familiar people and places, then I would find a placement closer to family/friends to help comfort you during this transition period.
  • If you’ve only moved to a new city for college or graduate school that’s completely different.  You experience the rigors of a DPT/PTA program together through presentations, projects, case studies, exams, and practicals.  It’s kind of like hazing and only your classmates will truly understand your PT problem struggles.  Through your experiences, you develop a support system. Depending on the work culture, your co-workers may or may not be interested in hanging out outside of work.

I’m an advocate for doing whatever is best for you. Travel therapy isn’t for everyone.  Like any experience, it can be what you want it to be.  You must have a recruiter that will listen and be your champion.  Some recruiters may throw you into any position to fill a void even if it is nothing that you want.

Still thinking about working as a Traveling PT? Perfect! Stay tuned for my next blogpost on the general outline for the process of Travel PT.

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