My guide to Studying and Working abroad Part 3 (Working)

My last two blogs focused on things to consider when moving abroad for masters. You can find it HERE and HERE. This blog post will feature things to consider when moving abroad to start practicing as a licensed physiotherapist. When I say abroad, I am referring to the countries I have worked in – The US and Canada. Ok, here we go-

  • One needs to be a licensed physiotherapist to be able to work in both USA and Canada. The US has a 250 question MCQ based written test with a passing of 75% called the NPTE. Canada has two tests- the written and the practical. The written component has 200 MCQ questions and the practical exam has 16 practical stations which covers cases of all aspects of entry level physiotherapy. It’s called the PCE.
  • If you plan to move to North America, prepare to start the process early as there are a lot of steps before you will be permitted to sit for the examination. This can easily  take up a few months.
  • To sum these steps in a nutshell, US and Canada would like to assess our foreign degrees and  make sure its equivalent to their standard entry level programs (DPT in the US and Masters in physiotherapy in Canada). If they find it to be at par with their respective standard, then one is allowed to sit for the test. If not, recommendations for courses are given that must be done by the foreign trained physiotherapist to be able to sit for the exam. All of this can take some time hence  start early.
  • For the US please refer to the FCCPT and FSBPT websites (in that order) for more information which is unfortunately out of scope of this blog post. You can find that information HERE and HERE. For Canada, please go to the website Canadian alliance of physiotherapy regulators for more information. It can be found HERE.
  • Make sure you have enough copies of your mark sheets and graduation certificates (multiple copies, sealed and stamped by your college or university). You will need more than one.
  • In my opinion,  to pass these tests, foreign trained physiotherapist must devote at least 2-3 months of full time study. Students graduating from american and canadian programs are trained to pass these board exams. I cannot speak for other countries but in India a lot of our tests are essay format written tests. It does not prepare us for the MCQ based examination that we need to pass to practice here.
  • Most of the exam questions require analytical thinking and problem solving to deduce the right answer. There are some questions that test factual knowledge and  our memory as well but predominately a lot of questions focus on different  scenarios and our ability to chose the best response with the information presented. Sometimes the answers might be easy to pick and sometimes more than one answer might seem correct.
  • Passing the american NPTE is quite straightforward, score 75% or more to pass. The Canadian exam is more complex, the passing score is not fixed and is set by the board of examiners and one must score more than the fixed score to pass. The candidates do not know the passing score that is fixed. You can read more about it at the CARP website HERE.
  • After one successfully passes the board exams, there are many different work settings to chose from. One could chose to work in outpatient offices, hospitals, skilled nursing facilities, long term care facilities, schools as pediatric physios or provide home physio.
  • Average salary for a new graduate in outpatient care varies state to state (USA), province to province (Canada) but to give you a ball park estimate, can start around mid $30’s/hour. Travelling home care Physios or pediatric physios  have slightly higher rates.

I  have a few more points coming in the final part 4 of this blog post. Stay tuned and always

Pursue excellence

Abhijit Minhas

(BPT, MS, CMP, FMT)

Considering a Physio Career Abroad?

Hola

We are shifting gears for this one. I have received too many questions from students/physios aspiring to pursue Masters/Career in Physiotherapy in the US/Canada etc that I feel I have a duty to oblige.  It has also become extremely difficult to answer the same questions over and over again so I will try to cover some of the most common and pertinent questions in a FAQ format. Here goes-

  1. What are some of the best colleges to pursue masters in sports/ortho/etc physiotherapy in US/Canada?

Most of the colleges in the US offer a 3 years DPT program which is a Doctor of physical therapy program. This is an entry level program which means that this is the minimum degree of education that one must have to practice as a physio. So the DPT is like our BPT program. There is no specific university which offers just sports/ortho/cardio-resp etc training. Depending upon which school (college) one gets admitted into and upon the interests of their professors, there can be some emphasis on some specialization but all in all this program covers the basics that one need to practice physiotherapy safely. To get better in your preferred field will require you to take CME/CEU’s (continuing education), work experience working in your field, internships etc. Also, there are hardly any programs in the US that offer Masters anymore. Canada has Masters in physiotherapy but that is an entry level program as well and will mostly cover topics we have studied in BPT already. The Canadian masters is a two year program

2. Is Masters in exercise physiology/Kinesiology (KIN) similar to a Masters in physiotherapy?

No, its a different field and a different profession. There is a lot of overlap in terms of what we learn. However, we have a broader scope of practice than a kinisiologist/ exercise physiologist. While, passing the NPTE exam in the US and the PCE in Canada is a mandatory requirement to practice as a physio; to practice as a KIN/ exe. physiologist one does not require to pass a national exam. Some gold standard certifications which might give one an edge are ACSM, ACE, NASM, PES etc. An exception here is the CSCS which is required to practice as a Strength and Conditioning Specialist. Please refer to my previous blog (Masters in the USA- Are you confused? Part 1) and MASTERS IN THE USA- Are you confused? Part 2 to know more about these fields/programs.

3. Can I practice as a physio after a Masters in exercise physiology degree?

You could take a masters in fine arts or business degree but as long as you have a Bachelors in Physiotherapy and pass the board exam you can practice as a physio.  YOUR MASTERS HAS NO INFLUENCE ON YOUR ABILITY TO PRACTICE AS A PHYSIOTHERAPIST (in Canada). However, recently US has changed its requirements to practice as a Physical therapist. Please check with FSBPT (Here) and NYSED (Here) for more details.

4. Is the NPTE/PCE very difficult?

While I haven’t given the PCE yet, it is somewhat based on the NPTE from what I hear. Yes they both are difficult but not impossible. Many international physios have passed this test. It requires a lot of hard work and dedication but its doable. The PCE has two parts, written and practical. The written component has 200 MCQ’s passing which one can appear for the practical. The NPTE is a 250 MCQ format exam. The hard part here for us is getting tested in a MCQ format rather than a essay format that we are used to.

5. What is the average salary of a physio in the US/Canada?

It depends. On a lot of things. Ones preferred practice setting, overall work experience,  North American work experience, language proficiency, interpersonal skills,  certifications after college, location, immigration status(unfortunately) etc. Pediatric physios working with children with disabilities in schools are  most likely compensated more than an outpatient physio. Depending upon where you practice salaries will change. Generally speaking, Physios in NYC have higher salaries than in physios in Idaho or West Virginia. Or in Canada, Physios in Alberta might make more than physios in Quebec. On the flip side if you take up a contract in the North Western territories up north in Canada where it gets very cold, you most likely have a higher salary than a physio working in Toronto. But to give you a rough estimate, a new grad physio or a new internationally trained physio can expect a starting salary of $32/hr as a starting point in both US/Canada in outpatient setting. Again, these number vary depending upon all the factors I mentioned above. I have added some links here to help you navigate this topic. Find them HereHere and Here. Again, at the cost of sounding repetitive, these are some estimates, use them as a guide.

I’d love to hear your feedback on this one. If I get a good response and more questions, Ill make this into a series of blog post. So send me your questions here.

In the mean time..

Pursue excellence-

Abhijit Minhas

(BPT,MS,CMP,FMT)

Speed and Agility Drills

As I have mentioned before many times, my masters in exercise science was just what I needed after completing my bachelors in physiotherapy. To over simplify it, It gave me an insight into exercise selection, administration and prescription which was only brushed in my bachelors of physiotherapy program. I believe this was for good reason, the bachelors degree in physiotherapy is focused on rehabilitation. Not as much on improving performance or training otherwise healthy adults. It brushes over it, but not thoroughly enough in my humble opinion. No wonder physios in countries like the US and Canada often go through this path of exercise science/ Kinesiology before entering physio school. I went the other way, but the bottom line is, there was a lot to learn and it is fascinating.

One of the facets of training which I was fairly unfamiliar with was training for speed and agility. Before we proceed, this is what the NSCA describes in its book ‘The essentials of strength training and conditioning’ speed and agility in terms of training-

Speed- the skills and abilities needed to achieve high movement velocities.*

Agility- the skills and abilities needed to explosively change movement velocities or modes.*

Most athletes need these attribute, the ability to get from point A to point B fast, this could be chasing a football/soccer ball, a run up for a fast bowler, sprinting to the finish line etc. Also, the ability to accelerate, change directions, decelerate etc. like in tennis or basketball. The ability to produce force fast in a certain direction would still require baseline/foundation strength. But we must also train for that quick first step in a sprint or that quick change in direction which must be practiced with drills. Just lifting heavy things might not help with that. These drills reinforce the ‘brain-to-muscle’ connection that we often talk about that is learnt with repetition.

One of the common drills I often saw being used by strength coaches as a warm-up or on a low training volume day is ladder drills. Here is a video of one of my colleague performing some basic (not simple) drills on the ladder. She has a track and field background in high school and collage and has practiced these drill many times over the years.  Enjoy-

  1. Forward sprint
  2. Forward sprint (Variation)-
  3.  Lateral In and out’s-

    4. Icky Shuffle-

    5. Cross behind forward-

 

I also use some of these drills in our senior population. After all, what is one of the major reasons for falls in seniors with balance issues? I think its one of them is the inability to contract muscles fast enough to prevent a fall. An example would be if they have one of their legs caught in the cable/carpet at home, its the inability to put the other leg forward to prevent a fall. Why not train them to move faster or to be able to maneuver around objects at home with ease. It can also be a great multi-planer cardio-vascular exercise for them. But of course at their own pace, keeping their medical history in mind and keeping these drills simple. There are many more drills and exercises which I will discuss in later blogs. What are some of the drills that you like? Feel free to share.

Until next time

Pursue excellence-

Abhijit Minhas

(BPT,MS,CMP,FMT)

 

 

MASTERS IN THE USA- Are you confused? Part 2

Sorry for the short hiatus people, but I am back with my first ever guest blog post by my fellow PT and a good friend Pulatsya Maliwad. He currently resides in charlottesville in the state of Virginia  and did a good job on going over his curriculum in the university of Pittsburgh. Here’s what he has to say-

Hi Friends,

First of all, I would like to thank my dear friend  Abhijit Minhas to provide me an opportunity to write a blog about my experience pursuing masters in physical therapy. A little about myself first, I am physical therapist and I have earned my masters degree of M.S.P.T. from University of Pittsburgh and B.P.T from M.S.University, India. I am here to share my experience pursuing M.S.P.T at the University of Pittsburgh.

As Abhijit has already mentioned in his blog, it is true that there are not many universities providing Masters in physical therapy course in USA, and as per my knowledge these are the available master’s courses-

1) University of Pittsburgh, Pittsburgh, PA.

• Course – Master of science in Rehabilitation sciences

• Concentration – Musculoskeletal Physical therapy or Neuro-muscular physical therapy

2) MGH institute of health professionals, Boston, MA.

• Course – Master of science in physical therapy for international students

3) Loma Linda University, Loma Linda, CA.

• Course – Master of science in rehabilitation

4) Oakland University, Rochester, MI.

• Course – Master of Science in physical therapy.

My program at University of Pittsburgh in Musculoskeletal physical therapy is a 1 year course with 3 semester starting from August to July of the following year. This course is a little hectic as the school has tried to shrink a 4 semester course into 3 semester pattern and also it is a little expensive tuition wise . I finished my course in August 2011 and I paid almost 50,000 USD for a one year course (I apologies for the jaw drops). And I might be wrong but the university has already increase tuition fees by 5000 USD so far ( again I might be wrong, please contact university for accurate information). Yes, the tuition is a little steep but it is worth the money. The things that I learned in the area of physical therapy in this course, I wouldn’t have learnt anywhere else. Basically, the musculoskeletal course is more leaned towards Manual therapy techniques in physical therapy but that is not the only thing it entails. I also had one neuro-muscular subject which taught me how to get approximate area of brain damage or level of spinal cord injury just by knowing patient’s symptoms. Yes I know what I am writing, but that is true. Many Neuromuscular masters PT’s will say that is not a big deal  but as an Orthopedic PT, it simplified a very complex topic I always had a tough time wrapping my head around. Well getting back to my favorite topic, Orthopedic course is basically divided into three major divisions – Upper extremity, Lower extremity and Spine. (I think that wasn’t very hard to guess!!!!)

1) Upper extremity

The part of Upper extremity is covered in the last semester. The course covers basic anatomy and bio mechanics of shoulder, elbow and wrist. Then it leads to common disorders of every joint and pathology behind it  followed by  the treatment part which majorly includes postural correction (Abhijit has already discussed this part very effectively), exercises and manual therapy. Now, whenever I heard about manual therapy in India, I always thought of Mulligan or Mckenzie. But that is far from the complete picture. There are different schools of thoughts and not all of them are supported by evidence which is a big deal in USA. So most of the techniques I learned were from different concepts and were all evidence based.

2) Lower extremity

This part is taught by Dr. Fitzgerald – a Knee genius. He has spent all his life in research for knee rehabilitation. His midterm exams still wake me up at night but all in all he was a great guy and his knowledge is amazing. He teaches only knee joint and for hip and ankle joint he either calls a specialist to teach or asks his teaching assistance. Once again, the course includes same stuff as UE like basic anatomy and bio mechanics leading to discussing different conditions and treatment options. One of the most interesting thing I learned was different patho-mechanics during daily activities and sports leading to injuries. This course covers common outpatient injuries but does not include orthopedic inpatient population found in hospital i.e total hip or knee replacement, fracture cases or congenital deformities etc.

3) Spine

This is my favorite part. At University of Pittsburgh, the spine is covered in two semesters.Cervical and thoracic spine in the last semester and Lumbar spine in the first semester.  These semesters deepened my understanding regarding bio mechanics of the spine. Honestly speaking, after my B.P.T. and mulligan workshop I knew only few treatments for low back pain – Short wave diathermy, Back extension exercises and Mulligan MWM’s. Sometimes I had no idea why I was even giving those treatments. But the course empowered me to perform better, more through assessment of patients with back pain complain and decide which treatment will get rid of the cause of pain. So in simple words, I learned to treat cause of pain instead of treating a symptom.

So this is just a brief review about what is covered in the orthopedic physical therapy track of the course. Other than these there were other subjects like

1) Falls and balance dysfunction (small portion covered in Musculoskeletal PT program but a major subject for Neuro PT program) covering causes of falls, different test for falls risk and treatment options.

2) Research subject including how to do a research, types of research and crazy mathematics about data.

3) Case presentations (kind of boring sometimes), and also an options to get one elective course for which I took cardio-pulmonary physical therapy (as I was always interested in pulmonary drainage techniques and have done them in hospitals in India. In USA they have respiratory therapist for it so mostly we don’t need to worry about suctioning or draining patient’s lungs).

I hope my blog will provide you with a brief idea about the M.S.P.T. course  offered at University of Pittsburgh, and if anyone has question please put it in comment box and I will try my best to answer your questions. One again thank you Abhijit for inviting me to write a blog and I would like to wish you good luck for your new endeavor.

Thank you

Poolatsya Maliwad PT

(BPT, MSPT)

 

Pulatsya Maliwad

I would like to thank Pulatsya for taking the time out of his busy schedule to contribute a very informative blog in this series. You can reach him at poolatsya2007@gmail.com. Hang tight while I try to get other great PT’s to write their experiences in this series.

Pursue excellence-

Abhijit Minhas PT

(BPT,MS,CMP,FMT)