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4 Reasons to Choose Diverse or Niche Clinical Rotations

by Taylor Speir, DPT

If you are lucky enough to have some input on where you go for your clinical rotations, you may be tempted to choose the basics: outpatient ortho, inpatient neuro, neuro peds, etc. Maybe you are a student who has known the patient population you want to work with since before you arrived on campus for orientation, or maybe you are that student who is open to many different settings. Whichever category you find yourself in, here are some reasons to look outside of the norm.

You can better market yourself when applying for a first job.

  • A tough thing about being a new grad PT is that you have to find a way to set yourself apart from the crowd in order to stand out in a job applicant pool. Maybe you had a rotation that focused on high-level athletes: you are applying to a clinic that mostly sees geriatric patients but they do treat high school athletes from time to time. This clinic may be eager to hire someone with sports experience to handle this part of the caseload, but you could stand out even more by mentioning your past experience with community outreach at local schools to bring in even more patients from this population!
    • Perhaps you had a rotation where you treated individuals with balance and vestibular deficits, but are applying to sports medicine clinics. You might be just the person they need to develop and market a new concussion rehab program!

You may fall in love with a subset of rehab you never knew existed.

  • I knew nothing about vestibular rehab, but I was hunting for a clinic that would meet my neurologic requirement for a rotation in a particular city. I ended up finding a ‘Dizzy and Balance’ program, not really knowing what I was getting into until months later when my curriculum covered vestibular, balance, and concussions. On paper, it did not sound like something I would naturally gravitate toward; however, it is hard to match that instant gratification and feeling of success from my patient no longer crying out of fear but out of relief and shock that her symptoms disappeared after canalith repositioning.
    • If you are open (or required by your school) to complete a rotation in acute care, you may find that they have an oncologic ward where they treat individuals with neurologic deficits from brain tumors, or orthopedic post-surgical precautions s/p hemipelvectomy, or pediatric patients learning to ambulate with a prosthesis as a consequence of osteosarcoma. Even if your heart lies in the outpatient world, your short time in acute care may lead you to pursue outpatient oncology rehab when you previously never knew it existed.

You will become a better clinician no matter the setting you end up in.

  • Pediatric orthopedics is mainly sports-related, but you may end up with a high-schooler with hemiplegia who really needs more balance and coordination work (hint: this happened to me). That previous experience in a vestibular and balance clinic may come in handy, even if you never treat a single kid with BPPV or concussion.
    • On the flip side, maybe you are working in neuro peds but had a sports-heavy rotation where you frequently incorporated a ball into various activities. Your high-schooler with hemiplegia just told you he hasn’t been able to play sports for years; your previous experience makes it easy for you to fabricate a basketball goal, set up a dribble-and-shoot soccer drill, or whatever else you can dream up! Maybe this attempt to help your patient play a sport for the first time in forever will make this his (and his parent’s) best treatment session ever.

Diversity can come in many different forms.

  • Diversity doesn’t mean you always have to seek out off-the-wall rotations, nor does it mean that if you have 2 ortho ones they can’t possibly be diverse! Across my 4 clinical experiences, I spent time in acute care, outpatient vestibular and balance, general orthopedics, and pediatric orthopedics. While I had 2 ortho affiliations, my final one was catered not only to the pediatric sports population, but my clinical instructor was also Schroth C1 certified and therefore I had additional exposure to a style of treatment that I only saw a slide or two of while in school. Disclaimer: I would not seek out an exclusively Schroth clinic for a rotation; only Schroth certified practitioners are able to provide Schroth therapy, therefore a rotation in such a clinic would result in students not being able to do anything other than observe. However, if Schroth is a small part of the clinic you end up in, excellent! You’ll be exposed to a very niche treatment and will perhaps find that you love it and would like to pursue certification in the future.
    • Another way to add some diversity to your experiences, even if you are eager to spend as much time with a given population as possible, is to change up your location. I attended PT school in Houston, TX, yet some of my classmates completed clinical affiliations in New York, Colorado, Oklahoma, Florida, Tennessee, South Carolina, and Louisiana. Maybe you are considering travel PT after graduation and aren’t sure if you’d be able to handle living away from family and friends; this way you could test it out with a known end-point. Maybe you think you would enjoy living in Seattle, so you spend a clinical rotation there only to find that you actually aren’t a fan; this way you learned before taking a more permanent position!

If you’re unsure of what all is out there, here are some diverse or niche PT options: vestibular/balance, sport-specific (runners, heavy-lifters, climbers, dance and performance, etc.), wound care, lymphedema, pelvic health, aquatics, oncology, Schroth, school-based, and many more! There are undoubtedly more reasons to be flexible (or even purposefully diverse) with your clinical rotations, but I hope that these 4 are enough to help more SPTs at least consider going a little bit outside the norm.


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