Top 5 Fridays! 5 Pieces of Advice for New Grads | Modern Manual Therapy Blog

Top 5 Fridays! 5 Pieces of Advice for New Grads

Dr. James Haefner, DPT from did an interview with me regarding 5 Pieces of Advice for New Grads. Here they are!

I think some of my answers are not necessarily only for PTs, but apply to anyone in health care depending on their ability to take certain courses.

1. What advice do you have for physical therapists in their first years of professional practice?

My advice is to get a system of assessment and treatment. Most schools still teach the tired and not so true history, AROM, PROM, palpation, special tests up the wazoo, come up with a diagnosis, and now what? I know we have to learn basics in school, but this ends up leaving most novice clinicians with too much info! Any clinician needs a system of assessment which leads to treatment. Classification has been shown in the research to improve outcomes versus treatment of patho-anatomical models. This leads me to my next answer!

2. What is one continuing education course you would recommend every physical therapist attend? Please provide a brief explanation.

Years ago, I would have told any new grad to take a series of manual therapy courses like Paris, Maitland, Grimsby, NAOIMPT, etc... While these courses will enhance your clinical decision making eventually, you will be overwhelmed with options. Your first day back with live patients, you will be left with dozens of ways to passively assess movement and often hundreds of new treatment techniques. Is complex better? Often not... it's also less reliable. That is why I tell all my students to take McKenzie Courses A-D. Certification is not necessary, but helps solidify your knowledge by getting you to really study the system and then have your knowledge practically and didactically tested. It's one of the most proven methods of assessment for reliability, and has been shown to have superior long term outcomes versus traditional OMPT in the lumbar spine.

3. What are some important components a new graduate should look for in their search for a first job?

If possible, you should look for freedom to assess and treat, plus quality time with your patients. I realize beggars cannot be choosers and I worked two jobs for the first two years of my career seeing 4-6 patients an hour and having 30 minutes for evals. Do not be discouraged or complacent. I have seen too many students settle on clinics that see way too many people and cannot possibly provide quality care. The clinics that do provide 1:1 are out there, and sometimes you have to form your own. I did not think that was possible 7-8 years ago, but decided to take a risk 10 years in and finally have a practice of my own.

Your future employer should be open to how you want to evaluate and treat, not dictate pathways per diagnosis.  A recent fellow mentee finished his hours, graduated from the program only to be employed by someone who wanted everyone to get a "fru-fru" type of massage and have the patients dictate the Tx a la carte, not the clinician. She took also took away IASTM and spinal manipulation even though on the interview, she said these treatments would be fine.

Lastly, you want to have an employer that pays for a decent amount of con-ed. One to two courses per year are enough to keep up with your learning.

4. What is one thing you would have done differently early in your career? And why?

I wish I would've learned to be lighter with my hands a long time ago. Telling patients to suck it up, and I have to plastically deform their fascia and joint capsules left a lot of people sore and occasionally bruised. That's not cool. If going lighter and lighter all the time with my forces and getting patients better faster is not an indication that interaction, education, and then manual therapy are the way to go, I don't know what is!

5. Any other words of advice for the new graduate?

Yes, you're always a student! Keep up with the learning, the more you learn the less you know and that is how it should be! As a know it all, I thought after taking Paris' courses that I was a bullet proof clinician. Yet, somehow 12 years ago, it was taking me 15-20 visits to make patients better. There are so many resources available to you online from twitter to facebook and of course blogs! You are practicing in a very exciting time! I find myself changing assessment, treatment, educational and interaction models with patients every 2 years or so. If you haven't had a paradigm shift in 2-3 years, you're not learning enough!

One last piece of advice. I thrive as a mentor. Feel free to post in the forum or contact me via the link in the sidebar. I try to get back to everyone within one business day! Good luck out there!


  1. I think maitland does a great job with an assessment system too. Although they miss out on education and hep.

  2. That may be true (haven't taken any of their courses formally), but the HEP and general education is EVERYTHING and the reason why patients who can replicate the treatments given by MDT do better in the long term.

  3. Barbara J. CarusilloJune 9, 2013 at 11:58 PM

    I so heartily agree with all you stated, especially the part about the more you learn, the more you don't know! Every new course I go to, where I learn something that is just so darn effective, and make so much sense that I keep wondering, why did I not know this before? Why could I not have figured this out? Also, some things that I wonder, How did anyone ever come up with this? (Because they thought outside the box and came up with something miraculous.) Since I have been a PT 34 years, and have gone to at minimum 2 courses a year, maybe in another 20 years, I will know something! (I also agree that McKenzie teaches a fabulous systematic way to evaluate, and I did A-D before ever doing the NAIOMT certifications).

  4. Where would we and our patients be without such pioneers? I love hearing something new and coming home and thinking about why these things work. I feel like if I don't have at least a mild paradigm shift every 1-2 years, I'm stagnant!