Every physiotherapist was at some point, a student. In 2024 we asked physiotherapists from around the world to share some of their student experiences and their transition into the workplace.
One hundred and one physiotherapists from 31 different nations shared their experiences with us. The most senior graduated in 1955 and the most junior were currently in their final year of study – a seven decade range.
The purpose of our project was to explore the similarities and differences of physiotherapy student experiences across time.
Similarities For All Physiotherapy Students
With the help of ChatGPT we identified eight similar themes across the responses of all generations:
1) Motivation to Become a Physiotherapist
Personal relationships with physiotherapists had a strong influence in choosing physiotherapy as a career. Stanley Paris (New Zealand, graduated 1958) reported following in the footsteps of his father. Judith Sanders (United Kingdom, graduated 1966) said, “Two of my older brothers girlfriends were physiotherapists and at 14, I considered them the bees knees!”.
Others had family members who received physiotherapy. Mark Laslett (New Zealand, graduated 1971) shared, “My older sister had a diving accident when I was 14 and became tetraplegic C5/6 and I was exposed to orthopaedics and physiotherapy from the age.” Natasa Tedman (Montenegro, graduated 2002) had a father with back pain who she hoped to help. Ram Prakash (India, graduated 2008) said, “I lost my grandma, who was hemiplegic for 18 years. I had felt powerless being not able to help her with her health problem. I wanted to become a physiotherapist, who can move an immobile patient, who adds life to years.” Aniqua Siddiqui (Pakistan, graduating 2024) said, “When I was in early teenage years my grandmother got frozen shoulder so a home health physiotherapist came to our house”.
Many physiotherapists chose their career because they enjoyed sport and human movement. Stephanie Maddrill (United Kingdom, graduated 1982) shared, “I was good at sport and labelled to be a Physical Education teacher but my voice was too quiet to shout on a hockey pitch.” Cornelia Furrer (Switzerland, graduated 1988) said physiotherapy was a, “Good mix of two areas of interest, namely medicine and sports”. Monique Caruth (Trinidad & Tobago, graduated 2006) explained, “I wanted to be a sports physiotherapist and work with cricket and football teams.” Likewise for Annette Tonkin (Australia, graduated 1977) who eventually achieved her goal of working at the Olympic Games.
For some physiotherapy was a second choice to medicine, or for Esida Hoxha (Albania, graduated 2011) a “fourth choice”. Others wanted to work in health care, but like David Nicholls (United Kingdom, graduated 1988) who “didn’t really fancy dealing with all of the blood and bodily fluids of nursing and medicine”, found physiotherapy an excellent first choice.
2) Challenging but Rewarding Educational Journey
The physiotherapy education process was consistently described as challenging, requiring a strong commitment to mastering both theory and practice. Respondents across all generations reported rigorous schedules, demanding courses, and extensive clinical training.
Beth Linker (USA, graduated 1992) said, “I got into a 4-year program that required that I receive no grade lower than a B-. There was a lot of ‘weeding out’ in the first two years.” Robert Reed (USA, graduated 1970) said, “It was the most intense, pressured experience I had had in my life.” Carrie Davies (USA, graduated 1979) said, “You would not ever miss a single class or you would get too behind.” Alba Ruth (Columbia, graduated 2007) said, “At some points I thought I couldn’t go on.”
Giuseppe Verde (Italy, graduated 1982) expanded by explaining the awesome responsibility of being a health care practitioner, “Practicing with your colleagues is very different from treating real patients. Knowing that a person depends on you to get better makes you question all the time whether you are doing things right or wrong.” Despite these challenges, many also expressed how rewarding the experience was, especially as they began clinical placements. Esida Hoxha (Albania, graduated 2011) said that being a physiotherapy student, “was as beautiful as it was difficult.”
3) Significant Role of Anatomy and Practical Skills
Anatomy and hands-on practical skills were consistently highlighted as memorable and essential components of physiotherapy education. Across all generations, respondents recalled how these aspects formed the foundation of their knowledge and clinical abilities, shaping their expertise in patient care. Pieter Kroon (Netherlands, graduated 1986) said, “The enthusiasm with which the orthopaedic course work was taught. The social fabric of our physiotherapy school was also very strong.” This emphasizes how the focus on practical skills, particularly orthopaedic training, played a crucial role in developing clinical competence. Mary Gorman (Ireland, graduated 1978) said “Most memorable were the anatomy labs, working hands-on and really seeing the muscles and joints.” The practical anatomy experience was fundamental in preparing physiotherapists to understand the human body in detail. Likewise Akira Kimura (Japan, graduated 1987) explained, “The anatomy and physiology training was almost the same as the doctor training course, so it was very fulfilling, and although it was difficult, I think it was fun to learn.” Fiona Morrison (Australia, graduated 1994) believes, “Most memorable were the anatomy labs, working hands on and really seeing the muscles and joints etc. Be good to go back and see the same again, this time with experienced eyes.”
4) Importance of Peer Support and Lifelong Friendships
Physiotherapists from different generations frequently mentioned the strong social bonds formed during their training. The shared intensity of the educational experience fostered lasting friendships and professional networks that many respondents cherished throughout their careers. Gwendolen Jull (Australia, graduated 1968) said “We established very firm friendships which have lasted a lifetime.” This underscores the camaraderie and support systems that helped students navigate the rigorous demands of the training. Wim Schoemans (Netherlands, graduated 1974) summarised with, “Mutual solidarity with a multiform origin of a social nature.” Patricia Grohne (United Kindgom, graduated 1967) put it more simply with, “Learning, loving and socialising together made for lifetime friendships.” Eliza Grech (Malta, graduated 2014) spoke fondly of, “Creating unbreakable bonds with my fellow colleagues that have lasted years.” And Mary Gorman (Ireland, graduated 1978) still keeps in touch with her classmates to this present day.
5) Evolution of the Profession
Many respondents discussed how physiotherapy education and the profession have evolved over time. From a focus on manual therapies and electrotherapy in the earlier decades, education has gradually shifted towards evidence-based practice and specialization. This evolution has been noted by respondents from different eras, who highlighted how changes in the profession influenced their training and career choices. Shirley Sahrmann (USA, graduated 1958) said, “My understanding of the nervous system helped extend my understanding of the factors in musculoskeletal conditions. I did neurological research for many years trying to understand the mechanisms of the upper motor neuron syndrome but gradually became more involved in the mechanisms of musculoskeletal disorders.” Peter O’Sullivan (New Zealand, graduated 1986) said, “I loathed electrotherapy – thought it was BS and a waste of time. This was the only unit I nearly failed…as I didn’t believe in it. I realized quickly there was very little evidence to support physiotherapy practice, and was determined to work to create some.”
6) Impact of External Events
Physiotherapists across generations shared how healthcare trends during their education impacted their learning and early careers. This included working with diseases prevalent at the time (such as polio) and responding to new medical advances, such as vaccines or changing patient demographics. The healthcare landscape often shaped the kinds of patients they worked with and the focus of their studies. Carolyn McCall (Australia, graduated 1962) said, “As a Girl Guide I went to Fairfield Hospital and visited polio patients – rolled plaster bandages and helped with stretching patients.” This experience stimulated her interest in physiotherapy. More contemporaneously, Martina Sultana (Malta, graduated 2021) said, “I’ll never forget the amount of panic when we realised that COVID lockdown was going to last last more than a week and all the logistical hassled that COVID brought with it.”
7) Importance of Mentors
Across all generations, physiotherapists consistently emphasized the crucial role of mentors in shaping their careers. Maryam Sada (Nigeria, graduated 2023) said, “I had the most amazing professors that not only taught me, but befriended and mentored me. They really shaped my interest and love in my profession.” The role of experienced mentors in shaping graduates’ early professional development is echoed in many respondents’ reflections. Anne Cunningham (Ireland, graduated 1978) said, “I learned a lot from a lovely manager, nice transition from student hood.” This highlights how supportive mentorship was essential in helping students navigate their first professional experiences. Lance Twomey (Australia, graduated 1961) said, “The head physiotherapist was a very smart English woman, Mrs. Elaine Morrill, while the senior staff included Mr. Eric Stovell, an excellent practical physiotherapist, from whom I learned a great deal.
Careless mentors can also have a powerfully negative impact. Ryo Mikami (Japan, graduated 2009) remembers, “When I was a student, I did not get a very good evaluation from my field supervisor during my clinical practice education. On the last day, I was even told, ‘You are not cut out to be a physical therapist.’ Therefore, I had a strong fear of doing physical therapy in front of my seniors after graduation.”
8) Challenging Transition from Student to Professional
Many respondents, regardless of the era, shared the difficulties they faced when transitioning from the structured environment of student life to the responsibilities of professional work. This shift was often described as overwhelming, but also critical to their development. Rhona Burslem (Canada, graduated 1967) said her first job was, “Scary… responsibilities that I truly was not ready for, but we went ahead and got on with it and learned along the way.” This shows how the first professional experiences often involved a steep learning curve, requiring physiotherapists to quickly adapt. The gap between theoretical knowledge and real-world practice that students had to navigate when starting their careers was identified. Mark Laslett (New Zealand, graduated 1971) said, “There I learned that much of what I was taught was useless. Vigorously exercising patients with frozen shoulders doesn’t work!”
Uncertainty was at the forefront of most graduates minds. Karla Velázquez (Mexico, graduated 2020) said, “Practicing with your colleagues is very different from treating real patients. Knowing that a person depends on you to get better makes you question all the time whether you are doing things right or wrong.” Nevertheless it was a joyful career for all, exemplified by Marian Mercedes Reguera-Garcia (Spain, graduated 1999) who said, “I was surprised that my boss paid me because I had a great time. I always thought that jobs were something to do, because people (I knew) left tired or protesting.” Or Janice Cohen (Australia, graduated 1961) who simply said, “Loved it.”
Generational Differences in Physiotherapy Students
Looking for generational differences, we split our respondents into five different generational groups, using the average age of 22 years upon graduation and determining our respondents birthdate by subtracting it from their date of graduation. The generational groups were:
- The Silent Generation – born 1928-1945, graduated 1950-1967
- The Baby Boomer Generation – born 1946-1964, graduated 1968-1986
- Generation X – born 1965-1980, graduated 1987-2002
- Millennials – born 1981-1996, graduated 2003-2018
- Generation Z – born 1996-2012, graduated 2019-2034
Once again we asked ChatGPT to assist in identifying any cross generational differences for our four questions.
1) Career Choice
Many physiotherapists from the Silent Generation were guided by external influences, often driven by the stability of healthcare careers or family guidance. Patricia Grohne (United Kingdom, graduated 1967) said, “My older sister was a registered nurse who had trained at King’s College Hospital, London and she encouraged me to become a physiotherapist.”
Baby Boomers were frequently inspired by personal interests or health trends. There was often a desire to blend physical activity and intellectual challenge. Brigitte Böttcher (Germany, graduated 1970) said, “I enjoyed gymnastics, dancing, and natural remedies… Physiotherapy seemed to fit what I was looking for.”
This reflects how the profession aligned with personal health philosophies and physical activities
Generation X physiotherapists often chose the profession due to exposure through personal experiences or as a more hands-on, less invasive healthcare option. Giuseppe Verde (Italy, graduated 1982) said, “I was eager to help people with disabilities, and in my Southern region (Sicily) there were quite a few of them at the time.”
Millennials and were typically motivated by a combination of personal passion and an interest in hands-on, practical healthcare work. Some were drawn to the profession after exposure to physiotherapy through sports or healthcare. Ivonne Reyes (Guatemala, graduated 1986) said, “I met a Belgian physiotherapist and liked the work he did.” This reflects how increasing global exposure to the profession influenced career choices.
Generation Z physiotherapists were drawn to the profession by its emphasis on holistic health, personal wellness, and the ability to make a direct impact on patients’ lives. Myrka Villalobos (Mexico, graduated 2021) said, “I like to help people rehabilitate and return to their activities or what they are passionate about.” This reflects the growing interest in preventive and holistic approaches to healthcare among the younger generation.
2) Educational Experience
For the Silent Generation educational experiences were strict, highly regimented, and often felt more like secondary school than higher education. Pamela Jeacocke (United Kingdom, graduated 1955) said her education was, “Very disciplined and strict protocols. The Sisters would enforce rules firmly.” This reflects the authoritarian, rules-driven nature of early physiotherapy training. The courses were also very structured. Hilary Crowley (United Kingdom, graduated 1966) explained the program as, “First six months was all theory. Next two years was half day course, and half day treating patients. Last six months was all practical.”
Baby Boomers received a more structured education with a growing emphasis on practical training. However, the systems were still formal and demanding. Catherine Sykes (United Kingdom, graduated 1975) said, “Our committed educators balanced the need for academic excellence and hands on experience, moving the focus of the programme from the former to the latter in terms on hours.”
Education for Generation X often involved more practical experiences. Elaine Miller (United Kingdom, graduated 1993) shared, “Within the first few weeks we were blindfolded or handed a wheelchair and told to get ourselves around the city. That was really useful, a simple but useful insight into how difficult everyday tasks can be for people with physics challenges.”
Millennials enjoyed more balanced and supportive educational environments, with mentorship and greater integration of academic theory and clinical practice. Nancy Cho (Canada, graduated 1982) explained how she was “Dual trained in physiotherapy and occupational therapy… The pathology course was memorable, learning about diseases and feeling fortunate to be healthy.”
Education for Generation Z was highly interactive, with an emphasis on technology and evidence-based practice. There was also more focus on student well-being. Martina Sultana (Malta, graduated 2021)
said, “The lecturers were always readily available and they were able to help us out, both academically and when we were struggling emotionally with all the pressure the university brings with it.”
3) Course Memories
The Silent Generation often recalled the challenging and sometimes trial and error aspects of their training. Stanley Paris (New Zealand, graduated 1958) explained, “When assisting a patient in the gym who was in a back pain class, I accidentally manipulated his spine producing instant relief of a long-standing condition.”
Baby Boomers most frequently mentioned the the medical aspects as memorable parts of their education. Catharina Broberg (Sweden, graduated 1964) said, “Almost every morning we had a patient demonstration by a doctor. We learned both examination and treatment… I liked internal medicine and neurology.”
Generation X tended to highlight the growing emphasis on peer relationships and mentorship during their education. Susanne Dick (Germany, graduated 1987) said, “We had a few great teachers, who were fun and supportive… a very good connection amongst the students.”
Millennials and Generation Z respondents frequently recalled their clinical rotations and exposure to new, evidence-based approaches as the most memorable parts of their education. Charalampos Fotiou (Greece, graduated 2014) commented on, “The novel information about the ways to help, the feeling of achievement when first engaging with patients, and most importantly the adoption of the ethos from the educators themselves, which also served as role models, and set the standard for which we all aspired to reach.
4) First Job and Transition from Student Hood
The Silent Generation faced abrupt and often overwhelming transitions into professional life, with little mentorship or support. Mary Cross (United Kingdom, graduated 1962) said, “My first job was at the Children’s branch of the St Mary’s Hospital, in ‘sole-charge’. It was the most challenging of all my experiences it took at least a month for me to adjust.”
For Baby Boomers, the transition was often smoother, but they still carried significant responsibilities early on. Kay Gray (Ireland, graduated 1975) said, “First job in a country general hospital, didn’t find transition difficult. I had to work mostly unsupervised due to small number of other staff members but someone always there to answer questions and were supportive.”
Generation X benefited from more structured transitions, often supported by mentoring and hands-on experience. Amato Machikicho (Zimbabwe, graduated 1991) explained, “every graduate had to do an Internship for twelve months (before getting an Open practicing certificate) in one of the, then only, four training Public hospitals”. However in less developed nations the transition was more abrupt. Ivonne Reyes (Guatemala, graduated 1986) said, “My first job was when I hadn’t graduated yet because at that time there were very few of us and we started working early.”
Millennials experienced highly structured transitions with formal mentorship programs, often designed to ease the adjustment to professional responsibilities. Pierre Trudelle (France, graduated 1987) said, “I started working in a hospital as a flying physio, replacing people on holiday or sick leave… This allowed me to work in all departments.”
Other Issues of Physiotherapy Students
The respondents also provided four other issues that affected their educational experience:
1) Gender
Physiotherapy has long been a predominately female profession. Lance Twomey (Australia, graduated 1961) was one of three men in his cohort of twenty and discovered that he “came to enjoy working predominately with very smart women”. As the lone male in his cohort, Fred Samorodin (Canada, graduated 1976) found his training “isolating”. The student gender disparity issues were experienced two-way. Tracy Bury (United Kingdom, graduated 1988), who had only been able to practice on females, found the male model for her first year anatomy assessment a significant challenge.
Gender issues between staff and students were also identified. Glenn Ruscoe (Australia, graduated 1989) reported that, “With some misandristic staff and tutors, male students learnt to keep their heads down to get through without failing and having to wait a year to repeat the same unit.” Challenges also existed for female students with inappropriate attention from male faculty. Elaine Miller (United Kingdom, graduated 1993) reported, “There was also a lot more wandering around in your underwear than was strictly necessary and a couple of male lecturers and placement supervisors that we all knew were best avoided.”
2) Relationships
For young adults, tertiary study is often a time of creating relationships, cheekily summarised by Judith Sanders (United Kingdom, graduated 1966), who “enjoyed visits to Leeds university for dissection of limbs and the very flirty young medical doctors who instructed the proceedings.” If the study workload alone was not enough, some students were starting families whilst studying. Greg Lehman (Canada, graduated 2010) and his wife had two babies.
Relationship breakdowns and loss were disruptive for some students. Cibelle Formiga (Brazil, graduated 1999) shared, “halfway through the course I lost my father in an accident and it was a great challenge to complete the course given my family’s circumstances. I thought about giving up, but my mother strengthened me until the end.”
3) Racism
Melrose Stewart (United Kingdom, graduated 1976) reported that, “The late 60’s and early 70’s was fraught with racism in the UK and physiotherapy education within the NHS was no exception. However, the then principal of the school was very welcoming to students from diverse backgrounds.”
4) Funding
The number of Physiotherapy schools expanded significantly over the period studied and funding did not always match student number growth. Wendy Smylitopoulos (Canada, graduated 1964) found her education, “Challenging in that the school of Rehab Med was just starting and we were the first class. We didn’t have a building for the first month or so and external lecturers or facility visits/ practicums were not set up far in advance”. Kristie Tyson (Australia, 2012) said, “The degree was still quite new at the uni and as such there were some teething issues such as having to source my own placements for some of my practical blocks, as they didn’t have enough for the whole class.”
Personal funds were also an issue. Elizabeth Ormond (Ireland, graduate 2003) shared, “I remember having no money and often eating cold beans for lunch as it was all I could afford. I still seemed to have enough money to on student nights out so I wasn’t altogether poor but obviously had poor money management skills or different priorities at the time.”
Conclusion
To summarise all that we have learnt would be impossible. So we would simply like to thank our contributors for sharing their stories and insights into their time as physiotherapy students.