Studying physiotherapy was as beautiful as it was difficult.
Every physiotherapist was at some point a student; a period of their lives likely full of unique but familiar experiences. In 2024 we asked physiotherapists from around the world to share their educational stories, including their transition into the work force. The purpose of our project was to explore the similarities and differences of physiotherapy student experiences across time and around the world.
One hundred and one physiotherapists from 31 different nations shared their memories. The most senior graduated in 1955 and the most junior were currently in their final year of study – a seventy year range, or a lifetime of experience.
Whilst we have shared respondents stories in their own words, for privacy reasons have removed their names. Instead they are identified by their nationality and graduation year, eg., USA 1984. And where necessary we used Google Translate to translate responses to English.
Similarities For All Physiotherapy Students
Using the help of ChatGPT, eight similar themes across responses were found. They were:
1) Motivation to Become a Physiotherapist
Personal relationships with physiotherapists had a strong influence in choosing physiotherapy as a career. New Zealand 1958 reported following in the footsteps of his father. United Kingdom 1966 said, “Two of my older brothers’ girlfriends were physiotherapists and at 14 years of age, I considered them the bees knees!”.
Others had family members who suffered injuries and illness and/or had received physiotherapy. New Zealand 1971 shared, “My older sister had a diving accident when I was 14 and became tetraplegic C5/6 and so I was exposed to orthopaedics and physiotherapy from an early age.” Australia 1989 and Montenegro 2002 had parents with back pain they hoped to help. India 2008 said, “I lost my grandma, who was hemiplegic for 18 years. I had felt powerless not being 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.” Pakistan 2024 said, “When I was in early teenage years my grandmother got a frozen shoulder so a home health physiotherapist came to our house”.
Many physiotherapists chose their career because they enjoyed sport and human movement. United Kingdom 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.” Switzerland 1988 said physiotherapy was a, “Good mix of two areas of interest, namely medicine and sports.” Trinidad & Tobago 2006 explained, “I wanted to be a sports physiotherapist and work with cricket and football teams.” Likewise for Australia 1977 who said, “I wanted to work in sport but didn’t realise that there wasn’t any sports physiotherapy at the time I went to University”. Ultimately she achieved her goal of working at the Olympic Games.
For some, physiotherapy was a second choice to medicine, or for Albania 2011 a “fourth choice”. Others wanted to work in health care, but like United Kingdom 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. Likewise for South Africa 1979, who said, “I always wanted to do something in the medical field but more active than being a doctor or carrying bedpans (nursing).”
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.
USA 1992 said, “I got into a 4-year programme that required that I receive no grade lower than a B-. There was a lot of ‘weeding out’ in the first two years.” USA 1970 said, “It was the most intense, pressured experience I had had in my life.” USA 1979 said, “You would not ever miss a single class or you would get too behind.” Columbia 2007 said, “At some points I thought I couldn’t go on.” Albania 2011 summarised, when she 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. The Netherlands 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. Ireland 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 Japan 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.” Australia 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. Australia 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. The Netherlands 1974 summarised with, “Mutual solidarity with a multiform origin of a social nature.” United Kingdom 1967 described it simply as, “Learning, loving and socialising together made for lifetime friendships.” Malta 2014 spoke fondly of, “Creating unbreakable bonds with my fellow colleagues that have lasted years.” And Ireland 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. USA 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.” New Zealand 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 realised 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. Australia 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, Malta 2021 said, “I’ll never forget the amount of panic when we realised that the COVID lockdown was going to last more than a week and all the logistical hassle that COVID brought with it.”
7) Importance of Mentors
Across all generations, physiotherapists consistently emphasised the crucial role of mentors in shaping their careers. Nigeria 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. Ireland 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. Australia 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. Japan 2009 remembered, “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 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. Canada 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. New Zealand 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. Italy 1982 and Mexico 2020 both expressed concern with the responsibility of treating “real patients”. Nevertheless the early career of respondents was generally joyful for all, exemplified by Spain 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 Australia 1961 who simply said, “Loved it.”
Generational Differences in Physiotherapy Students
Looking for generational differences, respondents were split into five different generational groups, using the average age of 22 years upon graduation and determining respondents’ birthdate by subtracting it from their graduation date. 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. United Kingdom 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. Germany 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. Germany 1987 said, “I was very interested in medicine, but did not want an approach with lots of pills and surgeries”
Millennials 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. Canada 2010 first studied chiropractic and said of their decision to switch, “Physiotherapy is far less embarrassing and is a profession one can be extremely proud of.”
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. Mexico 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. United Kingdom 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. United Kingdom 1966 explained her training programme 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 also received a structured education but with a growing emphasis on practical training. However, the systems were still formal and demanding. United Kingdom 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. United Kingdom 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 insight into how difficult everyday tasks can be for people with physical challenges.”
Millennials enjoyed more balanced and supportive educational environments, with mentorship and greater integration of academic theory and clinical practice. USA 2015 explained how her course was, “very memorable because my professors treated me as a colleague vs a student. That relationship was maintained as I finished my DPT.”
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. Malta 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. New Zealand 1958 explained, “When assisting a patient in the gym who was in a back pain class, I accidentally caused his spine to manipulate producing instant relief of a long-standing condition.”
Baby Boomers most frequently mentioned the the medical aspects as memorable parts of their education. Sweden 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. Germany 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. Greece 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. United Kingdom 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. Ireland 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 was always there to answer questions and were supportive.”
Generation X benefited from more structured transitions, often supported by mentoring and hands-on experience. Zimbabwe 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. Guatemala 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.”
Early Millennials were impacted by the Global Economic Crisis, often finding it difficult to get work upon graduation. Some had to travel internationally to get their first jobs: United Kingdom 2003 first worked in Australia, Albania 2004 first worked in Kosovo and United Kingdom 2007 volunteered in Nepal. Also many went directly to private practice from university, often without strong graduate support structures. Australia 2012 said, “I was working 60+ hour weeks for the minimum wage rates, and by three months was one of the more senior physiotherapists in the clinic.” Albania 2011 was not paid for the first three months of her employment in private practice.
Other Issues of Physiotherapy Students
The respondents also identified four other issues that affected their educational experience:
1) Gender
Physiotherapy has long been a predominately female profession. Australia 1961 was one of three men in his cohort of twenty and seemed to be surprised when he discovered that he “came to enjoy working predominately with very smart women.” As the lone male in his cohort, Canada 1976 found his training “isolating”. The student gender disparity issues were experienced two-way. United Kingdom 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. Australia 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. United Kingdom 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, summarised by United Kingdom 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. Canada 2010 and his wife had two babies.
Loss and relationship breakdowns impacted on student days. Brazil 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
United Kingdom 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. Canada 1964 found her education, “Challenging in that the school of Rehabilitation Medicine 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”. Australia 2012 said, “The degree was still quite new at the university 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 whilst studying were an issue for some students, such as Nigeria 2016. Whilst simply managing their funds was an issue for others. Ireland 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 go out on student nights 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 across seventy years of student experience would be impossible. However we have to enjoy the fact that not one respondent expressed any lasting dissatisfaction with their choice of profession. Whilst not all paths to independent practice were smooth the challenging experiences were highly valued and have produced many joyful careers.
We hope this gives you a real flavour of the experiences of students throughout across time and throughout the world. We would like to thank the respondents for sharing their stories and insights into their time as physiotherapy students.