Career advice: Part 1

I find at least one person a week asking me which career track to follow in future. Most questions come from physiotherapy interns just complete Bachelor of Physiotherapy (BPT), or physiotherapists completing Master of Physiotherapy (MPT).

Three common questions I receive are:

(1) should I continue studying MPT after BPT without doing some clinical practice?

(2) should I study in India or go abroad (western countries: Australia, Canada, UK or USA)?

(3) should I continue doing clinical practice after MPT or apply to become a lecturer or apply for a PhD?

Many of us (in Nepal) are not trained to take our decisions because our parents/guardians take our decisions for as long as they can. When it comes to advanced career path, parents can't help, so these graduates seek for external help and ask as many people as possible.

I struggle advising people one what career to pursue, because the same career pathway can be awesome for one and awful for another.  One size does not fit all!  This decision should be made by the person who is seeking advice.  In the past I have made some suggestions, and the person(s) take them did not happen to like what I suggested. They therefore blame me for what happened to me. On the other hand, I still love doing what I suggested them to do.

In psychology, relying on someone else is called having an external local of control (ELOC). An ELOC in general does not have a favorable treatment outcome.  For example, those who rely on others (doctors) to treat their pain have poorer outcomes. On the other hand, those who understand the course of pain, and take charge of the treatment of their pain conditions (i.e. internal local of control), perform better.  It is true for real life also.  My current approach is to help the person identify what they want to pursue and make their own decisions.

I think all areas of physiotherapy (musculoskeletal, cardiopulmonary, neurology, pediatrics, sports etc) have bright future. You just that you need to be good at what you become.  Here are my thoughts on some common questions people ask me (and others).

(Q1) should I continue studying MPT after BPT without doing some clinical practice?

My general advice would be to identify one area during the internship that you like the most, spend a few years (one to three) in clinical practice in the same area (or two areas), and they carry on with higher education in the area that you are more passionate about.

Considering my example, I spent three years teaching and working clinically before embarking on my MPT in orthopedics, while some of my friends and juniors completed their MPT before I started mine.  For me, I think during these three years of clinical practice and teaching, I developed a fair clinical reasoning skills, improved my knowledge on evidence-based practice, which ultimately helped me learn more advanced stuff during my MPT.  I am happy that I opted to delay my MPT. Many western countries will require you to have clinical practice before embarking on clinical MPT, and I support the idea.

But, my friends/juniors did equally well by doing their MPT without clinical practice.

(Q2) should I study in India or go abroad (western countries: Australia, Canada, UK or USA)?

I think I am in a position to answer this very well because I am exposed to a variety of educational systems.

I did not complain much when I was studying in India. I accepted the education system and I thought I did relatively well then.  In retrospect, I realized that: (1) curriculum could be much better, we should have taught how to ask questions and find answers for ourselves, and (2) we should have been exposed on clinical reasoning and made to think (not follow orders) and evidence-based practice. Most important missing elements were communication skills, ethics... and the list goes on.

In brief, I feel sad that all the important things that we actually as a physiotherapist or an academician/researcher were missing in my BPT education. Things are better now I hope, but not optimal yet. Similar is the condition with many MPT curriculum and how they are delivered. Many - have not seen what "good" training looks like - would disagree with me. I don't blame them.

I have seen exceptional students graduating in India and doing as well as anyone else in a western country. But a good education system will definitely support an extraordinary student.

Seeing the education system in New Zealand makes me want to re-live my undergraduate and postgraduate days. Many of my friends working/studying in good educational system have confessed this with me. This is a matter of ongoing discussion.

Where to study also depends on how much resources you have to pursue studies in western countries, and your communication skills in English (or German or Japanese depending on where you want to study).  If you are an exceptional student, western countries are good at identifying it and providing scholarships to those who deserve. All you need to do is ask, and convince that you deserve it. For example, I waited until my CV was good enough for a scholarship for my PhD.

(Q3) should I continue doing clinical practice/ lecture/ embark on a PhD?

This also depends on individual to individual. It is about embracing the decision and doing well in the area. There are sometimes when we may absolutely hate what we are doing, in that case we can always switch the subjects (or areas of clinical practice).

I know some clinicians who 'suck' at it but can teach well. I know teachers who are horrific but are good at handling patients. It is again identifying what is that you are good at or enjoy doing. Try it. Continue it. If you still like it, continue for longer. I think it is upto us to become a life-long learner, and trying new (but evidence-based) ways of managing same condition. I do not agree to those who say that teaching or clinical practice are monotonous. I think they are not trying newer ways in their teaching or clinical practice.

I will write another blog on PhD. It is a separate topic of discussion.


It is you who need to identify what you will do in future. Others can only provide guidance/ or options.  Before embarking on anything, identify a good mentor and work with him/her. Passion is contagious. Working with someone who is passionate about a subject will transmit some of his/her passion to the mentee. It will help you like the subject and stick to it for longer.

Also, try some career and personality quizzes that might help: