In this blog series, Lara shares her experience as an oversea-trained physiotherapist working in the UK. From guidance on the HCPC registration process to discussion around UK and international physio news, she hopes to provide help to foreign physios looking to work in the UK - and to connect with those of you who already are!
When I first arrived in the UK, I was desperate to start working as a physiotherapist but had no clue where to start... I remember contacting local physiotherapists randomly to see if they could point me in the right direction! This was 5 years ago and I wasn’t very successful with getting any replies...
So, with a little bit of courage, I got in touch with a physiotherapy manager in a hospital nearby and requested a meeting. She kindly accepted and the next thing I remember is being in the waiting area of the department I would be working at a few months later... I was so nervous that I don’t really remember the full conversation. She asked me if I had experience working in ‘inpatients’ (working with patients admitted to hospital). I remember answering that I had been lucky to do some placements in a hospital setting (I now know that whilst this might be normal in the UK, sometimes it can be a bit trickier to get this sort of experience in other countries). And she did end up giving me some really useful tips for me to focus on.
From then on, I won’t lie, it wasn’t quick, but answers started coming and people helped me along the way. I managed to get an interview for the bank force of the hospital I had been in. I panicked! I had no idea how the interview was going to be, nor if I could even answer the questions. There was no information online (now you have QP!), and to that date I had not met any other foreign physio in the UK.
That's when I met Magda, a Polish girl that worked in the same hospital. She agreed to have coffee with me. The main thing that transpire from my conversation with Magda is that physiotherapy education and training is not the same across the world. In the NHS, physiotherapy works on a social model rather than medical. Neither worse or better, it is just a different approach. I also learnt that the whole process of getting a job is different, from the application to the interview and then how you progress as a professional: have a look on my posts about CPD and banding. I was glad I could talk to someone who had gone through the same process, and I now realised that many UK-trained professionals may not realised how challenging it can be to settle here as a foreign-trained physio.
Thanks to Magda’s help I got that job and little by little I managed to climb the ladder onto better jobs. To get there, however, it was essential for me to know the ‘British ways’.
OVERVIEW OF PHYSIOTHERAPY IN UK
To become a physiotherapist in the United Kingdom you have to go through university. It is then a 3 year degree and when you qualify you are considered a ‘junior physiotherapist’. You would start looking for band 5 jobs (starter level if you like).
One of the big differences from other countries is that physiotherapy students in UK start their placements in their first year. They normally have 6 placements across the three years and the majority of them are in a public hospital setting.
This is something to consider when you apply for registration with HCPC as one criteria for refusal is having less amount of clinical hours (during your degree) than UK-trained physios.
Access to jobs as a newly-qualified physio
A high percentage of physiotherapists that train in UK end up working in the NHS upon qualification. When you apply for your registration through the HCPC, your application will be assessed against standards for UK physiotherapists: they will have a closer look at whether you have any experience in neurological, respiratory or orthopaedics physiotherapy, in inpatients and outpatients settings.
To access jobs in the public sector you have to go through the interview process, there is no exams or tests. However, the way of applying for jobs is different to other systems.
It is almost assumed that if you are a newly qualified, your first job will be what they call ‘rotational’. These type of roles consist of working in different settings and specialities as part of the same role. For example, my first qualified job was a band 5 rotational: each rotation lasted 6 months and every 6 months I was working in a different team, in a different department. Those were: elderly care, acute care and cardiology, respiratory ward and critical care, orthopaedics and musculoskeletal outpatients, inpatient orthopaedics, acute neurology and neurorehab.
To obtain your first rotational job at Band 5 level, you are not expected to have a profound knowledge of each speciality, but simply the knowledge you would have acquired during your university studies. You will receive support during your rotations and will have training to develop your skills in each area.
A normal week in a full time working physiotherapist consists of 37.5 hours. In private practice this might vary a little bit. To get an idea of salaries please check my post about the banding system.
Moving up to more senior roles and specialities
When you move up from Band 5 to Band 6 level, you can usually decide if you want to specialise in a specific area.
Which takes me to specialities! There is a huge focus on physiotherapy specialities in UK. I always say, think of a medical speciality and it doesn’t matter what it is, surely there is the same in physiotherapy. I love this. And before you ask, no, it is not necessary you do a master's degree in order to specialise. Another big focus here is to learn by experience and from regular CPD.
The more senior you get (band 7, 8...) the more interesting and niche the specialities can get! One I have heard recently: post-surgical physiotherapy after intestinal transplantation in paediatric patients! Have a read of this article about an UK-physiotherapist who won an award regarding her work in this area.
Independent prescribers: yep! Physiotherapist in UK can prescribe certain medication. Recent research has shown the positive impact of having physiotherapists able to prescribe, and this is starting to be implemented nationwide. However, it is not a free bar. In order to be an independent prescriber you have to undertake some training and the whole process is thoroughly regulated.
Working as a valued member of a multidisciplinary team (MDT)
In comparison to other countries, physiotherapy here is very well valued. Health teams have a good multidisciplinary working ethos and each professional’s opinion is listened to and taken into consideration. In other countries like Canada, Australia etc this might be normal as well, but unfortunately it is not a reality in some other countries. Hence why I always tell to my family the anecdote where on my first week working in a UK hospital, a consultant (lead doctor of a speciality) asked me directly my opinion and my thoughts on how long I thought a patient would need physiotherapy in order to be independent again (in my home country, doctors dictate how much physiotherapy a patient can have…)
As I mentioned above, physiotherapy in the UK, especially in the NHS, follows a social model. I found this to be another big difference and also something essential to know when you apply for jobs. Physiotherapists assist patients, along with Occupational Therapists, to improve and/or maintain patient’s independence in their homes. Because of this, when you work in a hospital, many teams are specialised in helping with that transition from hospital to home. It is also good to know the social care model not only of the country but also in the specific area (as services can vary). If you apply for a job where you might need to know about this, do not hesitate to ask about the set-up and services in the area prior your interview.
The CSP (Chartered Society of Physiotherapist), is an organisation led my its members and has its council elected periodically. They offer a wide range of services, among them they provide legal cover for physiotherapists, but also professional advice, etc. It is not mandatory to be part of the CSP but is highly recommended. In the past you could not be part of the CSP until you were HCPC-registered but they have recently introduced a membership for non-UK physiotherapists with access to some of their services. You can check this out on the CSP website.
I think this should give you a good understanding of how Physiotherapy works here in the UK. If you would like to know more, you can have a go at contacting your local physiotherapy department and request a shadowing day (being able to watch a physiotherapist at work for a day).
And of course, don't hesitate to contact us with any questions, or visit our EU / International page for more. Let's make sure you make the most of this beautiful country (and that comes from a Spanish physio ;P ).
About the author
Lara is a Spanish physiotherapist who has been working in the UK for the past 5 years. Having worked as a rotational physiotherapist over here, she's had experience in a wide range of specialities and now works as a Band 6 Physiotherapist. However, it hasn't always been easy finding her way and adjusting to the UK system. She's since been sharing her experience and helping other foreign-trained physios to come and settle here; firstly through her own blog, and now as part of the QP team!