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Career, Interrupted: Tales From A Graduating PTA Class

2020 was, to put it mildly, a challenging year for all of us. But it was especially challenging for those in the PT field who were least-equipped to cope with its effects: the graduating class of 2020. Many of these students-turned-PTAs still find themselves un- and under-employed even as the pandemic is (hopefully) nearing its end. It is the intention of this editorial to shine a light on the plight of the newest generation of PTAs, who entered the field at what was arguably its most difficult (though some would say “finest”) hour. 

For the purposes of this editorial, I will be focusing on the experiences of graduates of Macomb Community College’s PTA program (of which the author is a member; go Class of 2020!). This is done partly in an attempt to limit the number of interviews necessary to write this article, since obtaining a core-sampling of the entire graduating class of the state of Michigan would be prohibitively difficult (especially for a beginning PTA who hasn’t made many professional contacts yet). It is also done out of entirely human self-interest: the young PTAs interviewed are the author’s friends, classmates, and peers; it is only natural to want to bring greater awareness to the plight of one’s cohorts, to hope for their professional success and to celebrate in sympathetic joy when they are able to overcome their first and greatest hurdle: starting their careers in the midst of a completely unprecedented medical emergency which has transformed human life and livelihoods on a global scale. I hope that the readers will forgive this small conceit on my part. And now, on with the show!

Q: How did the onset of the pandemic (and the subsequent quarantine) affect your final clinical rotation? How long did it take until your CI certified you as an “entry level” PTA? Do you feel that you missed out on anything?

• Krissy Toth, PTA was one week into her final clinical when the quarantine went into effect. Unlike many PTA students, she was able to finish at her initial site, and got a full eight weeks out of it to boot. She felt she did get the full clinical experience, but was disappointed that social-distancing rules prevented her from job-shadowing the OTs or SLPs at her clinic. 

• In the case of Adam Done, SPTA, the pandemic affected his classes at MCC, rather than any of his clinicals. So far, he’s only been physically present on campus four times this semester! His main complaint was loneliness: the pandemic led to decreased socializing with his classmates, which (combined with the plethora of distractions at home) sapped his emotional energy and made it more difficult for him to study.

• It was a Friday morning when Angela Connor-Hildebrand, PTA heard about Governor Whitmer’s closing order during her morning commute to her clinical site. She finished her day working with special ed kids in the public school system, but because of the short notice, her last day was just like any other. That same day, MCC pulled all of its students from their clinical sites, citing concerns over students’ safety. Angela reported feeling satisfied with the backup clinical site she was eventually sorted into, saying it was “everything I thought it’d be, but I’ve got no real experience so I can’t say for sure.”

• Ginger Holman, PTA, said she had been “really excited about the venue” of her final clinical: Henry Ford Hospital in downtown Detroit, Cardiopulmonary Unit. She was very disappointed when it was cancelled after just one week. Ginger reported feeling “very sad about it,” and opined that although PTA students were barred from the site, PT students were allowed to continue their clinicals there without interruption. After a few weeks of shuffling and nervous thumb-twiddling, Ginger ended up at Henry Ford Macomb, right on MCC’s main campus, doing inpatient rehab for just four weeks before “tagging out” with the next student.

• Mike Cottone, PTA was just three or four days into his final clinical when the site (P.A.C.E.) told him they were unwilling to allow him (or any students) to return, citing concerns about the “novel coronavirus”. Mike eventually wound up doing his third rotation at the same VA Hospital where he had done his second rotation. Mike felt that it was unfortunate he couldn’t get experience with a wider variety of clinics, but was glad to be somewhere familiar and accepted that his options were kind of limited considering the pandemic. Due to social distancing requirements and patient reluctance, the outpatient clinic where he worked ran at only about 25% capacity for the remainder of his rotation there. Mike said he was only allowed on certain floors of the facility, and that he only saw one to three patients per day for weeks on end. He reported disappointment that he didn’t get as much experience as he’d hoped for from his third and final clinical, which was supposed to be the toughest and most intensive of all (at least in theory).

Q: How did the quarantine/pandemic affect your ability to study for the licensure exam? Did the pandemic add significantly to your stress?

• Krissy Toth, PTA says that the quarantine actually helped her study, that she “had time to myself” without distractions (though it probably helped that she went to a friend’s cabin up near Port Austin where she could study in complete isolation four days a week). Krissy wound up passing the examination on her first attempt.

• Adam Done, SPTA, didn’t need to study for the NPTE, but he did have classes and tests and exams, and the quarantine didn’t make studying for them any easier. Adam reported that the pandemic led to less socializing with his classmates, whom he only saw virtually for months on end, which drastically reduced feelings of camaraderie and esprit de corps. The quarantine also made it more difficult to study, because there were far more distractions at home (ranging from interesting books to dirty dishes) than at the local library or a coffee shop.

• Angela Connor-Hildebrand, PTA stated that the quarantine definitely added to her personal stress levels. Ang’s grandma Mary Jean Connor], her surrogate mother and lifelong role model, passed away at the ripe old age of 84 just two weeks into the quarantine. As a result, Ang said that her mental health “was really bad, honestly” for some time afteward. Ang stated that she felt more depression than usual as a result, and was less able to focus on her studies. Luckily, her clinical at Neil King PT helped restore her headspace, and when she took the NPTE in October, she passed on her first attempt.

• Ginger Holman, PTA responded that the pandemic undeniably added to her own stress as well, but for a different set of reasons. As her tweenage son adjusted to distance learning, Ginger found herself having to tutor him during the quarantine, even though she was supposed to be studying for her own exams(an experience which many parents can relate to). Ultimately, Ginger was forced to stop studying entirely and delay her licensure exam until October, like ~50% of her classmates.

• Mike Cottone, PTA declared that, for him at least, the quarantine was “favorable, probably” for studying. Instead of taking the licensure in July as originally planned, he delayed until October so wouldn’t feel pressured. Mike said he didn’t start taking the practice tests until September, though. Mike said that the quarantine was “a little bit of a de-stressor, actually”, unlike house-hunting and moving during the lead-up to the NPTE, which he says was considerably more of a stressor for him than the pandemic itself. Lots of little things added up over the months of isolation, and because he didn’t know how things would work out, that manifested in him as having a short fuse and a constant feeling of being on-edge. Mike is happy to report that things have improved for him greatly since then: he and his fiancee Shannon are currently enjoying a happy and relatively low-stress lifestyle with their dogs on their home with acreage in Kimball, Michigan.

Q: How did the pandemic affect your job search? Did it take you a long time to find a job? Are you working in the PT field at all right now?

• Krissy Toth, PTA had been a PT tech at HealthQuest before entering MCC’s PTA program, and went straight from her clinical to the clinic. She says she knew before graduating that she’d work at Healthquest, just not at which clinic in particular.

• Adam Done, SPTA had also worked at HealthQuest since before entering the PTA program (just like his coworker Krissy). Having already put in five years at HealthQuest, he has a standing offer for employment there after he graduates in 2021.

• After two years of studying, Angela Connor-Hildebrand, PTA struggled for many months to find employment in her chosen field. Despite graduating summa cum laude and applying for dozens of positions, for months she secured zero interviews for inpatient positions, not even PRN work, until just a few weeks ago when she finally found gainful employment with Neil King PT. It appears that Angela has a knack for graduating at just the wrong moment: the last time she matriculated was during the recession following the Gulf War. 

• Ginger Holman, PTA discloses that the pandemic vastly decreased the number of jobs which were available to new grads like her, saying that she had even gone so far as to apply for a couple of PT tech jobs. Ultimately, though, that proved unnecessary: Ginger was able to secure a position with Tririga PT in Warren, where she has been happily employed since late February. 

• Having passed the NPTE but feeling starved for cash, Mike Cottone, PTA went back to his old pre-PTA ways and took a job as a massage therapist, pending his licensure by the State of Michigan. Having a lead on a job prior to the NPTE, he parleyed his position as massage tech into a promise of a PTA position… but only when his license actually arrived. Though he passed the licensure exam handily in early October, it still took 11 to 12 weeks for his license to arrive (ironically, his temporary license from the state arrived just 48 hours before his formal license did, making the temporary license, in his words, “not a big help”).

Q: How has the pandemic affected your patients, and how you interact with them?

• Krissy Toth, PTA writes that her patients have a variety of opinions on COVID, ranging from contempt to conspiracy-theories. What messaging does she use with patients who want to talk about China “inventing” the virus in a lab, or how vaccines (allegedly) cause autism? She usually “just smiles and nods, changes the subject, and politely shifts their focus back to task at hand. Krissy has stated in interviews that these days her clinic mostly helps counsel patients on the ergonomics of their home offices (offering advice on both setup and modification).  They treat lots of back and neck pain brought on by excessive screentime and insufficient exercise. Toth states that her clinic offers no telehealth visits; all treatments are still done IRL, and that they take extensive precautions when dealing with patients. For example, clinicians are only allowed 14 minutes of hands-on contact per patient, including all time spent within six feet of patients (even if they’re only holding the patient’s gait belt). These social distancing rules are enforced even for PT techs. All staff must undergo a mandatory 2-week quarantine if they test positive for COVID-19.

• Adam Done, SPTA: writes that maintaining social distance during treatment is difficult, as is having to sanitize every surface even more thoroughly than usual. Mask-wearing is mandatory, of course, but they inhibit speech and can make communication with patients difficult, especially with geriatric pts who are often hard of hearing. Adam reports that his clinic has dealt with the pandemic by (among other precautions) limiting manual time to no more than 15 minutes per patient (down from the usual 20-35 minutes). If and when patients begin giving voice to conspiracy theories, Adam says he usually just tells them that “masks have been shown to help”, after which he tries to divert the conversation, pointing out that “you [patients] aren’t required to wear masks, but we [clinicians] are”.

• Angela Connor-Hildebrand, PTA tells us that she is “eager to start and get experience, but still wary of the virus.” However, after all this time the virus is really a non-issue in her workplace; most of her patients are so “over it” that they have no interest in discussing the issue further than they already have in the last 12 months.

• Ginger Holman, PTA: took several months after becoming licensed to find herself a job, but she is now happily employed at Tririga PT in Warren, Michigan, where she says “I love what I’m doing [and I’m] Hoping to suggest a few changes here and there eventually.”

• Mike Cottone, PTA tells that his work is pretty steady right now. He’s seeing fewer post-surgical and MVA patients, and fewer high-functioning patients, but the latter is common for this time of year because lots of people haven’t met their deductibles yet. In general, Mike reports, his patients don’t downplay the pandemic, and he doesn’t even hear COVID mentioned on a weekly basis. Every table requires an extra wipe-down after each session, though, so there’s a financial side to the pandemic. So far, only one of his coworkers has lost a family member to the virus.

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