Which specialisation in physiotherapy should you choose after BPT

As a physiotherapy career coach, I get many DMs on my Instagram from PT students like you. All asking which specialisation in physiotherapy should they choose. As we graduate, many of us get confused about what to do next after BPT. While you are sure that you want to pursue Masters, you still may be wondering which specialisation in physiotherapy to choose. After all there are so many options.

I asked 5 experienced MPTs (MSK, Neuro, Cardio, Sports, Women’s health) pros and cons in their chosen field. Here is what they had to say:

MSK Physiotherapy

Abhijit Minhas gave this interview. Abhijit completed his BPT from India and his Masters in exercise science from USA. He is currently working in Canada and has work experience of about 15 years.

Pros:

1. Always in business- being in the MSK/ortho field you will always have enough clients. Given our modern society and lifestyle problems there’s no dearth of people dealing with MSK issues. More common than other conditions like neuro/peads. Stats and number are on our side and we get the biggest piece of the Physios pie.
2. Most awareness among the general populace- when asked the question about what a physio does, ‘most’ people know physiotherapists to treat MSK related issues. The awareness/exposure of MSK physios is far greater than our neuro/cardio-respiratory/womens health etc colleagues.
3. Gratification- the gratification of seeing improvement in our patients is much faster given the nature of the condition that we deal with making it a popular choice among physios. Compare the prognosis of patients dealing with LBP vs say stroke patient, we tend to get quicker results.
4. Variety- within the spectrum of conditions/ disabilities affecting people today, we see the maximum variety. It’s not uncommon to see patients with multiple joint/muscle issues, along with metabolic disorders etc. The same may not be said for our neuro/ other colleagues. Eg- hard to have patients (though not impossible) dealing with multiple neuro conditions (spinal cord injury/ Parkinson’s/ muscle dystrophy etc) at the same time. To say it plainly, we treat more conditions which means more work/business.

Cons:

1. Burnout- while this may be true for all fields of physio, the fast paced nature of an orthopedic outpatient clinic combined with sheer volume a physios treats in a day may lead to quicker burnouts.
2. Physically demanding- it’s hard work and you earn every dollar/rupee you make. Lifting, stretching, exercise demonstrations, manual therapy etc all require a lot of physical exertion and gets harder as we get older. This is one of the many causes of attrition within our field though in all fairness neuro rehabilitation is also as demanding on the body (but with fewer clients seen per day).
3. More patients mean more documentation- it is not uncommon for MSK physios to treat 20-25+ patients per day and all this work comes with a larger volume of documentation. Charting may often take an additional 1-2 hours of your day over your regular 8+ hour work day and this can get very exhausting. While documentation is not exclusive to just MSK physios, we deal with the maximum volume which means we deal with the maximum charting.

Neuro Physiotherapy

Pallavi Sarje gave this interview. Pallavi completed her MPT neuro from India. She has work experience of over 13 years.

Pros:

1. Beyond the intellectual and professional benefits, working as a neuro physiotherapist offers deep personal satisfaction. Helping patients overcome their challenges and witnessing their progress can be profoundly rewarding.
2. I personally feel it’s high demanding field. demand for neuro physiotherapists is strong and growing and will always grow, driven by an aging population and increased survival rates from conditions that affect the brain and nervous system. This high demand translates into strong opportunities.
3. Neuro physiotherapists have the flexibility and variety to work in various settings, including hospitals, rehabilitation centers, private practices, community health centers, and research institutions. This diversity allows for a dynamic work environment where one can engage with different patient populations
4. Unlike orthopedic surgeons, mostly we don’t get plethora of things in prescription. Just 2-3 things like gait training, balance training etc

Cons:

1. It is both emotionally and physically taxing. We handle patients with severe disabilities, which can be emotionally draining, especially when progress is slow or outcomes are not as expected. Physically, the job is demanding, requiring us to assist, support, and physically train patients.
2. The combination of physical demands, emotional stress, and sometimes challenging work hours can lead to burnout and compassion fatigue.
3. Managing the expectations of patients and their families can be challenging. Communicating realistic goals and outcomes requires a lot of sensitivity and there can be tension when expectations are not aligned with clinical realities.

Cardiorespiratory Physiotherapy

Dr. Sayyeda Uneza Fatima (PT) gave this interview. Sayyeda completed her BPT and MPT in cardiorespiratory with a gold medal. She has about 7 years of work experience.

Pros:

1. The patient a cardio PT can see no other field can manage as heart and lung patients are very fragile and require expertise to handle
2. It is a lesser explored field so lots of scope is there for growth
3. Amazing field for people who like acute care like ICU post op etc

Cons:

1. We have to explain to people almost every time of what physiotherapist do in cardiac and lung patients
2. People including many physios think chest PT is only percussion vibration so not much appreciated and chosen by PTs
3. Takes time for results not like some manipulation and ding the pain is gone.. it requires patience to treat patients

Sports Physiotherapy

Dr. Abhishek Wagh (PT) conducted this interview. Abhishek holds a Masters in sports physiotherapy and currently works with Olympic and Paralympic athletes at Olympic Gold Quest.

Pros:

1. Get to roam around the world with team or athletes
2. Better salary in India than other branches of Physiotherapy
3. Get more recognised as a physio because of media attention on elite athletes and teams
4. You stay in touch with games events and that is entertaining if you are a sports lover
5. Can get to represent your country.

Cons:

1. Staying away from family for long time, which leads one to sacrifice on family emergency celebrations.
2. Getting good opportunity in sport takes time and also luck plays an important role.
3. You are constantly under microscope and is expected to be on toes as it can reflect in players performance
4. Taking leaves gets difficult because of the demands of tight sports schedule

Pelvic Health Physiotherapy

Dr. Induu Kashyap (PT) gave this interview. Dr. Induu specializes in pelvic, menstrual, and sexual health, as well as corporate wellness. She has over 14 years of experience.

Pros:

1. Although in past few years, the awareness about women’s health physiotherapy and number of women’s health physiotherapists have increased tremendously, however females are a major part of population and the female specific conditions are also highly prevalent, hence we still need more number of the women’s health physiotherapists meaning the women’s health physiotherapy has a very good scope of practice.
2. From earning POV, women’s health physiotherapy is a good field because people are ready to pay as 1) we have less women’s health physiotherapists as discussed previously, 2) people tend towards the holistic and conservative management which physiotherapy always provide (and also we have researches showing its results in the women’s health) and 3) nature of conditions (like urinary incontinence, pelvic organs prolapse, sexual dysfunctions, pelvic pain, osteoporosis, menopause symptoms, etc.) affects them adversely including their interpersonal relationships.
3. Women’s health physiotherapists get special place and respect in the society as they cover an ignored population type and their unique health concern. They empower the females through education and importance they deserve, and also help bridging the gap between females and their societies, work places, etc.

Cons:

1. Although a lot of awareness has come within females about their health and wellbeing but still there are certain areas of health which they tend to keep under the carpet and some such areas of issues are pelvic floor health, sexual health, menstrual health, breast health, etc. Also females don’t come and address their issues because they have tendency to normalise many health issues (like urinary incontinence with advancing age, painful periods or painful penetration, osteoporosis, etc. ).
2. Often females conditions are stigmatized. This plays a role of hindrance in their approach to us for treatment and hence we need to work very hard in educating them so that we can address this large population effectively.
3. As previously discussed, women’s health physiotherapists have to work quite hard in their area to bring in the patients. This will require so much patience and marketing (physical and digital). But the best part of this is that we get the productive results very fast because females are really wanting someone to address their issues. In short, as such there is no advantage, we just need to educate more & promote more.

Here’s the list of Pros and Cons featuring PTs with years of experience in their chosen specialisation in physiotherapy. While deciding which specialisation in physiotherapy to choose for your Masters can be confusing, a good old pros and cons list can bring clarity.

So, what’s the final answer? Which specialisation in physiotherapy do I recommend for you? Well, that depends. There’s no one-size-fits-all formula here. We’re all different, with different interests and career goals. Therefore, the recommended specialisation for one PT may not be the same for another.