Bringing their skills to Birmingham

Yvette (Y), who is originally from the Philippines, is a senior Band 6 physiotherapist at Mosley Hall hospital, a community hospital offering general medical and sub-acute care in Birmingham. While Graham (G), a recent graduate who is originally from Hong Kong, works as Band 5 rotational physiotherapist at West heath Hospital, in South Birmingham.

What made you want to come and work or study in the UK?

Y: It wasn't originally my intention to come here, but I had a friend who was already working here, and she suggested I come so I said “Ok, I’ll give it a try”.

I was fascinated with the history of the country, with the kings and queens, and the castles, from watching TV and reading books. But originally, I wanted to go to America because our Philippine system of education is the same as the American system, so there’s only very few physios here that came from the Philippines because most of us wanted to go to America – and that was my plan.

But then I ended up coming here, and I loved it.

G: I studied my bachelor’s degree here, at the University of Birmingham. While I was studying high school back in Hong Kong I wanted to study overseas, because I wanted to gain some other experiences from being in a different country.

And I heard from others saying that the University of Birmingham was a really good university for delivering physiotherapy education. So, I did some research, and I attended interviews at different universities. Then, comparing them all, I decided that Birmingham would probably be a good place for me, so I chose this place.

And since graduating I started working here in May this year.

What kind of patients and type of conditions do you treat in your current role?

Y: I work in a general geriatric area. So, we get all sorts of conditions, such as stroke, multiple sclerosis, Parkinson's disease or other very rare neurologic conditions, fractures and patients with dementia. I've been exposed to lots of different areas of physiotherapy, like respiratory. But I’m happy where I am now because we get to see a bit of everything in a general medical area so, for instance, you still come across patients who have respiratory problems. So whatever other skills I’ve gained, I know that I’m still able to apply them now, because all the knowledge I gained in the different areas where I’ve worked before is still relevant now.

G: On my ward the patients are also generally elderly, so most of them are in their 70s, 80 and 90s, but some of them are also slightly younger, in their fifties or sixties. Many of the patients we see are very confused, because most of them are having dementia or even Parkinson's disease. And their mobility will be affected, and their insights of safety will also be affected in different areas as well. So, it can be quite challenging for therapists to actually educate them about how to do functional tasks or how to regain the ability of doing them. Also, most of our patients have complex medical histories, and one of the things I’m learning is how important it is to take those into account. 

And what first inspired you to become a physiotherapist?

Y: I always love science when I was growing up. I was fascinated with anatomy and physiology, and biology, ever since I was a kid and then, when I was in high school, my granddad had a stroke, and he was in a coma for about three weeks. After that he I saw he needed some help and so he went for physiotherapy, because he needed to relearn how to walk - and I was amazed with his development.  

Slowly and gradually, over a few weeks, he went from being wheelchair bound to being able to walk again. So, I said to myself, “Wow, this has really had a big impact on his life and helped him re-learn how to walk”. So that's why I enrolled in physiotherapy, because of that feeling of being able to see someone walk again or recover.

It gives me so much joy. I just feel that it's very rewarding, especially when I was on working on a stroke ward and I would see lots of patients who couldn’t put their weight on one part of the body and then, after a while, because of physiotherapy they were able to walk again, get back some independence and be functional again. It's such a rewarding feeling to be able to see patients move again.

G: So, for me, it all started when I was at 16 to 17 years old watching the Champions League games. Because I'm a football fan, I really like watching football and when I saw my favourite team, Manchester United, I saw the physios treating the players, and I was quite fascinated and thought one day I might work for the club doing something like that. So that made me want to try to become a physio.

Then, during my time at university, everything I learnt was very clinical and very biological. So rather than spending time thinking about which Premier League players I might be treating, I spent more time learning about anatomy and gaining all kinds of different clinical knowledge. And through my placement experiences, I started to enjoy the clinical environment more and more, and I found that I like working in hospitals.

So, I’ve ended up doing something quite different from what I first imagined.

What was it like coming to the UK?

Y: When I first came here in 2003, there was no work for overseas trained physiotherapists. And it wasn't easy for me to get into a hospital to get the supervised best practice the HCPC required me to have. I sent lots of request letters, but I kept being told that their priority was to give places to students who had trained in this country, so it was really hard. It was a very challenging time at the start. And then, when I applied to be a physio assistant, they would say: “Oh, you're already qualified, why are you applying to be a physio assistant?”. So, I would try to explain that it was because I wanted to get experience, and I wanted to get to know the system, because although the treatment and the assessment process was the same, the NHS system itself was different from where I came from.

But it was all just so hard. Thankfully, because of my perseverance and prayers, some people gave me the opportunity to grow and develop in my career, so I was able to make it.

I think it's much easier now, because we have lots of overseas physios coming here, so it's a smoother process now. Things have changed dramatically over the years.

G: I would say I'm really privileged to have had an ample opportunity in Hong Kong to learn English. As it meant that when I came here, I didn’t have any big problems in terms of communication, because most of the time I was able to understand what people were saying and I was also able to communicate with them fluently.

But there are certain things that I had to get used to as well when I came here - like the weather. And also, about making friends or dealing with people communication-wise. For instance, before I came here to stay and to study, I didn't really know exactly what you needed to do when you greet someone here.

Or, when you have something to say, what the most appropriate manner would be to say it. That's something I needed to learn from my mistakes, and from my experience since I came. For instance, people here might ask “How's your day been?” and things like that as a greeting gesture, which is very polite. 

But when I first came here, I thought they genuinely wanting to know what exactly had been going on throughout my day.

So, there would be this kind of awkward moment where they would hear me recap the whole story of my day, since I woke up in the morning.

Have you experienced any discrimination or microaggressions in the workplace, due to your heritage?

Y: Yes, sometimes with elderly patients, or with their next of kin or family members, I feel like they can become selective and maybe won’t say things to me. For instance, say I’m working with somebody else, who is a native of this country – like a therapy assistant - they will usually talk more to the therapy assistant or the other person who is there.

It's probably because they have the same accent, and I don't have the same accent as them. But not all of them are like that. There are just a few who are like that.

G: I’ve also heard some comments from patients, maybe stating something about my race, or telling someone they don't like Chinese people treating them.

They usually say it behind my back, which kind of adds a little bit more to the disappointment, because I just overhear these things.

But I try not to take it personally, because for some patients I know that probably isn’t their intention - and with the patients on my ward, sometimes it may be due to the condition they have, so they can't stop themselves or they may lack some control of their behaviours.

But even when I was not in the hospital environment, like when I’m strolling around in a park, or just going somewhere in Birmingham, I might get comments in terms of my race. Sometimes, it could be happening on a bus - from a bunch of kids – or it could be from someone who is a bit drunk on the bus. 

So, generally, things still happen here, which I think everyone can take steps to address more. We can't change what people think or do because they have their own freedom to choose not to or to do it. But as long as we all try to spread better awareness, as far as we can, then I think that would be the right thing to do.

Do you feel like the physio profession in the UK is becoming more diverse?

Y: Yes, it’s becoming more diverse now, compared with when I just started. Especially in the hospital where I'm working, we are very diverse, which is great. When there’s more diversity there's more equality, and we all understand each other better, and you just feel more comfortable working. I think our trust strongly fosters diversity, and we have very supportive colleagues and managers too and Birmingham itself is a very diverse community, so having a diverse range of staff reflects that.

G: I started my course in 2020, in the middle of Covid, and at that time a lot of Asian students went to study abroad, so I was quite lucky to be one of them.

Since then, I think the course has become more diverse than ever before, because I remember hearing from my seniors that before then they only had three or four students in their cohort who came from Hong Kong – and that was the only place they had foreign students from. 

Whereas for my cohort, I had classmates from Japan, India, Pakistan and loads of places. There are like 20 overseas students, including me, in a cohort of about 90 students, so I would say that was a big step up in terms of diversity.

Have you had any major milestones in your career so far?

Y: I think one milestone I’ve had already is that I’ve been able to work as a senior physio and been able to train and mentor students from three different universities here in Birmingham and one in Coventry. So, I’m grateful that I could pass on the skills and knowledge that I have to the students, at the same time mentor new Band 5 physios as well, while they are doing rotations. I feel like I learned from them at the same time they learned from me, and I also I learned from them while doing a supervision. I think it’s really great that this is where I am now and I'm just grateful.

Being a member of a multidisciplinary team and being able to facilitate the safe discharge of patients to their homes - that already feels like a great milestone in my career.

Another one was being a CSP Steward from 2021 to 2024, which gave me the opportunity to help other members and network with other CSP stewards and reps in the West Midlands.

G: Well, because it's very early on in my career, I am still waiting for my major milestones to come. But, when I was a student, I got a chance to be invited to be one of the medical volunteers at the Commonwealth Games in 2022, which were held in Birmingham. So, I attended an interview, and I was very honoured to be selected.

It gave me a chance to learn a lot, not only on the clinical side of things but also to be a part of the community in such a big event. I was very honoured to meet a lot of people and to build connections, and it gave me a lot of experience that I think I could apply in different areas and clinically. So, I would say that was a major step in my career.

Do you have future goals that you're aiming for?

G: Well, during one of my placements, I found out I really enjoyed paediatric physiotherapy quite a lot, because I had a chance to work at a Children's Hospital. So, I can see myself within the next 10 years working in a paediatric setting – and ideally in an inpatient environment as well. So that's something I can aspire to, to become a paediatric physiotherapist. 

But right now, I still want to gain more experience in different areas before going into paediatrics, because I'm pretty sure once I go into paediatrics I won't leave it – so as I’m still young and it's early on in my career I want to experience different things first.

Y: I want to keep challenging myself to learn more. There are a lot of training courses in the trust that I want to take, and different leadership skills that I want to gain. I always want to learn and progress, and I would like to do a master’s degree.

What advice would you give to other physios who come to work or study in the UK?

G: Based on my own experience, what I would say to them is: try to embrace the new things you have encountered here, both the good and bad. I know it can be quite hard, but try not to be afraid of the challenges you encounter, because everything takes time for you to get used to it.

Y: I would say: become a CSP member, because then you will have support. You’ll be kept updated about physio research, current events and news, there are free online courses available on the CSP website, and they’ll be an advocate for you at work. I always ask students and junior physios, on their first day, “Are you a CSP member?” and encourage them to join…I’m always promoting it.