First job as a physio: primary care, hospital or abroad?

Your diploma is almost in (or is already on the table) and you are about to take your first real step as a physiotherapist. Exciting. Perhaps also a bit overwhelming. Because how do you choose between that practice around the corner, that hospital where you did your internship, or that adventurous option abroad?

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Good to know: your first job is not your final destination. It's a starting point where you can discover yourself as a therapist, find out which patients you'd like to treat and where you can chart your path. Give yourself that space and don't stare blindly at the idea that this choice should be forever.

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Let's go through the three most common options.

Option 1: Frontline — Speed and independence, but workload

Primary care is where most physical therapists start. You work in a practice where patients (usually without a referral) walk in with all kinds of complaints. From that athlete with an ankle injury to that man who sprains his back while gardening. So a lot of variation.

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What it offers you? You quickly build up your own caseload, learn how to deal with many different complaints and gain a great deal of independence. It is dynamic work where you gain a lot of experience very quickly.

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But there is also a downside. The frontline in the Netherlands has no collective agreement. You have to negotiate your salary and employment conditions yourself. As a starter, you earn an average of between €40,000 and €53,000 per year, which is considerably less than in a hospital or what you earn in Switzerland: €80,000 to €90,000 per year. You often do administration in your own time, you often pay for education yourself, and you have to arrange a pension plan yourself. The workload is also tough: tight schedules, little time per patient, and your file also needs to be updated.

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Still, the frontline can be a great place to start. If you want to grow fast and are not afraid of a tough working week, you can really sink your teeth into this. Do choose a practice that really invests in you.

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Option 2: Hospital or rehabilitation — Multidisciplinary learning with a fixed structure

Working in a hospital or rehabilitation center is a completely different world. Here, you treat more complex patients and work closely with doctors, occupational therapists and other specialists. This multidisciplinary aspect is extremely valuable for many starters.

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The big advantage? You have a collective agreement. Clear agreements about salary (what is often 45-61% higher than in primary care), fixed working hours, paid training and a pension plan. You are taken seriously as a professional and are often given the space to specialize. Do you want to focus on orthopedics, neurology or geriatrics? In a hospital, you can grow up that way.

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The flip side? The work is often more protocol-driven. You have less freedom and must stick to the way the institution works. For some physios, that feels like a straitjacket; for others, it provides rest.

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Also important: the competition is fierce because the employment conditions are better. But when you get into it, you really have a solid foundation to build your career.

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Option 3: Abroad (such as Switzerland) — Higher salary, adventure and contract security

And then there is option three: the big step. Switzerland is a popular choice, and for good reason. The salary is simply a lot higher: as a starter, you earn between €80,000 and €90,000 gross per year. That is almost double the size of the Netherlands. And although life in Switzerland is more expensive, there will be a lot more left at the end of the month.

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But it's not just about the money. Working in Switzerland also means that physical therapists are seriously valued. You often have more time per patient, less red tape and better employment conditions. You'll build work experience in a different context and discover what really works for you as a therapist.

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Of course, there is also a downside. You must learn the language within two years (German at a minimum B2 level), say goodbye to your familiar environment and adapt to a new culture. But for many physios, that's just the beauty: you're not only growing as a therapist, but also as a person.

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Do you want to consider that step? Then make sure you are properly supervised. For example, take a look at how the takeoff process works: from application to your first day of work. And don't forget: you can always go back. This step is not irreversible.

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Job interview checklist: what to ask?

Okay, you've made a choice and you're about to have an interview. What questions should you ask to find out if this workplace really suits you? Here are the most important ones:

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Working conditions:

• What about the salary? Will I receive a collective labor agreement salary or do we have to discuss it individually?
• What are the secondary conditions? (Think of vacation days, pension plan, travel allowance)
• Will I get vacation pay and a 13th month?

Education and development:

• Does the practice/institution pay for my courses and courses?
• Do I get time to attend courses during working hours?
• Are there opportunities for growth within the organization?

Workload and planning:

• How many minutes do I get per patient?
• How much time do I get for administration and file keeping?
• What is the expected weekly caseload?

Guidance:

• Will I get a mentor or counselor in the beginning?
• How often are there intervisions or team meetings?
• Can I ask colleagues if I have any questions?

Culture:

• How would you describe the work atmosphere?
• What type of physical therapist is a good fit for your team?
• What are the long-term expectations?

Feel free to also ask if you can join us sometime. Then you'll get a much better feel about the job than during a formal job interview.

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Why you can still switch later

Your first job doesn't have to be perfect. It's a learning phase where you discover what you like and what you don't. Where you can see if you prefer to work with elderly people or athletes. Either you love protocols or, on the contrary, you love freedom.

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If, after a year, you notice that primary care isn't your thing after all? Then you switch to a hospital. Do you find yourself looking for more adventure? Then you're still looking abroad. Many physios make multiple switches in their early years. And that's ok. Your career is not a straight line.

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Get off to a good start, grow further

Your first job is a starting point, not a destination. Choose a place where you feel welcome, where you can learn, and where you have the space to develop yourself. Whether that's in the front line, in a hospital or on the other side of the border.

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Want to know more about working in Switzerland as a starting physio? Check out our vacancies whether get in touch for an informal conversation.

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And remember: no matter what choice you make, you can always switch. Your first job is primarily a stepping stone for your career. Get off to a good start, grow further, and discover what really suits you.

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