Hi! My name is Aly, and I’m a second year DPT student at Texas Woman’s University in Houston, TX. Last month, I took my first pelvic floor and Women’s Health continuing education course. I had a lot of questions throughout the whole process, so I thought I would share my personal experience in hopes of persuading another student like me to take the leap.
Before starting my DPT program in 2015, I knew little of Women’s Health or pelvic PT, save a few mentions of Kegels. My introduction to Women’s Health came from Dr. Kimberlee Sullivan of Sullivan Physical Therapy in Austin, TX, who gave a guest lecture to my class in our first semester. I was intrigued and curious, and appalled at the lack of knowledge and care offered to women and men with pelvic pain, but still wasn’t totally convinced. Did I really want to be all up in someone’s business all day?
After a second lecture in my second year by Dr. Uchenna Ossai, I knew it was something I wanted to pursue. I talked to my Director of Clinical Education and set up my internship with a Women’s Health therapist, who strongly recommended I take a Pelvic Floor 1 course before my rotation. This was not something I had considered doing (“I’m broke; why am I taking continuing education before I’ve finished my first education? When do I find time for this??”), but after she mentioned it, I realized I wouldn’t be able to get the most out of my internship without it. Internal pelvic floor exams put our patients in extremely vulnerable positions, and learning and practicing a proper exam before treating patients would be ideal.
This is where all my questions began. I looked for classes to take through the Section on Women’s Health (SOWH) and Herman and Wallace Pelvic Rehabilitation Institute (H&W). Both offer a Pelvic Floor series of courses, but may cover different topics in different courses. Both Pelvic Floor Level 1 courses include external and internal vaginal pelvic floor exams, and each participant is expected to participate as both a therapist and patient within the labs. The SOWH course covers the topic of urinary incontinence with deeper anatomical and physiological explanations, while the H&W course more briefly covers urinary incontinence and other urogynecologic pain syndromes. A friend who has taken both courses enjoyed H&W for the repetition of important and basic knowledge in an easy to understand way, and enjoyed SOWH for all of the evidence based research you are provided with throughout the course. Please note that I am not endorsing one course over the other, as both would be excellent choices to get your feet wet.
Some other considerations when choosing a course are location, timing, and price. When looking at the cost of the course, you also have to consider if you’ll be paying for a flight, a hotel, and food for the weekend. Before deciding which course to take, I would recommend checking if either course is being offered in your city, in a city within driving distance, or in a city where you would have a place to stay, as this would significantly reduce the burden of cost.
Next, I would look at the timing of the courses being offered. If you’re starting a rotation, do you need to take a course before you begin? Can you take it during your rotation? Do you have a Friday off from school or rotation that corresponds with a date that the course is being offered? It’s also important to realize that these courses typically fill up 2-3 months prior to the date, so being organized in advance is a must. You can put your name on a waitlist if the course is full, but there is no guarantee a spot will open up.
Finally, you’ve already considered price with the location of the course, but as a student you’re also eligible for discounts. H&W offers a 10% student discount, and SOWH offers a student discount as well as a member and multiple course discount.
Another thing you may want to consider in the long run is the certifications you are able to get obtained based on the courses you take. If you take the series of Pelvic Floor courses through the SOWH, you are eligible to apply for the Certificate of Achievement in Pelvic Physical Therapy (CAPP-Pelvic). The Pelvic Rehabilitation Practitioner Certification (PRPC) is another certification offered through H&W. You don’t have to take any specific courses for this, however the H&W courses and resources are helpful for preparing. Finally the WCS is the board specialization exam you sit for after completion of a residency program or 2000 hours of patient contact hours in Women’s Health.
I chose to take the H&W course because there was one being offered in the city I live in at a convenient time for me, and also because I was still in my second year when I took the course. The SOWH policy for continuing education courses is that only students in the last half of their third year are able to attend. However, I know they are re-evaluating this policy, so stay tuned.
I was so excited after actually registering for my course, even though it was 2 months away. I couldn’t wait to learn all the pelvic floor things I hadn’t learned in school. Having that 3 day spread in all caps in my planner was something I looked forward to every time I flipped to March.
Then, before I knew it, it was the Thursday night before the course and it hit me. I was super nervous. Beyond the worries of taking my first continuing education course (“What if I’m the only student?” “What if I don’t understand anything they’re talking about?” “What should I wear?” “How long will it take to get there?”), there was the obvious “I’m going to see another person’s vulva tomorrow.”
And then the, “Someone else is going to see my vulva tomorrow.”
And then, “Why am I doing this again?”
Luckily, I have a new grad friend working in Women’s Health who was able to give me some advice and talk me down from my panicked state. But, I still went to bed and woke up pretty darn nervous.
I arrived to the course early on Friday morning, because nothing makes me more anxious than running late. And trust me, late anxiety and vagina anxiety combined would have been way too much for me to handle. I saw a friendly face while registering and had a friend to sit next to which definitely helped soothe the introvert in me.
There were about 50 people taking the course, 2 instructors, and 4 teaching assistants. I was one of three students, and there was a wide range of experience amongst the practitioners in the room, from those learning about the pelvic floor for the first time to those who were expanding their knowledge for their current practice. Physical therapists, physical therapy assistants, and occupational therapists were all represented. The course began with introductions, goal setting, and an overview for the course. It would be 3 days long, with lectures and labs on different topics occurring each day.
In addition to being extremely qualified and knowledgeable, the instructors were warm and welcoming which helped me to realize that I was in the right place despite what the knots in my stomach were telling me. By the time the second lecture was over midway through the morning, I almost felt completely at ease with the same excitement I had first had when registering for the course.
And then it was time. The first lab was upon us. The instructors did a great job of addressing the elephant in the room and letting everyone know it was okay to be nervous and to participate to your comfort level.
Many of the students (including me) prolonged our break time by waiting in the long bathroom line, grabbing an extra drink of water, and awkwardly meandering around looking for a partner. We introduced ourselves, and then both confessed to how nervous we were. After realizing that a lot of the participants felt the same way I did, I felt better. After the first lab was finished, it felt like a weight had been lifted. It wasn’t nearly as difficult or uncomfortable as I had made it out to be in my head. Examining and evaluating a pelvic floor could be much like any other part of the body. As the weekend continued, it only got easier.
I learned so much at my first Pelvic Floor 1 course and am glad I decided to take it as a student to reaffirm my interest and prepare me for my internship in Women’s Health.
Here are some other questions you might have about taking a PF1 course and may be too embarrassed to ask:
- Male therapists are welcome at both courses. For the SOWH courses, male participants are required to bring a lab model with them for the lab portion of the course. In the H&W course I took, the male participants were not required to bring a model, and were allowed to participate to the comfort level of the female participants. Female participants who were comfortable being a “patient” for a male participant were asked to invite male participants to be a partner, or males were able to observe in groups of 3 with willing female participants.
- You are able to participate in the lab portion of the course as a patient if you are menstruating. In my course, this was up to you and your comfort level, but there is no contraindication to internal vaginal exams while on your period.
- If you are pregnant, you need to bring a medical model or a letter from your physician that clears you to participate in labs.
I’ll leave you with two of my favorite things I learned at the course. The first one came from Dr. Jessica Reale, one of the instructors, who eloquently stated that after delving into Women’s Health and pelvic PT, it’s important not to “get sucked into the blackhole of the vagina” and never come out. While we’re learning how to treat the pelvic floor internally and externally, it’s important to take a step back and make sure we’re holistically treating the whole patient, regardless of what approach we take.
Secondly, Dr. Holly Tanner, the other course instructor, spoke with us about how much body language, words, and the way we say them matter to our patients. One of my favorite quotes from the weekend was “Stand in front of the mirror and watch what your face does when you say vagina.” We need to feel comfortable speaking with our patients about topics that they may feel uncomfortable about to put them at ease, whether we are Women’s Health therapists or not.
While I don’t claim to be an expert, I hope this helped answer some questions you may have had about taking a PF1 course as a student. Please feel free to reach out to me if you have any additional questions and I’ll do my best to answer them! I hope this inspired you to take the next step in your journey into pelvic PT!