Career paths of male physical therapist students entering a female-dominant profession
Rozier, Carolyn K
Female-dominant professions, including physical therapy, are attractive to men for a variety of reasons. What is unknown, however, are some of the factors that enter into the career choices of male physical therapist students who enter a female-dominant profession. A qualitative study was undertaken that involved analysis of 20 interviews of male students. A theory, grounded in the data, was developed and is presented as a model for the development of the career paths of male physical therapist students. Gender stereotypes, reflected in the beliefs and knowledge of other health care professions and in attitudes about roles and responsibilities, influenced the initial physical therapy career choice as well as future career plans. Life experiences such as an orthopedic injury or interest in sports often led to the discovery of physical therapy as a career choice. However, most students did not know that physical therapy is a female-dominant profession when they first became interested in the profession. The model also provides insight into factors that affect students’ future employment plans.
Key Words: Career choice, Female-dominant profession, Gender, Physical therapy.
Occupations may be segregated by gender if the particular attributes of the job are viewed as masculine or feminine and if the majority of workers are male or female.1 This gender segregation of professions may be a factor in the career choices made by both men and women. Although women are more likely to select a traditionally male-dominant career, men may be discouraged from selecting a female-dominant profession because of perceptions that the attributes of the job are feminine.2-5
Historically, physical therapy has been a profession consisting of a higher percentage of females than the percentage in the general population. The first physical therapy professional organization in the United States was called the American Women’s Physical Therapy Association. Men did not begin to enter the profession in increasing numbers until after WW II.6 Today, men make up 30% of the membership of the American Physical Therapy Association.7
Previously, research has focused on the career development of women entering male-dominant professions.8-12 Kanter8,9 developed the classic theory of tokenism in which the minority women in dominant male groups are described as tokens. These tokens experience increased visibility, yet with isolation from male peers, they are subjected to increased performance pressure and react by underachieving. Kanter believed that if men were tokens in a female-dominant profession, they would experience similar pressure. However, in a study of male nurses, Heikes13 determined that the male token experience led to higher status in the profession. Snavely and Fairhurst14 found that male nurses did not respond to token pressure by under-achieving. Male nurses, teachers, librarians, and social workers actually felt pressure to move into more prestigious and higher-paying positions.15 Further research by Houser and Garvey16 showed that the support of significant others (especially men) was a powerful influence for a woman to enter a nontraditional field.
Research into the male minority experience in a female-dominant profession and the reasons why men choose to enter such a profession indicates that these men may make career decisions or be influenced in their choice in a different way than men who enter a male-dominant field.13,15,17,18 Men enter gender-atypical careers in times of economic stress or upheaval, when jobs are not readily available in gender-typical fields, or when they perceive that opportunities for advancement are not available in gender-typical fields.19,20 For instance, men may more readily enter the female-dominant profession of nursing, if they perceive that jobs are readily available and that they will be able to rise quickly within the profession into various leadership positions.21-23 In nursing, however, men are generally discouraged from choosing this career because the roles of the nurse are not perceived as masculine.2 In general, gender segregation of occupations may discourage people of the opposite sex from considering such occupations.2 In addition, research focused on males entering female-dominant professions revealed that people entering non-gender-typical careers were influenced to make that choice by others in that career of either gender.20 Factors also have been identified that discourage men from pursuing gender-atypical careers, such as the belief that female-dominant careers have less social desirability and prestige than male careers24 and the belief that fathers tend to disapprove of sons pursuing gender-atypical careers.25,26
In order to study why men enter gender-atypical careers, several researchers have focused on male nurses, because nursing is so obviously a female-dominant profession.23 Boughn23 found that men choose nursing for job security and salary, but that they also have a desire to care for others. In addition, these male nurses believed that a nursing career would give them a sense of power. McCutcheon27 determined that men in nursing had more feminine characteristics than men in gender-typical careers, but male nurses did not have more feminine characteristics than men in general. Barkley and Kohler22 found that high school males did not generally perceive male nurses as feminine, but 90% of those surveyed would not consider a career in nursing. As a group, male nurses tend to choose to work in specialty areas that are considered more masculine, such as emergency department care, administration, anesthesia, and higher education.26,28,29
Various studies have attempted to identify characteristics of allied health careers that appeal to students.30-34 Rider and Brashear30 were the only researchers to attempt to identify specific factors that males found attractive about the female-dominant profession of occupational therapy. They identified high salaries and advancement opportunities as attractive factors. However, in contradiction, Posthuma35 indicated that low salaries and lack of opportunity for advancement were reasons why men might leave the occupational therapy profession.
Although salary and advancement opportunities are 2 factors that are important for men in occupational therapy, no study has examined factors that are important for men choosing a career in physical therapy. Buchanan et al36 studied factors influencing selection of a first job in physical therapy, and Pearl37 studied reasons clinicians remained in their positions, but neither study indicated separate factors for males.
Recently, research has emerged that attempts to provide insights into the processes men use to choose careers in traditional female professions such as nursing.13,14,38 Although available research identifies factors that are important to choosing a career to physical therapy, the specific factors influencing career decisions of male students to choose the female-dominant profession of physical therapy have not been identified.33,36,37,39 The purpose of this study was to examine the career decisions and paths of male students to determine a common career development process toward a career in the female-dominant profession of physical therapy.
In considering the study’s purpose, a qualitative research approach was appropriate. Qualitative inquiry seeks to understand, explain, and/or develop theory about human experiences using a holistic approach. Many qualitative methodologies exist, arising out of the fields of anthropology, sociology, and education. Because this study on the career paths of male physical therapist (PT) students sought to develop a theory of their career development process, Strauss’ Grounded Theory was used.40 Grounded Theory was designed especially for generating and testing theory. Distinct features of this style of qualitative analysis include theoretical sampling and methodological guidelines such as making constant comparisons and the use of a coding paradigm.
General Procedures for Grounded
In general, qualitative research is not a linear process. Gathering data, analysis, and writing occur throughout no matter the qualitative method used. Although not linear, the general sequence used in Grounded Theory is:
1. Collect data (identify participants and gather experiential data).
2. Conceptualize data through coding.
3. Look for core categories central to the integration of the theory.
4. Gather more data based on analytic grounds and for theoretical purposes (theoretical sampling).
5. Make comparisons according to various subdimensions.
6. Continue until analysis no longer contributes anything new.
7. Organize theory components by noting, linking, and building theory through memos and diagrams.
Participants in qualitative research are individuals with knowledge about and experience in the phenomenon of interest. Therefore, the target population was male students enrolled in the final year of a professional (entry-level) physical therapy program in the united States. All of the participants were called from purposive lists of male PT students solicited from physical therapy programs located in California, Louisiana, Missouri, Mississippi, New York, Ohio, Texas, and Wisconsin. Researchers randomly chose 15 men to be interviewed via telephone, and these interviews were the basis for the development of the theory. Researchers also randomly chose 5 additional men to interview, and these interviews were used to validate the theory. The participants ranged in age from 22 to 43 years, with a mean age of 29 years.
Confidentiality was maintained throughout the study. Researchers conducting the telephone interviews knew only the participant’s name and telephone number. The participants had no knowledge of each other. In addition, verbatim quotes used in this article are illustrative, and no identifiable information, such as name or state, was attached to specific quotes.
Data Collection Instrument and Procedures
Because the purpose of the study was to develop a theory of career choice and development of male students in the female-dominant profession of physical therapy, the researchers developed open-ended questions to allow full elaboration of the phenomenon. Rozier and colleagues41,42 developed initial questions from the results of a questionnaire concerning gender-based differences in physical therapy. These initial questions were modified after completion of 4 practice interviews with male students. Modifications clarified questions that the men did not answer fully. A few questions were changed to allow better flow from a frequently given answer to the next related question.
The interview questions were worded such as to allow participants to determine what they would talk about within broad parameters. Interviewers used familiar appropriate colloquialisms so that the interview appeared more as a friendly conversation than a formal interview. This is consistent with a qualitative paradigm. Broad questions included,
Tell me a little about your background. Tell me a little about your family life growing up. Why did you decide to pursue physical therapy? What has physical therapy school been like for you as a guy? Create an image of yourself in 5 years.
If these general questions did not elicit a full elaboration, the interviewer had additional questions. For instance, under the general question,
What has physical therapy school been like for you as a guy?
the interviewer could ask,
What percentage of the class is guys?
Can you give examples of how you socialize with female students?
In question development, the researcher assumed that all participants were aware that physical therapy is a female-dominant profession. However, after the first 7 interviews, it became clear that this assumption was false. Therefore, an additional question was added to the remaining 13 interviews regarding the issue of when participants realized that physical therapy is a female-dominant profession. This additional question ensured a precise, direct answer that did not require researchers to draw an inference from answers to other questions.
The data consisted of information obtained in semi-structured interviews conducted via telephone. Interviews varied between 30 and 50 minutes in length, were recorded on audiocassettes, and were transcribed verbatim. Researchers entered the transcribed interviews into a HyperResearch* computer program for data management.
To put participants at ease and encourage frank elaboration, 2 male interviewers, who themselves were second-year students in a professional physical therapy program, conducted the interviews. Thus, researchers assumed that the participants answered questions truthfully from their own point of view. This assumption may be false. To combat this potential design limitation, the subjects were told only that the research concerned the male experience in physical therapy.
Another potential design limitation concerning interviewers is that the same person did not conduct all interviews. Interviewers may have differed in their skill to elicit full, elaborate answers. In addition, some participants were more difficult to interview, offering little information to some questions. This problem was compounded by the need to maintain participant anonymity, thus precluding member checking. Researchers addressed this potential design limitation in 2 ways. First, all interviewers completed 1 or 2 practice interviews, which were then reviewed by the primary author along with the interviewer. Second, beyond the initial data analysis and theory development, researchers sought clarifying information from additional participants using informal theoretical sampling and added a validation phase to the study.
A single researcher could introduce theory bias. To address this issue, 2 researchers developed an initial version of the theory, and 2 different researchers validated the theory.43 Two researchers analyzed each interview line-by-line and word-by-word to conceptualize the data in code. A coding paradigm emerged from the data that included core categories such as “Career Choice,” “Expressed Gender Role Stereotypes,” “Career Plans,” and “Family Influences.” As stated previously, data collection and data analysis occurred simultaneously; therefore, interviews continued until analysis revealed no new categories. Two additional researchers revised the categories and developed a grounded theory of the career path development of male PT students. Peer-review sessions were held with faculty and student researchers to review the theory as it emerged from the data along with the related memos and diagrams.
Informal theoretical sampling sessions were held with male PT students at the authors’ institution to solicit their opinions of the theory. These male students were asked if the theory reflected their experiences. Thus, researchers were able to explore the core categories and the relationships between them for confirming or disconfirming cases.
For the study’s validation phase, 5 male students who had not yet been called were randomly selected for interviews. A male PT student interviewer asked these participants questions similar to the questions used in the original interviews and included questions seeking clarification of and agreement with issues developed in the grounded theory. Two researchers analyzed and coded these interviews based on categories that emerged from and related to the grounded theory. Researchers used peer review to determine the parts of the grounded theory that appeared to be confirmed by the additional interviews.
A theory outlining the primary influencing factors on the career paths of male students who enter the female-dominant profession of physical therapy emerged from analysis of the interview data. All of the participants were influenced by similar factors involved in their career paths: (1) “Career Choice-Physical Therapy” included codes describing how they chose physical therapy, other careers considered, and factors that led them to consider physical therapy; (2) “Physical Therapy School” represented the common point on the career path for all participants, including description of their experiences, male/female ratios in class, and relationships with faculty and other students; and (3) “Future Plans” included codes indicating any specialty interest and 5- and 10-year job predictions.
As the data were analyzed, 6 categories emerged in relation to factors influencing the career path: (1) “Beliefs/Knowledge About Health Care Professions,” (2) “Roles/Responsibilities,” (3) “Values/Interests,” (4) “Gender Stereotypes,” (5) “Life Experience,” and (6) “Role Models.” The Figure illustrates the relationships among the categories and how each category affects the career path. An arrow from one category to another indicates the direction of influence between categories. The major influences of the choice of physical therapy as a career are related to the participants’ previous beliefs, knowledge, values and interests, and current and future responsibilities. These same influences had an impact on what they anticipated for their futures. All of these influences made up part of the life experiences of the students. Gender stereotypes influenced the participants’ beliefs, knowledge, roles, and responsibilities. The issue of role models was found to be derived from life experiences, but it was unclear how the category “Role Models” directly influenced the factor “Career Choice-Physical Therapy” or “Future Plans.”
Beliefs/Knowledge About Health Care Professions
All of the students had previous knowledge of other health care professions, but none of the male students indicated that their career choice was based on whether or not the career is female- or male-dominant. Responses about their knowledge of the profession of medicine revealed a prevalent belief that physicians do not spend as much time with patients as do other health care professionals. One student said,
I don’t like the fact that they don’t have a lot of patient interaction. I’m kind of a people person, so I like the people part of physical therapy.
The idea that physicians did not have a life outside work was a concern. Another student said,
I decided I wanted to have more of a family life than a physician might have, and I thought that physical therapy kind of had the best of everything.
Most had not considered any other female-dominant profession, and those who considered nursing had ruled it out because,
…the thing about nursing is there’s no autonomy.
Another student indicated that if he had gone into nursing,
…[he] probably would have preferred going into something like being a care flight nurse or nurse anesthetist or something like that, which…would be more masculine.
Those who did not say they had considered nursing were asked why. Many said it was because they believe, in the back of their minds,
…that society views it as a really female-dominant profession and…[they] don’t think society views physical therapy in the same way.
Thus, the students’ knowledge of other career choices and related gender issues influenced their decisions to choose physical therapy.
The men reported that they learned that physical therapy is female-dominant when doing volunteer work, right before entering physical therapy school, or not until they were in physical therapy school. Common comments were made such as,
Before I got into it, I wasn’t completely aware that it was that high a percentage…. I quickly learned that it is a female-dominant profession.
I didn’t realize it until I got in and they announced on our first day of physical therapy school that our class pretty much fit the statistics of male to female.
One student said,
Actually, I pretty much realized it when I was doing volunteer work. I was working with all women.
When I saw the ratio was, what is it, 11 guys and 25 girls in our class, that was my first indication.
That particular student indicated he had believed physical therapy to be a male profession because of his experiences:
I guess my personal experience with physical therapy was from a sports injury…and in those outpatient clinics that I have been at, I have seen that they [therapists] are predominately male or at least half and half.
The fact that physical therapy is a female-dominant career was not acknowledged by the male students early in the process of career choice, but gender issues related to their choice of physical therapy were expressed through the category “Beliefs/Knowledge About Other Health Care Professions.”
The participants’ roles and responsibilities included those of student, husband, father, and boyfriend. Nine of the students were married; 5 had children. All participants acknowledged the stereotype that men were traditionally the primary breadwinners, while women raised the children. When considering how this stereotype might affect PTs, one subject stated,
More men are in administration, because they are more apt to take those positions, whereas women are more relegated… [to] having kids and maybe they just don’t have the time to take more responsible positions.
A subject acknowledged that the role as breadwinner affected him when he said,
We have kind of determined that my wife won’t work for awhile, at least not fulltime, and so I am always kind of thinking about…how much money will I be bringing in, how much money will we need?
Thus, students acknowledged that their own roles did influence their career choice.
These male students believed that compassion is one characteristic of a good PT, and because the personality trait of compassion is considered a feminine quality, the issue of gender roles is raised within the category “Values/Interests.”44-46 One student indicated that,
I get the impression that they are trying to teach us to be compassionate.
But I think a male can be compassionate also.
As far as something they liked about physical therapy, all mentioned that working with people was important to them. However, a majority of students also named a good salary and job security as being important. When asked to name characteristics of a good PT, many different traits were mentioned, with compassion and intelligence being common themes. Some expressed the need for respect. One student said,
I went into physical therapy for a number of reasons: my belief that it was a well-respected and well-thought-after profession.
An interest in sports, a masculine theme,44 was another common theme, as expressed by one student,
I’m very sports oriented, so I played some sports in college.
When asked about how more men entering physical therapy might change the profession, no common theme emerged. One student said,
I really don’t have any feelings that a male or female will make a better therapist. I think it comes from the heart, not the hormones.
The expression of gender stereotypes was not considered as strong in this category compared with “Beliefs/Knowledge” or “Roles/Responsibilities”; therefore, in the Figure, the category “Values/Interests” is not circled for gender stereotypes.
Career Choice-Physical Therapy
Students expressed various individual reasons for choosing physical therapy as a career, indicating that beliefs and knowledge about health care professions, roles and responsibilities, and values and interests all influenced their choices. The majority of students had considered medicine, but most expressed dissatisfaction with the time that medical school requires, as indicated by these comments,
I’m 30 years old. I didn’t want to put in the extra time that medical school requires.
If it didn’t take so much time and energy, I think I would have probably pursued medical school.
Gender issues did seem to exdude nursing from consideration, as one student mentioned,
It did have a female connotation to me, that just females are nurses, which is really wrong…. I probably shouldn’t be thinking that.
In addition, an interest in sports or an interest that developed as a result of an athletic injury influenced other students, as stated by this student,
I am a relatively athletic person, and that was something that attracted me [to physical therapy].
The role of breadwinner for a family and the participants’ views of how a career in physical therapy could provide for a family, or provide them time to spend with their families, also affected the career choice. As one student explained, he wanted to be able to find a job easily:
I have 2 kids and 1 on the way, and it is very important that I find a job right away.
Another example is one of a student who believed that physical therapy would allow him time with his family. He said,
I wanted to have a family and wanted to have a family life.
Physical Therapy School
All of the students reported that family and friends supported them in their decision to go to physical therapy school, and, in general, students reported that their parents supported them. None of the students mentioned that family or friends expressed any concerns about a male choosing a gender-atypical career. The majority of these students attended class with more or an equal number of females and were taught by more or an equal number of females. Only one student reported a male majority faculty. AU students believed they were treated the same as the female students and felt accepted in their class. As one student said,
We actually have a pretty good relationship, the whole class, guys and girls get along quite well.
Another student was enthusiastic about his class and said,
I would say all of us guys are very well accepted by the female students…we all go out and party together, or study, or whatever, and we celebrate everybody’s birthday, and we have little parties, and I would say it’s definitely a good little clique.
The most common description of physical therapy school unrelated to gender issues was that it was more difficult or challenging than their previous education.
The students all expressed interest in eventually working in a specific area of physical therapy, with the majority interested in outpatient orthopedics/sports but with pediatrics also sometimes being mentioned as an additional interest. As one student said,
I want to try pediatrics sometime soon…. I had a little taste of everything except pediatrics….
Another student indicated,
I am keeping my hand in pediatrics…to keep my options open.
and another indicated,
I have a child, and I have worked a little bit in pediatrics, and I think I might be interested in something like that.
Orthopedics/sports can be considered to be a masculine-oriented specialty,44 and the desire to manage their own practice, become an administrator, or gain further training19 also can be considered typical of a male career path. Only one student did not profess to have a masculine-oriented future plan such as to practice in orthopedics/sports, to own a practice, to be an administrator, or to gain further education. That student was the oldest subject and indicated that future plans included retirement. Most participants, however, indicated they wanted a position of more responsibility, or some sort of management type of position. Some students said,
I could see myself working probably in a sports medicine clinic.
I do have some ambitions of possibly getting some management.
…owning my own corporation, running managed health care right out of the United States.
The students had varied educational backgrounds, with the majority reporting previous physical therapy volunteer work or work experience in a variety of settings. Previous careers included occupational therapy, nursing, business, fitness training, or various jobs such as manual labor, sales, and deep sea diving. A common experience for all students was that they had experience in athletics or had sustained an injury that introduced them to physical therapy. These life experiences affected their values and interests and their knowledge about health care that, in turn, influenced the choice of physical therapy as a career. An example is one student who initially read about physical therapy in Sports Illustrated and said,
Then when I blew my knee out and really got into it, that’s what kind of turned me on to it.
Their lives led them to physical therapy, as illustrated by this comment,
Actually, it started with my knee, and then I started volunteering for the hospital that I had my knee surgery done in…a couple of months after that, I started volunteering for the outpatient clinic that I was getting my therapy at. Then I took on jobs in both places while I was going to school and then had a job working for a work hardening center. I pretty much worked the last 6 years in physical therapy every vacation that I could get.
All of the students reported having role models who they admired and/or who influenced their lives. All, except one student, reported a PT as a role model. Students reported both males and females as role models. All students expressed the idea that both their mothers and fathers influenced them, with some reflecting that both parents had an equal influence and some that their mother had the greatest influence. Only one student listed his father as having a primary influence on his life. Like his father, who had an MBA degree, this student had originally gotten a degree in business. However, his mother also had a business background, teaching high school business classes. Participants did not indicate that their parents influenced their choice of physical therapy as a career. More often, a therapist, or other role model, was indicated as influencing career choice, but only after the student had become interested in physical therapy. One student described a therapist who helped him get into school,
She kind of took me under her wing and tried to teach me as much as she could and help me as much as she could to get into physical therapy school.
The very first role model was my own physical therapist that I had that worked on my ankle.
A direct link from the category “Role Model” to the category “Career Choice-Physical Therapy” was not indicated, but an indirect influence was indicated through the category of “Life Experiences.”
Although each student expressed some gender stereotypes, not all mentioned the same one. The most common male stereotype mentioned was that men are more assertive or aggressive than women. For example, one student said,
Women are too passive, like some of the women in our class are just too dang passive, and I can’t see them being PTs. I can’t see them motivating patients like patients need to be motivated.
This difference between male and female was also expressed in relation to aggressiveness in their careers. One student said,
The males are definitely out there to own their own business, make the bucks, make a name for themselves, maybe sometimes lose sight of why we actually got into it for-patient care.
The most common stereotype expressed about women was that women are more compassionate than men. Evidently, the issue of gender was a sensitive one for the participants, because over half of the participants said they did not want to express a stereotype or they tried to be positive when speaking about gender differences. For instance, one student stated,
Ideally, I guess it would be nice if men and women contributed equally to the profession.
And another said,
The stereotype answer would be that the males perceive that it [going into pediatrics] could sort of stigmatize or demean their manliness.
Gender stereotypical beliefe held by the students were expressed in the theory and influenced the categories “Beliefs/Knowledge About Health Care Professions” and “Roles/Responsibilities.” These categories then influenced the factors “Career Choice-Physical Therapy” and “Future Plans.” A prevalent gender stereotype about nursing, for example, was,
I do have it in the back of my mind that society views it [nursing] as a really female-dominant profession [thus, implying that physical therapy is not female-dominant].
A further stereotype regarding male nurses was that men are more career-oriented, whereas females are more patient-centered, as one student expressed,
Yeah, most of the men that I know are more concerned about getting ahead and being promoted…and the women are more concerned with patient care.
Role stereotypes were further revealed when beliefs about physical therapy were discussed. One of the expressed stereotypes was that most male therapists like sports, as this student stated,
It is possible that they [men] look at outpatient orthopedics as being more sports oriented, and if you look at sports, like football, and the injuries in basketball, it is mostly male-dominated.
The stereotype of pediatrics being a feminine specialty was prevalent because of, as one student said,
I guess it’s just back to that motherly thing, I gotta go back to that caveman instinct and say, you know, the motherly instinct and the caring and nurturing, I would say that is probably what leads so many females to be in that [pediatrics]….
When management and salary in physical therapy were discussed, the majority of students believed that there are more male than female managers. When asked why this might be the case, perceptions of the students indicated either male stereotypes or female stereotypes. One student outlined the career interest of men as,
…power, money, prestige. ‘Cause it’s in their [men’s] nature.
Another student indicated why fewer women might be in administration,
Because they’re [women] just satisfied getting out with their degree and working for somebody.
One student even rejected the idea that it is a female profession. When asked why the profession is female-dominant, one student said,
I would think that it would be more male because to me physical therapy is for the masculine profession.
In the category “Roles/Responsibilities,” all participants acknowledged the stereotype of males as the primary breadwinners, while women are responsible for raising children. For instance, one student used nursing as an example,
Most of the male nurses that I know are more of a primary support, financial support for their families, so it seems they are more worried about financial situations, so they are trying to get continuing education and seeking promotions.
Another student said,
They [women] are relegated to having kids, and maybe they just don’t have the time to take more responsible positions.
Theoretical sampling, using 5 additional student interviews, confirmed the basic grounded theory, as indicated in the Figure, while also clarifying further interactions concerned with gender stereotypes. The categories “Beliefs/Knowledge About Health Care Professions,” “Roles/Responsibilities” and “Values/Interests” influence the career path at the level of the factors “Career Choice-Physical Therapy” and “Future Plans.” Gender stereotypes in the category “Beliefs/Knowledge About Health Care Professions” were confirmed as related to nursing, with all of the theoretical group indicating they had not considered nursing as a career and all expressing gender-stereotypical comments about nursing. The lack of knowledge about physical therapy being a female-dominant profession was also confirmed. One of the students in the theoretical sample refused to believe that physical therapy is a female majority profession, and another said,
It’s dominated by females, but I don’t think it has any influence on treatment people get, and I don’t think if we males are doing it, that it is a feminine profession.
Another aspect of prior knowledge of physical therapy was that all 5 students in the theoretical sample had known a male PT. In reviewing the previous interviews, it was found that all of these participants had at least known a male therapist prior to entering physical therapy school. One student who expressed interest in pediatrics indicated that he knew 2 male therapists working in pediatrics. Gender-related influences on future plans were confirmed to be related to masculine interests such as sports or related to an aggressive approach to a career. The theoretical sample confirmed that life experiences influence knowledge about health care professions, roles, and interests, which, in turn, influences career choices. Common experiences of the males included being a patient, having a friend or relative visit a PT, and participating in sports.
To further explore the “Roles/Responsibilities” category, the students in the theoretical sample were asked directly about whether they agreed that males tended to be more aggressive in their careers because of the breadwinner role. They all agreed with the statement. The sample also confirmed the role of breadwinner as an important influence on their future careers. All 5 students in the sample indicated high salary as an important aspect of a career in physical therapy, but in the original interviews, not all participants mentioned salary as important. However, all students in the sample indicated that there are gender differences in pursuit of a career and that the breadwinner role of the male is an important motivator for advancing his career related to salary and/or promotion.
The impact of role models on career choices was not clearly delineated with the original group of students, and the theoretical sample did not clarify the issue. Role models were varied, but the sample did confirm that a role model did not need to be male or female. Not all information in the sample could confirm that knowing a therapist in a particular specialty influenced their future career paths. Thus, the influence of role models seems to be through the life experience of the student.
The career paths of male students who enter physical therapy are similar and can be illustrated in a model. This model includes gender-related beliefs that influence career paths. The details related to this model can be compared with other research concerning males who choose gender-atypical careers and with other research on career choice. The males in this study mentioned many of the factors found by Brown-West31 as reasons students choose various allied health professions. Those reasons included working with people, prestige, professional autonomy, opportunities for advancement, income potential, and the effect on family life.31 Those factors were all mentioned in one context or another, even if it was an instance of comparing physical therapy with nursing or medicine. One student said,
I did consider medical school, but with a family, it was kind of hard.
Another student was encouraged to go to medical school, but he said,
I enjoy working, but I am not so dedicated that I don’t want to have a personal life.
One subject who also had a degree in nursing said,
Well, I went and got some career counseling, and they, at that time, told me not to pursue physical therapy, because they said it was too competitive and that you had to get straight A’s in college.
He went into nursing but indicated,
The thing about nursing is that there is no autonomy. . .. I’ve always remembered how impressed I was with the knowledge base that the physical therapist had. . .and how much autonomy they had in their jobs.
Some research has shown that men enter female-dominant fields when opportunities for advancement are not available or jobs are not readily available in male-dominant fields.15,20 This was not directly expressed by the students, but, in general, they indicated mat job security was certainly a positive factor, and one student mentioned,
That [easy-to-find job] is important to me. That, I guess, could have been one of the reasons that I liked about the career of physical therapy that there was such need.
Salary was usually mentioned as a positive factor in choosing physical therapy, but the students were careful not to list it first or only mentioned it as an aside, as this subject did,
The pay. That’s something else that’s lucrative, too. You know, it’s not the main reason for me to get into the field, but it is a nice added bonus that the salaries are nice.
The participants expressed the need to work with others as a strong motivation. These findings coincide with the findings of the study by Rozier and Hamilton,33 which indicated the extrinsic factors of salary, job availability, and prestige, as well as the intrinsic factor of a desire to work with people, influence the choice of physical therapy as a career.33
In the study by Broughn,23 men chose to enter the gender-atypical career of nursing for job security and salary, but also because of a desire to help people and also because nursing would give a feeling of empowerment. The male PT students seemed to choose physical therapy for the same reasons. The need for feeling empowered is expressed when they choose physical therapy because of the autonomy, respect, and prestige they believe a career in physical therapy will give them. One student expressed this desire when discussing his future plans:
Hopefully, I’ll have my own business. . .. I’ll be well respected in the community. . ..
I enjoy the prestige. It means a lot to me that physical therapists, as a whole, enjoy the respect that they get. From what I’ve seen, they’re well respected in their profession. The profession of physical therapy seems to attract really nice people, and when you help others, you know it makes you look good. It helps others, and it’s just a good thing all the way around.
Although Strange and Rae4 and Luhaorg and Zvian5 concluded that gender role, in terms of self-concept, does not play a part in the choice of occupation for men, the roles and responsibilities of the students seemed to influence their choice of careers. For example, they did not believe that physical therapy is a feminine profession, even though they may have realized there are many women in the field. They recognized nursing as feminine but did not recognize physical therapy that way. As one student said,
I don’t see any aspect that is feminine except for the fact that females tend to be more sociable and [have] more interpersonal relations than men.
A lot of physical therapy is, like, grimy, dirty work. In rehab, guys are slobbering on you, and plus you’re going to have to be somewhat physically inclined to handle or move patients around, and I don’t think that the meek female ideal is what we have of physical therapy.
Other research on gender roles has shown that, once in a gender-atypical profession, a male may experience role strain if he does not have the support of coworkers, family, or clients.28,47 The PT students reported no adverse reactions from family and friends to their going to physical therapy school. As one student said,
My parents were thrilled, my brothers. . .. I don’t know if they really knew too much about physical therapy.
Okrainec29 did not find role strain among men in nursing, and the PT students also did not reveal direct feelings of conflict. They indicated that they did not feel they were treated differently than the female students, even though more than half indicated the faculty were predominately female. They also reported no difficulty in being accepted by the female students, as exemplified by this statement,
There is no problem at all. In fact, something I found kind of interesting is that when you look back, most of the class presidents are males, which I felt was kind of strange considering that it is predominately females in the class.
There is the suggestion also that to reduce role strain, men may seek out specialties within a career that are more masculine.48 The male students planned on entering specialties that might be considered more male oriented such as orthopedics or sports medicine, and they all believed that men tended to eventually gravitate to management positions. Research has confirmed that men in female-dominant professions do gravitate to managerial positions.15,48,49 However, there was no indication that the students had these interests due to any overt role strain. The interests appeared to be related to the “Values/Interests” or “Roles/Responsibilities” category. This finding would be similar to that of Pratto et al,50 who found that the career values of men were along the lines of status, power, and high income.
The fact that all students had at least known a male therapist might have affected how they viewed physical therapy as a career. As Reid51 found, children base beliefs about job capability on who they saw working in a certain career. Because the students knew a male PT, they believed that the career was acceptable for males to pursue. However, in further exploring the topic of role models in the data, students mentioned people of both genders, and not all were PTs.
A model of the influencing factors on the career paths of male students in physical therapy reveals that gender beliefs held by the males in relation to their roles, knowledge about health care careers, and their interests do influence their specific choice of a career and their future plans when they enter the profession. When making the career choice of physical therapy, males did not know that physical therapy is considered a female-dominant profession and did not consider physical therapy a feminine profession, although they indicated that nursing is a feminine as well as female-dominant profession. The males assumed physical therapy to be a male-oriented profession because of the relation to sports and their acquaintance with male therapists. Predictably, the male PT students disavowed choosing the career knowing that it was predominately female. Although they did express the belief that females may not be inclined to go into administrative positions, they also did not acknowledge that, as males, they might be able to advance more quickly in a female-dominant profession. Thus, what they did not know, or a misconception about the gender dominance of the profession, appeared to influence their career plans. Future career plans centered on gaining positions of more responsibility related directly to their roles as breadwinners and indirectly to their expressed desire for respect in their careers.
The results of this study have the potential to be helpful in designing materials for recruitment into the physical therapy profession. For instance, males may need to have contact with male role models or other male students in order to become interested in physical therapy. Programs in physical therapy may use the information in this study to revise their student orientation programs to ensure that gender-related issues are addressed or to be aware that male students do not appear to need special attention to be integrated into the physical therapy class. These male students did not initially perceive the profession as gender-atypical, implying that the gender identity of the profession is not well known. This information could be used in developing marketing campaigns for the profession.
Further exploration of the career paths of males in physical therapy should include men who have worked in the profession for several years and who have already established their careers to determine whether men do seek out a masculine career path. It would also be interesting to determine whether current PT students have a different view of the profession than veteran therapists who entered the profession when it was composed of an even larger percentage of females. Another interesting topic to explore would be an investigation of the female view of the gender identity of the physical therapy profession.
Special thanks to the graduate students at Texas Woman’s University who assisted with this research.
* HyperResearch 1.55, Research Ware Inc, PO Box 1258, Randolph, MA 02368-1258.
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Carolyn K Rozier, PT, PhD
Mary E Thompson, PT, PhD
Julie Shill, PT, MS
Marijo G Vollmar, PT, MS
Dr Rozier is Professor and Dean, School of Physical Therapy, Texas Woman’s University, Box 425766, Dentan, TX 76204. Address all correspondence to Dr Rozier.
Dr Thompson is Associate Professor, School of Physical Therapy at Texas Woman’s University-Dallas, 8194 Walnut Hill Ln, Dallas, TX 75231.
Ms Shill is a graduate of Texas Woman’s University and is a therapist in Texas.
Ms Vottmar is a graduate of Texas Woman’s University and is a therapist in Oregon.
Received November 13, 2000, and accepted April 20, 2001.
Copyright Journal of Physical Therapy Education Fall 2001
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