Sub theme 3: Am I Good Enough to be an OT?

Cathy had successfully completed her OT training, had HCPC registration and had applied for numerous jobs but had not secured a post at the time of

interview. She exhibited uncertainty and fear which were linked to feelings of self-worth and value. Despite ‘doing very well on all assessments’ and

successfully qualifying Cathy described a ‘nagging doubt’ about being ‘good enough’ to be an OT. This seemed to be reinforced by her inability to secure a

job at the time of interview. However, this was at a time when newly qualified band 5 posts were scarce.

I was so looking forward to getting a job at the end of it and thought that I would have no trouble in getting a job …So yeah that’s how I now feel. So I think I was in this very hazy yes, nearly there, going to get a job, can’t wait, but now I feel quite deflated after having the amount of interviews that I have had and almost getting there, but not quite getting there and it’s almost like the carrot has been dangled, you know, you still try to grab it, but as a disabled person I can’t help thinking, yeah, you have the policy, but there is always a way round it, you can always use an excuse not to employ me and say because I said something or I didn’t add something, but that is me being cynical (Cathy).

Cathy was frustrated at not being able to secure a job and expressed her concerns about discrimination. She remained cynical about why she has not been employed, recognising that policy and legislation count for little

(Vickerman and Blundell, 2010). Cathys use of a metaphor, ‘the carrot has been dangled’ indicates that she is desperately looking to be rewarded for her hard work and get a job. However, she currently feels she is being punished as she has not been able to secure one.

Similarly, Tina had successfully completed her OT training and was awaiting graduation when interviewed. She had not applied for Health Care and Professions Council (HCPC) registration or secured a job.

Tina’s fears as a newly qualified graduate were multifactorial. She questioned her ability to cope within a working environment as a result of her final

placement experience which had a significant impact upon her self-confidence and self-esteem. She was also afraid to apply for HCPC registration fearing rejection based on her diagnosis and had therefore not completed the application. She lacked knowledge and understanding about HCPC

registration and acknowledged that she had avoided investigating it for fear of their response. Tina feared that despite her hard work and reward that she still may face rejection based on her diagnosis. Tina recognised the decision was out of her control, which increased her anxiety. Tina also appeared to

doubt her own clinical abilities and appeared to be resistant to taking responsibility for herself and others.

I haven't applied for my HCPC, there is still a bit of me that is scared to apply in case someone says no. That was never

discussed before I started the course at all. I didn’t know about it. So it wouldn’t have really occurred to me and my health has improved considerably over the last * years anyway and might still continue to improve, but I definitely don’t want to hear someone say you can never be an Occupational Therapist because that would make the whole last * years have a rather different

connotation. It hasn’t happened, bit scared it might and don’t know, because obviously I will have to declare it ...I don’t know really how to handle that and it is definitely partly the reason why I haven’t applied for my HCPC; that’s cowardly isn’t it (Tina).

Tina’s narrative highlights the need to ensure that all students are familiar with the HCPC registration process and should therefore be integrated into routine Academic Personal Tutor (APT) meetings with final year students.

Tina recognised that she was anxious about attending graduation and

acknowledging that she had not secured a job as an Occupational Therapist. She identified the skills she had developed throughout her training but worried about becoming an Occupational Therapist. Tina also expressed concerns about the potential for stigmatisation and discrimination linked to her disabilities within the job market.

I think the job market is particularly difficult, you are at a bit of a disadvantage to start with, which doesn’t help, maybe that is just a great excuse at being bad at interviews. So, it is going to be hard with a declared disability there is no doubt about it; it is going to be harder and I have got to be more selective about what I apply for, if I can get my registration, which again limits the availability of jobs… Everybody is struggling for jobs, you know, being a disabled student looking for a job …, just means you get the cursory interview, doesn’t necessarily mean you get the job, or anymore help getting the job and as an employer, if I had the choice between employing someone that I didn’t have to make reasonable adjustments for rather than having to go through a whole process of making reasonable adjustments, I can see why, even employers such as the NHS would take the easy route. (Tina)

Tina attempted to review the interview process through the eyes of the employer believing that employers pay lip service to the process ‘even within the NHS’.

Whilst, it is likely that most students would at some point experience a crisis of confidence during their training, it is interesting that the participants who

expressed their anxieties about being good enough to be an Occupational Therapist in this study had both already qualified. Thus, perhaps indicative of the impact that their disability had had on their self-confidence.

Velde (2000) also suggested that, as students, her participants (qualified Occupational Therapists) had faced greater challenges in education, practice placement and securing their first post which is reflective of the findings of others (French, 1988) and concurs with the experiences of Tina and Cathy. At the time French (1988) conducted her study within the UK however, the job market was more prosperous than at the time Tina and Cathy qualified. Despite the struggles to secure their first post the participants in Velde’s (2000) study had a wealth of experience and had had a number of roles including those within advanced practice and management and leadership. Thus, demonstrating the value added and respect commanded as a qualified therapist with a disability and this is confirmed within other studies (French, 1988).

As can be seen from this research the search for employment can be

daunting and frustrating as well as instilling fear of discrimination as outlined by both Cathy and Tina. Vickerman and Blundell (2010) advocate the

incorporation of opportunities to explore employability and career options with students with disabilities in order to ‘confront barriers to employment’ (p29). Opportunities for greater support at this time may reduce the fears and anxieties associated with identifying employment whilst empowering individuals with disability. It is therefore proposed that further formal

professional development opportunities are offered within the programme to support employability and career development.