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carol mccrum advanced clinical practice physiotherapist

A Conversation With Advanced Practice Physiotherapist Dr Carol McCrum

We recently spoke with Dr Carol McCrum about her career journey into advanced practice physiotherapy.

Tell us a bit about your professional journey. How did you become an advanced practitioner? How did you get started, and where has it taken you?

I studied physiotherapy at Sydney University. I graduated in 1986 and then undertook my early career rotations at Royal South Sydney Hospital, chosen for its strong reputation for excellent musculoskeletal rehabilitation. I then had the opportunity to undertake a master’s programme in my specialty in musculoskeletal physiotherapy, which was considered a specialised course in the field to help develop my clinical expertise. The master’s programme also helped expose me to research and sparked my curiosity with investigating aspects of care we needed to understand better. I went on to work in private practice and was very fortunate to work with two very experienced clinicians which supported my professional development and ability to make critical decisions in practice. There was also the opportunity to support with teaching courses they ran which helped my own clinical development as well as prompted an interest in supporting others’ professional education, which I had so greatly valued.

 I then had the opportunity to go to the UK in 1997, which was a very unexpected development for my career and took up a clinical specialist post in musculoskeletal physiotherapy, coincidently with other very experienced colleagues also interested in teaching and research. And with the healthcare pressures in the UK and the innovative approach to using non-medical expertise, I was able to undertake some extended scope practices which included training in musculoskeletal injections, imaging and pathology requesting, and also undertook study to become a non-medical independent prescriber. The medicines knowledge was such a valuable adjunct to providing our specialist physiotherapy skills in assessment and optimising people’s care.

The UK had also developed Allied Health Consultant posts and I was very lucky to be successful in becoming a Consultant Physiotherapist in Musculoskeletal Medicine in 2005. This involved setting up a new triage service for orthopaedics referrals and undertaking rheumatology assessment clinics. The post also had responsibilities including professional development and being involved in strategic directions of services as well as research component.

During that time, I undertook my PhD and that was an incredible learning journey, opening up so many opportunities to be involved with professional activities, further research and in helping support others research development. Following COVID, I returned to Australia, and I was very grateful to take up a post at Canberra Hospital in the Rheumatology Department, triaging the retained waiting list with the support of the MDT, and also supporting the Allied Health Office with advancing advanced practice roles in the organisation.

Can you tell us about the biggest challenges you’ve faced during your career, or perhaps opportunities that you’ve really had to make a difference to patient or community outcomes?

With my involvement in the rheumatology specialty as part of my Consultant role, there was a call to be involved in a UK NICE guidance on a rheumatology conditions, and I was encouraged to apply. I wasn’t confident I had sufficient knowledge; however, I was successful in joining the Guideline Development Committee. It was an incredible experience over the years of developing the guideline. It helped develop my clinical expertise and to understand the importance of national strategy around healthcare provision, as well as to work with and learn from a breadth of clinical leaders within the field and people with lived experience of this condition.

From that guideline involvement, I was awarded a NICE Fellowship to champion the implementation of the guideline. The experience helped me consider how to influence and make connections, as well as being a platform for so many other valuable experiences. In particular, the Fellowship helped meet and develop a supportive clinical network that has made a very significant difference with all our efforts to improve the diagnosis and early intervention of this condition. It highlighted the value of becoming involved in any opportunity, such as being on a committee or being part of a professional network for learning and growing in your own development, as well as making a difference to people’s care through the work undertaken.

Some of the challenges I had was when I was new in the consultant physiotherapist role: I was required to set up a new service that had no precedent. It was a very exciting challenge to work out ways to meet the people that were key to a successful setting up, and to influence and get their help in the strategy. As well, it was key to ensure that there was a win-win situation, and working out what these were for the people who were needed to be involved to help the service be effective and sustainable. This ranged from the medical records team and administration team, right through to the Chief Financial Officer, and I was very lucky that the experience was one that greatly developed my ability to then undertake other similar challenges in the future.

What has been a defining event or highlight of your career experience?

The most defining event has been undertaking my PhD while I was also working full time. It provided a wonderful opportunity to continue to learn and pursue an interest in a field I was very interested in. The journey was the amazing experience, needing determination while also in a new role, however it also enabled meeting inspiring clinical researchers and learning so much about the importance of scoping other people’s views and ideas for the value this brings to understanding something we might be exploring. The PhD journey opened up so many opportunities to meet incredible people, be involved in interesting work and research. I’m very grateful for the opportunity to have undertaken the study which was invaluable.

In terms of your experience as an advanced practitioner, what would you like to see done differently?

It seems very important in Australia that we develop a united approach for allied health professions towards advanced practice to unite in our efforts around defining the roles and our credentialing processes. This includes working together on education and training processes for this incredibly valuable workforce for our healthcare services.

 It seems so important to have a collaborative approach to allow a national strategy that supports allied health to utilise their expertise in advanced practice roles and make the contribution to health services that can be brought by our specialist knowledge, skills, and capabilities. We really do have superpowers that make a very big difference to our patients/service users as well as to the value of healthcare delivery.

What advice would you have for others providing care in a similar role or going through similar experiences or stepping up into the profession or with everything you’ve experienced in your career? What advice would you give your graduate self on the precipice of stepping into this profession?

My advice would be to undertake early in your career all the opportunities you can for developing the breadth of your knowledge and experiences, which is important to build on your clinical expertise. As your career progresses, that foundational knowledge is key to being a capable advanced practitioner.

Take every opportunity you have or make opportunities, take any chance for learning, or being involved in a project or research activity. There is always something to be learned and your involvement is always valuable for your experiences and what you bring to these involvements. Use a mentor, or several mentors in different areas, to help when you need support, or help you consider where you might take your learning or your career and ask their view on how to help solve an issue. Use your passion and enthusiasm and be determined to make the difference that you know you can. Attend conferences, take the opportunity to meet colleagues within and outside your field, offer to support others’ work or to shadow colleagues you admire or inspire to help your own development.

Finally, you don’t have to be perfect to be amazing, and so be prepared to step up and enjoy the experience in the opportunities that you take up and surround yourself with people that are also amazing, or seek them out to help guide and inspire you either within and outside your profession. Don’t be afraid to challenge traditional ways of thinking and have the confidence in yourself and in knowing what you bring is extremely valuable. Be the person that says ‘yes, I can help you with that’!

Many thanks to Dr Carol McCrum for providing these insights. 

Join the Advanced Practice Collective, a Community of Practice for advanced allied health practitioners with an interest in continuing professional development and peer group discussion. | Join us for the Advancing Practice Across Australia Summit on Wednesday, March 6, 2024 at the Ann Harding Conference Centre, University of Canberra. This in-person event is a unique opportunity to connect with healthcare leaders and expand your knowledge of advanced clinical practice for the Allied Health, Nursing and Midwifery workforce.