Purpose: This study aims to examine the anticipated and actual challenges encountered by occupational therapy and physiotherapy students during their first full-time professional placement and to understand the strategies they implemented to manage their multiple life roles. Design/methodology/approach: Longitudinal qualitative research examined students' anticipated and reported challenges with their first block professional placement and the strategies they implemented during it. In total, 22 occupational therapy and physiotherapy students were interviewed at two time points (pre- and post-placement), producing 44 interview data points. Transcribed interviews were analysed thematically using a hybrid approach. Findings: Pre-placement, students perceived potential challenges related to the distance between their placement location and where they resided and their ability to maintain balance in their multiple roles. Post-placement, the main reported challenge was maintaining role balance, due to unexpected challenges and students' unanticipated tiredness. Students implemented strategies to assist with managing multiple roles and reflected on the benefits and drawbacks of placements. They also considered the necessary future adjustments. Practical implications: This study highlighted the importance of social support and the need for proactive recovery strategies to negate the tiredness that students experienced on placement. Originality/value: This is the first study, to our knowledge, to investigate how allied health students, on their first block of professional placement, balanced their multiple roles over time.