Doctor of Physical Therapy

A Doctor of Physical Therapy (DPT) degree is a post-baccalaureate degree that takes 3 years (8-9 semesters) to complete. A DPT is considered as a clinical doctor who is educated in many areas of rehabilitation. A Transitional Doctor of Physical Therapy Degree is also offered for those who already hold a professional Bachelor or Master of Physical Therapy (PT or MPT) degree. As of 2015, all accredited and developing physical therapist programs are DPT programs.[1] The DPT degree currently prepares students to be eligible for the PT license examination in all 50 states. As of March 2017, there are 222 accredited Doctor of Physical Therapy programs in the United States.[2] After completing a DPT program the doctor of physical therapy may continue training in a residency and then fellowship. As of December 2013, there are 178 credentialed physical therapy residencies and 34 fellowships in the US [3] with 63 additional developing residencies and fellowships.[4] Credentialed residencies are between 9 and 36 months while credentialed fellowships are between 6 and 36 months.

In 2000 the American Physical Therapy Association (APTA) passed its Vision 2020 statement, which states (in part):

"By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health."[5]

As this statement highlights, the DPT program is an integral part of the APTA's continued advocacy for legislation granting consumers (i.e. patients and clients) direct access to physical therapists, rather than requiring physician referral. Direct access is said to decrease wait times for access to care and even help reduce both cost to consumer and overall healthcare costs.[6] As of January 1, 2015, all 50 states and the District of Columbia currently allow some form of direct access to physical therapists.[7]

History of the DPT degree

In 1992, the University of Southern California initiated the first post-professional "transitional" (DPT) program in the United States.[8] This "transitional" DPT takes into account a physiotherapist's current level of knowledge and skill and purports to offer programs that upgrade clinical skills to meet the needs of the current health care environment.[9][10] Creighton University followed by initiating the first entry-level DPT program in 1993.[11][12]

Time frame

Undergraduate Doctor of Physical Therapy Residency (optional) Fellowship (optional)
4 years 3–4 years[13][14][15][16] 9 to 36 months[17] 6 to 36 months[18]

The typical time frame for completion of a Doctor of Physical Therapy is 3 to 4 years after earning a bachelor's degree. Depending on residency and fellowship training, if undertaken, the doctor may have completed several years of additional training.

Admission

Admission to a Doctor of Physical Therapy program is highly competitive. As of 2011 the average GPA for enrolling students was 3.5[19] with a range of 3.1 to 3.9 for all programs.[19] On average there were 354.7 applicants per program with an average of 43.3 students enrolled per class[19] for an average matriculation rate of 12.2%. The range for applicants to all programs as of 2011 was 34-1358, and the range of enrolled students was 6-354.[19] A bachelor's degree generally is required before beginning a Doctor of Physical Therapy program, but there is no requirement on the degree earned, as long as all prerequisite course requirements are met.[20]

Transition Doctor of Physical Therapy degree

The t-DPT degree is conferred upon completion of a structured postprofessional educational experience that results in the augmentation of knowledge, skills, and behaviors to a level consistent with the current professional (entry-level) DPT standards. The t-DPT degree enables the US-licensed physical therapist to attain degree parity with therapists who hold the professional DPT by filling in any gaps between their professional baccalaureate or master's degree PT education and the current professional DPT degree education.[21]

The post-professional DPT (Transitional) degree is designed to provide the doctoral credential to those who currently holding a master's or bachelor's degree in the field. Post-professional DPT (Transitional) degree programs are typically offered on a primarily online learning model and are often one year in length.[22]

Controversies

The use of the title doctor by physical therapists and other non-physician health care professionals is controversial.[23] In a letter to The New York Times, the president of the American Physical Therapy Association responded:

"To provide accurate information to consumers, the American Physical Therapy Association has taken a proactive approach and provides clear guidelines for physical therapists regarding the use of the title "Doctor." These guidelines state that physical therapists, in all clinical settings, who hold a Doctor of Physical Therapy degree (DPT) shall indicate they are physical therapists when using the title "Doctor" or "Dr," and shall use the titles in accord with jurisdictional law."[24]

The DPT degree has been described as an example of "credential creep" or degree inflation in The Chronicle of Higher Education. Citing concerns that the DPT, and similar professional doctorates in areas such as occupational therapy, do not meet the standards of traditional doctorate degrees, the journal states: "The six-and-a-half-year doctor of physical therapy, or DPT, is rapidly replacing a six-year master's degree ... The American Physical Therapy Association ... has not set separate requirements for doctoral programs. To be accredited they need only to meet the same requirements as master's programs."[25]

Critics question whether the rigor of the physical therapy curriculum and the current scope of practice warrant the conferral of a professional degree similar to that characteristic of medicine, dentistry, or nursing.[26] Proponents counter that the existing curricula are "victims of 'curricular inflation'."[27] As Rothstein[28] and Moffat[29] noted, the previous master's and even baccalaureate curricula rival that of most other doctoral programs, and these curricula often require more than the typical 72 credits mandated for a doctoral degree.[30] The 2000 Fact Sheet from APTA reported that the mean number of credits required for the professional phase of the typical baccalaureate program was 83.0 credits and that the typical master's degree program required 95.5 credits.[31] As of 2009 the typical number of prerequisite credits was 114.2 and the total number of professional credits was 116.5 for a total of 230.7 credit hours.[32] This is well in excess of the typical 72 professional credits mandated for a doctoral degree. Additional credit hours may be earned in residency and fellowship as well. Threlkeld et al.[33] suggest that the scope of existing physical therapy curricula already matches that of a professional doctorate, further submitting that students of a well-defined DPT program will have earned the right to be recognized with the doctoral title.[34]

Professional degree (entry-level)

The professional (entry-level) DPT degree is currently the degree conferred by all physical therapist professional programs upon successful completion of a three- to four-year post-baccalaureate degree program in the United States, preparing the graduate to enter the practice of physical therapy. Admission requirements for the program include completion of an undergraduate degree that includes specific prerequisite coursework, volunteer experience (or other exposure to the profession), and completion of a standardized graduate examination (e.g., GRE).[35]

Typical prerequisite courses may include two semesters of anatomy and physiology with labs, two semesters of physics with labs, two semesters of chemistry with labs, a general course in psychology, another course in psychology, statistics, two semesters of biology,[36] and may include other courses required by specific schools.

The physical therapist curriculum consists of foundational sciences (i.e., gross anatomy, cellular histology, embryology, neurology, neuroscience, kinesiology, physiology, exercise physiology, pathology, pharmacology, radiology/imaging, medical screening[37]), behavioral sciences (communication, social and psychologic factors, ethics and values, law, business and management sciences, clinical reasoning and evidence-based practice[38]), and clinical sciences (cardiovascular/pulmonary, endocrine and metabolic, gastrointestinal and genitourinary, integumentary, musculoskeletal, neuromuscular). Coursework also includes material specific to the practice of physical therapy (patient/client management model, prevention, wellness, and health promotion, practice management, management of care delivery, social responsibility, advocacy, and core values). Additionally, students have to engage in full-time clinical practice under the supervision of licensed physical therapists with an expectation of providing safe, competent, and effective physical therapy.

Advanced clinical science degree

The "advanced clinical science" doctorate (e.g., DPTSc or DScPT, DHSc, ScDPT) is one of several degrees conferred by academic institutions upon successful completion of a post-professional physical therapist education program. This program is intended to provide an experienced clinician with advanced knowledge, clinical skills, and professional behavior, usually in a specific specialty practice area. These programs typically culminate work that contributes new knowledge to clinical practice in the profession. Completion of these advanced clinical science doctoral programs may include credentialed clinical residencies and lead to ABPTS clinical specialization or other advanced certifications.

United Kingdom

Some UK universities now offer a DPT as a post-professional qualification, but the qualifying degree remains Bachelor or Master of Science, Physiotherapy (with honours). The Doctor of Physiotherapy in the UK differs from a US clinical doctorate in that it is a 5-year post-professional Physiotherapy specific research programme, which is offered at the University of Sussex in Brighton. Other UK institutions prefer to offer a generic ProfD (Professional Doctorate) as this is recognised across many professions from veterinary medicine to pharmacy.

References

  1. ↑ http://www.capteonline.org/uploadedFiles/CAPTEorg/State_Boards/MasterListofAccreditedPTPrograms.pdf#search=%22DPT%22
  2. ↑ http://aptaapps.apta.org/accreditedschoolsdirectory/default.aspx?UniqueKey=
  3. ↑ http://www.abptrfe.org/home.aspx
  4. ↑ http://www.abptrfe.org/apta/abptrfe/Directory.aspx?navID=10737432672
  5. ↑ "Vision 2020". American Physical Therapy Association. 2011-10-04. Retrieved 2012-02-19.
  6. ↑ "Direct access to physical therapists being sought". Elm Leaves. 2012-02-12. Retrieved 2012-02-19.
  7. ↑ http://www.apta.org/Media/Releases/Legislative/2014/7/1/. Missing or empty |title= (help)
  8. ↑ Physical Therapy:
  9. ↑ The Postprofessional Clinical Doctorates [Draft Document]. Consensus Conference on Postprofessional Education. Alexandria, Va: American Physical Therapy Association; 1998.
  10. ↑ Massey B. 2001 APTA Presidential Address: We have arrived! Phys Ther. 2001;81:1830- 1833.
  11. ↑ Doctor of Physical Therapy | DPT Program | Creighton University
  12. ↑ Murphy W. Healing the Generations: A History of Physical Therapy and the American Physical Therapy Association. Alexandria, Va: American Physical Therapy Association; 1995.
  13. ↑ College of Pharmacy and Health Sciences - Entry-Level DPT Curriculum
  14. ↑ http://www.oakland.edu/upload/docs/SHS/PT/2011DPTBrochure%20.pdf
  15. ↑ http://www.northeastern.edu/bouve/pt/pdf/Post%20Baccalaureate%20DPT%20Curriculum%20Plan%20-%2011-9-11.pdf
  16. ↑ DPT, Doctor of Physical Therapy, Overview, School of Health and Medical Sciences - Seton Hall University, New Jersey
  17. ↑ "www.apta.org" (PDF). Retrieved 2012-07-18.
  18. ↑ Residency vs. Fellowship
  19. 1 2 3 4 "2011-2012 Fact Sheet: Physical Therapist Education Programs" (PDF). Commission on Accreditation of Physical Therapy Education. 2013-03-14. p. 17. Retrieved 2013-05-16.
  20. ↑ http://www.apta.org/ProspectiveStudents/Admissions/PTProcess/
  21. ↑ FAQ: Postprofessional DPT (Transition)
  22. ↑ "FAQ:Postprofessional DPT (Transition)". American Physical Therapy Association. 2011-03-01. Retrieved 2012-02-19.
  23. ↑ "When the Nurse Wants to Be Called ‘Doctor’". The New York Times. 2011-10-01. Retrieved 2012-02-19.
  24. ↑ "APTA Responds to The New York Times on Physical Therapists Using the Term 'Doctor'". American Physical Therapy Association. 2011-10-05. Retrieved 2012-02-19.
  25. ↑ "Credential Creep" (PDF). The Chronicle of Higher Education. 2007-06-27. Retrieved 2012-02-19.
  26. ↑ Messaros, A (October 1999). "Fatal assumption [letter to the editor]". Physical Therapy. 79 (10): 981–982.
  27. ↑ Threlkeld, A; Jensen, G; Royeen, C (October 1999). "Author response". Physical Therapy. 79 (10): 986–990.
  28. ↑ Rothstein, J (April 1998). "Education at the Crossroads: For Today's Practice, the DPT [editorial]" (PDF). Physical Therapy. 78 (4): 358–360.
  29. ↑ Moffat M. APTA Presidential Address: Will the legacy of our past provide us with a legacy for the future? Phys Ther. 1994;74:1063-1066.
  30. ↑ Sahrmann, S (November 1998). "Moving Precisely? Or Taking the Path of Least Resistance?" (PDF). Physical Therapy. 78 (11): 1208–1218.
  31. ↑ 2000 Fact Sheet: Physical Therapist Education Program. Alexandria, Va: American Physical Therapy Association; October 2000.
  32. ↑ 2009 fact sheet: Physical Therapist Education Program. Alexandria, Va: American Physical Therapy Association; August 2009
  33. ↑ Threlkeld A. Jensen G, Royeen C [author response]. PhysTher. 1999:79:986-990.
  34. ↑ http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/69169
  35. ↑ DPT - Frequently Asked Questions - USC Division of Biokinesiology and Physical Therapy
  36. ↑ Columbia University Program in Physical Therapy
  37. ↑ Doctor of Physical Therapy (DPT) Coursework — Azusa Pacific University
  38. ↑ Curriculum | Physical Therapy Program | George Fox University
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