By Jonathan Scheeler | March 4, 2020
The Physical Therapy profession in the United States went through significant changes in the 1990’s. During this time, the profession was fighting for its members to be seen as autonomous practitioners in the healthcare landscape. The APTA’s House of Delegates were also debating the future of physical therapy in the US, ultimately arriving at Vision 2020. This statement, adopted by the APTA in 2000, clearly stated that the professional association desired all practicing clinicians to be doctorally trained by the year 2020. CAPTE followed suit in 2002 noting that all accredited programs in the US must be at the post-baccalaureate level. Though DPT programs began in the early 1990’s, the APTA’s adoption of Vision 2020 and CAPTE’s advancement of credentialing criteria motivated a vast number of academic programs to shift away from bachelors and masters programs and transition directly to a Doctorate.
As physical therapy education was transitioning to the doctorate level, current practitioners were left slightly alienated. The earliest transitional Doctorate of Physical Therapy (tDPT) program was introduced in 1992; however, there was a large spike in tDPT options in the early 2000’s, as universities determined pathways to assist their alumni in transitioning from the bachelors or masters to doctorate degrees. The last masters program faded away in the late 2000’s, resulting in all entry-level programs being offered as doctorate programs.
Fast forward, 2020 is upon us. Vision 2020 is no longer recognized as an active vision statement by the APTA and all students seeking to become licensed physical therapists in the US have been enrolled in doctorate programs for the past 12 years. With this in mind, why are there still transitional programs offered within the US? Looking at the CAPTE-trained physical therapy population, there is still a small percentage of professionals that have pursued other endeavors over the past 10 years; including residencies, specializations, and other academic or professional advancements. These individuals are now exploring the transitional doctorate programs.
The leading driver of transitional DPT programs in today’s universities are foreign-trained physical therapists. Although the standard for physical therapy in the US is technically a masters degree, the majority of foreign-trained physical therapists coming to the US to practice possess a bachelors or masters equivalent PT degree. Two aspects drive these individuals to seek out tDPT programs. The first is their credentialing evaluation. The Federation of State Boards of Physical Therapy (FSBPT) sets the standards that allows prospective PTs to sit for the national PT license exam. Within these standards, the FSBPT set the bar for foreign-trained PT’s to sit for the licensure exam. The “bar” is a credentialing evaluation form called the Course Work Tools (CWT).
Over the last decade, the Course Work Tools Version 5 (also known as CWT5) was utilized to evaluate foreign-trained PTs’ credentials against the US standard. Once all deficiencies were met, the foreign-trained PT could sit for the National Physical Therapy Examination (NPTE) and have the opportunity to become a US licensed PT. However, in 2017, the CWT was updated to Version 6 (CWT6). Significant changes were seen in the CWT6 as opposed to the CWT5. One of these changes was the credits required shifted from 150 to 170, a 13% increase that focused on professional credits. Also, on the CWT5, subjects were only required to be met if the state board to which the applicant was applying for licensure also required them. In contrast, on the CWT6, all subjects on the form must be met. The credits must be taken from a regionally accredited university and must be recognized by that university. Typically, entry-level DPT programs do not offer their professional courses to non degree seeking students. Thus the primary way foreign-trained PT’s can meet any deficiencies they have is through a transitional program.
The second driver of the foreign-trained PTs seeking a transitional DPT program is the want to become a US licensed PT and be equivalent to a typical US licensed PT. Being that a majority of practicing PT’s in the US have attained their DPT, a foreign-trained professional wanting to practice and become licensed in the US also wants to invoke Vision 2020 to become doctorally trained.
Finally, future requirements for foreign-trained PT’s looking for a license in the US will be required to have an educational credentialing review performed. Though the standards are still being set, given that all US programs are doctorate programs, we may see a push for this educational credentialing review towards the DPT as opposed to the current CAPTE standard of the masters level.