The educational requirements to pursue a career in physical therapy have changed over time and continue to change to equip future physical therapists with the best knowledge and skill sets to practice in today’s health care system. There was a time when you could get a bachelor’s degree in physical therapy as an undergraduate and go on to physical therapy school, but that was phased out in the 1990s. Many schools have created majors that allow students who want to go to physical therapy school to meet those requirements and pursue other health care fields. The advantage of this is that you will have a degree that will allow some flexibility if you change your mind or do not get into physical therapy school.
Currently you need at least a minimum of a master in physical therapy to go out into clinical practice. You have to complete a three-year program that covers all the areas of physical therapy and provides you with the knowledge and skills to pass the National Physical Therapy Exam. But a new degree, a doctor of physical therapy, has emerged with the aim of better preparing students for the complexity and interdisciplinary approach to health care that you will face in practice. The American Physical Therapy Association has decided that by 2020 a DPT will be required to obtain a license and practice physical therapy.
Bachelor of Physical Therapy, Master of Physical Therapy
You used to be able to practice physical therapy with a bachelor of physical therapy, and you will still find physical therapists out there with a BSPT. That was phased out in the 1990s, but some schools offer bachelor degrees that are geared toward students interested in physical therapy. For example, California State University in Fresno’s physical therapy department offers a bachelor’s in Interdisciplinary Health and Rehabilitation Sciences that prepares undergraduates to pursue a further education in several health professions including physical therapy. This is advantageous because if you change your mind and want to pursue another career in the health care field or do not get into physical therapy school, you will have other options. Alcorn State University allows students to obtain a bachelor’s in biology with a physical therapy focus so that the prerequisites for physical therapy school can be met. Other colleges offer a bachelor’s in pre-physical therapy.
If you want to practice in the United States as a physical therapist, you will have to at least have a master of physical therapy before taking the National Physical Therapy Exam and state licensing exams. It takes about three years to obtain a master of physical therapy degree. However, these programs are slowly being replaced by doctor of physical therapy programs, which will be the minimum degree required to practice as a licensed physical therapist in the future.
Doctor of Physical Therapy (DPT)
Students who have an undergraduate degree or have completed three years of physical therapy school can pursue a doctor of physical therapy (DPT), which is offered at 142 of the accredited programs in the United States. This allows a physical therapist to delve more deeply into the field under supervision. You would study all the areas of medicine as you did in physical therapy school, put on seminars, get involved in rounds and clinical studies, and learn an evidence-based approach to clinical practice.
The goals of a doctor of physical therapy are to teach you how to make independent judgments in managing a wide variety of patients with different conditions, to learn to take care of patients in the different settings, to collaborate with other health care professionals, and to learn to take on the many roles of a health care professional, such as practitioner, educator, researcher, administrator, and collaborator.
While a master in physical therapy currently allows you to become licensed and practice, the DPT is becoming the accepted standard for people who want to practice physical therapy and will be required by 2020. If you are currently in physical therapy school, you may want to consider getting a DPT. If you are considering physical therapy school, it may benefit you to go right into a DPT program. Like a master in physical therapy, it will take three years to complete and you will have to pass the National Physical Therapy Exam and the state licensing exam.
Advanced Clinical Science Doctorate (DPTSc)
Believe it or not, there is an opportunity to go further in your education after obtaining a doctor of physical therapy. It is called a Doctorate in Physical Therapy Science (DPTSc). It not only trains you to practice clinical medicine, but it also provides you with the foundation to pursue a career in teaching and clinical research. You will have to have at least a master of physical therapy to enter into a DPTSc program because you have to be licensed or be able to obtain one since you will be working in a clinical setting as part of your training. It is a PhD program, and like any graduate program, you will have to meet certain requirements, such as minimum GPA and GRE scores that are less than five years old. These programs are very competitive because they only admit a handful of candidates each year.
A faculty member will serve as a mentor. Throughout your time in the program, you will have a project that focuses on a specialty area of physical therapy such as neurological, pediatric, public policy, and behavioral science. You will take graduate level classes in your area of emphasis, and research and statistics courses so you can design experiments and interpret the data you gather in your project. Teaching physical therapy students in the classroom and clinic will also be part of your training in a DPTSc program. As part of your research, you will write a proposal for your project, have qualifying exams, and ultimately an oral defense that you have to pass to obtain your DPTSc. The time it takes to obtain a DPTSc varies, but if you are interested in teaching in a physical therapy program or conducting clinical research, you should consider going into a doctoral program.
Most health professions allow you to specialize and become an expert in a specialty area. Once you graduate school and are licensed, you can decide to do a residency in an area of physical therapy. Under the supervision of clinicians, you will focus on examining, diagnosing, and managing patients with specific problems, such as cardiopulmonary, orthopedic, or neurological. According to the American Physical Therapy Association, a residency must be 1,500 hours of clinical work that takes between nine to thirty-six months. Once you successfully complete your residency, you take a test that will allow you to be board certified in that specialty.
If want to learn even more about a particular field of study after a residency, you can do a fellowship. You will have to be licensed and certified in a specialty area, have completed a residency program, or show that you have skills in a particular area to qualify. You will have advanced instruction in the specialty, receive a lot of mentoring, and manage many patients. This will all allow you to gain clinical experience in your specialty area. You have to do at least 1,000 hours in six to thirty-six months.
Completing a residency or fellowship will allow you to see patients with very specialized problems that cannot be treated by your colleagues in general practice. You will likely end up working in a referral practice, where patients with specific conditions related to your specialty will be sent by their doctors or other physical therapists. You will also be able to teach and conduct scientific research. Some physical therapists go into practice and decide later on to complete a residency or fellowship if they find they want to focus on a particular area. There are several specialty areas in physical therapy to choose from.
No matter what specialty you choose, you will obtain a complete medical history with every patient, and then conduct your own examination and specialty testing. Then you will develop exercises that will be done under your supervision. Once the patient gets stronger and more comfortable, you will create a regimen they can do in the gym or at home. And remember, even if you specialize, you will have to treat the whole patient. This means there will be crossover between specialties, and you cannot forget information that does not apply to your specialty.
The area of cardiopulmonary physical therapy helps people with cardiac and pulmonary conditions, such as congestive heart failure or a collapsed lung. People who have had lung or heart surgery will likely be referred to you as part of their aftercare. Your patients will tire and become out of breath easily, limiting their mobility, which can result in a lower quality of life. To treat patients with cardiopulmonary issues, you will have to have an excellent understanding of the normal physiology of the lungs and heart and how diseases alter that physiology. Make sure to pay extra attention to that section in physical therapy school. You will also have to know how to manage and treat these patients in a safe and effective manner.
Pulmonary function tests and exercise tests will be commonplace. Pulmonary function tests will allow you to measure lung volume, the ability of air to flow into the lung, and how well oxygen passes through the lungs and is carried throughout the body. Many cardiopulmonary diseases will impair one or more of these processes, and results obtained from pulmonary function tests will give you more information about your patients’ conditions. You will also do exercise tests in which you obtain baseline vital signs, such as blood pressure, heart rate, and the percentage of red blood cells saturated with oxygen, and then measure their changes as the person increases their physical activity. All of this information will be used by you to create an exercise program that helps the patient increase their lung volume by gradually increasing their activity level and teaching them what their limits are due to their condition.
Geriatric physical therapy is focused on increasing mobility and strength in the elderly. Because you will be dealing with an older population, they will likely have one or more health problems, such as cardiovascular disease, diabetes, Alzheimer’s disease, or arthritis. Injury and decreased mobility that causes joints to stiffen and muscles to waste away will be common problems.
The goal of geriatric physical therapy is to improve balance and strength, reduce pain, improve coordination, and help people remain active in their old age. One of the biggest concerns with old people is falling, which often causes hip fractures that lead to a decrease in health and increased hospitalization rates. With physical therapy, the hope is that the individual can regain strength and mobility so they remain independent for as long as possible.
The exercises for older adults are focused on their injury or what is limiting their mobility. Stretching, walking, and water exercises can be used to help older adults stay active. Another therapy that you will commonly use as a geriatric physical therapist is manual therapy. You manipulate the joints and muscles in hopes that circulation and mobility are restored. Massage is another form of manual therapy that can be used. It will also be important to educate people on how to be safe when they do their everyday tasks. This may include learning how to use devices made to assist them so they can maintain their independence and a high quality of life. If you are interested in geriatric physical therapy, it is recommended you volunteer or shadow at a nursing home.
If you decide to specialize in neurological physical therapy after physical therapy school, you will examine and manage people who have mobility issues due to problems with the brain or spinal cord. The brain and spinal cord send messages to our bodies on how to move, so any disease that affects them will have a serious effect on mobility.
You will be dealing with people who have had injuries to their brain and spinal cord because of accidents, people with weakness or paralysis due to a stroke, and people with diseases such as amyotrophic lateral sclerosis. You will also manage older adults with Parkinson’s, which affects motor skills, and children born with spina bifida or cerebral palsy. People suffering from the effects of a brain tumor may also seek out a neurological physical therapist.
The most typical symptoms people with neurological problems will mention to a physical therapist is being dizzy, falling because of poor balance, having a hard time getting around, needing more assistance with everyday activities, and having to rest after a few minutes of walking.
As a physical therapist in this specialty, you will be conducting various neurological tests to determine if the problems started in the brain or the spinal cord. You will be assessing the risk of someone falling either from neurological or other reasons, which is very important for seniors. Testing to determine why someone is dizzy or having balance issues will be conducted. Based upon the results, exercises will be done to restore balance and reteach the brain and spinal cord how to control movement. Because of the nature of neurological injuries and diseases, the course of physical therapy is often longer than in other areas of the field.
If you are interested in orthopaedic physical therapy, there are plenty of residencies to look into after physical therapy school. Orthopaedic physical therapy is a specialty that focuses on injuries and conditions that affect joints, bones, and muscles. They will deal with people who have problems with their knees, back, feet, ankles, and elbows. These injuries could be due to traumatic accidents or diseases. Common injuries are related to work, such as repeating motions or improperly lifting heavy items. Sports injuries will also be commonly seen in your practice.
Your goal will be to strengthen the ligaments and tendons that connect muscles to joints. You will have several types of therapy in your arsenal. In this specialty, you will perform massage, particularly deep tissue, which not only increases flexibility and mobility but also increases circulation of blood to that joint. Icing therapy, heat therapy, and electrical stimulation are other methods used in this specialty. Icing therapy and heat therapy can be done at home, but a physical therapist may do ice massage or use ultrasound, which goes deeper into the tissues than a heating pad.
A major part of orthopaedic physical therapy is dealing with people experiencing a lot of pain. One of your jobs will be to help them work through it in addition to restoring and/or increasing strength, flexibility, and mobility of their joints. Their pain may also cause emotional issues such as depression and anger and might result in some of your patients not doing the exercises you suggest they do at home. You will have to convince them that the exercises they do in a session and at home will decrease their pain over time.
If pediatric physical therapy is your calling, make sure you volunteer with infants and children before or while you are in physical therapy school. As a pediatric physical therapist, you will see children with congenital defects and acquired ones due to illness or injury. You will also work with children that have developmental conditions that put them behind other children in their age group.
Spina bifida, scoliosis, and torticollis are congenital conditions affecting the spine and neck that limit a child’s mobility. Cerebral palsy is also a condition a pediatric physical therapist will deal with. You will see young boys and girls who are growing with knee pain known as Osgood-Schlatter. You may also see children who have problems that fall into the other specialties, but you will have to understand how they might be different in a child that is growing versus an adult who is not.
As a pediatric physical therapist, you will be working with kids and have the same goals you would have working with adults, such as improving mobility and strength. But there will be some differences like working with children that have developmental delays and also their exercises will be done to accelerate their progress.
Working with children will require you to be patient, as it may take longer for them to learn exercises. You have to be able to convince them to do exercises they may not want to do. You have to be very caring and empathetic to the child and get excited with their progress. You will also have to interact with parents, make sure they are on board with the plan of care you design, and help their children follow through with their exercises.
If you develop an interest in sports medicine physical therapy while in physical therapy school, you will be entering a specialty that is increasing in demand. You will treat people with orthopedic injuries and those that hurt themselves on the job, but most of the time you will be treating athletes who have sustained an injury while playing sports.
These injuries will most commonly be to tendons, ligament, joints, and muscles. The goal of physical therapy will be to reduce pain and inflammation and restore strength, mobility, and flexibility so that the athlete can resume his or her ability to play sports. The exercises you will have your patients do in a session and at home will mimic moves they do as an athlete, so the exercises you assign to a hockey player will likely be different from the ones you assign to a basketball player.
There are many perks to this specialty, such as being able to work in almost any setting including hospitals, clinics, rehabilitation centers, sports complexes, nursing facilities, and in a private practice. If you have to travel for work, all travel expenses are paid in addition to insurance, lodging, and processing documents for international travel. In addition to evaluating and treating your patients’ injuries, a major focus in sports medicine physical therapy is educating athletes on techniques they can use while playing sports to reduce the likelihood of future injuries.
If you are interested in physical therapy and women’s health, it is possible to combine the two fields by specializing in treating women. Physical therapy that specializes in women’s health will allow you to manage problems that are particular to women that impair their strength and mobility in recreation, work, and daily life. Common conditions that particularly affect women throughout their lives are lymphedema, osteoporosis, pelvic pain, prenatal and postpartum issues, and urinary incontinence.
Lymphedema is a condition that occurs when the lymph system, our drainage system that removes fluid from tissues, gets blocked up. This usually occurs when lymph nodes are surgically removed. Swelling occurs in the affected area and can limit mobility in severe cases. Physical therapists manually drain the area using massage and then place compression bandages over it. Osteoporosis is a condition common in menopausal and postmenopausal women in which the bones lose density, leaving women at risk for fractures so physical therapy for these women focuses on preventing fractures that could limit their mobility. Pelvic pain and urinary incontinence are also problems that are common in women, and you will manage these problems to decrease pain and strengthen the pelvic floor.
A physical therapist that specializes in women’s health also helps women before and after pregnancy, which affects the joints and muscles due to changes in hormones and increases the physical demands on muscles. Some muscles in women become tight during pregnancy and weak afterward. Physical therapy exercises can be done to help loosen and strengthen them during each stage. Physical therapy can also help women adjust to changes during pregnancy that can lead to problems with balance, mobility, and pain in the joints and muscles.
If you know that women’s health is the specialty you want to pursue before going to physical therapy school, it would benefit you to work at an obstetrician/gynecologist’s office or with an organization that promotes women’s health.