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Raising the bar
Tuesday November 13, 2012

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Cost of DPT programs vs. Starting Salaries

Many DPTs with heavy student loan debt are seeing sticker shock when they begin their first jobs, educators said.

ďEmployers didnít really make a significant change in pay for the added DPT credential,Ē said Deborah L. Givens, PT, DPT, PhD, chairwoman of the physical therapy department at Creighton University.

Multiply tuition costs by three years, and itís easy to see total costs mounting from a low of $15,000 to a high of $135,000 ó a cost that doesnít include room and board, extra fees and other expenses.

According to CAPTE, the average annual tuition for a DPT at a public in-state school last year was just more than $14,000, but the range of tuition costs varied among public schools from a low of about $5,000 for the year to a high of $34,000. DPT tuition at private schools and public out-of-state schools was even more expensive, averaging about $27,000 a year. The range at these two types of schools ran from $10,000 to $45,000.

At the same time, a starting PT salary generally is about $50,000, according to the educators, although some settings pay more than others.

The DPT graduate does have two strong avenues for higher incomes during their careers, however, Givens said. They should be more prepared to be entrepreneurial and start their own clinics or be able to work more quickly up the ladder in other settings with the advanced degree, she said. Either path would lead to higher salaries to help manage their school debt.


In 1996, Creighton University in Omaha, Neb., awarded the first Doctorate of Physical Therapy or DPT, the beginning of a monumental shift in physical therapy education.

While it took several decades to move the professionís end degree from a bachelorís to a masterís, physical therapist educators said it has taken just 16 years to move the entire PT educational system to the doctorate level.

Today, just one out of 212 accredited programs still offers a PT masterís degree program, according to the American Physical Therapy Association. And of the 22 new PT educational programs in development at schools across the country, all are starting DPT programs.

The University of Puerto Rico education system is the last holdout with an end degree for PTs at the masterís level, but that also will change by 2017 to stay in compliance with a requirement by the Commission on Accreditation in Physical Therapy.

Otherwise, the DPT is the only way to become a PT today. Numbers tell the story of this huge transition in education levels (see sidebar).

"I think people see the value of the degree," said Rob Landel, DPT, OCS, CSC, FAPT, director of the DPT program at the University of Southern California in Los Angeles, rated No. 1 by U.S. News & World Report. "The applicants see that what theyíre going to get for an extra year is worth it. Itís just one more year."

More time for curricula

The extra time in a DPT program allows an expansion of curricular content in several key areas, said Jody Frost, director of academic/clinical education affairs for APTA. Among the additions are courses in exercise physiology, pharmacology, radiology and imaging, evidence-based practice, professionalism and ethics, she said.

There is now a documentation component in PT education that includes health information systems and reimbursement, Frost said. And, importantly, the doctorate program includes the application of the patient/client management model in physical therapy across all systems (musculoskeletal, neurologic, cardiovascular pulmonary, integumentary, GI-GU, etc.) and across the lifespan and all levels of acuity, health promotion and wellness.

Critical thinking is a key component to the DPT curriculum, said Dale Avers, DPT, PhD, associate professor at the department of physical therapy education at the State University of New York Upstate Medical University at Syracuse. "We are teaching at a higher level to the elements of critical thinking," she said. "Time in the program now allows for it."

The requirement for supervised student clinical education also has been lengthened to a minimum of 30 weeks of full-time clinical education, Frost said. There also are part-time clinical experiences integrated throughout the curricula at different times, she said.

The extra curriculum and clinical time prepares students to easily transition to the workforce, said Deborah L. Givens, PT, DPT, PhD, chairwoman of the physical therapy department at Creighton University. "DPTs are more capable of hitting the ground running," she said. "At Creighton they put 46 weeks total in the clinics before graduation."

Easier recruitment

The DPT program has made it easier to recruit students, Avers said. "We have 33 students in our DPT program a year and around 250 viable applicants," she said. "Itís pretty attractive for people to have a doctorate. There is a traditional prestige to it."

USC had 1,200 applicants for 97 spots this year, Landel said.

Nationwide, the acceptance rate into DPT programs averages 44 student openings for a total of 357 applicants, of which 234 are labeled as qualified, according to CAPTE.

Many PT schools, such as SUNY Upstate Medical, are expanding to meet demand. "We have plans to expand to 40 students in the next three years," Avers said.

Landel said USC is looking seriously into offering a blend of online courses with its regular classroom curricula in the next five years.

Nationally, the window is closing rapidly for tDPT programs, which generally are offered on weekends or other times that fit with the schedule of a full-time job and often have an online component. More than 15,000 licensed PTs have completed their tDPTs since 1999, Frost said.

Today about 70 schools offer tDPT programs either on campus, online or via a combination of the two, according to Frost. But just three schools are developing a tDPT program, and many schools report they have closed or are in the process of winding down their tDPT programs. "Sixteen programs have closed since 2005 as academic programs recognize that they will have a limited time frame as the demand for these programs by licensed PTs wanes," Frost said.

2013 is the last year SUNY Upstate Medical will offer the tDPT, Avers said. "A lot of the therapists who are 45 to 60 years old are holding out to retire instead of going back for their DPT," said Avers, who directs the universityís tDPT program. "We have to drag them in kicking and screaming because they think they have to spend a lot of money and time. But I have yet to find one tDPT candidate who didnít say it was worth it."

Advantages to a DPT

While virtually all new PT graduates now will hold a doctorate, no state specifically requires a DPT degree for licensure at this time — only that the candidate successfully has graduated from an accredited program and passed the national exam, Frost said.

But the DPT plays a supporting role in the professionís push for patients to have direct access to a PT without having to be referred by a physician, educators said. "PTs are now educated in everything that is necessary to recognize when a patient is presenting in a certain way," Landel said. "The DPT allows us to make that argument a lot more convincingly."

Some form of direct access to PTs is available in 47 states and the District of Columbia, Frost said.

The DPT also gives extra weight for the PT in working with physicians as part of a team, Landel said. "There is a national recognition that PTs are so much better educated now," he said. "The science is much deeper as is the breadth of what they learn in clinical settings."

Younger physicians generally are more welcoming of DPTsí expertise than older physicians, and value the relationship more, Givens said. "If medical doctors see a PT as a referral source, they become more engaged," she said. "We try to push that weíre all part of a team."

As to whether or not a DPT should be called "doctor," that depends on whom you ask. "We still identify ourselves as a PT and not your doctor," Givens said. •

Teresa McUsic is a freelance writer.

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Tuesday November 13, 2012
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