How long does it take to get a phd in physical therapy

Physiother Can. 2011 Spring; 63(2): 140–142.

The practice of physical therapy is quickly advancing and moving into new realms. This is an exciting period of growth and development in our profession, and the changes in health care delivery, social demographics, and globalization of health care are perfect opportunities for physical therapists to take on new and emerging roles in our health care system and to provide leadership in the field. As the profession forges ahead, a question arises: Is it time to discuss the idea of a “clinical doctorate” as the requirement for entry level to practice?

A clinical doctorate (or “practice doctorate”) programme is an entry-level degree that prepares students with the competencies required to enter clinical practice and become eligible for licensure.1 In physical therapy, this is often called the Doctor of Physical Therapy (DPT) degree; it differs from a PhD, where the focus is on research and the production of original scholarly work, and from a “post-professional doctorate” or “advanced practice doctorate,” which offers study in advanced or specialized clinical competencies to professionals who have graduated with another entry-level qualification, such as a bachelor's or master's degree.

The title “doctor” is used across many health care professions in Canada. Physicians and surgeons, chiropractors, dentists and dental surgeons, podiatrists, optometrists, naturopaths, and veterinarians all require a doctoral degree for entry to practice. Common themes that have been identified across these professions include autonomy in practice, knowledge of research, a specific number of credit hours required for the programme, and a specific number of clinical hours required. Some professional programmes also require that the student complete a residency prior to full licensure.1

What is Happening in other Countries?

In the United States, the American Physical Therapy Association has mandated that all programmes for physical therapy be at the doctoral level by 2020, and 213 of 232 physical therapy programs have already transitioned to the DPT.2 The first doctorate-trained physical therapists in the United States graduated in 1996 from Creighton University in Nebraska, and models of the programme were being built as early as the 1980s.3 Bond University, which offers the only clinical doctorate programme in physiotherapy (D Phyt) in Australia, graduated its first class in 2009.4 This programme offers a 2-year problem-based curriculum to train students at the doctoral level. In Europe, there are currently no clinical doctorate programs in physiotherapy.

Justifying the Need for a Higher Credential

Although there are some who argue that a doctoral degree would acknowledge the rigorous academic training and advanced clinical skills already possessed by our current graduates, others question whether the issues facing the physical therapy profession today and in the future can be solved by entry-level doctoral programmes.3,5–7

Threlkeld et al.6 developed a theoretical framework describing three major forces that would influence the movement from a master's degree to a doctorate at entry level: external forces, intra-organizational forces, and internal forces. Although these were primarily discussed with reference to the US system of health care and education, much of the framework is readily applicable in Canada. Threlkeld et al. defined external forces as those that lie outside the immediate educational programme8 and broadly categorized these forces into society and professional community. Societal needs include the changing demographics of our population, such as ageing and increased immigration; delivery of culturally sensitive health care; and the explosion of research in genomics and its influence on health. Professional community issues are those such as the influence of a doctoral degree on salaries, workforce demand issues, market niches for new graduates, and views on the title “doctor” on the part of other health care professionals and the general public.6 Intra-organizational forces were defined as influences of the universities and academic settings in which the doctoral programme would be delivered;6 each physical therapy department would need to evaluate its ability to deliver this programme, whether the programme matches the mission of its institution, and whether the departmental structure exists to allow the delivery of an entry-level doctoral degree programme. Finally, internal issues were defined as those within the professional programme itself, for example, whether programme faculty support a transition to a higher-level degree, whether the outcomes for the degree match the curricular goals, and whether the students have expectations and meet outcomes consistent with those of a doctoral degree.6

Perhaps the most important conclusion to be drawn from examining this framework is that a broad range of stakeholders needs to be involved in the discussion of entry-level doctoral programmes. These stakeholders include, but are not limited to, physical therapy clinicians, health professional colleagues, members of the public, health care policy makers, hospital administrators, academic leaders within the university, members of regulatory boards, physical therapy educators, and researchers. The unique views of each of these stakeholder groups on the impact of the DPT will deepen our understanding of critical issues and provide the foundation for discussion.

The Debate

Many of the arguments for and against moving toward the DPT credential have been well described in the physical therapy literature, as well as in the literature on other health professions.5,9–11 Table ​1 summarizes the major points that cross disciplines.

Table1

Arguments For or Against Moving to a Doctorate in Physical Therapy (DPT)

Evaluating Our Current Position

In Canada, we have only recently (in the past 10 years) moved from a bachelor's degree to an entry-level master's degree. As we think about entry-level education, it may be the right time to critically evaluate the impact that the entry-level master's programme has had on our profession. A unique opportunity for such evaluation was available in the United States in the late 1980s and early 1990s, when both bachelor's- and master's-trained physical therapists were graduating at the same time. Several surveys explored the differences in practice patterns, use of research, and other professional issues between bachelor's- and master's-trained students. Although results varied among surveys, physical therapists with master's entry-level education indicated more appreciation for research and a greater likelihood of conducting research, anticipated greater involvement in both research and teaching, and anticipated greater level of preparedness to enter the profession where there was direct access to patients.12

Evaluation of the Canadian experience with master's entry-level education may be used to explore a number of questions, including the following:

• Has the master's degree improved patient care?

• Has the master's degree affected employment patterns, workforce issues, or salaries for physical therapists?

• Are more master's-level graduates taking on leadership, administrative, or advocacy positions in the health care system?

• What has been the impact on involvement in professional organizations, research, clinical teaching, or academic appointments of entry-level physical therapists?

• Has there been a change in the degree of hands-on therapy being provided by physical therapists?

• Is there a change in demographics or aptitudes in the pool of students applying for physical therapy programs?

• Is there a difference in the public perception of physical therapists who are trained at the master's level?

Although these are just a few of the questions we need to explore, this type of critical inquiry would put us in a better position to truly discuss how a change in the entry-level degree can affect our profession.

Summary

Whether the conversation takes the form of debate or discussion, this may be the right time for physical therapists across the country to start talking about the DPT. It is our responsibility to determine the educational needs of our own profession, and it is essential that we start these conversations early, with a broad range of stakeholders.

References

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Articles from Physiotherapy Canada are provided here courtesy of University of Toronto Press and the Canadian Physiotherapy Association