The Department of Physical Therapy at Texas State has prepared a proposal for consideration and approval by the university and then the Texas Higher Education Coordinating Board that would convert the current MSPT program to a DPT with the first class starting as soon as Summer 2008. The program is designed as a three year entry level program. The faculty completed a thorough evaluation of the MSPT program in preparation for the design of the DPT curriculum. Courses that have been added include a pharmacology course, a medical imaging and diagnostics course, a series of clinical decision making courses, and an additional clinical education course. Other courses have been reconfigured – for instance, the musculoskeletal series now includes an anatomy course as well as an evaluation and intervention course and the neuroscience course sequence has been expanded from three courses to four courses. Additional hours have been added to the research component and to the management component.

The rationale for the entry-level DPT is based on at least four factors – the level of practice inherent to the growing role of the physical therapist in health care today; the societal expectations for the autonomous health care practitioner as indicated in the Guide to Physical Therapist Practice; the goals of the profession for the coming decades – direct access, evidence based practice, “physician status” for reimbursement purposes; and the academic workload required to meet the competencies for practice in this century.

This proposal allowed the department faculty to analyze the current curriculum to determine what works well and what changes need to be made as well as to add components that will support the growing role of the physical therapist. This DPT curriculum will provide the student with a solid professional grounding with the breadth and depth required for successful clinical practice.

The Doctor of Physical Therapy (DPT) is a post baccalaureate degree conferred upon successful completion of an entry-level doctoral professional education program.

Physical therapy education in the US has undergone a number of changes since the advent of the first programs during the 1900’s in response to the need for “reconstruction aides” during WWI. In 1918, the Office of the Surgeon General of the Army developed the first formalized training programs for physical therapists. In 1928, the American Physical Therapy Association (APTA) established the first guidelines for minimum course requirements of schools training physical therapists. These schools awarded a certificate in physical therapy. In 1960, the baccalaureate became the required degree offered by physical therapist education institutions.

By the 1970’s, discussions were being held about post baccalaureate education for physical therapists. In 1976, the APTA Board of Directors appointed a task force to review and evaluate physical therapist entry-level education. With professional autonomy as a priority, the task force recommended that entry-level education programs be developed at the post-baccalaureate level. In 1979, the APTA House of Delegates adopted RC 14-79, a resolution calling for entry-level education of the physical therapist at the post baccalaureate level. The level (masters or doctoral) was left to the decision of the institution.

The transition from the baccalaureate degree to the post baccalaureate degree for entry-level was quite gradual. In 1993, the APTA developed and published the Normative Model of Physical Therapist Professional Education, a consensus document that confirmed this recommendation, and the Guide to Physical Therapist Practice. As these documents became widely used and accepted, the APTA HOD encouraged the Commission on Accreditation in Physical Therapy Education (CAPTE) to end accreditation of baccalaureate programs. In response, CAPTE announced that effective January 1, 2001, it would no longer accredit baccalaureate-level education programs. Over 20 years after the resolution was presented, the goal of post baccalaureate education was achieved.

In 1993, Creighton University accepted the first class into their inaugural entry-level “DPT” program. Soon after that, the University of Southern California and Slippery Rock University joined Creighton to be the first three institutions in the US to offer the DPT. The pace for transition of programs to the DPT has been much faster than the transition from baccalaureate to post-baccalaureate degree preparation for entry-level physical therapist practice. As of September 1st, 2006 there are 163 of the 210 programs in the US at DPT entry level programs.

The DPT is an integral part of the APTA Vision 2020 - “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 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.” This statement does envision that physical therapy will be a doctoring profession. Obviously, the hallmarks of a doctoring profession require a certain level of evidence of doctoral professional education, code of ethics, autonomous decision-making, provision of specific services, and a unique theoretical body of knowledge, a service mission, and recognition by society. The transition to the DPT is warranted based on the increased scope, rigor, depth, breadth, and length of entry-level programs. It is also based on the assumption that programs will be better positioned to successfully recruit the most qualified applicants in a highly competitive applicant marketplace; and the decision is in the best interests of the practitioner of the future.

The movement by health care professionals to change the entry level degree is not new; many programs have grown from certificate to bachelor’s to masters and now to doctoral degrees given the changes in health care over the past 100 years. The most well known professional doctorate is the Doctor of Medicine (1910), followed by the Doctor of Dental Science in the 1920’s. Pharmacy made the transition from the traditional four year bachelor’s degree to a five year program as early as the 1950’s. In the 1970’s the Doctor of Pharmacy was proposed and implementation has occurred across the country. By 1992, the American College of Clinical Pharmacy House of Delegates voted to support the Pharm D as the sole professional degree in pharmacy. In the 2000’s, the audiology profession started the transition to the Doctor of Audiology (Aud D), with five states indicating that a doctoral degree in audiology is required for licensure. And most recently, the nursing profession has adopted the Doctor of Nursing Practice.

Until the mid 1990’s, TWU was the only institution in Texas that was authorized to offer a post-baccalaureate degree in physical therapy. The Texas Higher Education Coordinating Board (THECB) was firmly entrenched in holding the entry-level degree at the baccalaureate level. The PT programs in Texas developed a united front and worked closely with the APTA, the TPTA, and the THECB to come to an understanding that Texas had to be open to the transition. This occurred and all programs at public institutions made the transition to a master’s degree in physical therapy prior to the CAPTE decision. These programs have once again worked together to meet the challenge of the transition to the DPT and all are in progress at this time.

There are ten physical therapist educational programs in Texas. Eight are public; two are independent with one private and one military. The public programs are offered at Texas State University-San Marcos, Angelo State University, University of Texas Health Science Center – San Antonio, University of Texas Medical Branch at Galveston, University of Texas at El Paso, Texas Tech University Health Science Center, University of Texas Southwestern Medical Center at Dallas, and Texas Woman’s University (Houston and Dallas). Hardin Simmons University is the only private program in Texas and has implemented their DPT program. The military program is the US Army – Baylor program; they also offer the DPT.

DPT at Texas State University-San Marcos

The physical therapy program received initial accreditation of the BSPT program in May 1986 prior to the December 1986 graduation of the first class enrolled in the program. Since that time over 200 students have completed the BSPT program and obtained licensure as physical therapists. The last BSPT cohort graduated December 1996. The MSPT program accepted the first cohort of 32 students for matriculation in June 1995, graduated May 1997, and the MSPT curriculum was accredited May 1998. Over 200 students have now completed the MSPT curriculum and obtained licensure to practice physical therapy. We are excited about the continued transition of our program and look forward to the implementation of the DPT in June 2008.