How to Become Licensed as a Physical Therapist in the United States, as a Foreign-Trained Physiotherapist

I am writing this article due to the fact that when I was applying for this process, I could barely find any information or personal experiences of people on the internet who had successfully gone through the process. This is to help you, a motivated physiotherapist, to become licensed to practice in the United States. 

The steps in short:

1. Apply for a Type 1 Comprehensive Credentials Evaluation via the FCCPT

2. Once you are found to be “substantially equivalent” to a US Doctor of Physical Therapy, you will receive an equivalence certificate which is automatically sent to the State/jurisdiction that you initially applied to (i.e. Texas)

3. You then contact the jurisdiction that handles licensing for PT and they will then set you up with an account with the Federation of State Boards of Physical Therapy FBSPT, the company that runs the National Physical Therapy Exam (NPTE).

4. You apply to take the exam on one of the four dates they list per calendar year. 

5. Take your 5.5 hour exam and once you pass, these results are automatically sent to the jurisdiction you indicated.

6. Apply for a PT licence through your jurisdiction, then you are licensed!

Sounds simple right? Unfortunately the reality is much more complex. Here’s my experience and how to avoid the complications I had. The process for me from start to finish took almost 3 years.

First you apply for your Type 1 review. This took 7 months for me, but I believe they are trying to get these done sooner now. You need to send: a notarised copy of your physiotherapy diploma (i.e. by a notary public), for Australians, The Australian Health Practitioner Regulation Agency (AHPRA) to send them a certificate of good standing (the FCCPT have these forms), an application form and your University to send them the syllabus of the Physiotherapy degree you took. You need to have ALL subjects/topics covered in their credentials review in order to be equivalent. You CANNOT be deficient in a single area. You will be assessed on general education (i.e. subjects that are NOT specific to physiotherapy - e.g. chemistry, physics, maths… just like a usual undergrad US college degree asks of you), professional/physio-specific education and clinical placement hours. If you are deficient in clinical hours, you can use your employer to sign off on a certain amount of hours that they stipulate in their website. You should also expect to be deficient in many general education subjects since we don’t do gen-Ed’s in Australia. 

It may be worthwhile looking at the CW6 criteria on the FCCPT to ensure/ask your university to include those topics in their syllabus, so you avoid having to do what I did - which I explain in the next section.

Unfortunately my university did not send a very comprehensive syllabus and so I was not found substantially equivalent. You will receive an email with this:

When I read through what I was deficient in for professional education (which was almost 60 topics/deficient areas), I saw that we actually covered an extraordinary amount of these - i.e. Interventions: Airway clearance techniques. But my university did not stipulate this in the syllabus they sent. 

What I then had to do was ask my university to kindly add this to their syllabus to resend to the FCCPT. 6 months later of just waiting, the director of my physiotherapy program/head of the physio department, comes back saying “sorry, we dont keep records of what we taught in previous years”. And was left hanging. It took them almost 7 months to respond to me. The FCCPT then said, “we accept lecture slides, subject guides, handouts etc, as long as its stamped by the University and is accompanied by a cover letter”

So, luckily, I kept ALL of the files for every single subject in my laptop and went through every single deficiency listed above and found the corresponding lecture file or guide etc to accompany it. I then asked my university to print ALL of these out and stamp it and mail it. FCCPT WON’T accept emails. It must be physical mail. So I emailed everything to my university and they mailed it to the FCCPT with my file number on it. As long as every document you send has the subject name, the date and semester it was taken written on it (which corresponds to the subject outlined in the syllabus) then it will be accepted. 

If you're deficient in areas that you know you’ve taken already, make sure you have files to back it up. 

After La Trobe sent ALL of the extra documents, I applied for a credentials re-evaluation (which is faster, took about 3 months) and received this:

All up, this meant about 10 subjects worth of courses I needed to take. Most of these subjects you can definitely expect to be deficient in since we do not study this in Australia: i.e. Interventions: Wound debridement. 

Once you feel like there’s nothing else your university can send to prove that you’ve covered these deficiencies in your coursework, you then apply for a PLAN through the FCCPT. Your PLAN advisor will send you a list of Universities that have online courses that cover these deficient areas. Take your time as you read since there are subjects that cover more than one deficient area - i.e. for me, the University of St Augustine’s course for Evaluation covered both the “systems review” AND the “Documentation” deficiency so I could get two for one there.

The gen-ed’s are easy. Just do them through the University of Phoenix (chemistry, physics etc) since they start courses every month versus having to wait until an actual college semester to commence. College Mathematics may be tricky, since I had to take the exam in person at a community college. Perhaps they have a satellite office for overseas students. This is through the CLEP exams. I had to study the content on my own through study.com and then just take the exam.

Professional classes are similar and thanks to covid you can pretty much do all of them online. They all seem to have their own start date that you need to organise and enrol in in advance so that you start on time. You just email the person the FCCPT PLAN advisor provides and you state that you’re a foreign PT trying to gain equivalence via the FCCPT. They all know what that means. You may need to do the Basic Life Support (BLS) cert (for the patient-related emergency procedures deficiency) through the American Heart Foundation in the USA in person - however you should ask your PLAN advisor to clarify this. It’s approximately a 2 hours CPR course.

I was then deficient in clinical hours. I did my hours through a University who just said for me to find a clinic, give them the documents the Uni needed signed, do the hours then they send that to the Uni. 

After you’ve completed every course, you then get all of the institutions to send all the transcripts to the FCCPT. The BLS cert you just need to get notarised then you mail it to them. 

You then reapply for another credentials re-evaluation. You then will receive something like this:

As you can see above, where it says “equivalency” it now says “equivalent”.

This is your biggest hurdle. Now, it's time to take the exam

The Jurisdiction you indicated for your credentials to be sent to will receive this equivalency notice from the FCCPT. You then call them saying that your equivalent, they will find the email and confirm. They then give you information to make an account with the FSBPT. Once confirmed, your jurisdiction will send you a “letter to test” or something along those lines that you need to provide the FSBPT that basically confirms that your state is allowing you to take the exam. You then select the date you want to take the exam. 

In terms of study, this exam is exceptionally hard. It’s even harder for us since we have been out of uni for so long are more specialised in our area of practice, which is not examined to the level we know. Instead your neuro, cardio, lymphatic, wound and other areas are heavily tested. It is a 5.5 hour exam with 250 questions and you can read how its done online. (50 questions aren’t scored - you will read about this when you get to it). There are plenty of resources out there. I used “PT Final Exam”. Listen to podcasts and answer as many questions as possible. I did a total of 10 practice exams (200 questions each).

Once you pass the exam all you do now is apply for your license through your jurisdiction (the state you're applying to) and you’re pretty much set to go. 

In terms of getting a US Visa, for Australians, the Australian E3 is the easiest one to get - you just need a sponsor employer. I’ve been through this process and know what’s required to gain this visa. I don’t know how other countries can apply.

I am a greencard holder/permanent resident of the United States, therefore I don’t worry about employers any longer and hence why I am now self-employed running my own practice. 

**The FCCPT logo is used for educational purposes only, not for endorsement or monetary gain.