Each January, 36 working physical therapist assistants (PTAs) from across the country converge in Findlay, OH, to take the first steps toward becoming doctors of physical therapy (DPTs). Because of their already-completed bachelor's degree (a program requirement) and working experience in the physical therapy field, these students are eligible to enroll in the University of Findlay's unique PTA-to-DPT bridge program, which meets every other weekend on the Findlay campus, and includes three full-time clinical affiliations in acute, subacute and outpatient care.
"The program is stressful," conceded Sue Cox, administrative assistant in Findlay's physical therapy department, adding that students must maintain 40 hours per month of employment as a PTA to remain in the three-year bridge program. It's typical for several students to drop out along the way, as the pressures of coursework, clinical rotations and travel schedules clash with their work and family responsibilities back home.
Still, for this small cohort of students, putting in the additional hours of coursework and assuming added tuition debt is a short-term trade-off for the added benefits in terms of job opportunities, salary expectations and on-the-job responsibilities.
Defining Bridge Programs
Bridge programs are defined as a transitional program that culminates in a higher clinical degree within your current profession, affording a broader range of clinical responsibilities. Not to be confused with academic-track programs (i.e., a master's-level PT returning to school for a DPT), which signify additional academic training but not necessarily a difference in on-the-job responsibilities, bridge programs are typically offered to associate-level professionals. And they're not limited to the PT field.
Occupational therapist assistants (OTAs) can select from a large assortment of OTA-to-OT bridge programs nationwide. Many involve evening and weekend coursework combined with online learning to allow OTAs to continue working while earning their degree. These programs culminate in a bachelor's or master's degree in occupational therapy.
Concordia University in Mequon, WI, offers a Transitional Program for Occupational Therapy Assistants (TOTA) that culminates in a bachelor's degree in rehabilitation science and a master's degree in occupational therapy.
Each fall, a group of 20 OTAs begin the three-and-a-half year program, said Linda Samuel, PhD, OT, dean of the school of health sciences and director of Concordia's occupational therapy program.
Classes operate on a combination online and weekend class format, allowing students to continue full-time work while completing classes. Tuition is currently $7,735 per semester and the program operates on a three-semester per year basis.
"The course structure is rigorous," said Samuel, and covers both traditional coursework and field work. "We have students come from all over the country, in all areas of practice and all age groups. Most of our students have families and need to be employed as the assignments are applied to the clinic."
Demand for Bridge Programs
As entry-level requirements for health care degrees evolve, bridge programs must frequently adapt to accommodate student needs. PTA-to-PT programs, once commonplace, have all but disappeared from the educational landscape. These programs were established when the PT entry-level degree was still at the bachelor's level, according to the American Physical Therapy Association (APTA).
Now that the profession has moved to an entry-level master's (with the ultimate objective of having all entry-level PTs at the doctoral level), most PTA-to-PT programs have closed, as undergraduate course credits earned in a PTA program cannot be applied to graduate-level PT programs.
"A PTA who decides to become a physical therapist is changing careers, not advancing from a PTA to a PT," reads a statement on the APTA's educational resources website. Currently, Findlay's bridge program is the only such accredited program in the country, according to Cox.
Because of this, demand for these transitional programs is high.
"I cannot understand why this market is not being tapped," said Polly Bowers-Maness, a PTA in Nacodoches, TX. "PTAs need to be able to gain the additional education if they are willing. The experienced PTA would make a wonderful candidate for a DPT. Just allow us to work to pay our bills while we fill the education gap."
Cox estimates that about double the number of Findlay's program capacity applies each year. There is no waiting list, so those who don't make the cut must wait a year and re-apply.
Like Findlay's program, Concordia's TOTA program is in high demand. "We generally receive 35 to 40 applications for our 20 spots," said Samuel. "If a student meets all the criteria but isn't placed, they're guaranteed a spot next year."
Many students of bridge programs cite the added clinical stature and prospect of running a department as main reasons for returning to school.
"Our students are confident OTAs who want to learn more about planning and developing the treatment plan for their patients," said Samuel. Cox added that because students undergo clinical affiliations in a variety of job settings as part of their curriculum, many end up being exposed to new patient populations and specialties. Some even change careers, either within their existing facility or moving to another employer altogether.
And the prospect of a higher salary after graduation leads many to look past the initial tuition cost. Based on the U.S. Bureau of Labor and Statistics Occupational Handbook, the median salary in May 2010 for OTs was $72,320; for OTAs it was $51,010. Physical therapists earned an average of $77,990 according to the most recent Bureau of Labor Statistics estimates, compared to $49,800 for PTAs.
"Technically there is enough difference that the increased wages could help to pay for the cost of tuition," said Samuel. "The cost is a factor but we also have a number of students who are nearing retirement and want to become an OT."
LPN Bridge Programs
The therapy fields aren't the only disciplines with bridge programs; working nurses can also benefit. LPN-to-RN programs are commonplace, and many can be completed online, allowing students to continue working and fit coursework around their schedules. Others maintain a traditional on-campus curriculum.
At Gordon College, a state-affiliated college in Barnesville, GA, working LPNs can elect to pursue an RN degree through its three-semester LPN-to-RN bridge program. Like Findlay's program, Gordon's begins each January, with students attending on-campus classes and earning their RN degree at the end of the spring semester the following year.
Candidates must have at least one year experience working as an LPN in addition to meeting Gordon's admission criteria for its two-year associate nursing degree, explained Saadia Ramsaran, spokesperson for Gordon's nursing education department.
Students must have a minimum cumulative 2.5 GPA for their LPN degree, must have completed essential core courses, and must pass a test of essential skills during the fall semester prior to starting the program.
Though the test assesses a candidate's technical nursing aptitude, "working LPNs should know the material and should be able to pass it," Ramsaran said. Admission can be competitive-last semester, the program received 32 applicants and 15 were ultimately accepted, Ramsaran said.
But if you make the cut, like OTs and PTs, your career outlook can be improved greatly. "Employers in our area are looking for RNs," said Ramsaran. "And it doesn't look like it's slowing down anytime soon."
Bridge programs are a commitment-both in time, money and effort. If you're considering one, it helps to be prepared.
"I think the hardest adjustment for the student is time management," Samuel said. "It takes approximately one semester to find time for work, school and their home and family. It's important that students try to integrate all phases of their life and make time. Families and friends also need to be supportive and understanding."
If you feel you're ready to make the leap, Cox recommends starting by asking your current employer if they'll help offset some of the tuition cost-since many insurers are beginning to mandate that their covered therapy services be provided by clinicians holding higher degrees, many employers might feel the long-term investment is worth it to reimburse for the education of a valued and skilled employee.
This could be the most valuable asset of bridge programs, according to many health providers-the creation of a more robust and better educationally prepared health care workforce.
"We have to grow with societal needs and meet them," said Bowers-Maness. "In rural East Texas, there are not enough therapists to treat the population of geriatric [patients], much less pediatric and specialty areas. The PTA is a great source to fill those needs, but we need the opportunity to grow."
Jonathan Bassett is managing editor of ADVANCE and can be reached at firstname.lastname@example.org.