Research Report

Minority Applicants to Physical

Therapist Education Programs
2010 –2012
Matthew A. Nuciforo
M.A. Nuciforo, PT, DPT, OCS,
FAAOMPT, Department of Physi-
Background. In 2011–2012, despite comprising 35% of the US population, cal Therapy, Rosalind Franklin Uni-
minorities comprised 20% of applicants to and 15% of enrolled students in accredited versity of Medicine and Science,
physical therapist education programs. Solutions aimed at addressing current dispar- 3333 Green Bay Rd, North Chi-
ities in health care may include educating physical therapists in environments reflect- cago, IL 60064 (USA). Address all
ing the increasing diversity of the US population. correspondence to Dr Nuciforo
at: matthew.nuciforo@rosalind
franklin.edu.
Objective. The purposes of this study were: (1) to describe the underrepresented
minority (URM) applicant pool to Physical Therapist Centralized Application Service [Nuciforo MA. Minority applicants
to physical therapist education
(PTCAS) member programs and (2) to investigate differences in application patterns
programs 2010 –2012. Phys Ther.
between white and URM applicants in 2010 –2012, including total number of pro- 2015;95:39 –50.]
grams to which they applied, likelihood of applying out of state, and application to
© 2015 American Physical Therapy
programs with minority faculties.
Association

Design. This was a national, retrospective descriptive study. Published Ahead of Print:
August 28, 2014
Accepted: August 24, 2014
Methods. De-identified data for 11,690 applicants in 2010 –2011 and 13,462 Submitted: November 25, 2013
applicants in 2011–2012 were obtained, including applicant demographics, selected
metrics, and admission decisions. Descriptive statistics and analysis of variance with
multiple comparison procedures (Tukey honestly significant difference test) were
used to investigate differences between white and URM applicant metrics and
application patterns.

Results. White applicants achieved significantly greater grade point average and
Graduate Record Examination scores than Hispanic and African American applicants.
Although there were no significant differences in the average number of programs
applied to between white and URM applicants, Hispanic applicants were significantly
more likely to apply to programs within their state of residence. Underrepresented
minority applicants were significantly more likely to apply to programs with minority
faculties.

Limitations. This study did not attempt to generalize the results beyond PTCAS
institutions.

Conclusions. Hispanic applicants demonstrated a significantly increased likeli-

hood of applying within their state of residence. Underrepresented minority appli-
cants demonstrated a significantly greater tendency to apply to PTCAS member
institutions with minority faculties.
Post a Rapid Response to
this article at:
ptjournal.apta.org

January 2015 Volume 95 Number 1 Physical Therapy f 39

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 Minority Applicants to Physical Therapist Education Programs
A
ccording to 2010 US census
data, the racial/ethnic minor-
ity population has grown sub-
stantially over the last decade. The
greatest growth occurred among the
Asian and Hispanic populations,
each over 40%. In 2010, Asians com-
prised 4.8% and Hispanics 16.3% of
the total US population. The African
American population grew 12.3% to
comprise 12.6% of the total popula-
tion. Overshadowed by the growth
of minority populations, the white
population sustained a meager 5.7%
growth in 2000 –2010.1 Despite cur-
rently comprising 72.4% of the total
US population, by 2045, non-
Hispanic whites are projected to no
longer constitute a majority of the
population.2
In contrast to the increasing diversity
of the US population, minorities
remain underrepresented in the
physical therapy profession. Accord-
ing to US census data from 2006 –
2010, 80.9% of all physical therapists
were white. Only 4.5% self-identified
as Hispanic, 3.9% as African Ameri-
can, 9.4% as Asian and less than 1%
as American Indian, Alaskan, or
Native Hawaiian or Pacific Islander.3
Among members of the American
Physical Therapy Association (APTA)
as of 2010, only 2.1% of physical
therapists were Hispanic, 4.7% Asian,
1.4% African American, and less than
1% American Indian, Alaskan Native,
or Hawaiian or other Pacific Islander.4
In response to health care inequities
and disparities, APTA’s Vision State-
ment for the Physical Therapy
Profession5 and Guiding Principles
to Achieve the Vision6 support
increased enrollment of physical
therapists from underrepresented
racial and ethnic minority groups.
Although total enrollment within
physical therapist education pro-
grams has increased approximately
55% since 2003, white student
enrollment has maintained a steady
majority of around 80%. Also,
40 f Physical Therapy Volume 95
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although the US Hispanic and Afri-
can American populations have
grown by 43% and 12.3%, respec-
tively, in the last decade, Hispanic
and African American enrollment
declined by nearly 17% and 30%,
respectively, from 2004 to 2011.7
In 2011–2012, minorities comprised
a meager 15% of enrolled students
in accredited physical therapist edu-
cation programs. Hispanic enroll-
ment (4%) and African American
enrollment (3.4%) were appreciably
underrepresented compared with
the general population.7 The decline
of minority enrollment of these races
in particular will only contribute to
an already disproportionate repre-
sentation within the profession.
The Need for Diversity
Although there is a paucity of evi-
dence addressing the benefits of
diversity in physical therapy, analo-
gies may be drawn from medicine.
The recent Institute of Medicine
(IOM) report Unequal Treatment:
Confronting Racial and Ethnic Dis-
parities in Health Care8 cited sub-
stantial evidence that minorities are
less likely than whites to receive
needed services, including clinically
necessary procedures, even after
correcting for access-related factors,
such as insurance status. Although
the reasons for this disparity are
likely multifactorial, the underrep-
resentation of minorities in medi-
cine and health care presents a clear
challenge to public health. While a
direct link between a more diverse
health care workforce and improved
patient outcomes has not been fully
revealed, a strong framework in
support of diversity within medi-
cine has been established. A recent
review by Saha and Shipman9 dem-
onstrated minority physicians were
more likely than whites to serve indi-
viduals from their own racial back-
grounds and to provide care to
underserved populations. Moreover,
African American and Hispanic phy-
sicians are disproportionately more
Number 1
likely to provide care for patients
receiving Medicaid and uninsured
patients than white or Asian physi-
cians.10 Patient-provider racial and
ethnic concordance among minori-
ties also has been shown to posi-
tively influence use of health care
services and patients’ view of the
quality of those services.9 Although
the focus of research has been on the
physician workforce, it may be sur-
mised that the impact of increased
minority representation may like-
wise apply to other professions,
including physical therapy.
Emphasizing diversity and providing
all students, including nonminority
students, with curricular and extra-
curricular opportunities to address
racial and multicultural issues have
been previously associated with
widespread beneficial effects on
student cognitive and affective
development.10 –12 White medical
students educated in schools with
a more racially diverse student pop-
ulation were more likely to rate
themselves as highly prepared to
care for minority populations and
expressed more positive attitudes
about equitable access to care than
those in less diverse schools.11 Med-
ical students also have reported
that a diverse educational environ-
ment enhanced classroom discus-
sions, challenged values when racial
conflicts occurred, and prepared
them to work more effectively with
diverse patients.12 Addressing the
underrepresentation of minorities in
many health care professions, includ-
ing physical therapy, and implement-
ing planned diverse educational
experiences may affect the disparity
of health care delivery, as cited in the
IOM report.
January 2015

Diversity in the Health
Professions and
Physical Therapist
Education Programs
Given the disparity in health care
delivery, the increasing diversity of
the US population, and the benefits
of diverse educational experiences,
there is a clear need for increased
representation of minorities among
health professional students. The
underrepresentation of minority
students is not limited to physical
therapy but is reflective of similar
challenges facing other health pro-
fessions. White applicants com-
prised 61.9% of all applicants to US
medical schools in 2012. Hispanic
applicants composed a mere 8.2%,
and African American applicants
composed 8.4%.13 Among applicants
to US physician assistant programs in
2011–2012, 65.6% were white, far
surpassing the numbers of Hispanic
(8.4%) and African American (3.0%)
applicants.14 Whites comprised 82%
of all students enrolled in master’s-
level occupational therapy programs
in 201115 and 84% of students
enrolled in master’s programs in
speech and language pathology.16
Similarly, among students enrolled in
bachelor of nursing programs, 72%
were white.17
Table 1.
Percent of Total Applications to Physical Therapist Centralized Application Service (PTCAS) Member Programs in 2010 –2012 by
Race/Ethnicity Designation
Race/Ethnicity
White (not of Hispanic origin)
African American/black
American Indian/Alaskan Native
Asian
Hawaiian/Pacific Islander
Hispanic/Latino
Declined to state
a
Designations are not mutually exclusive. *In 2000, Asian and Hawaiian/Pacific Islander groups were combined.
January 2015
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Minority Applicants to Physical Therapist Education Programs
According to the Commission on Factors Affecting Minority
Accreditation in Physical Therapy Applicant Patterns to
Education (CAPTE), enrollment of Physical Therapist
white students remained essentially
unchanged from 2003–2004 (80.9%)
Education Programs
Although several studies have
to 2011–2012 (81.3%).7 Despite this
described various minority recruit-
finding, the profession has experi-
ment strategies in physical therapy,
enced meager growth in minority
few have sought to describe actual
applications to education programs.
minority application patterns and
In a 2000 national study of physical
address possible reasons for minority
therapy applicants, Goldstein and
underrepresentation relative to the
Gandy18 identified 83.3% of the
general population. Factors influenc-
applicant pool as white, not of His-
ing physical therapist program
panic origin. In 2010 –2011, white
choice have been shown to differ
applicants comprised 66.74% of all
between underrepresented minority
applicants to Physical Therapist Cen-
(URM) and white applicants and
tralized Application Service (PTCAS)
matriculants. Program cost and
member programs.19 Although a
financial considerations,21–24 pres-
portion of this shift in race can
ence of minority faculty,22,25 and stu-
be accounted for by applicants
dent diversity22,24 have all been
who declined to state ethnicity, an
shown to influence minority appli-
option not available in 2000, the His-
cant decisions. In a survey of first-
panic, African-American, and Ameri-
year physical therapist students,
can Indian/Alaskan Native groups
URM students were more likely than
together grew from 7.5% in 200018
white students to consider cost in
to 11.5% 2012.20 Collectively, all
selecting a physical therapist educa-
minority groups comprised 20.9% of
tion program.22 In a similar study of
the total applicant pool to PTCAS
students at 10 physical therapist pro-
institutions in 2011–2012.20 Table 1
grams, Johanson23 found a signifi-
shows the percentages of applicants
cantly higher percentage of URM
and matriculants in 2010 –2011 and
applicants identified availability of
2011–2012 compared with 2000.
financial aid as an important or
deciding factor in program choice
(P⬍.003). Among African American
students, 84.2% identified availability
PTCAS Cycle (2010–2011)a PTCAS Cycle 2011–2012a
Total
Applicants Total Accepted Total Accepted
in 200018 Applicants Applicants Applicants Applicants
83.3 66.74 70.37 66.44 71.58
3.6 5.29 3.19 5.21 3.20
0.5 0.87 0.72 0.97 0.68
7.9 7.65 6.82 8.27 6.90
* 1.25 0.99 1.12 0.68
3.4 5.16 4.45 5.28 4.31
13.03 13.47 12.72 12.65
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42
Table 2.
Descriptive Statistics–Applicant Metricsa

f
PTCAS Cycle 2010–2011 PTCAS Cycle 2011–2012

Race/Ethnicity SGPA CGPA QGRE VGRE AGRE SGPA CGPA QGRE VGRE AGRE

White (not of 3.11 (0.52) 3.38 (0.34) 598.87 (90.01) 448.06 (75.18) 3.95 (0.57) 3.14 (0.49) 3.40 (0.34) 607.00 (90.95) 457.56 (80.12) 3.92 (0.58)
Hispanic origin) n⫽7,719 n⫽7,700 n⫽6,801 n⫽6,801 n⫽6,358 n⫽8,830 n⫽8,837 n⫽7,699 n⫽7,700 n⫽7,622

African American/ 2.75 (0.56)b 3.09 (0.38)b 515.16 (105.80)b 410.57 (74.56)b 3.60 (0.60)b 2.80 (0.48)b 3.11 (0.35)b 526.41 (105.90)b 412.47 (77.14)b 3.53 (0.58)b

Physical Therapy
black n⫽616 n⫽614 n⫽462 n⫽461 n⫽419 n⫽673 n⫽673 n⫽518 n⫽520 n⫽509

American Indian/ 2.94 (0.54) 3.25 (0.36) 570.29 (94.53) 439.13 (78.12) 3.92 (0.63) 2.82 (0.52)b 3.16 (0.38)b 558.13 (103.07)b 445.07 (78.54) 3.66 (0.54)b
Alaskan Native n⫽80 n⫽80 n⫽69 n⫽69 n⫽63 n⫽91 n⫽91 n⫽75 n⫽75 n⫽74

Asian 2.82 (0.76)b 3.19 (0.38)b 624.94 (100.89)b 453.84 (96.62) 3.84 (0.66)b 2.94 (0.54)b 3.19 (0.39)b 644.86 (95.07)b 460.49 (97.17) 3.85 (0.61)

Volume 95
n⫽862 n⫽830 n⫽731 n⫽731 n⫽694 n⫽1,060 n⫽1,061 n⫽932 n⫽933 n⫽927

Hawaiian/Pacific 2.79 (0.48)b 3.11 (0.34)b 576.92 (100.85) 449.23 (81.41) 3.93 (0.54) 2.84 (0.46)b 3.12 (0.35)b 580.00 (95.14) 427.38 (82.43)b 3.84 (0.52)
Islander n⫽92 n⫽92 n⫽78 n⫽78 n⫽77 n⫽92 n⫽92 n⫽80 n⫽80 n⫽78

Hispanic/Latino 2.94 (0.54)b 3.23 (0.36)b 569.71 (103.33)b 435.61 (74.94)b 3.83 (0.58)b 2.98 (0.51)b 3.25 (0.36)b 580.53 (97.93)b 439.57 (78.40)b 3.78 (0.57)b

Number 1
n⫽579 n⫽576 n⫽485 n⫽485 n⫽453 n⫽670 n⫽671 n⫽578 n⫽579 n⫽563

2⫹ race/ethnicity 2.81 (0.57)b 3.13 (0.38)b 591.68 (89.12) 450.18 (74.09) 3.90 (0.53) 2.90 (0.53)b 3.18 (0.38)b 589.34 (91.27) 442.50 (77.84) 3.72 (0.56)b
designations n⫽132 n⫽131 n⫽113 n⫽113 n⫽101 n⫽165 n⫽165 n⫽136 n⫽136 n⫽134

Declined to state 3.04 (0.61) 3.32 (0.36)b 599.89 (93.04) 459.38 (82.65)b 3.94 (0.58) 3.08 (0.51)b 3.32 (0.36)b 616.01 (91.51)b 472.41 (85.48)b 3.92 (0.59)

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n⫽1,610 n⫽1,588 n⫽1,345 n⫽1,345 n⫽1,234 n⫽1,808 n⫽1,810 n⫽1,499 n⫽1,499 n⫽1,485
a
Designations are mutually exclusive. Data are presented as mean (SD). PTCAS⫽Physical Therapist Centralized Application Service; SGPA⫽science grade point average; CGPA⫽cumulative grade point
average; QGRE⫽quantitative section, Graduate Record Examination; VGRE⫽verbal section, Graduate Record Examination; AGRE⫽analytical section, Graduate Record Examination.
b
Significant differences compared with white (not of Hispanic origin) applicants (post hoc Tukey honestly significant difference test, P⬍.05).
Minority Applicants to Physical Therapist Education Programs

national sample.
ing program completion.24

to programs with minority faculty.

pool to PTCAS member programs

January 2015
URM students, it was not a deterrent
and first-year students or graduates

applying out of state, and application

to which applied, likelihood of
including total number of programs
and URM applicants in 2010 –2012,
application patterns between white
relation between minority faculty
a study of 76 physical therapist edu-

did not translate to a significant cor-

URM students value faculty diversity
URM students as one of the largest

and (2) to investigate differences in

(1) to describe the URM applicant
The purposes of this study were:
advance diversity may be rooted.
foundation upon which strategies to
therapist programs may provide a
patterns of application to physical
current disparities in health care
one potential solution addressing
in pursuit of physical therapy as a
therapy faculty was identified by
ard et al26 found that although a lack

delivery. A greater understanding of

increasing URM representation is but
fession of physical therapy through
Addressing diversity within the pro-
has been conducted utilizing a large
cation patterns to doctoral programs
research examining minority appli-
career. Despite this evidence, no
of ethnic diversity within physical
(r⫽.173, r⫽.219). In contrast, Gab-
P⬍.01). However, this association
and minority applicants (r⫽.426,
between full-time minority faculty
cation programs, Splenser et al25
Prior research also indicates that
nonacademic challenges faced dur-
deciding factor compared with

identified a significant correlation

(P⬍.001) in program selection.22 In
issues also have been identified by
62.3% of whites studied. Financial
of financial aid as an important and

Method
Participants
Following execution of a data use
agreement with APTA, de-identified
applicant data from 2010 –2012
were provided by Liaison Interna-
tional (Watertown, Massachusetts),
developer and manager of PTCAS.
The sample consisted 11,690 appli-
cants to 128 member institutions in
2010 –2011 (PTCAS11) and 13,462
applicants to 146 member institu-
tions in 2011–2012 (PTCAS12). An
applicant was defined as a prospec-
tive student who completed all
PTCAS requirements in submitting a
verified application to at least one
PTCAS member institution. Based on
annual accreditation report data pro-
vided by CAPTE, physical therapist
programs with at least one full-time
or part-time minority core faculty
were identified.
The Association of American Medi-
cal Colleges’ (AAMC) definition of
underrepresented in medicine was
applied to identify URM applicants
to physical therapist programs.
In 2003, the AAMC modified its
definition to include all racial and
ethnic populations that are under-
represented in the medical pro-
fession relative to the general pop-
ulation.27 In accordance with this
definition, Hispanic/Latino, African-
American, American Indian/Alaskan
Native, and Hawaiian/Pacific Islander
applicants were considered to be
underrepresented in physical ther-
apy based on census data. Asians
remain overrepresented relative
to US population (4.8%)3 among appli-
cants (PTCAS11⫽7.65%, PTCAS12⫽
8.27%),19,20 accepted applicants
(PTCAS11⫽6.82%, PTCAS12⫽6.9%),19,20
and practicing physical therapists
(9.4%).3 According to PTCAS pro-
cedure and in compliance with
US Department of Education report-
ing requirements, applicants could
select one or more racial or ethnic
categories. Race and Hispanic origin
are separate concepts; thus, the
January 2015
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Minority Applicants to Physical Therapist Education Programs
“Hispanic/Latino” category was a
separate field within the PTCAS
application. Applicants with mul-
tiple minority racial categories
selected were categorized as “2⫹
Race/Ethnicity Designations” for this
study.
Data Analysis
Descriptive statistics were used to
summarize sample metric character-
istics, including science and cumula-
tive grade point averages (SGPA and
CGPA, respectively) and quantita-
tive, verbal, and analytical Graduate
Record Examination (QGRE, VGRE,
and AGRE, respectively) scores for
all applicants in both PTCAS11 and
PTCAS12. An analysis of variance
(ANOVA) was used to assess differ-
ences in metrics between URM and
white applicants. Tukey honestly sig-
nificant difference (HSD) post hoc
testing was performed to compare
all possible pairs of means between
white applicants and each minority
applicant group. Prior research iden-
tifying variables predictive of suc-
cess in physical therapist education
programs28,29 and on the National
Physical Therapy Examination30,31
were utilized to guide the selection
of metric variables. Furthermore,
we sought to extract the data most
readily available from PTCAS and
available to the majority of PTCAS
institutions. The PTCAS computes
several standardized grade point
average (GPA) calculations to assist
participating programs in evaluating
applicants using uniform and con-
sistent criteria, regardless of dif-
ferent undergraduate institutional
transcript policies. In accordance
with PTCAS GPA calculation proce-
dure, all grades (including repeated
classes) are entered into the GPA
calculation. The SGPA calculation
includes anatomy and physiology,
biology, chemistry, and physics
course work. Math, movement sci-
ence, social/behavioral science,
and other science courses were
excluded from all SGPA calculations.
Volume 95
The CGPA calculations included all
undergraduate, graduate, and pro-
fessional courses completed.32 In
the instance of multiple Graduate
Record Examination (GRE) scores,
the highest score for each subtest
was utilized as the independent vari-
able. To maintain consistency in GRE
score reports, revised GRE scores
using the new scoring system were
recoded to the old system using Edu-
cational Testing Service concor-
dance tables.
Differences in number of total appli-
cations submitted among URM and
white applicants were assessed
using ANOVA. In post hoc testing,
each racial/ethnic group included
in the URM definition was com-
pared with white applicants using
the Tukey HSD test. Similarly, dif-
ferences in application patterns
between white and URM applicants
relative to number of applications
to in-state versus out-of-state pro-
grams and to programs with and
without minority faculty were stud-
ied. Analysis of variance was first
used to assess for differences
between whites and URM applicants
as a group, with post hoc Tukey HSD
testing utilized to identify differ-
ences between white applicants and
each minority group. Based on the
initial results, a secondary analysis
was performed on Hispanic in-state
applicants to assess for differences in
rates of application to public and pri-
vate institutions. Statistical analyses
were performed with Statistical
Package for the Social Science soft-
ware (IBM SPSS 19.0, IBM, Armonk,
New York). A P value of ⱕ.05 was
considered statistically significant.
Results
Descriptive statistics of applicant
metrics for individual URM groups
compared with white applicants are
summarized in Table 2. In PTCAS11
and PTCAS12, non-Hispanic whites
achieved significantly higher GPA
and GRE scores than African Ameri-
Number 1 Physical Therapy f 43
 Minority Applicants to Physical Therapist Education Programs

can and Hispanic/Latino applicants

(P⬍.05). With the exception of

.056

1.000

.000

.987

.998

.001

.001
Pb
American Indian/Alaskan Native
Combined PTCAS Cycles 2010–2012

applicants, SGPA and CGPA rose for

Applicants all applicant groups from PTCAS11
Difference

1.810b

0.334b
White

⫺0.375

0.087

0.288

⫺0.085

1.076
Mean

From

to PTCAS12. Although not consistent

across all groups, increases in GRE
subscale scores also were noted
between the 2 cycles.
5.07 (4.13)

4.69 (3.83)

5.15 (3.52)

6.88 (5.63)

5.35 (5.43)

4.98 (4.14)

6.14 (5.44)

5.40 (4.58)

5.24 (4.34)
X (SD)

In PTCAS11, URM applicants as a

group applied to an average of 4.73
programs, minimally less than the
average of 4.81 programs for non-
16,567

1,293

171

1,956

184

1,252

297

3,432

25,152
n

Hispanic white applicants (P⫽.878).

Both white and URM applicants
applied, on average, to a greater
.578

1.000

.000

.350

.981

.023

.024
Pb

Significant differences compared with white (not of Hispanic origin) applicants (post hoc Tukey honestly significant difference test, P⬍.05).
number of programs in PTCAS12
(5.29 and 5.31, respectively) but
again without significant between-
Applicants
Difference

1.931b

0.379b
2011–2012 PTCAS Cycle

group differences (P⫽.997). Results

White

⫺0.334

⫺0.034

1.039

⫺.171

1.162
Mean

From

of ANOVA with multiple comparison

procedures for each applicant group
are displayed in Table 3. Among all
applicant groups, Asians applied to
5.29 (4.31)

4.95 (3.95)

5.25 (3.69)

7.22 (5.42)

6.33 (7.09)

5.12 (4.26)

6.45 (6.06)

5.67 (4.79)

5.49 (4.54)
X (SD)

the greatest number of programs in

both application cycles. Asian appli-
cants, applicants of 2 or more races/
ethnicities, and applicants who
Designations are mutually exclusive. PTCAS⫽Physical Therapist Centralized Application Service.
8,848

677

91

1,094

92

673

165

1,822

13,462

declined to state race or ethnicity

n

applied to a significantly greater

number of programs in 2010 –2012
compared with white applicants
.257

1.000

.000

.975

1.000

.151

.183
Pb

(Pⱕ.001).
One-Way Analysis of Variance for Total Applications, by Cyclea

Although there were no significant

Applicants
Difference

1.629b
2010–2011 PTCAS Cycle

White

⫺0.409

0.226

⫺0.431

0.010

0.946

0.286
Mean

differences between white and His-

From

panic applicants in total number of

programs to which they applied, His-
panic applicants demonstrated a sig-
4.81 (3.90)

4.40 (3.67)

5.04 (3.34)

6.44 (5.87)

4.38 (2.64)

4.82 (4.00)

5.76 (4.53)

5.10 (4.31)

4.96 (4.15)

nificantly increased likelihood of

X (SD)

applying within their state of resi-

dence and a correspondingly
decreased likelihood of applying out
of state in both PTCAS11 and
7,719

616

80

862

92

579

132

1,610

11,690

PTCAS12 cycles (P⬍.05). The aver-

n

age numbers of in-state and out-of-

state programs applied to by white
Hispanic origin)
Race/Ethnicity

2⫹ race/ethnicity

and URM applicant groups are dis-

American Indian/
African American

Declined to state
Alaskan Native

Hawaiian/Pacific

Hispanic/Latino

designations

played in Table 4. Consistent with an

White (not of

Islander

increased total application rate,

Table 3.

Asians applied to significantly more

Asian

Total

in-state and out-of-state programs

than white applicants in both appli-
b
a

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 Minority Applicants to Physical Therapist Education Programs

cation cycles (P⬍.001). Secondary

Applicants
Difference
analysis of Hispanic applicants to

1.25b

⫺0.52b
White
Mean

From

⫺0.05

0.09

⫺0.26

0.69

0.21
Applications in-state programs revealed a signifi-
Out-of-State
Combined PTCAS Cycles 2010–2012

cantly increased likelihood of apply-

ing to private as opposed to public

3.21 (3.84)

3.15 (3.61)

3.30 (3.30)

4.46 (5.26)

2.95 (4.95)

2.69 (3.72)

3.89 (5.05)

3.41 (4.21)

3.31 (4.04)
institutions (P⬍.001). The numbers
X (SD) of private and public in-state pro-
grams applied to by Hispanic appli-
cants are displayed in Table 5.
Applicants
Difference
In-State Applications

⫺0.32b

0.55b

0.55b

0.39b

0.13b
White
Mean

From

⫺0.01

0.3b
In both PTCAS11 and PTCAS12,
URM applicants as a group were
significantly more likely to apply
1.86 (1.60)

1.54 (1.58)

1.85 (1.72)

2.41 (2.43)

2.41 (2.20)

2.29 (2.04)

2.25 (2.18)

1.99 (1.82)

1.93 (1.76)
to PTCAS member institutions
X (SD)

with minority faculty than white

applicants (PTCAS11: URM⫽3.20,
white⫽2.80, P⬍.001; PTCAS12:
Applicants
Difference

Significant differences compared with white (not of Hispanic origin) applicants (post hoc Tukey honestly significant difference test, P⬍.05).
URM⫽3.42, white⫽2.94, P⬍.001).
1.30b

⫺0.59b
White
Mean

From

⫺0.03

⫺0.12

0.25

0.92

0.33
Based on program data provided by
Applications
Out-of-State

CAPTE, 115 programs were identi-

fied as possessing at least one full-
2011–2012 PTCAS Cycle

3.36 (4.03)

3.33 (3.69)

3.24 (3.41)

4.65 (5.04)

3.61 (6.46)

2.77 (3.89)

4.28 (5.67)

3.68 (4.44)

3.49 (4.21)

time or part-time minority core fac-

X (SD)

ulty (X⫽2.14, SD⫽1.47). Results of

ANOVA with multiple comparison
procedures for each applicant race
Applicants
Difference
In-State Applications

in PTCAS11 and PTCAS12 are dis-

⫺0.31b

0.63b

0.79b

0.42b
White
Mean

From

0.08

0.24

0.05

played in Table 6. Hispanic and Afri-

can American applicants were signif-
icantly more likely than white
Designations are mutually exclusive. PTCAS⫽Physical Therapist Centralized Application Service.
1.93 (1.65)

1.62 (1.60)

2.01 (1.73)

2.56 (2.52)

2.72 (2.50)

2.34 (2.00)

2.17 (2.13)

1.98 (1.85)

2.00 (1.81)

applicants to apply to programs with

X (SD)

minority faculty and correspond-

ingly less likely to apply to programs
without minority faculty (P⬍.05). A
Applicants
Difference

1.18b

similar pattern was observed among

White
Mean

From

⫺0.08

0.33

⫺0.75

⫺0.44

0.38

0.07
Applications
Out-of-State

American Indian/Alaskan Native and

Hawaiian/Pacific Islander applicants
in combined data from 2010 –2012,
2010–2011 PTCAS Cycle

3.03 (3.61)

2.95 (3.52)

3.36 (3.19)

4.22 (5.52)

2.28 (2.59)

2.60 (3.51)

3.41 (4.11)

3.11 (3.91)

3.11 (3.83)
X (SD)

but this relationship failed to reach

In-State Versus Out-of-State Applications, by Cyclea

statistical significance.

Discussion
Applicants
Difference
In-State Applications

⫺0.33b

0.45b

0.45b

0.57b

0.21b
White

This study revealed significant differ-

Mean

From

⫺0.10

0.32

ences in applicant metrics and appli-

cation patterns among white and
URM applicants to PTCAS member
1.78 (1.55)

1.45 (1.55)

1.68 (1.71)

2.22 (2.29)

2.10 (1.82)

2.22 (2.08)

2.35 (2.26)

1.99 (1.78)

1.85 (1.70)
X (SD)

programs in 2010 –2012. With a few

exceptions, URM applicant groups
reported lower average GPA and
GRE scores than white applicants.
Hispanic origin)
Race/Ethnicity

2⫹ race/ethnicity
American Indian/
African American

Declined to state
Alaskan Native

Hawaiian/Pacific

Hispanic Latino

These findings are consistent with

designations
White (not of

prior studies of the academic metric

Islander
Table 4.

profiles of URM applicants in other

Asian

Total

professions. Medium to large stan-

dardized mean differences in under-
b
a

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 Minority Applicants to Physical Therapist Education Programs
graduate GPA (0.5– 0.9) have been
demonstrated between African
American and Hispanic applicants in
comparison with white medical
school applicants.33 African Ameri-
can and Hispanic medical school
applicants achieved lower average
Medical College Admission Test
(MCAT) scores in 2009 compared
with white applicants. However, in
refute of test bias, URM and white
groups have achieved academic suc-
cess at rates equal to those predicted
by MCAT scores.33
Lower metric profiles may disadvan-
tage URM applicants. In a 2008 study
of US and Canadian medical schools,
standardized test scores and under-
graduate GPAs were rated as the
most important factors for deciding
who to invite to submit secondary
applications and interview.34 Among
applicants to physical therapist pro-
grams in 2008 –2011, SGPA was the
greatest predictor of successful
admission to PTCAS member pro-
grams.35 It is important to note that
this analysis identified average
scores among applicant groups and
does not suggest uniformly high or
low intellectual capability as evi-
denced by GPA and GRE scores for
all applicants in various racial
groups. A high level of variability is
generally acknowledged within each
group. Furthermore, statistically sig-
nificant differences may not equate
to academically meaningful determi-
nants of success within physical
therapist programs. Despite the
inherent variability, admissions poli-
cies with sole regard for GPA and
Table 5.
Hispanic/Latino In-State Applicationsa
2010–2011 PTCAS Cycle
Public Private
Race/Ethnicity X (SD) X (SD)
Hispanic/Latino 1.14 (0.954) 1.57 (1.620)
a
PTCAS⫽Physical Therapist Centralized Application Service.
b
Significant difference (paired t test, P⬍.05).
46 f Physical Therapy Volume 95 Number 1
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standardized test measures may dis-
advantage URM applicants. These
results may provide further evidence
supporting a broader review of appli-
cant qualifications. The AAMC, for
example, supports balancing appli-
cant metrics with experiences and
attributes through holistic review.
Experiences may include educa-
tional background, employment his-
tory, research experience, or experi-
ence in a health care setting.
Applicant attributes include such
abilities as oral communication, crit-
ical thinking, integrity, motivation,
intellectual curiosity, and empathy.
Using this framework, applicants are
evaluated by criteria that are institu-
tional specific and mission-driven.
Diversity, as defined by the AAMC, is
a student-specific, multifaceted con-
cept that extends beyond race and
ethnicity.36
Increases in applicant metrics
across nearly all applicant ethnic
groups, combined with an increase
in total applicants from PTCAS11
to PTCAS12, provide evidence of
increasing competition for admis-
sion to physical therapist education
programs. As a result, programs may
consider academic enrichment or
related pipeline programs to boost
profiles of URM applicants. Such pro-
grams beginning as early as the sec-
ondary level may serve to generate
increased awareness of physical
therapy as a career choice and pre-
pare future applicants for academic
success. Prior research has provided
evidence of positive outcomes asso-
ciated with racial/ethnic minority
2011–2012 PTCAS Cycle
Public Private
P X (SD) X (SD)
.000b 1.21 (1.027) 1.56 (1.612)
and disadvantaged students’ partici-
pation in structured pipeline pro-
grams.37,38 Intensive premedical
enrichment programs have been
shown to increase the chances of
medical school acceptance among
minority applicants even after con-
trolling for grades, standardized
test scores, and other variables.38
Programs in medicine and those
currently in existence in physical
therapy may serve as examples
for increasing URM applications to
all physical therapist education
programs.
Although overall application rates
did not differ significantly between
white and Hispanic applicants, His-
panic applicants demonstrated a
greater likelihood of applying to
in-state versus out-of-state programs.
This finding is consistent with prior
research on undergraduate program
choice and perhaps illustrates the
importance of familism in the His-
panic culture. Desmond and López
Turley39 defined familism as a social
pattern in which individual interests,
decisions, and actions are condi-
tioned by family, which takes prece-
dence over the individual. Hispanic
adults and adolescents have been
shown to value interdependence
and family obligations and thus may
desire to enroll in a program in prox-
imity to home, upholding family ties
that shape their identity. Compared
with other ethnicities, Hispanic high
school seniors are more likely than
other racial/ethnic groups to value
living at home while attending col-
lege.39 With this finding in mind,
Combined PTCAS Cycles 2010–2012
Public Private
P X (SD) X (SD) P
.000b 1.18 (0.995) 1.56 (1.615) .000b
January 2015
 Minority Applicants to Physical Therapist Education Programs

physical therapist education pro-

Applicants
Difference
No Minority Faculty grams may find it most beneficial to

⫺0.69b

0.26b

⫺0.50b
White
Mean

From

⫺0.19

⫺0.27

0.04

⫺0.01
target recruitment and career explo-
Combined PTCAS Cycles 2010–2012

ration to Hispanic applicants within

their local area.

2.19 (2.12)

1.50 (1.76)

1.99 (1.78)

2.45 (2.52)

1.92 (2.74)

1.69 (1.89)

2.23 (2.73)

2.18 (2.23)

2.14 (2.16)
X (SD)
In addition to familism, it is possible
that Hispanic applicants were influ-
enced by financial considerations.
Applicants
Difference

This study provided interesting

White
Mean

From

0.31b

1.55b

0.42b

1.04b

0.34b
Minority Faculty

0.28

0.56
results related to the impact of finan-
cial considerations on the increased
likelihood of applying to in-state pro-
2.88 (2.57)

3.19 (2.58)

3.16 (2.39)

4.42 (3.67)

3.43 (3.12)

3.29 (2.83)

3.92 (3.23)

3.22 (2.90)

3.10 (2.78)
grams among Hispanic applicants.
X (SD)

Although it is difficult to demon-

strate a direct relationship between
program cost and application rates,
Applicants
Difference

Significant differences compared with white (not of Hispanic origin) applicants (post hoc Tukey honestly significant difference test, P⬍.05).
the increased likelihood of applying
No Minority Faculty

⫺0.73b

0.34b

⫺0.52b
White
Mean

From

⫺0.31

⫺0.01

0.20

0.03
to in-state private as opposed to pub-
lic institutions was not consistent
with prior research21–24 when
2011–2012 PTCAS Cycle

2.35 (2.24)

1.61 (1.86)

2.03 (1.87)

2.68 (2.60)

2.34 (3.57)

1.83 (2.00)

2.55 (3.17)

2.38 (2.37)

2.31 (2.30)

known differences in average tuition

X (SD)

rates were considered. According to

CAPTE data, the average tuition at a
private institution was more than
Applicants
Difference

twice that of public institutions in

White
Mean

From

0.40b

1.59b
b

0.34b

0.96b

0.35b
Minority Faculty

0.28

1.05

2011–2012.7 Other factors beyond

tuition, such as increased availability
of financial support at private insti-
Designations are mutually exclusive. PTCAS⫽Physical Therapist Centralized Application Service.
2.94 (2.62)

3.34 (2.64)

3.22 (2.49)

4.54 (3.47)

3.99 (3.93)

3.29 (2.85)

3.90 (3.37)

3.29 (2.99)

3.18 (2.82)

tutions, or additional nonfinancial

X (SD)

factors, such as increased student

body diversity, which could not be
measured in this study, also may
Applicants
Difference
No Minority Faculty

⫺0.63b

⫺0.49b

have influenced these results.

White
Mean

From

⫺0.06

0.15

⫺0.51

⫺0.18

⫺0.05

Although the findings did not consis-

Applications to Programs With Minority Faculty, by Cyclea

tently reach significance among all

2010–2011 PTCAS Cycle

2.01 (1.95)

1.38 (1.63)

1.95 (1.69)

2.16 (2.38)

1.50 (1.42)

1.52 (1.73)

1.83 (1.98)

1.96 (2.02)

1.95 (1.97)
X (SD)

URM applicant groups, this study

does provide evidence as to the
importance of minority faculty in
URM student recruitment. Unfortu-
Applicants
Difference

White

nately, the overall disparity of URM

Mean

From

1.48b

0.50b

1.13b

0.34b
Minority Faculty

0.22

0.28

0.08

applicants to physical therapist edu-

cation programs is paralleled by a
lack of racial and ethnic diversity
2.80 (2.51)

3.02 (2.52)

3.09 (2.27)

4.28 (3.91)

2.88 (1.89)

3.31 (2.80)

3.93 (3.01)

3.14 (2.80)

3.01 (2.72)
X (SD)

among program faculty. In 2011–

2012, African American and Hispanic
faculty combined composed slightly
more than 5% of all core faculty at
Hispanic origin)
Race/Ethnicity

2⫹ race/ethnicity
American Indian/
African American

Declined to state
Alaskan Native

Hawaiian/Pacific

Latino/Hispanic

CAPTE-accredited programs. Fur-

designations
White (not of

thermore, more than 40% of all pro-

Islander
Table 6.

grams lacked URM faculty.7 The

Asian

Total

importance of a diverse faculty has

been cited by medical students as a
b
a

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 Minority Applicants to Physical Therapist Education Programs
strong contributor to the overall
impact of diversity on educational
experiences.40 Based on our study,
enhancing URM applications appear
to be associated with the need to
further enhance faculty diversity. It
also is possible that the increased
rate of application to programs with
minority faculty demonstrated in this
study is a consequence of regional
demographic differences in the gen-
eral population rather than repre-
senting an intentional decision of
minority applicants. Underrepre-
sented minority applicants may
apply to certain geographical areas
or programs for many reasons, such
as a desire to stay close to home.
Programs in the applicant’s local
area may happen to also have a
greater representation of minority
faculty. Nonetheless, physical thera-
pist education programs may con-
sider striving to create an environ-
ment attractive to both the increased
recruitment and retention of URM
students and faculty.
Limitations
Because this research focused on
PTCAS application data, this study
did not attempt to generalize the
results beyond PTCAS institutions.
However, the PTCAS applicant data-
base provided the best available data
reflective of the national pool of
applicants to physical therapist edu-
cation programs in 2010 –2012.
Approximately 70% of all accredited
programs were PTCAS members in
2011–2012. In comparing applicant
metrics, one must recognize varia-
tion in admissions processes and
requirements across physical thera-
pist education programs. The GRE is
not required by all PTCAS member
programs and thus is not a uniform
variable. Moreover, in 2010 –2011,
GRE scores were self-reported by the
applicant and not verified by PTCAS.
The impact of applicants who
decline to state racial or ethnic status
also may have a profound impact on
future conversations of admissions
48 f Physical Therapy Volume 95
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and diversity. Approximately 13% of
applicants declined to report racial
or ethnic status to PTCAS in 2010 –
2012. Other professions have specu-
lated that this group may comprise
white and mixed race applicants and
applicants who simply are uncom-
fortable talking about race.41
Although the true composition and
reasoning behind nonreporting are
unknown, this group could have
affected the findings of this study.
Future research identifying possible
reasons for declining to state racial
and ethnic status and the degree to
which these applicants willingly
contribute to conversations related
to diversity in the classroom may
serve the profession. The impact of
financial considerations such as dif-
ferences in financial aid availability at
public and private institutions and
student minority representation
within programs also would contrib-
ute to a more thorough understand-
ing of URM application patterns.
Unlike medicine, the extent to
which a diverse physical therapist
workforce addresses disparities in
access to quality care experienced
by underserved populations is not
well established in the literature.
Future research should identify the
degree to which the same conclu-
sions can be drawn in physical
therapy. Furthermore, this study
investigated one aspect of applicant
diversity: race and ethnicity.
Addressing the current health care
needs of our society and improving
diversity within our profession
extend well beyond racial or ethnic
origin. In a broad sense, diversity is a
multifaceted concept encompassing
demographics, personal characteris-
tics, abilities, and experiences. The
profession would benefit from fur-
ther research investigating additional
factors affecting diversity beyond
race and identifying the presence of
differing attributes and noncognitive
variables between URM and white
applicants. Further qualitative evalu-
Number 1
ation of recruitment and retention
policies at those programs that
matriculate and graduate the greatest
number of URM applicants also may
guide the profession toward closing
the disparity gap.
In conclusion, today’s physical ther-
apists pose little resemblance to the
diverse population they serve.
Together, Hispanic/Latino, African
American, American Indian/Alaskan
Native, and Hawaiian/Pacific Island-
ers comprise 30% of the total US
population1 but only 9.1% of the US
physical therapist population3 and
only about 12% of applicants to
PTCAS member programs. Even less
resemblance will result in future
years if our profession fails to
address the current disparity. This
study examined the metric profiles
and application patterns of white
and URM applicants to PTCAS mem-
ber institutions in 2010 –2012. The
results of this study indicate that
non-Hispanic whites achieved signif-
icantly higher GPA and GRE scores
than African American and Hispanic/
Latino applicants. Furthermore,
URM applicants demonstrated a sig-
nificantly greater tendency to apply
to PTCAS member institutions with
minority faculty, and Hispanic appli-
cants demonstrated a significantly
increased likelihood of applying
within their state of residence. In
accordance with the IOM’s recom-
mendation to increase the number of
health professionals as a key compo-
nent in the elimination of health dis-
parities, the physical therapy profes-
sion may use this data to guide future
URM recruitment efforts.
The author thanks Libby Ross, Director, Aca-
demic Program Services, American Physical
Therapy Association, for her consulting and
assistance in securing accurate de-identified
data from Liaison International. The author
also appreciates the assistance of colleagues
Dr Wendy Rheault and Dr Judith Stoecker for
their assistance and support throughout this
project.
January 2015

The research proposal was approved by the
Rosalind Franklin University of Medicine and
Science Institutional Review Board.
A portion of the data from the manuscript
was given as a poster presentation at the
Combined Sections Meeting of the Ameri-
can Physical Therapy Association; Febru-
ary 4 –7, 2014; Las Vegas, Nevada.
DOI: 10.2522/ptj.20130585
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