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Orthopaedics - New Eligibility Requirements for the 2026 Exam Cycle


Approved exam candidates must be physical therapists who hold a current permanent/unrestricted license to practice physical therapy in the United States or any of its possessions or territories.

Applicants must pay both an application and examination fee.

Fees and deadlines may be found here.

Applicants Must Meet Requirements for Option A or Option B

Option A

Applicants must submit evidence of 2,000 hours of direct patient care as a licensed United States physical therapist (temporary license excluded) in the specialty area within the last 10 years, 25% (500) of which must have occurred within the last three years.

Option B

Applicants must submit evidence of successful completion of an APTA-accredited postprofessional clinical residency  within the specialty area, completed within the last 10 years. Applicants who are currently enrolled in an ABPTRFE-accredited clinical residency or are enrolled in a residency program that has been granted candidacy status, may apply for the specialist certification examination in the appropriate specialty area prior to completion of the clinical residency. These applicants will be conditionally approved to sit for the examination, as long as they meet all other eligibility requirements, pending submission of evidence of successful completion of the ABPTRFE-accredited clinical residency to APTA’s Specialist Certification Program, no later than one month before the examination window opens. To verify your residency program’s credentialing status, please visit

In addition, members must meet the minimum requirements of the specialty area(s) for which they apply.

Additional Requirements by Speciality Area

In addition to meeting the general requirements, applicants for Cardiovascular and Pulmonary certification must also meet these requirements:

Advanced Cardiac Life Support Certification Applicants must be currently certified in Advanced Cardiac Life Support (ACLS) by the American Heart Association.

Submission of one Data Analysis Project or Case Report

Data Analysis Project
Applicants must submit evidence of participation in a clinical data analysis project directly related to the cardiovascular and pulmonary specialty area within the last ten years. Acceptable data analysis projects include treatment efficacy studies, such as a quality assurance or utilization review project, program analysis, structured surveys, formal systematic reviews as well as formal clinical research trials. Projects that will not fulfill this criterion include projects that do not start with a question or purpose do not devise a methodology to answer the question, collect data, determine the results and reach a conclusion. Examples of projects that are not acceptable include a literature review, a case report or case series, or the development of patient education materials. Projects must be completed, and dissemination concluded at an appropriate level and degree that is congruent with the scope of project at the time of application submission. Examples of appropriate and reasonable dissemination include a conference presentation or publication for a funded research project, or presentation or inservice to the primary stakeholders of the project's results in the case of a data analysis or quality assurance project.

Submission of the data analysis project should be in the form of (1) a brief statement that describes your specific involvement (study design, data collection, data analysis, etc.) and (2) project description that includes an abstract summarizing the project in which you participated (written in standard form, i.e. purpose, methods, results and conclusions): and a brief statement of the limitations of the study design/methodology, method of disseminating the results, and how the project has changed the candidate's practice of cardiovascular and pulmonary physical therapy.

Whether the applicant fulfills the data analysis project requirements will be evaluated according to the following questions:

  1. Is the project related to cardiovascular and pulmonary physical therapy?
  2. Has the applicant submitted evidence of participation that demonstrates scholarly activity and knowledge of the research process? Acceptable roles in the project include defining the study
    question or purpose, devising the study methodology, and data analysis. Participation in data collection only does not fulfill this requirement.
  3. Has the project been completed, and the results disseminated to advance the practice of cardiovascular and pulmonary physical therapy?

Successful applicants will be able to answer yes to all of the above questions. Please see the Candidate Guide for additional guidance about project submission.

Case Study
Alternatively, applicants have the option of submitting one case report demonstrating specialty practice in cardiovascular and pulmonary physical therapy. This case study must be based on a patient/client seen within the last three years.

In addition to meeting the general requirements, Clinical Electrophysiology specialist applicants must also meet the following.

Clinical Education Experience Documentation Applicants
Applicants must submit a list of any individual learning experiences (at least 1, no more than 3) related to the practice of clinical electrophysiologic physical therapy completed within the past 10 years (since July 1, 2010). The experience(s) must be with a physical therapist who is board-certified in clinical electrophysiology or a physician (MD or DO) who is board-certified in electrodiagnostic testing (i.e., a neurologist or physiatrist).

Applicants must submit a letter from the colleague who provided oversight of the educational experience. The letter must describe the interaction between the colleagues, and state that in the opinion of the more experienced colleague the applicant is prepared to practice clinical electrophysiology (electrodiagnostic testing) independently (see sample letter below). The Clinical Electrophysiologic Specialty Council will determine whether an experience meets the requirements for this standard.”

Patient Reports 
Three actual patient reports will be submitted and reviewed by a panel of board-certified physical therapists. Submitted cases must be representative of abnormal findings and include one of each of the following:

  • one report must be for a patient with a proximal level compromise representing a radiculopathic process.
  • one report must be for a patient demonstrating a peripheral nerve entrapment, and
  • one report must be for a patient demonstrating a polyneuropathic process.

Testing Logs Applicants
Applicants must submit a log of the most recently completed 500 electrodiagnostic examinations conducted within the last ten years (since July 1, 2010). This log should include the date of the study (month and year) and outcome of testing (e.g., polyneuropathic process, proximal compromise or nerve root involvement, focal peripheral nerve compromise, etc.). Any protected health information must be removed from the log.

Good News! 

There are no additional requirements for these specialties.

In addition to the general requirements, for the Oncology Certification, applicants must also submit one case report demonstrating specialty practice in oncologic physical therapy. This case study must be based on a patient/client seen within the last three years.


One of the roles of a specialty council is to provide input on the development of specialty-specific minimum eligibility requirements for certification in a specialty area, based on American Board of Physical Therapy Specialties guidelines, and to review these eligibility requirements annually.

Upon review of the current eligibility requirements, the Orthopaedic Specialty Council has determined that modifications are necessary to align the assessment process of candidate eligibility with the full scope of physical therapist orthopaedic specialty practice as defined by the Orthopaedic Description of Specialty Practice.

New Requirements for Initial Orthopaedic Specialty Certification as of 2026 Exam Administration

The Orthopaedic Specialty Council has instituted the following minimum eligibility requirements to sit for the initial orthopaedic specialist certification examination. Table 3 outlines the changes from current requirements, which are summarized here:

  • 2,000 direct patient care hours subdivided into body region groupings.
  • The requirement for evidence and approval of regional direct patient care hours modified.
  • Direct contact hours may be replaced by observational or mentored hours under the direct supervision of a certified orthopaedic clinical specialist.

Table 3. Comparison of Current and New Initial Certification Requirements


Eligibility Requirements


Current (pre-2026 exam administration)

Approved as of 2026 exam administration

Option A

Requirement 1: Direct patient hours.


2000 direct patient care hours; no regional breakdown required.


2,000 direct patient care hours, or evidence of observational or mentored patient care hours, subdivided into body region groupings.

Requirement 2: Examination.

Successful completion of examination

Successful completion of examination.

Option B

Requirement 1: Orthopedic residency.

Completion of orthopedic residency fulfills requirements.

Completion of orthopedic residency fulfills requirements.

Requirement 2: Examination.

Successful completion of examination.

Successful completion of examination.

View complete details.

The following requirements are also required for Sports certiifcation applicants.

CPR Certification
The applicant must be currently certified in Cardiopulmonary Resuscitation (CPR) by completing pre-approved courses from the American Heart Association’s BLS Healthcare Provider Course or American Red Cross' CPR for the Professional Rescuer course. Additional courses may be approved, submit details to program staff for review and consideration.

All courses must be in-person.

Acute Management of Injury & Illness
The applicant must submit evidence of current knowledge in national First Responder standards and Emergency Cardiovascular Care (ECC) guidelines with your application.

Acceptable evidence includes proof of completion of specialty council approved coursework or certification that covers approved course content.

Applicants who wish to have the specialty council evaluate whether an equivalent level emergency care training course meets the minimum eligibility requirements must submit information about the course (syllabus, description, textbook, etc.) to the Sport Specialty Council for review prior to the application submission deadline.

Direct Patient Care Hours

For initial certification candidates, there is an additional requirement for the direct patient care hour eligibility requirement for initial certification and recertification candidates. 100 hours of the direct patient care hour requirement must be documented as athletic venue coverage. Athletic venue coverage may include activities supporting or observing medical care provided in preparation for, during, or following practices, training, or competitions.

Type of Duty



Supporting Medical Care

Preparation (prior)


Observing Medical Care







A minimum of fifty percent (50%) of the hours must be performed in association with a contact sport (e.g. basketball, boxing, diving, field hockey, flag or tackle football, ice hockey, lacrosse, martial arts, motocross, rodeo, rugby, ski jumping, soccer, team handball, water polo, and wrestling). The remaining hours may be performed in association with coverage of contact, limited contact (e.g. baseball, gymnastics, etc.) or non-contact sports (e.g. ballet, dance, etc.). A listing of contact, limited contact, and non-contact sports is provided on page 4.

Rationale for Additional Athletic Venue Requirement

 The Description of Specialty Practice (DSP) for Sports Physical Therapy outlines the key competencies including: Rehabilitation/Return to Activity, Acute Injury/Illness Management, Sports Science, Medical/Surgical Considerations, Injury Prevention, and Critical Inquiry. During the current  application process, we require evidence of clinical practice to ensure that the candidate has not only learned the concepts of Sports Physical Therapy but also gains experience in the clinic with these concepts. We ensure that the candidate has been exposed and equipped with the particular concepts of Acute Injury/Illness Management with the emergency care certification requirement of having one of the following:

  • Certification as an Athletic Trainer, Certified (ATC) or
  • License as an Emergency Medical Technician (EMT) or
  • Certification as an Emergency Medical Responder (EMR)2

Note that this title was previously an Emergency Responder or First Responder)

What lacks in consistency and clarity is the experience of the candidate with utilization of these designations (ATC, EMT or EMR). With the current application process, there is no requirement that ensures the candidate actively functions in any of these capacities. This dilemma becomes more apparent, when one looks further into the subdivisions of this Acute Injury/Illness Management competency. These subdivisions include the Examination, Evaluation, Diagnosis as well as Prognosis, Intervention, Outcomes of the acutely injured or ill athlete. The ability to complete those competencies in the sports physical therapy clinic on the acutely injured or ill athlete is rare. Conversely, the exposure to ensure proficiency not just knowledge of this competency is relatively easily attained on the athletic venue. These points were substantiated with the recent revalidation study, resulting in the 2023 Sports Description of Specialty Practice.

The Sports Specialty Council is attempting to rectify this dilemma by requiring certification candidates to complete athletic venue hours as part of the application process, which will accomplish the following goals:

  1. Improve not just the knowledge of this competency but also the application of this knowledge, thus improving the possibility of not just equipping but also developing sports physical therapy specialists in acute injury/illness.
  2. Provide more consistency between the different routes to qualify for the sports board certification examination (i.e., residency route vs direct patient care hours) Currently, all accredited sports physical therapy residency programs require 200 athletic venue hours.

What Activities Constitute Venue Coverage?

Applicants for specialization certification in sports physical therapy and applicants for re- certification should utilize the following guidance in calculating venue coverage hours. Because each situation is different, there is no specific list of activities that may always be included or excluded as venue coverage. However, a guiding principle to consider for defining venue coverage is: the activities in which a therapist participates immediately preceding, during or immediately following an official competition or practice athletic events, or tactical athlete and/or military competitions or physical training. This work can be fee based or pro bono. Time spent providing support of medical or athletic training personnel in any of the stated circumstances may qualify. Hours may be performed in support of primary services provided by a Medical Doctor (MD), Doctor of Osteopathy (DO), Certified Athletic Trainer (ATC), or a Physical Therapist that is a board certified Sports Clinical Specialist.

Physical therapists should check with their state practice act and the regulations of the respective sporting organization to ensure acceptable involvement by the PT.

Some examples of approved venue coverage activities include:

  • Time spent providing injury management and consultation for athletes in venues where athletes practice and compete (e.g. interscholastic, club, intramural, collegiate, Olympic and professional) practices and competitions.
  • Time spent as part of a pre-participation physical medical team for athletes.
  • Time spent providing medical support for running and cycling events (e.g. holiday 5K, organized marathons, triathlons, bike races).
  • Time spent providing care and injury management for tactical athletes/military personnel in combatives training, group physical training evolutions, obstacle course).

Sport classification by contact level1:

Contact Sports

Limited Contact Sports

Non-contact Sports

Basketball, Boxing, Diving

Field Hockey, Football (flag, tackle), Ice Hockey, Lacrosse

Martial Arts, Rodeo, Rugby

Ski Jumping, Soccer

Team Handball, Water Polo, Wrestling, Motocross



Boarding (skate, snow, and wake/knee)

Canoeing/Kayaking (white water)

Cheerleading, Cricket, Fencing

Field Events (pole vault and high jump)

Field Hockey, Gymnastics, Handball, Horseback Riding, Racquetball

Skating (ice, in-line, roller)

Skiing (cross-country, downhill, water), Software

Squash, Ultimate Frisbee, Volleyball


Archery, Badminton, Body Building

Canoeing/Kayaking (flat water)

Crew/Rowing, Curling, Dancing

Field (discus, javelin, shot put)

Golf, Orienteering, Power Lifting, Race Walking, Riflery

Rope Jumping, Running, Sailing

Scuba Diving, Strength Training, Swimming

Table Tennis, Tennis, Track

Weight Lifting

1Medical Conditions Affecting Sports Participation. Stephen G. Rice and the Council on Sports Medicine and Fitness. Pediatrics 2008;121;841.

Initial certification eligibility requires candidates to document a minimum of 50 venue coverage hours in contact sports. Another 50 hours minimum may be in contact, limited contact, or non-contact sports. All 100 hours must have been acquired within the past 10 years.

Candidates with limited capability to cover organized sporting events (e.g. military PTs, federal PTs employed outside the United States) may submit a request to receive credit for venue coverage hours provided while supporting military physical training or tactical athlete training (e.g. SWAT/FBI physical training).

The request and materials to be reviewed are to be e-mailed to

In addition to the general requirements, Women's Health certification applicants must also submit:

  • one case reflection demonstrating specialty practice in women’s health. This case study must be based on a patient/client seen within the last three years.

Note: First examination administration anticipated in Spring 2022.

In addition to meeting the general requirements, applicants must also submit:

  • one case report demonstrating specialty practice in wound management physical therapy. This case study must be based on a patient/client seen within the last three years.


  • have current CPR Certification
    The applicant must be currently certified in Cardiopulmonary Resuscitation (CPR) by completing the American Heart Association's BLS Healthcare Provider Course or American Red Cross’ CPR for the Professional Rescuer course.


Two (or More) Certifications at Once

Requirements for Applying for More Than One Specialty

If interested, physical therapists may wish to consider applying for more than one specialty. However, it is recommended that this is done in different years. Applying for two certifications simultaneously is not advised due to the amount of preparation and subsequent certification maintenance.

Applicants must submit a complete set of application materials and fees for each specialist certification exam. ABPTS policy does not permit an applicant who applies for certification in a second specialty area to submit the same direct patient hours that are used for the first application/specialty area. Specialty councils review all submitted applications for duplication of hours.

Examination Requirements

The applicant must sit for and pass a written examination which tests the application of advanced knowledge and clinical skills identified in the Physical Therapy: Description of Specialty Practice (DSP). The DSP includes content related to the knowledge base for the specialty. Refer to the exam content outline included in the application and the DSP book for detailed information on the exam.

Examinations are administered at PSI Testing Centers throughout the U.S. and abroad. Contact the Specialist Certification Program at 1-800/999-2782, ext. 8520 or for additional information about sitting for the specialist certification examination in an international location.