in edinburgh. students can qualify as physiotherapists by completing a four-year bachelor of science degree or a two-year master's degree (if they already have an undergraduate degree in a related field). to use the title 'physiotherapist', a student must register with the health and care professions council, a uk-wide regulatory body, on qualifying. many physiotherapists are also members of the chartered society of physiotherapists (csp), which provides insurance and professional support. united states the primary physical therapy practitioner is the physical therapist (pt) who is trained and licensed to examine, evaluate, diagnose and treat impairment, functional limitations, and disabilities in patients or clients. physical therapist education curricula in the united states culminate in a doctor of physical therapy (dpt) degree, with some practicing pts holding a master of physical therapy degree, and some with a bachelor's degree. the master of physical therapy and master of science in physical therapy degrees are no longer offered, and the entry-level degree is the doctor of physical therapy degree, which typically takes 3 years after completing a bachelor's degree. pts who hold a masters or bachelors in pt are encouraged to get their dpt because apta's goal is for all pt's to be on a doctoral level. wcpt recommends physical therapist entry-level educational programs be based on university or university-level studies, of a minimum of four years, independently validated and accredited. curricula in the united states are accredited by the commission on accreditation in physical therapy education (capte). according to capte, as of 2022 there are 37,306 students currently enrolled in 294 accredited pt programs in the united states while 10,096 pta students are currently enrolled in 396 pta programs in the united states. the physical therapist professional curriculum includes content in the clinical sciences (e.g., content about the cardiovascular, pulmonary, endocrine, metabolic, gastrointestinal, genitourinary, integumentary, musculoskeletal, and neuromuscular systems and the medical and surgical conditions frequently seen by physical therapists). current training is specifically aimed to enable physical therapists to appropriately recognize and refer non-musculoskeletal diagnoses that may present similarly to those caused by systems not appropriate for physical therapy intervention, which has resulted in direct access to physical therapists in many states. post-doctoral residency and fellowship education prevalence is increasing steadily with 219 residency, and 42 fellowship programs accredited in 2016. residencies are aimed to train physical therapists in a specialty such as acute care, cardiovascular & pulmonary, clinical electrophysiology, faculty, geriatrics, neurology, orthopaedics, pediatrics, sports, women's health, and wound care, whereas fellowships train specialists in a subspecialty (e.g. critical care, hand therapy, and division 1 sports), similar to the medical model. residency programs offer eligibility to sit for the specialist certification in their respective area of practice. for example, completion of an orthopedic physical therapy residency, allows its graduates to apply and sit for the clinical specialist examination in orthopedics, achieving the ocs designation upon passing the examination. board certification of physical therapy specialists is aimed to recognize individuals with advanced clinical knowledge and skill training in their respective area of practice, and exemplifies the trend toward greater education to optimally treat individuals with movement dysfunction. physical therapist assistants may deliver treatment and physical interventions for patients and clients under a care plan established by and under the supervision of a physical therapist. physical therapist assistants in the united states are currently trained under associate of applied sciences curricula specific to the profession, as outlined and accredited by capte. as of december 2022, there were 396 accredited two-year (associate degree) programs for physical therapist assistants in the united states of america. curricula for the physical therapist assistant associate degree include: anatomy & physiology exercise physiology human biology physics biomechanics kinesiology neuroscience clinical pathology behavioral sciences communication ethics research other coursework as required by individual programs job duties and education requirements for physical therapy technicians or aides may vary depending on the employer, but education requirements range from a high school diploma or equivalent to completion of a 2-year degree program. o-net reports that 64% of pt aides/techs have a high school diploma or equivalent, 21% have completed some college but do not hold a degree, and 10% hold an associate degree. some jurisdictions allow physical therapists to employ technicians or aides or therapy assistants to perform designated routine tasks related to physical therapy under the direct supervision of a physical therapist. some jurisdictions require physical therapy technicians or aides to be certified, and education and certification requirements vary among jurisdictions. employment physical therapy-related jobs in north america have shown rapid growth in recent years, but employment rates and average wages may vary significantly between different countries, states, provinces, or regions. a study from 2013 states that 56.4% of physical therapists were globally satisfied with their jobs. salary, interest in work, and fulfillment in a job are important predictors of job satisfaction. in a polish study, job burnout among the physical therapists was manifested by increased emotional exhaustion and decreased sense of personal achievement. emotional exhaustion is significantly higher among physical therapists working with adults and employed in hospitals. other factors that increased burnout include working in a hospital setting and having seniority from 15 to 19 years. united states according to the united states department of labor's bureau of labor statistics, there were approximately 210,900 physical therapists employed in the united states in 2014, earning an average of $84,020 annually in 2015, or $40.40 per hour, with 34% growth in employment projected by 2024. the bureau of labor statistics also reports that there were approximately 128,700 physical therapist assistants and aides employed in the united states in 2014, earning an average $42,980 annually, or $20.66 per hour, with 40% growth in employment projected by 2024. to meet their needs, many healthcare and physical therapy facilities hire "travel physical therapists", who work temporary assignments between 8 and 26 weeks for much higher wages; about $113,500 a year. bureau of labor statistics data on ptas and techs can be difficult to decipher, due to their tendency to report data on these job fields collectively rather than separately. o-net reports that in 2015, ptas in the united states earned a median wage of $55,170 annually or $26.52 hourly and that aides/techs earned a median wage of $25,120 annually or $12.08 hourly in 2015. the american physical therapy association reports vacancy rates for physical therapists as 11.2% in outpatient private practice, 10% in acute care settings, and 12.1% in skilled nursing facilities. the apta also reports turnover rates for physical therapists as 10.7% in outpatient private practice, 11.9% in acute care settings, 27.6% in skilled nursing facilities. definitions and licensing requirements in the united states vary among jurisdictions, as each state has enacted its own physical therapy practice act defining the profession within its jurisdiction, but the federation of state boards of physical therapy has also drafted a model definition to limit this variation. the commission on accreditation in physical therapy education (capte) is responsible for accrediting physical therapy education curricula throughout the united states of america. united kingdom the title of physiotherapist is a protected professional title in the united kingdom. anyone using this title must be registered with the health & care professions council (hcpc). physiotherapists must complete the necessary qualifications, usually an undergraduate physiotherapy degree (at university or as an intern), a master rehabilitation degree, or a doctoral degree in physiotherapy. this is typically followed by supervised professional experience lasting two to three years. all professionals on the hcpc register must comply with continuing professional development (cpd) and can be audited for this evidence at intervals. specialty areas the body of knowledge of physical therapy is large, and therefore physical therapists may specialize in a specific clinical area. while there are many different types of physical therapy, the american board of physical therapy specialties lists ten current specialist certifications. most physical therapists practicing in a specialty will have undergone further training, such as an accredited residency program, although individuals are currently able to sit for their specialist examination after 2,000 hours of focused practice in their respective specialty population, in addition to requirements set by each respective specialty board. cardiovascular and pulmonary cardiovascular and pulmonary rehabilitation respiratory practitioners and physical therapists offer therapy for a wide variety of cardiopulmonary disorders or pre and post cardiac or pulmonary surgery. an example of cardiac surgery is coronary bypass surgery. the primary goals of this specialty include increasing endurance and functional independence. manual therapy is used in this field to assist in clearing lung secretions experienced with cystic fibrosis. pulmonary disorders, heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis, treatments can benefit from cardiovascular and pulmonary specialized physical therapists. clinical electrophysiology this specialty area includes electrotherapy/physical agents, electrophysiological evaluation (emg/ncv), physical agents, and wound management. geriatric geriatric physical therapy covers a wide area of issues concerning people as they go through normal adult aging but is usually focused on the older adult. there are many conditions that affect many people as they grow older and include but are not limited to the following: arthritis, osteoporosis, cancer, alzheimer's disease, hip and joint replacement, balance disorders, incontinence, etc. geriatric physical therapists specialize in providing therapy for such conditions in older adults. physical rehabilitation can prevent deterioration in health and activities of daily living among care home residents. the current evidence suggests benefits to physical health from participating in different types of physical rehabilitation to improve daily living, strength, flexibility, balance, mood, memory, exercise tolerance, fear of falling, injuries, and death. it may be both safe and effective in improving physical and possibly mental state, while reducing disability with few adverse events. the current body of evidence suggests that physical rehabilitation may be effective for long-term care residents in reducing disability with few adverse events. however, there is insufficient to conclude whether the beneficial effects are sustainable and cost-effective. the findings are based on moderate quality evidence. wound management wound management physical therapy includes the treatment of conditions involving the skin and all its related organs. common conditions managed include wounds and burns. physical therapists may utilize surgical instruments, wound irrigations, dressings, and topical agents to remove the damaged or contaminated tissue and promote tissue healing. other commonly used interventions include exercise, edema control, splinting, and compression garments. the work done by physical therapists in the integumentary specialty does work similar to what would be done by medical doctors or nurses in the emergency room or triage. neurology neurological physical therapy is a field focused on working with individuals who have a neurological disorder or disease. these can include stroke, chronic back pain, alzheimer's disease, charcot-marie-tooth disease (cmt), als, brain injury, cerebral palsy, multiple sclerosis, parkinson's disease, facial palsy and spinal cord injury. common impairments associated with neurologic conditions include impairments of vision, balance, ambulation, activities of daily living, movement, muscle strength and loss of functional independence. the techniques involve in neurological physical therapy are wide-ranging and often require specialized training. neurological physiotherapy is also called neurophysiotherapy or neurological rehabilitation. it is recommended for neurophysiotherapists to collaborate with psychologists when providing physical treatment of movement disorders. this is especially important because combining physical therapy and psychotherapy can improve neurological status of the patients. orthopaedics treatment by orthopedic physical therapists orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopedic surgery, acute trauma such as sprains, strains, injuries of insidious onset such as tendinopathy, bursitis, and deformities like scoliosis. this specialty of physical therapy is most often found in the outpatient clinical setting. orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations. joint and spine mobilization/manipulation, dry needling (similar to acupuncture), therapeutic exercise, neuromuscular techniques, muscle reeducation, hot/cold packs, and electrical muscle stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are modalities employed to expedite recovery in the orthopedic setting. additionally, an emerging adjunct to diagnosis and treatment is the use of sonography for diagnosis and to guide treatments such as muscle retraining. those with injury or disease affecting the muscles, bones, ligaments, or tendons will benefit from assessment by a physical therapist specialized in orthopedics. pediatrics pediatric physical therapy assists in the early detection of health problems and uses a variety of modalities to provide physical therapy for disorders