The APTA has distinct and separate definitions of fellowship and residency programs. Please refer to the link below: http://www.abptrfe.org/FellowshipPrograms/AboutClinicalFellowshipPrograms/

A clinical fellowship program in physical therapy is a post-professional planned learning experience in a focused advanced area of clinical practice. Similar to the medical model, a clinical fellowship is a structured educational experience (both didactic and clinical) for physical therapists, which combines opportunities for ongoing clinical mentoring with a theoretical basis for advanced practice and scientific inquiry in a defined area of sub-specialization beyond that of a defined specialty area of clinical practice, i.e. beyond orthopedic PT.

A fellowship candidate has either completed a residency program in a related specialty area, is a board-certified specialist in the related area of specialty (OCS), or has demonstrable clinical skills within a particular specialty area. Fellowship training is not appropriate for new physical therapy graduates. (ABPTRFE 2013) Orthopaedic manual physical therapy (OMPT) is a sub-specialty of orthopedics, and therefore an OMPT fellowship must follow a demonstrated period of post-professional clinical experience in orthopedic physical therapy.

Benefits: You do not need to change employment or relocate, as you may need to with a full time program. You set the pace and time frame of your fellowship experience to complete your goals while maintaining your “life” outside of physical therapy. You “pay as you go,” so costs are spread out over 30-36 months.

Challenges: The part-time program, however, requires more discipline to complete your study plan without the daily stimulus of a group progressing through a full time program together in the same location. As we are not all in the same building, you are also responsible for the scheduling of your training and examinations, documentation of hours and progress through the program, within 36 months.

On completion of the entire Fellowship program, the MTI graduate can apply for the Fellowship credential with AAOMPT (FAAOMPT) and can proudly say they have been fellowship-trained in OMPT. AAOMPT is a Member Organization with IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists). The FAAOMPT credential will therefore be recognized internationally as having reached a high standard in OMPT.

No. The AAOMPT no longer awards the FAAOMPT designation though a portfolio or challenge process for those who did their training in the US. The only route to FAAOMPT is attending an ABPTRFE-accredited and AAOMPT-recognized postprofessional OMPT fellowship program.

The OCS is the orthopaedic certified specialist certification offered annually by the American Board of PT Specialties in a written exam format. MTI encourages its students to take the OCS certification, but does not require it for fellowship entry or for fellowship graduation. AAOMPT does not currently require it for the FAAOMPT credential.

Manual physical therapy is a sub-specialty of orthopaedics. The manual physical therapy fellowship credential (FAAOMPT) can only be earned by graduation from a credentialed fellowship program in OMPT.

No. By definition a fellowship program is post residency or after a period of orthopedic clinical experience, which means that as a new grad you cannot be eligible for enrollment in the fellowship program.

However, you can enroll as a new grad in the Certification Program. At the end of the first year of the Certification Program you can then matriculate in the Fellowship program, upon successful passing of the requisite written and practical exams. In essence the first year courses function as leveling courses, ensuring you will have the requisite experience, knowledge and psychomotorskills to enter the Fellowship Program.

Yes. The non-refundable application fee is $100.

The MTI Fellowship Program averages 27 months, with a maximum of 36 months. Once the Fellowship officially starts, the “clock is ticking.” All the hours involved in didactic, practical, clinical independent study needs to be completed within 36 months and the total hours must exceed 1000 hours.

If a significant life event interrupts your Fellowship Program, you can normally apply for a leave of absence during the program or on a rare occasion an extension at the end of the program of 3 months, to allow you to complete all the requirements. Approval of a leave of absence or extension will be on a case-by-case basis. The goal is to complete the fellowship within the 36-month time frame. Fellowships that extend beyond 36 months for very unusual and valid circumstances will require medical or other documentation. If there has been a major interruption or significant time since didactic and clinical examinations, extra requirements or assignments may be required prior to graduation.

MTI acknowledges past experience and it will contribute to the strength of your application. However, previously acquired continuing education hours in manual physical therapy courses and related science and medical courses cannot be transferred into the Fellowship Program.

The clinical instruction component of the curriculum is the strength of this program and the core of fellowship training in general. Advanced evaluation and treatment skills are emphasized. A sound framework of clinical reasoning and decision-making is utilized as well as significant time in instruction in skilled treatment.

The hours must be completed in a facility where an MTI approved mentor (FAAOMPT) is immediately available on-site during the 440 hours. Working under the direct on- site mentorship of MTI’s clinical faculty is critical. The mentor will be “looking over your shoulder,” feeling what you are feeling, analyzing your diagnostic and advanced clinical reasoning processes and challenging you to explain and to explore.

Fellows-in-training must receive a minimum of 130 hours of 1:1 directly mentored patient contact, i.e. clinical instructor in the room and who is not concurrently treating other patients/clients.

You will need a total of 310 hours of indirect clinical mentorship. These are the hours within the fellowship program in which you are working with patients/clients and your mentor is available for immediate or rapid feedback to your clinical questions in person.

The mentoring hours need to be done with MTI approved faculty at an MTI approved clinical site. This ensures you will see the proper patient mix during your hours, as well as getting the highest level mentoring you deserve. MTI picks their mentors extremely carefully, and they are picked based on their clinical skills and ability to explain difficult concepts in easy to understand terms. All MTI mentors are FAAOMPT’s. Click here for MTI approved clinical sites and faculty.

Education literature supports the one instructor to 2 or 3 student model and more than one fellow-in-training with one instructor and one patient can be extremely effective in the right situations. However, for some patients, this will be too many people in the room or “too many hands on them”.

No. The curriculum hours must be acquired during the 36-month fellowship. Previously acquired mentored hours in manual physical therapy cannot be transferred into the program.

Yes, you will need a license in the state in which you are receiving the clinical mentoring. You will need to obtain a temporary or permanent PT license. Licensing laws and addresses of PT licensing boards can be obtained through APTA at www.apta.org or from the Federation of State PT Licensing Boards at www.fsbpt.org.

You will also need to be in compliance with any restrictions on scope of physical therapy practice in the State in which you are treating patients. Pay special attention to any restrictions on manipulation, dry needling or direct access.

Yes, you are required to carry your own personal malpractice insurance policy (your name on it), as your employer’s group policy may not cover you if you are off site.

MTI’s Fellowship Program costs will be similar to other orthopaedic manual physical therapy fellowship programs. The clinical mentoring is defined out as a separate cost. As it is a part time program, the cost will be spread out over longer periods and you “pay as you go”. Travel expenses are not included in the estimates.

Application Fee $100
First year leveling courses 8 weekend courses

2 home study courses

Written/Practical exam

Second and third year courses 9 weekend courses

3 home study courses

Written/practical exam

Manipulation DVD

Supervised Hours (440) $6500

There is an admission cost and then you pay “as you go.” We do not require payment for the entire program prior to entry.

There are a number of ways to pay for the Fellowship Program. You do have the option of paying for the program yourself, but there are many employers who will assist you with the cost when they realize the benefits of having a fellowship-trained employee. Some employers may be willing to cover the part or the entire cost of your program in return for a commitment to remain employed with them for a certain length of time. Some companies may offer a salary deferral program, whereby there will be no upfront cost to you for the program; however, you will receive a lower salary during the period of your fellowship. These types of arrangements may mean that there is no post-fellowship requirement to remain employed with the company.

No. Unfortunately Federal rules have changed and this is no longer possible.

To graduate from the program, you will need to have completed all course work. This means you will have to make up the class at a later date, which might necessitate travel to a different course location.

Classes are taught approximately every 8 weeks over a two and a half year period. There will be 17 weekend courses and 5 home study courses during that timeframe.

The curriculum is designed in a stacked format, which means that each subsequent course builds on the previous courses. Therefore, all courses needed to be taken in the sequence intended. The curriculum includes 17 onsite weekend courses as well as 5 online homestudy courses.

The first year curriculum is outlined below. These hours do not count as part of the fellowship curriculum hours:

Course Title Total Hours in the Program
Foundations 32
Introduction to Evaluation and Treatment of the Lumbar Spine 32
Introduction to Evaluation and Treatment of the Cervical Spine 24
Introduction to Evaluation and Treatment of the Extremities 24
Introduction to Evaluation and Treatment of the Thoracic Spine 8
Exams 4
Total hours 124

Students who matriculate into the fellowship-­‐training track will then follow the curriculum outlined below:

Course Title Total hours in the program
Pain Science 8
Advanced Lumbar Spine 40
Advanced Cervical Spine 40
Advanced Thoracic Spine 8
Integrated Treatment Concepts 8
Medical Exercise Therapy 16
Spine Manipulations 8
Extremity Manipulations 8
Introduction to Adverse Neural Tension 8
Gross Anatomy 16
Advanced Extremities 40
EBP 12
Clinical Pharmacology 12
Clinical Radiology 12
Ethics/Medical Legal Issues 4
Differential Diagnosis 6
Advances in orthopedic surgery and regenerative medicine 4
Directed Projects (including, but not limited to EBP, 120
Radiology, Pharmacology, Differential Diagnosis). Awarded hours with documentation of work
Grand Rounds (varies per clinical setting) 30
Clinical Mentoring
1:1 clinical supervision/instruction from clinical faculty while treating patients 130
1:1 patient/client related planning/discussion/review of diagnostic test, evaluation, plan of care etc. 40
Clinical Practice with mentor accessible onsite 270
Fellow Project: case study presentation suitable for journal submission, based on final live patient exam 120
Exams 40
Total hours in Program 1006

As you all know, over the past 3 years we have been trying hard to work with APTA/ABPTRFE to get in compliance with the new Quality Standards which will take effect on January 1, 2020.  The most visible change that you probably will be familiar with is the change in admission requirements for the Manual Therapy Fellowship Programs.

As Manual Therapy Fellowship Programs we have to adhere to IFOMPT standards. If we don’t, we will lose our IFOMPT member status as a country, and our graduates cannot obtain Fellow status in the AAOMPT anymore. As it stands, IFOMPT standards are not compatible with ABPTRFE’s new Quality Standards. One example is that the new ABPTRFE standards only require 75 one on one contact hours, whereas IFOMPT standards require 150.

Additionally, there are provisions in the new ABPTRFE standards that make it virtually impossible for the larger multi-site programs like MTI, to survive from an economic standpoint.

Despite multiple meetings, lots of feedback from students, Program Directors and the AAOMPT Board of Directors, the ABPTRFE ultimately did not want to make accommodations for Manual Therapy Fellowship Programs. The new Quality Standards will take effect on January 1st and they will not be up for review until 2023.

This means is that we were facing the choice of stepping away from the ABPTRFE as our credentialing body, or having Manual Therapy Fellowship Programs slowly fade away into oblivion. Instead of being the standard bearer of excellence in orthopedic Physical Therapy, we would once again become an outlier, just like we were before the AAOMPT was formed in 1991.

Stepping away from the ABPTRFE as our credentialing agency is not a step to be taken lightly for a variety of reasons. However, over time it became clear that this needed to happen.

The AAOMPT board of Directors has decided that moving forward, there will be 2 routes for gaining the AAOMPT credential and recognition of our Fellows:

  1. 1: ABPTRFE minimum Standards + IFOMPT Standards
  2. IFOMPT Standards

Each Fellowship Program was asked to vote which route they were going to take. The Manual Therapy Institute has voted for IFOMPT Standards only. The AAOMPT will take over the credentialing, with the help of another credentialing agency. This will take time, and significant financial resources, but we do believe this is the best choice, considering all options.

What this means for us is that we will be doing business as usual. So our admission process will stay in place as it always has been. There will be no OCS/Residency requirement per January 1st. The first year of the Program will serve once again as “Pre-Fellowship” training and successful passing of the mid term written/practical exam will grant students automatic matriculation to the Fellowship portion of the program.

New grads can apply to the first year of the program, just as always.

Students don’t need to take their OCS, unless they choose to do so.  And most important, students will be Fellows in the AAOMPT upon graduation of the Fellowship program.

A lot of the credit for all this needs to go to the current AAOMPT Board. They have really stepped it up over the last 6 months and were instrumental in allowing the individual programs to step away from ABPTRFE while staying in compliance with IFOMPT standards.

This is a lot of change in a very short time; so if you have any questions at all, contact me.

No, you do not need completion of a Residency Program or an OCS to apply for MTI’s manual therapy program.

As we have made the decision to step away from ABPTRFE as our credentialing body, our admission process will stay in place as it always has been. There will be no OCS/Residency requirement per January 1st.

The first year of the Program will serve once again as “Pre-Fellowship” training and successful passing of the mid term written/practical exam will grant students automatic matriculation to the Fellowship portion of the program.

New grads can apply to the first year of the program, just as always.  Students don’t need to take their OCS, unless they choose to do so.


And most important, students gain Fellow status in the AAOMPT upon graduation of the Fellowship program.

The Manual Therapy Institute

Program Outcomes

2020 2021 2022 2023
# FiTs Admitted 33 38 28 13
# FiTs Graduated 25 32 38 42
# FiTs voluntarily withdrawn 0 2 1 5
# FiTs Failed 1 0 0 0