APTA has distinct and separate definitions of fellowship and residency programs. A fellowship is designed for the graduate of a residency or board-certified therapist to focus on a subspecialty area of clinical practice, education, or research. (www.apta.org/education/clinical fellowship and residency programs)

APTA (2000) defines a Fellowship program as:
"A clinical fellowship is a postprofessional, funded, and planned learning experience in a focused subspecialty area of clinical practice, education, or research. The fellowship is intended for postdoctoral, post-residency prepared, or board-certified therapists."

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

A clinical residency is a planned program of postprofessional clinical and didactic education designed to significantly advance the physical therapist’s preparation as a provider of patient care services in a defined area of clinical practice (i.e. .Has its own DSP i.e. orthopedics). [APTA 2000] Typically, the residency experience prepares an individual to become a board-certified clinical specialist (i.e. OCS, orthopedic clinical specialist).

NAIOMT is credentialed by the American Physical Therapy Association (APTA) as a post-professional clinical fellowship program for physical therapists in orthopaedic manual therapy. 
NAIOMT’s Fellowship program began in 2003 and was approved by AAOMPT in 1998, APTA-credentialed in 2000, and APTA-recredentialed in 2004 and 2009.

The NAIOMT faculty consists of skilled experienced clinicians many of whom have presented nationally and internationally. AAOMPT- recognized programs meet their published standards, and the curriculum is within the DASP-OMPT (2008). For further information on AAOMPT Standards, contact: www.aaompt.org

The majority of the NAIOMT faculty is fellowship trained and their biographies can be reviewed on the NAIOMT website, here. The most senior faculty members each have over 38 years of clinical experience and are nationally and internationally recognized.

Consult the web sites of AAOMPT and APTA (www.aaompt.org and www.apta.org Professional Development) for their list of approved and credentialed OMPT Fellowship programs. Visit the web sites of the different fellowship opportunities to explore the programs and faculty to find the Fellowship program that will fulfill your educational needs. Talk to graduates of the different programs to find “first hand” information.

Explore further what NAIOMT has to offer you on your pathway to clinical excellence on www.naiomt.com:

• Submit an application for information to NAIOMT and receive a 20-minute interview with the Fellowship coordinator to further answer your questions. Go to > Programs > Clinical Fellowship Program and scroll to " Information and Application Package"
• Contact NAIOMT faculty and attend one of NAIOMT’s core or specialty classes to experience their style of OMPT
• Visit a NAIOMT faculty or clinical instructor in the clinical setting to see first hand the advanced expertise of the NAIOMT-trained clinician

You typically 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.

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. You are also responsible for the scheduling of your training and examinations, documentation of hours and progress through the program, ideally within 36 months.

NAIOMT has always utilized the initials “COMT” Certified Orthopaedic Manual/Manipulative Therapist to signify NAIOMT’s advanced certification in Orthopaedic Manual Physical Therapy (post level IV examination).  This is an internal certification within NAIOMT. On completion of the entire Fellowship program, the NAIOMT graduate can apply for the Fellowship credential with AAOMPT (FAAOMPT).

In the US, there is no standardization of the term “certified manual therapist”. Other OMPT programs use other designations and some also use “COMT”.

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 is through attending an APTA-credentialed and AAOMPT-recognized postprofessional OMPT fellowship program.

Yes. NAIOMT hours are eligible for credits in certain post professional doctoral programs. The credits can be obtained from NAIOMT core courses with examinations and from structured fellowship or mentored clinical hours.

NAIOMT faculty associates with many universities, and we are proud to have been affiliated with the following advanced degrees since the mid 1990s.
DSc                 Andrews University, Berrien Springs, Michigan
t-DPT              Pacific University, Hillsboro, Oregon
t-DPT, PhD    Texas Women’s University, Dallas and Houston, Texas

Andrews University, Berrien Springs, Michigan
Andrews University and NAIOMT have partnered to offer a DScPT Program in orthopaedic manual physical therapy. This degree represents one of the most clinically relevant programs in the United States! The program utilizes a combination of short course format, independent study and distance learning.

Applicants are also able to receive credit for previous achievements through our competency review process. Graduates will leave the program certified as an orthopaedic manual therapist and will have the credentials to market themselves as one of the most respected orthopaedic specialists in their area!

Contact the PT professional advancement coordinator, DSc. Program: 800 827 2878
http://www.andrews.edu/cas/pt/programs/postpro.html

Pacific University, Hillsboro, Oregon*
Pacific University recognizes that fellowship education provides an optimal environment for integrating academic and clinical knowledge. Students who have successfully completed NAIOMT core courses with examinations and/or clinical fellowship or mentored training can apply their work toward the required 32 credit hours for a transitional DPT. Only administrative fees are charged for the transfer of credits.  The program utilizes a combination of the weekend course format, independent study and distance learning.

* As of 2008, the transitional DPT Program at Pacific University is currently not accepting new applicants. Contact the associate coordinator of transitional DPT program for more information: 1 503 352 7257      www.pacificu.edu/pt/tdpt/index.cfm

Texas Women’s University, Dallas and Houston, Texas
Texas Women’s University campuses at Dallas and Houston offer post-professional degrees:
      tDPT (24 credit. hours beyond a master’s, 18 core + 6 elective)
      PhD (60 credit hours beyond a master’s).
TWU also offers a Certificate in Orthopedic Manual Therapy,

The School of Physical Therapy Post-Professional Admissions Committee will review the application prior to acceptance into the degree program. The 12 credit hours of course work taken as a part of the TWU-OMT certificate program may be counted toward a graduate degree if approved by the School of Physical Therapy and the Graduate Dean. NAIOMT classes are therefore typically accepted as elective credits to both degrees.

For more information contact:
https://www.twu.edu/physical-therapy/post-professional-education.asp
Kam Mukherjee, School of Physical Therapy, TWU,. Phone: (214) 706-2310,
Email: kmukherjee@twu.edu
Sharon Wang, PT, PhD, OCS, COMT, FAAOMPT Program Director
Email: swang@twu.edu

The OCS, is an orthopaedic certified specialist certification though the American Board of PT Specialties. It has a written examination and is offered annually by ABPTS. (Go to www.apta.org)

NAIOMT encourages its students to strive for the OCS certification, but does not require it for fellowship entry or for fellowship graduation and AAOMPT does not currently require it for the FAAOMPT credential.

Manual therapy is a sub-specialty of orthopaedics, and the manual therapy fellowship credential (FAAOMPT) is only earned by extensive clinical mentoring, practical examinations, “live patient” examinations and a scholarly written paper and graduation from a credentialed fellowship program in OMPT.

The minimum time frame for the NAIOMT OMPT clinical fellowship is 12 months, the maximum is typically 36 months. Intakes are flexible and year-round. 

 Once the Fellowship officially starts, the “clock is ticking”. The majority of the total hours of didactic, practical, clinical and self-study in OMPT needs to be completed within 36 months and the total must exceed 1500 hours.

No. A Fellowship program is a planned program, over a specific amount of time, with a concentrated effort and specific outcome goals over the defined time span. Occasional hours could not be part of a fellowship program – however – supervised clinical placements (SCP) are excellent ways of obtaining clinical continuing education.

The majority of the hours normally must be acquired during the 36-month fellowship period. NAIOMT acknowledges your past experience and may transfer some contact hours acquired from manual therapy courses and related science and medical courses.

The didactic and practical hours must be postprofessional and within 5 years before the beginning of your Fellowship. To transfer hours, you will need to provide details of the course and a certificate of attendance to the NAIOMT fellowship program for evaluation. The courses or study hours must meet the fellowship guidelines for the transferability of credits.

No. By definition, a fellowship program is post residency or after a period of orthopaedic clinical experience, (typically 1-2 years). Even if you have documentation of a higher level of orthopaedic training and clinical affiliations within your PT training, a period of post-professional orthopedic clinical experience is required.

Map out your time frame and goals carefully with a NAIOMT clinical instructor, faculty or the Clinical Fellowship Director or Coordinator.  We also recommend that you attend one of our classes or sample some supervised/mentored clinical hours before registering, to help ensure that our style and approach will meet your professional development needs.

The NAIOMT fellowship will especially suit the physical therapist who has multiple other obligations but also want to add advanced clinical training into that busy life.

The Fellowship director and coordinator will assist you in the temporal planning of the 2-3 year fellowship to enable you to meet all the fellowship graduation requirements and pace the study in a way that will work best for you.  This will demand a high level of self-discipline to self-pace your fellowship without constant peer or faculty support.

Your fellowship plan and timeline was designed by you and your clinical instructor, with guidance from the Director to fit your life demands and learning goals, and was approved by NAIOMT. However, if things change, we record your completed hours as a partial fellowship.  If you were to start again at a future date, some of the hours may be transferable.

If a significant life event interrupts your Fellowship Program, you can normally apply for a leave of absence for up to one year or an extension of up to 6 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.

APTA requires 1000 hours for an APTA-credentialed fellowship. AAOMPT requirements include a component of 440 clinically supervised/mentored hours.

The NAIOMT Fellowship Program requirement is 1500 hours of postprofessional study. NAIOMT identifies 568 hours (of the 1500 total) to be didactic and practical hours, 440 clinical, and the remaining hours from other study and the fellowship project.

This is the capstone and heart of the fellowship experience; working under the direct or indirect supervision/mentorship of a skilled clinician 440 hours.

The hours must be completed in a facility where a certified orthopaedic manual physical therapist is immediately available on-site or offsite (by telephone or electronic communication) during the 440 hours. NAIOMT requires that greater than 50% of those hours are under the supervision/mentorship of a NAIOMT Clinical Fellowship Instructor.

This is the capstone and the most critical part within the 440 hours of the clinical fellowship experience. Working under the direct on-site supervision/mentorship of the CFI who is “looking over your shoulder”, feeling what you are feeling, analyzing your diagnostic and clinical reasoning processes and challenging you to explain and to explore.

Fellowship students must receive a minimum of 130 hours of 1:1 directly supervised/mentored patient contact, i.e. clinical instructor in the room and not concurrently treating other patients/clients. The fellowship student can spend 20 of those hours purely observing the clinician and not actively involved in the patient management. (AAOMPT Standards 1999)

In a part time flexible program, a “typical week” is hard to describe and variable. Plan a timetable that will work best for you and the CFI. You must space the 130 clinical hours of 1:1 direct interaction over a minimum of one year. (AAOMPT Standards 1999)

The physical site of the supervised/mentored clinical hours is the site that works best for you, your CFI, your employers, your patients/clients and your budget. 

NAIOMT approved clinical instructors are in many locations in the US.  The student may go to the instructor’s work site for instruction (on-site instruction); the instructor visits the student’s site of work (off-site) or you meet at a different site (independent site)

Fellowship students are to receive a minimum of 40 clinical tutorial contact hours. The intent of the tutorial is to provide small group clinical problem solving opportunities and peer and faculty interaction, usually in a 1:6 ratio or better. They are oral and/or written/electronic discussions with the clinical instructor and faculty and focus on advanced clinical reasoning of cases and relevant theory.

The tutorial hour are achieved through face-to-face, message board, and/or teleconference or electronic interaction. The tutorial enhances the ability to prospectively and retrospectively analyze patient management. Ideally the tutorial is done in real-time with immediate or prompt feedback. (Adapted from AAOMPT Standards 1999)

You will need a total of 440 hours of indirect clinical supervision/mentorship.  These are the hours within the fellowship program in which you are working with patients/clients and your mentor (clinical fellowship instructor or certified manual physical therapist) is available for immediate or rapid feedback to your clinical questions.

NAIOMT core and specialty courses are highly recommended, but completion of all of the 8 core classes is not required at this time. Up to 50% of the theoretical and 50% of the practical hour total requirements can be obtained from classes taught by experts who are not NAIOMT faculty.

• CORE: NAIOMT provides 287 hours within it core classes Levels 500-800/I- IV: core classes 500, 600, 610, 640, 700, 710, 720 and 800. Typically 50% theory, 50% practical. 
• SPECIALTY: NAIOMT offers specialty classes taught by NAIOMT faculty (i.e. 555, 670, 780 etc)
• ELECTIVES: Approval of the transfer of hours is subject to NAIOMT review of the class content and instructor credentials. These should be in the categories of OMPT and related sciences within the DACP-OMPT (Theoretical components: communication and patient education, scientific inquiry, clinical anatomy, clinical neuro-anatomy and neurophysiology, clinical histology and biomechanics, applied medical series, applied exercise physiology. Related theory:  clinical research methodology, EBP, radiology, pharmacology, advanced anatomy)
• INDEPENDENT STUDY: Directed and documented independent study directed by your CFI, or selected structured home study courses from recognized organizations or individuals (i.e. APTA, Orthopaedic Section, etc.)

During your 12-36 month Clinical Fellowship, you will be working on a Fellowship project approved by your CFI, Fellowship Director and the Board of Directors of NAIOMT. Fellowship programs approved by AAOMPT have a research or special project as part of their graduation requirements and recommendations.

• NAIOMT Fellowship Program Objective: The Fellowship student Graduate will demonstrate the ability to promote and assist in research and outcome measurement.
• The DACP-OMPT (1998) recommends that the graduate contribute to physical therapy literature, which may include: research, presentation at a national or state meeting or to a journal, case report, literature review, theory paper, computer or A/V development of PT education or patient care delivery

Before you get concerned with the "research" word, your NAIOMT graduation is at this time not dependent on the completion of a full research project, BUT we must see a professionally written work, like a case study, suitable for publication in a journal or newsletter, that reflects our mission and objectives and contributes to the manual physical therapy profession.
The project does not need to be a solo effort, you could work with another fellowship student or students to produce the project. The fellowship project is part of the 1500 hour requirement, but does not substitute for the theory hours.

During your 12-36 month Clinical Fellowship, you will be working on a Fellowship project approved by your CFI and Fellowship Director. Fellowship programs approved by AAOMPT have a research or special project as part of their graduation requirements/recommendations.

• NAIOMT Fellowship Program Objective: The Fellowship student Graduate will demonstrate the ability to promote and assist in research and outcome measurement. 
• The DACP-OMPT  (2008) recommends that the graduate contribute to physical therapy literature, which may include: independently or part of a research team; submission of a case report, literature review or theory paper; develop computer or A/V technology to be used in PT education or direct patient care delivery.

Before you get concerned with the “research” word, your NAIOMT graduation is at this time not dependent on the completion of a full research project, BUT we must see a professionally written work suitable for publication in a journal or newsletter, that reflects our mission and objectives and contributes to the manual physical therapy profession. Ideally, we would prefer the student to write and publish a case report.

Examples of past NAIOMT Fellowship projects include:

• Published case reports, i.e. elbow injury and manipulation and EMG monitoring of multifidus, post manipulation
• Poster and platform presentations at AAOMPT annual meetings
• Papers which educate the OMPT community, colleagues, referral sources, insurance parties and legislators on the scope of physical therapy - especially in relation to manipulation.
• Analyses of outcome studies from clinics with or w/out without NAIOMT-certified manual  PTs
• Publication of articles on exercise protocols for lumbar instability
• NAIOMT newsletter publication of case histories and articles

A NAIOMT–approved Clinical Fellowship Instructor (CFI) is a NAIOMT Faculty member, and/or is physical therapist, who has completed our Fellowship and CFI-training program. The CFI is under a contractual agreement with NAIOMT to provide high quality clinical education (supervised/mentored clinical placement) opportunities that meet our guidelines.

Please see the CFI list and clinical sites on the NAIOMT faculty page, here.

The clinical site is wherever the CFI is providing clinical supervision/mentorship. It may be at your (off-site) or their (on-site) place of employment or at an independent site. The Fellowship Director or coordinator will assist you in locating a site.

Some NAIOMT-approved clinical fellowship instructors may temporarily or permanently employ fellowship students; others are able to travel to the fellowship student’s employment site.

Host (independent) sites have offered 1-3 week clinicals for 2-6 Fellowship students, with a visiting CFI. A NAIOMT faculty/CFI visits.

The licensing laws in each state differ, so you and your CFI in conjunction with NAIOMT will need to verify your ability to practice in that state for the specific number of days or weeks without a PT license in that State, or you may need to obtain a temporary or permanent PT license. You both will also need to be in compliance with all malpractice insurance and other requirements, policies and procedures at the site where you will be working with patients/clients.

It is the responsibility of you and your CFI to ensure you are in compliance with all state regulations and physical site policies and procedures. You are urged to carry your own personal malpractice insurance policy, as your employer’s group policy may not cover you if you are off site.  The physical therapy practiced must be within the scope of practice for that state.

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  

The NAIOMT Clinical Fellowship Director and Coordinator are available to assist you in finding the Fellowship arrangement and location that works for you.

• Timeline and potential starting date
• Learning goals
• Logistics (site, costs, travel, site orientation, accommodation etc)
• NAIOMT-approved clinical fellowship instructor (CFI) you plan to work with
• Finances

There is a process of Fellowship student application, selection and interview (distance or in person). Placement will be subject to availability of CFIs and physical sites. NAIOMT will not discriminate on the basis of race, color, creed, gender, age, disability or sexual orientation.

Yes. Up to 25 clinical hours can be completed in a “pre-fellowship” or supervised/mentored clinical placement (SCP) and applied to the fellowship (if you apply and are accepted within 2 years). This enables you to experience postprofessional clinical supervision/mentorship to see if it meets your learning needs. If the full fellowship program is not right for you at that time, you will still have experienced some valuable clinical education.

NAIOMT’s Fellowship Program costs will be similar to other orthopaedic manual physical therapy fellowship programs. As it is a part time program, the costs will be spread out over longer periods and you “pay as you go”. You may be able to transfer some hours of previous education. Some costs may be higher due to travel expenses of you or the CFI.

Estimated expenses (as of 4/09):  

• NAIOMT Core courses levels I-IV approx. 41 days costs vary with location, typically @   $130 - $185 per day, averaging  $160 per day
• NAIOMT Specialty classes: estimated 30-40 days @ $150 - $300 per day        
• Non-NAIOMT elective courses (variable costs)
• Structured distance or home study courses (e.g. Ortho HS courses) = low cost/hour      
• Clinical hours 130 of 1:1 direct mentoring CFI @ consultant rates typically $60-150/hour plus travel expenses, or may be part of con education $ or benefits within an employment setting   
• Clinical tutorial 40 hours - variable, dependent on work situation and CFI   
• CFP Message Board for FREE tutorial hours   
• Indirect clinical hours – student discussion with CFIs, calls, e-mails. Typically minimal cost and often included in direct mentoring charges
• NAIOMT Fellowship credentialing and annual dues: Dues 3 years @ $80, registration and graduation fees approximately $330
• NAIOMT Exams (written, cases and oral-practical) approximately $2665