One of the best parts about being a physical therapist is that we have endless opportunities to niche down. From working with developmentally challenged infants to focusing on seniors with Parkinson’s disease, we can take our passion for helping others and apply it in countless ways. But, while there are tons of certifications out there, there are only a handful of sanctioned, board-certified clinical specializations for physical therapists. 

We did some digging to explore what these specializations are, and we connected with several PTs to pick their brains on why they chose to specialize—and to learn how specialization has helped them grow their careers

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What is a physical therapy specialization?

There are currently nine board-certified clinical specializations within the PT world, all of which are designated by the American Board of Physical Therapy Specializations (ABPTS). In the board’s own words, these specialties were created to “advance the profession of physical therapy by establishing, maintaining, and promoting standards of excellence for clinical specialization, and by recognizing the advanced knowledge, skills and experience by physical therapist practitioners through specialist credentialing.”

As of this article’s publication date, there are 24,000 board-certified physical therapists in practice. That number might seem small compared to the roughly 209,000 licensed PTs practicing in the US. Again, this is because board-certified clinical specialization is different from many of the other certifications available to physical therapists. This can be confusing in some instances. For example, many orthopedic and sports-focused PTs pursue the Certified Strength and Conditioning Specialist (CSCS) certification as well as the Board-Certified Clinical Specialist in Sports Physical Therapy (SCS) specialization. 

This article is meant to delve more deeply into the specifics of the actual board-certified clinical specializations in the PT field. 

What are the requirements for board-certified clinical specialization?

There are some standard requirements that apply to all of these specializations. In order to specialize, you must:

  • Hold a current permanent and unrestricted license to practice physical therapy in the US (or any of its possessions or territories). 
  • Pay an application and review fee—and meet the minimum eligibility requirements by the application deadline. 
  • Submit an application and review fee for each specialist certification exam you plan to take. 
  • Take—and pass—said certification exam for the clinical specialty in question.
  • Meet additional criteria unique to the relevant clinical specialty (more details here). 

It’s important to note that you cannot use the same patient care hours to apply for multiple specialty applications. 

Now, let’s get down to the specifics for each specialty!

ABPTS Physical Therapy Clinical Specializations

1. Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy (CCS)

ABPTS has certified 349 cardiovascular and pulmonary specialists as of June 2019. This specialization indicates advanced clinical practice and expertise in the treatment of patients with various cardiac and respiratory disorders. 

Why choose this specialization?

Cardiopulmonary rehab programs play a vital role in recovery for a wide variety of patients— from those who have suffered heart attacks or undergone open-heart surgery, to those with chronic obstructive pulmonary disease (COPD) or other respiratory diseases. This type of work is not only highly rewarding, but it also tends to be somewhat less physically demanding than traditional PT work. With such a small subset of the PT profession holding this clinical specialist designation, you’ll have many doors open for you professionally. For example, if you want to teach a cardio-pulm course at the local PT program, you might not need a DPT or PhD—at least not at the adjunct level.

For more information, visit the ABPTS info page for the CCS.

2. Board-Certified Clinical Specialist in Clinical Electrophysiologic Physical Therapy (ECS)

Although this clinical speciality has been around for years, ABPTS has reportedly certified only 192 clinical electrophysiologic specialists as of June 2019. This specialization indicates advanced clinical practice and diagnostic abilities with electromyology (EMG) and nerve conduction studies (NCS). 

Why choose this specialization?

This is one of the rarest choices for specialization, as the application is somewhat narrow. ECS specialists administer EMG and NCS to study the location and severity of peripheral nerve and/or muscle injuries. This type of work tends to be less physically demanding than standard PT interventions, and it is known to pay well—with average reimbursement ranging from $325-425 for a single EMG/NCS study. On the flipside, there appears to be only one accredited residency in the nation for this specialization, which is located in Pennsylvania. So, most PTs will need to temporarily relocate to pursue this career path. 

For more information, visit the ABPTS info page for the ECS.

3. Board-Certified Clinical Specialist in Geriatric Physical Therapy (GCS)

ABPTS has reportedly certified 3,065 geriatrics specialists as of June 2019. This specialization indicates advanced clinical practice and expertise in the treatment of older adults. 

Why choose this specialization?

As the baby boomer generation gets older—and remains more active in their later years than previous generations did—they will require more specialized care. As such, some companies specifically look for geriatrics-certified specialists, while others will help cover the cost of obtaining specialization certification. It’s a growing specialty—one that’s worth a look! Bryce Williams, PT, GCS, COS-C, a Home Health Quality Review Specialist at Providence St. Joseph Health, says, “I wanted to take a proactive approach to practicing at the top of my license and become an expert in treating the patient population with whom I spend most of my time.” Bryce wound up leveraging this expertise in his utilization review career. He notes that the GCS has helped him a lot in this non-clinical role, as a big part of his job is being a coach, mentor, and resource for clinicians.

For more information, visit the ABPTS info page for the GCS.

4. Board-Certified Clinical Specialist in Neurologic Physical Therapy (NCS)

ABPTS has reportedly certified 3,035 neurologic specialists as of June 2019. This specialization indicates advanced clinical practice and expertise in the treatment of patients with neurologic impairments and disorders. 

Why choose this specialization?

Those with NCS designations typically find no shortage of work options. While specialization doesn’t always mean a higher paycheck, many facilities do actively seek out those who hold the NCS designation. Also, if you’re hoping to teach, most PT programs devote a good chunk of time to neuro coursework. An NCS could give you more options for a career in physical therapy education, too, as many PT departments require instructors who teach those courses to have some sort of specialization or advanced training in neuro.

For more information, visit the ABPTS info page for the NCS.

5. Board-Certified Clinical Specialist in Oncologic Physical Therapy

The oncology specialty is the newest of the nine, with only 68 specialists having been certified since its inception in 2019.

Why choose this specialization?

With life-extending treatment options and other advancements in the cancer world, there is increased demand for rehabilitative care. Working with this unique population can be a fulfilling way to specialize in the physical therapy world, and one can niche down even further by choosing to work with specific populations like children or older adults.

For more information, visit the ABPTS info page for the oncology specialty

6. Board-Certified Clinical Specialist in Orthopaedic Physical Therapy (OCS)

This is one of the oldest and most popular specialities, with 15,596 specialists as of June 2019.

Why choose this specialization? 

If you love working with orthopedic diagnoses, the OCS is a great way to advance your skills and professional standing. While it’s expensive and time-consuming to pursue the OCS, many therapists feel it’s worth the effort, as this designation is one of the most widely recognized by the physician community. Also, many clinics specifically seek out OCS-certified therapists during the hiring process. Again, while this may not translate to higher pay, it does tend to open more opportunities for employment, including teaching options. 

Peter Sablove, PT, MPT, OCS, is a physical therapist at El Camino Hospital in Mountain View, CA. He pursued his OCS as a way to better serve his patients, advance his practice, and learn as much as he could about the latest concepts in orthopedics. “I felt like it was not just about taking a test, but about ‘upping my game,’” he explains, noting that he prepared for the exam slowly over several years so he could really absorb the information and apply it in his daily practice. He adds, “The title of Board-Certified Orthopaedic Specialist communicates to colleagues and patients my commitment to our learning profession. It shows that I'm current with my practice and committed to my practice.” 

For more information, visit the ABPTS info page for the OCS.

7. Board-Certified Clinical Specialist in Pediatric Physical Therapy (PCS)

While there are quite a few physical therapists who treat children, there are far fewer pediatric-certified specialists! In fact, only 2,041 have been certified as of June 2019!

Why choose this specialization?

Pediatrics is a diverse field, and a PT can practice with all types of patients, from young children to teens. Plus, there are tons of settings, including clinics, hospitals, patients’ homes, and even schools. There doesn’t tend to be much, if any, pay increase associated with earning your PCS, but it does carry the same weight as the aforementioned specializations. This means you’ll likely have more employment options and greater opportunity in academia. Plus, you’ll feel confident that you’re delivering the best care possible to your patients. 

Debby Mooney, PT, DPT, PCS, is a school-based physical therapist in New Jersey with 20-plus years of practice under her belt. “Being in a school-based model, as opposed to a medical model, I sometimes feel isolated from the medical world,” she says. “I pursued my PCS to improve my evidenced-based knowledge via collaboration and intense study sessions with other PCS candidates.” She adds that her PCS affirms that she is practicing with the highest level of skill and knowledge in her practice area. Mooney also expects that the PCS will open additional non-clinical career options in the future, such as teaching and/or becoming a physical therapy clinical reviewer

For more information, visit the ABPTS info page for the PCS

8. Board-Certified Clinical Specialist in Sports Physical Therapy (SCS)

Many physical therapists exclusively treat athletes, and the SCS is a perfect complement for this career path. According to ABPTS, 2,411 sports specialists have been certified as of June 2019.

Why choose this specialization? 

Sports rehab can be a competitive niche, especially in saturated cities. The SCS designation does tend to set you apart professionally and, as with the other specializations, it can open additional career opportunities. Sports injuries are often challenging to diagnose, so the SCS is a great way to improve your diagnostic skills while simultaneously building your résumé. 

Caitlin Mouille, PT, DPT, SCS, MTC, is a senior physical therapist at the Sports Medicine Center for Young Athletes at UCSF Benioff Children’s Hospital in Oakland. She pursued her SCS to increase her overall knowledge about sports-related injuries. “I felt that it was important for me to increase my competency in examination, evaluation, diagnosis, treatment, and prevention of these type of injuries,” she explains. She adds that the SCS will likely help her advance her career and work her way up the clinical ladder. Plus, the recertification requirements help her stay up-to-date with her skills.  

For more information, visit the ABPTS info page for the SCS.

9. Board-Certified Clinical Specialist in Women's Health Physical Therapy (WCS)

The women’s health specialization is on the newer side and, as of June 2019, ABPTS reports having certified 489 PTs with this designation. The certification denotes advanced expertise in the domain of women’s health physical therapy diagnosis and treatment. 

Why choose this specialization? 

Pelvic health is a growing practice area in the physical therapy world, and women’s health is a great niche. From pre- and postpartum women to those suffering from incontinence, there are tons of patients who can benefit greatly from seeing a specialized therapist. In addition to opening doors professionally, this type of specialization can help you build trust with your patients. When you’re dealing with sensitive treatment topics, having an extra board-certified specialization can help reassure—and enhance communication with—your patients.

Susan C. Clinton, PT, DScPT, OCS, WCS, FAAOMPT, is the co-owner of Embody Physiotherapy & Wellness. Not only was she part of the inaugural WCS class, but she also was an item writer and initial supporter of the movement toward board certification in women’s health. She is proud that the WCS has given such a strong legitimacy to PTs’ involvement in women’s health care, as it gives therapists “a higher professional standard with MDs, PhDs, other health care providers, and insurance companies.” She also adds that it’s helpful for clients to know that PTs can pursue advanced training specifically for women’s health. For Clinton, the WCS has also created plenty of new professional opportunities, including the ability to teach at the university level as well as become a women’s health expert for media outlets.

For more information, visit the ABPTS info page for the WCS

Are you specialized? We’d love to hear why you pursued a specialization and how it has helped you advance your clinical skills and your career. Tell us your story in the comment section below.


Meredith Castin, PT, DPT, is the founder of The Non-Clinical PT, a career development resource designed to help physical, occupational, and speech therapy professionals leverage their degrees in non-clinical ways.

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