Physiotherapy Licensure Guide for UK Graduates ( USA )

Regulatory Authority:

In the United States, physiotherapists are known as physical therapists and are licensed on a state-by-state basis. Each state (and DC) has its own State Physical Therapy Board (e.g. California Physical Therapy Board, New York State Board for Physical Therapy) that issues licenses. Collectively, licensing exams and standards are coordinated by the Federation of State Boards of Physical Therapy (FSBPT), which administers the National Physical Therapy Examination (NPTE). There is no single national license – you must obtain a license in each state you wish to practice, but all require passing the NPTE and meeting that state’s requirements.

Recognition of UK Credentials:

A UK physiotherapy degree does not automatically grant licensure in the U.S. Foreign-educated therapists must undergo a credential evaluation process to determine if their education is “substantially equivalent” to a U.S. accredited physical therapy program. Typically, this is done through agencies such as the Foreign Credentialing Commission on Physical Therapy (FCCPT) or others approved by the state boards. The evaluation uses the FSBPT’s Coursework Tool (CWT) to compare curriculum content (credit hours in areas like biology, clinical sciences, etc.). As of 2025, U.S. entry-level physical therapy programs confer a Doctor of Physical Therapy (DPT) degree (usually a 3-year graduate program after a bachelor’s).

A UK BSc or MSc may have fewer total academic credits than a DPT, so the credential review will look at whether all required subject areas and clinical hours are covered. In many cases, UK-educated physiotherapists can achieve equivalency, but they might need to have a Master’s or MSc in addition to a BSc, or take additional general education courses if missing (for example, U.S. programs include courses in humanities and social sciences as prerequisites). Each state sets its own rules on this, but most follow similar guidelines. HCPC registration itself is not directly recognized in the U.S. – it’s the university coursework that matters for credentials. After a successful credential evaluation, the individual is deemed eligible to sit for the licensing exam and ultimately for state licensure.

Exams or Additional Requirements:

The primary exam required is the National Physical Therapy Examination (NPTE). This is a standardized licensure exam administered by FSBPT for all states. The NPTE is a computer-based test with 250 multiple-choice questions covering all aspects of PT practice. International candidates must first obtain a credential evaluation report (and in many cases, a Healthcare Worker Certificate) before they can be approved by a state board to take the NPTE. Once the credential evaluation shows your education meets U.S. standards, you apply to a state board for licensure candidacy; the board then allows you to register for the NPTE through FSBPT.

There is no additional clinical/practical exam in the U.S. (the NPTE is purely written). However, many states require a separate Jurisprudence Exam or Jurisprudence Assessment Module (JAM) – which is a short, open-book test on that state’s laws governing PT practice. This is usually done online and is not difficult; it ensures you know things like scope of practice, ethical rules, and supervision ratios in that state. A few states also require applicants to show proof of recent CPR certification or other small requirements. Some states offer a temporary license to allow practice under supervision while waiting to take the NPTE, but those are time-limited and not all states offer them. Ultimately, to practice independently, you must obtain the full license via the NPTE route.

Language Requirements:

Since English is the primary language of PT practice in the U.S., applicants must prove English proficiency if they did not complete their physiotherapy education in an English-speaking program. Graduates from the UK are typically exempt from taking an English language exam. In fact, U.S. federal regulations for healthcare worker visas list that graduates from countries like the UK are exempt from the TOEFL English exam requirement.

Visa note:

If the person is not a U.S. citizen or resident, they will likely need a visa to work, which in turn requires a Healthcare Worker Certificate (issued by agencies like FCCPT or CGFNS) that certifies both the equivalency of the credentials and English proficiency.

Once licensed in the U.S., you are considered to have permanent licensure (with renewal requirements) equivalent to any U.S.-trained physical therapist, and can work in hospitals, clinics, etc., without restriction.