While considerable variation exists in admissions criteria, most DPT programs consider a mixture of cognitive (e.g., GPA and GRE scores) and noncognitive (e.g., interviews, essays, letters of recommendation, and clinical experiences) factors [27,28,29]. The GRE evaluates general cognitive skills with sections on verbal reasoning, quantitative reasoning, and analytical writing, but does not measure discipline-specific knowledge and lacks contextual relevance for allied health professions [30, 31]. While undergraduate GPA and GRE scores have been shown to have some predictive validity for student success in DPT education and success on the NPTE, some authors have questioned the value of these legacy metrics, suggesting that they are limited and may be misleading among certain applicants [18,19,20,21,22,23,24, 29].

Despite these criticisms, a recent systematic review of 31 studies found that the inclusion of cognitive outcomes, namely GRE scores, undergraduate cumulative GPA, and undergraduate pre-requisite GPA, provides evidence of which students are most likely to manage the rigor of DPT education and successfully pass the NPTE [27]. Alternatively, another systematic review by the same author evaluated 29 studies of programs using holistic admissions practices and found that noncognitive outcomes were insignificant or inconsistently associated with student DPT program success and NPTE performance [28]. These findings are not surprising given the subjective nature of personal statements, written essays, and interviews [32]. The authors found some evidence that personal attributes like emotional intelligence and grit may predict student success; however, they also found that sociodemographic variables were more likely to predict poorer academic and test performance, namely older age, individuals identifying as an underrepresented racial/ethnic groups, and individuals reporting English as a second language [28].

Current admissions practices may fail to adequately evaluate other desirable and possibly essential attributes and characteristics of candidates seeking to enter contemporary DPT education and clinical practice, including as primary care providers. The DPTAT is proposed as a tool that would be designed to identify candidates with critical reasoning fluency, probabilistic thinking, proprioceptive-spatial modeling, and applied biomechanical reasoning—capacities fundamental to differential diagnosis, movement analysis, and autonomous, first-contact, primary care settings [10, 11]. Additionally, the DPTAT will emphasize professional dispositions such as adaptability under uncertainty, cognitive empathy, and ethical judgment within the context of interprofessional collaboration and complex decision-making. These attributes, rooted in the cognitive and affective demands of contemporary physical therapist education and clinical practice, seek to offer a more valid and profession-defining approach to DPT program admissions.

Considering the tremendous investment of time, effort, and financial resources required to obtain a DPT degree and enter the profession, program admissions practices should embrace the solemn responsibility of being student-centered, evidence-based, and committed to selecting candidates that are most likely to succeed. Alternatively, when admissions practices are not informed by the available data, students and programs are put at an increased risk of setbacks and failures, including higher rates of academic difficulty and attrition, delayed clinical readiness, lower graduation rates, and declining NPTE passage rates [15, 16, 22, 33,34,35]. The consequences of ill-informed or misguided admissions practices have real-world effects on students’ psychological and financial well-being, including the devastating effects of failure to complete a professional doctoral degree after having invested significant time and money and not reaping the benefits of earning potential as an early career provider [15, 17, 27, 28, 33,34,35,36]. Additionally, student attrition and declining NPTE passage rates reflect poorly on institutions, which can negatively impact their ability to recruit top candidates who are increasingly drawn to other professions.

The selection of appropriate cognitive and noncognitive factors to be used in DPT program admissions should be evidence-based and remain focused on the selection of candidates most likely to graduate and enter the profession [21, 22, 29, 32]. The consequences of misalignment between program demands and candidate preparation are more than just academic: students ill-equipped for the rigors of doctoral education are more likely to experience psychological distress, academic difficulty, attrition, or program dismissal [19, 33,34,35,36,37]. Entrance examinations have been shown to inform student risk of failure or academic difficulty in graduate health professions education, including medicine, nursing, and public health [36, 38,39,40,41,42]. A recent program-specific study found that a prerequisite entrance examination can improve predictive validity for students’ first-semester DPT program GPA. While the findings in this study were modest, explaining 24% of the shared variance, the implications are profound and support the theoretical rationale for developing discipline-specific cognitive metrics [33]. These data signify a challenge and an opportunity: given the increasing focus on value-based education and clinical practice, can the physical therapy profession develop a tool to support selection of candidates that is rigorous and standardized, predictive but not reductionist, and that provides equal opportunity without sacrificing precision and relevance?