Structural Barriers and Admissions Practices in Physical Therapist Education: A Case Study of Ohio Programs

Underrepresentation of marginalized groups persists in the physical therapy workforce, reflecting structural barriers within health professions educational programs' admissions processes. This qualitative study applied a structural competency (SC) framework to examine admissions practices across Doctor of Physical Therapy (DPT) programs in Ohio and identify systemic barriers to diversity. Semi-structured interviews were conducted with admissions representatives from 6 of Ohio's 12 DPT programs (50% response rate) and supplemented by analysis of publicly available admissions materials from all 12 programs. Interview transcripts were thematically analyzed, and findings were triangulated with website data to enhance rigor. Three themes emerged: 1) institutional factors-variability in definitions of diversity, resource allocation, and faculty training; 2) admissions processes-inconsistent use of holistic review, reliance on academic cutoffs, and variable interview practices; and 3) recruitment strategies-challenges in outreach, advising, and sustaining pipelines to underrepresented applicants. Findings indicate that while some programs integrated intentional diversity, equity, and inclusion (DEI) efforts, inconsistent policies and resource disparities limited progress. To advance equity in DPT education, programs should adopt standardized DEI frameworks, enhance faculty development, and implement transparent, legally aligned holistic admissions practices. Collaborative resource-sharing and intentional recruitment strategies may mitigate these barriers and advance workforce diversity.