Pathway to CPO

This short video outlines the basic steps from high school graduation to becoming a certified Prosthetist/Orthotist. It is a great place to start if you have discovered the field and want to learn more about what you would need to do to become a clinician.

If you watch this and want even more details about each step, you should read the blog post “Path to Becming a CPO“.

Path to Becoming a CPO

So you want to be a Certified Prosthetist and Orthotist? What are the steps to get there? In this article I will outline each step along the way.

The short answer is that to become a practitioner you have to:

A. Complete a Bachelor’s degree

B. Earn a Master’s degree

C. Complete one or two residencies, and

D. Pass your board exams. 

If you want to understand more of the details, keep reading below.

Let me start by zooming in on and expounding the steps a little more:

  1. Graduate with a Bachelor’s degree
  2. Apply and get accepted to a Master’s program
  3. Earn the Master’s Degree
  4. Apply for and get a residency
  5. Take and Pass your Combined Written Board Exam
  6. Finish your first residency and get a second residency
  7. Take your Written Simulation and Practical Board exams in the first discipline
  8. Finish your second residency 
  9. Secure a job
  10. Pass your second Written Simulation and Practical Board Exam

Congratulations, you made it!

Now, to understand more of the details of each step, read on below.

1. Graduate with a Bachelor’s degree

No program requires any specific degree, but each has a set of prerequisite classes. In general, you will need to take courses in Anatomy and Physiology, Biology, Chemistry, Physics, Statistics, and Psychology. There are slight variations between programs, so be sure to check on the specific schools you plan to apply to.

Anecdotally, many students entering the profession today have undergraduate degrees in engineering (biomedical, mechanical, or other), but there are still plenty of others coming with varying backgrounds. 

In addition to completing the prerequisite courses required, you will need to spend time shadowing, or (if you are really lucky) working in a local O&P clinic. This component is critical to most of the programs. They really want to make sure you have had the exposure to understand what being an O&P Professional entails. Some of the programs have a specific number of exposure hours required (40-100) while others simply weight your experience along with your other qualifications.

2. Apply and get accepted to a Master’s program

The National Commission on Orthotic and Prosthetic Education (NCOPE) facilitates the application process through a central application service called OPCAS. This website is where you will go to fill out the applications for each program. There you will find application details and deadlines. In general, most programs are closing applications around the end of the calendar year for admission into the next year’s class. So if you are wanting to start in the Summer or Fall of 2021 (for example) you would need to apply by the end of 2020. For many people, this means applying for graduate school during your last year of undergraduate (just like you probably applied for college during your senior year of high school).

3. Earn the Master’s Degree

This one almost goes without saying. The programs range from about 1.5 years to 2.5 years. While you are in school you will be getting some combination of classroom instruction, patient encounters, and clinical shadowing experience.

The majority of programs graduate their students during the summer. This means the majority of companies are on a resident hiring cycle that coincides with that timeframe. If your program graduates at a different time of the year (December, for example) you may have to work a little harder to find a January start date. That said, because you are not competing with students from other schools for those same spots, it can work to your advantage in some cases as well.

4. Apply for and get a residency

NCOPE not only oversees the Master’s programs, they also oversee the residencies. Just like there is a central application for the Master’s program, there is also one when it comes time for residencies. In years past, companies interested in hiring and training a resident could choose if they wanted to use the service, but slowly it is becoming required by NCOPE. 

Some time toward the second half of your graduate program (if not sooner), you’ll want to start thinking about where you would like to do your residency. In another post I will describe the different residency options, but here they are in the simplest terms:

A. (2) 12 month residencies, one in each discipline 

B. (1) 18 month combined residency

C. The Baylor program integrates them into the Master’s program, so you complete your residency requirements before graduating (there are pros and cons of course).

The first option is still the most commonly followed, so I’ll follow that route in the steps below.

5. Take and Pass your Combined Written Board Exam

In order to become a Board Certified Practitioner, you will have to complete your residencies and pass the Board Exams. Historically there have been three tests in each discipline: Written (multiple choice), Written Simulation, and Practical. This was a total of six tests. You could sit for your board exams after you had completed the residency for that discipline. If for example, you did the Orthotics residency first, then after you had finished that residency, you could take all the Orthotic tests while you started and completed your prosthetics residency. If, instead, you did the 18 month combined residency, you would wait until completing it and then take all six tests at its conclusion.

However, during 2019 NCOPE announced that graduates of Master’s programs can now take a Combined Written (multiple choice) exam anytime after they graduate. This made a lot of sense, and also reduced the total number of tests from six to five, so that’s great. You don’t have to take it right after graduating, but since it is designed to test you on content you are supposed to learn during school (as opposed to material/skills you will further develop during residency) it probably makes the most sense to take it not long after graduating.

6. Finish your first residency and get a second residency

At this point you can really focus on patient care and skill development. Most of your book work is done. Like before, you’ll want to start thinking about your second residency (if that applies to you) at some time during this period. You will use the OPRESCAS system to apply for your second residency, just like for the first. In many cases, people will choose to do both residencies at the same location if things are going well.

At this point you are considered “Board Eligible” in your first discipline. Depending on the state where you work and the company you are going to be working for, you may be able to negotiate for a slightly higher wage/salary at this point. If, for example, during your second residency in prosthetics you are going to continue to see orthotic patients, it would be very reasonable to expect better pay than your first year.

7. Pass your Written Simulation and Practical Board exams in the first discipline

The Written Simulation test is taken locally at a testing center and consists of a “Choose-Your-Own-Adventure” style test where you are asked to make treatment decisions and justify them as you go along.

The Practical exam is administered a few times a year in Florida. You fly down there, spend a few days, and are tested on actual patient care. They have patient models and volunteer CPO test proctors who will ask you to do things like evaluate muscle strength and range of motion, take casts, and articulate treatment plans.

Once you pass these two tests you can finally add some letters to the end of your name! Certified Orthotist (CO) or Certified Prosthetist (CP). By now, if you are still doing any work in this discipline in addition to your second residency you should definitely expect a pay bump.

8. Finish your second residency 

With one discipline finished, you are almost there. You’ll just need to keep working and learning the other side of things for the rest of the year.

9. Secure a job

As always, as that second residency winds down you’ll want to have a plan in place for a smooth transition to a long-term job. Plenty (if not the majority) of people stay where they are and get hired on. If that’s not your plan, you’ll need to be reaching out and developing relationships with clinics where you would like to work.

If you go the two residency route, when you take your first job out of residency you will be certified in one discipline and board eligible in the other. If you go the 18 month route, you will be board eligible for both disciplines, but not quite certified in either. You will, however, be done six months earlier.

10. Pass your second written simulation and practical board exam

Your last step to becoming a fully certified practitioner will be passing the Written Simulation and Practical Board exam in that second discipline. Once you have done that, congratulations! You have made it to the real starting line. Ahead of you lies a rewarding and challenging career as a CPO.