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The Road to the NPTE

by Mark Denesha, PT, DPT


Sitting down to take the National Physical Therapy Examination (NPTE) marked the culmination of seven years of hard work, dedication, and sacrifice. For those of you that will be sitting this exam in the future, don’t look at this effort as an obstacle. Instead, change your perspective.

Approach the NPTE knowing that each day, hour, and minute spent scrutinizing the fine details of our chosen field, Physical Therapy, will only make you better than you were the previous day. Your journey does not end with the NPTE . . . it begins.

Want the Ultimate Guide to the NPTE? Download it!

Who am I?

My name is Mark Denesha, PT, DPT. I graduated from SUNY Downstate in Brooklyn and I like longs walks on the beach—but not in flip-flops (research says so; they lead to adverse changes in peak GRF and ankle/knee kinematics).

My road to the NPTE

I’m going to chronicle every aspect of my journey to the NPTE: registration, studying, and lessons learned. Admittedly, the last thing I need is another distraction, but I’ve found that having a full schedule forces me to leverage my time. Oddly enough, when I have an abundance of free time, nothing gets accomplished. Altruistic intent aside, I view this project as a win-win.

  • I’ll be forced to hash out a strategy: a plan of attack, if you will. I tend to be more of a “fly by the seat of my pants” kind of guy.
  • Daily & weekly reflection of materials will be required to successfully convey, to you, what I found easy/difficult.
  • This article will serve as a resource for future students (that’s right: you!).

“Pressure makes diamonds?” Added pressure—success is the only option.


Registering for the NPTE

So, you’ve decided to register for the NPTE. It can be pretty overwhelming, right? I’m here to walk you through the process of registering and getting started with your NPTE journey!

The idea of becoming a physical therapist fades as its reality creeps closer. I discussed registration with my classmates and friends that had already graduated. It all sounded very confusing. Honestly, when I sat down with my laptop, the first stop was researching how to register for the NPTE in my state.

After this research, I went directly to and settled down into my couch to get comfy. They have A LOT of information.

They recommended that I go through these five steps first.

  1. Find your jurisdiction requirements.
  2. Complete a state Application Form.
  3. Register and Pay
  4. Special Accommodations
  5. Jurisdiction Approval

Registering online

This was painless and didn’t take much time.

Start Here

Registering consists of five sections.

  1. Personal information
  2. Demographics
  3. Select Product
  4. Payment Info.
  5. Final Confirmation

Applying for State Licensure

You’re going to need to apply for Licensure as well. Fill out Form 1 and mail it to:

NYS Education Department

Office of the Professions

Division of Professional Licensing Services

PO Box 22063

Albany, New York 12201

Limited Permit

Do you plan on working, perhaps part-time, while you study? If so, you’ll need to apply for a Limited Permit. You can work for 90 days after graduation without having to actually hold the permit, but you must apply and pay the fee.

Breakin' the bank

Let’s tally it all up, shall we?

NPTE – $407

Licensure – $294

Limited permit – $70

Prometric Fee – $85

TOTAL = $856

Be prepared for these expenses beforehand! Whether you set aside a nest egg while you’re in school, or you outline a budget for yourself, it’s good to be on top of your finances.

Dates and Deadlines

The deadline for registration is June 16th, but I recommend reserving your spot sooner than later. Seats are first come, first serve and, according to the website, fill up fast.

Once you register, things start to feel real. The ball is rolling and there’s no stopping you now.

Quick Version (For NY Residents)

I live in New York, so I thought I'd drop all the information my fellow New Yorkers would need here! Here are the links you need to register for the NPTE.d

  1. Download and complete Form 2
  2. Download and complete Form 1
  3. Register and Pay

Starting to study . . .

It’s time to find a study guide/s and look into weekend courses.

Additional Resources

NPTE Candidate Handbook—free download

71% – 562

That was my score on a Retired NPTE. There’s definitely room for improvement, but I’m on the right track. Now that I can see where the gaps in my knowledge are, I know what to focus on while studying!

PEAT - The breakdown

We purchased the Practice Exam and Assessment Tool (PEAT), as a class, for $79 each. Taking the practice exam provided me with a baseline by which I could tailor my studying accordingly. My worst category was “Physical Therapy Examination.” I correctly answered 35 of the 53 questions, but would have needed 40 to pass. I need to step up my Neuromuscular and Nervous System game, where I only scored 60%.

Want the Ultimate Guide to the NPTE? Download it!


Purchasing the PEAT was a no-brainer for me. Everyone had great reviews of the PEAT and said that it helped them a lot. For $79, I couldn’t pass it up. It includes the test that I took, the retired NPTE, and another practice exam. According to the FSBPT website, the questions are the same format that I will see on the NPTE. As you see above, it provides a detailed performance report and for each question it provides explanations, rationales, and references. Access to the material is available for 60 days.


Aside from the PEAT, I needed a review book. O’Sullivans and Scorebuilders seemed to have the best reviews. I talked with recent grads and the majority preferred O’Sullivans. A common theme was that people tended to score higher on the Scorebuilders practice exams than O’Sullivans. This is because the questions on O’Sullivans are harder. I’d like to avoid any sense of false confidence and I think O’Sullivan’s will keep me honest. I hope the difficult questions will over-prepare me. O’Sullivan's also comes with three practice exams on a flash drive.

If you want a book that has great pictures and is easy to read, I suggest Scorebuilders. If you want detail and depth of information, go with O’Sullivan's.

In the video below I unbox my review book and discuss this article. I also briefly review my tentative schedule and strategy for studying. My excitement to receive the study guide in the mail seems a little abnormal…

TherapyEd can be purchased here.

Scorebuilders can be found here for $85.

You can also get Mometrix's NPTE Secrets Study Guide here.

My study strategy for the NPTE

NPTE “study season” unofficially begins on June 1st. I spent a lot of my time going over the questions I missed on the retired NPTE that I mentioned earlier. I’ll be reading through the rationales and will hopefully be able to hone in on what my weaknesses are. My goal by the end of the week is to create a list of SPECIFIC areas that will need extra attention.

June 8th is when the real studying begins. I’ll have six weeks to get my A-game ready. I scheduled six to eight hours of studying per day. Fridays were my designated testing days. I have three practice exams from O’Sullivan’s and the PEAT. I also met with one of my classmates on a weekly basis, which helps with moral support and accountability.

The waiting game begins

We have officially completed the DPT program. Our grades are being submitted and the Registrar’s office will be receiving notification from our department chair that our forms can be sent to Albany. Now, I wait for my ATT and hope that I’m lucky enough to get a seat at a testing center nearby.


Below I’ve provided some useful links/resources as we prep for the NPTE.

Make sure to check out our NPTE Audio Study Series

Try this article from Jasmine Marcus PT, DPT - Test Taking Tips for the NPTE


You’ve graduated! Now what?

Two weeks ago, my class and I walked across the stage at Carnegie Hall, and were introduced as newly minted Doctors of Physical Therapy. Hard to believe the day finally came, and the moment was fleeting, but I tried to absorb as much as I could. The evening was spent with the most important people in my life: my family. I couldn’t have done it without them!

The following week, the excitement of graduation had faded and the reality of the NPTE sank in further. It’s around the corner, and it will come and go as quickly as graduation did. Stick to a study plan, and you’ll be good to go!

Authorization to Test (ATT Letter)

Finally, authorization to schedule my exam, through Prometric, arrived yesterday. This process can be lengthy! For future students, I urge you to complete your paperwork as soon as possible. The sooner your documents are processed, the sooner you'll receive your ATT. This easy tip will increase your odds of getting to test at a facility nearby, as seats do fill quickly. I'm lucky and was able to find a seat July 22nd at 8:30 am in Manhattan. Bring it on NPTE!

Starting the process of studying

I spent the first two weeks after graduation preparing and engaging in some light studying. I accessed the retired NPTE that I had taken a few weeks earlier, and went through all the questions I missed. Some were careless mistakes, but the majority was material that I certainly need to revisit. The specific areas included EKGs, statistics, and neuromuscular. After, I went over the questions that I answered correctly. Most of my answers made sense, but some were undeniable guesses. A few I managed to reduce to two choices and simply flipped a coin. Make sure you take time to understand why answers are both incorrect and correct. The first week was merely a “warm-up” before the real studying began.

Want the Ultimate Guide to the NPTE? Download it!

Getting on the study grind

Monday, June 8th – This marked the first official day of my study journey! A reminder on my phone went off at 8:30 am to make sure I got my brain in gear.

Breakfast – Check!

Coffee – Check!

O’Sullivan’s – Check!

Pen & Notepad – Check!

Chapter 1 – Musculoskeletal

10 minutes later I found myself slouched over on my couch, struggling to keep my eyelids open. The material is DENSE! As many of the reviews said, it’s not an easy read. My warm-up week didn’t really prepare me for the amount of detail O'Sullivan's reaches. Originally, I scheduled and allotted myself six to eight hours per day of study time. After every hour I stood up, stretched, and did some pushups. Despite my body and brain calisthenics, I only managed three hours per day. The material was all relatively familiar and so after three days, I decided to move on to the areas that I was weakest in. This helped. I started on neuromuscular, and although the brain anatomy and tracts are not my most beloved topics, the novelty of it kept my attention. In total, I covered about 100 pages in O’Sullivans. I need to get more done!

Staying at home was a bad idea. Starting fresh tomorrow, week 2 of studying, I will head to the library. I'm always more productive in a positive setting where work is being done. The comfort of my apartment, on the couch wearing gym clothes, doesn’t get the gears turning in my brain. I'm confident that I'll be able to better concentrate myself and yield more productive hours this week.

Review Course

I chose not to take a review course. A few of my classmates, however, did participate in the TherapyEd weekend course. They had nothing but good things to say and my one friend told me:

I learned a lot, but it wasn’t a magic course that taught me everything I need to know for the test.

You'll need to properly dedicate yourself in order to learn all the material.

Time. We need to put in the time to learn and fully understand the concepts. I think that is the key to success for this exam. Unfortunately, there aren't any magic tips or tricks to passing, but I do have four study tips to be more efficient. With five weeks until the exam, I needed to prioritize and effectively make use of my time.

Helpful Resource

Some great news! I have access to the Home Study Bundle and Webinar sessions with PT Final Exam.

The material is great and they even provide 248 practice questions. The questions are formulated very similar to the ones I took with the retired NPTE. The biggest benefit for me thus far has been the organization. They do a great job of providing a break down of the topics that you NEED to be familiar with. This allowed me to visually see what topics I still need to cover.

They also offer a Mastermind class. Will Crane does a fantastic job fielding a ton of questions. They covered practice questions in depth and I found his insight very helpful. The sessions are recorded so that you can access them later. I think using this resource in conjunction with my review book will thoroughly prepare me!

Four study tips

What have I learned in one week of studying? Here are four study tips that you should apply now!

  1. Environment is key!
    Reduce distractions. A great application I found for Google Chrome is called “NewsFeed Eradicator.” It will make your Facebook newsfeed empty! Genius. You no longer have any reason to waste valuable minutes on nothing.
  2. Have multiple resources.
    Don’t rely on just one text or review guide.
  3. Take breaks every hour—move your body!
    I stretch and do calisthenics every hour. This keeps my mind fresh!
  4. Be accountable!
    Have a friend. Have a blog. This short article has allowed me to reflect on my progress, or lack thereof. I'll adjust accordingly, and be sure to have a phenomenal week of studying.

It’s almost test day

So, you’ve made it. Tomorrow is the big day and all the good advice says that we shouldn’t study today. We should relax our brains. That's easier said than done!

Try to take it easy—you’ve studied enough, and you’re going to do great!

For future students, here are a few lessons learned.

Want the Ultimate Guide to the NPTE? Download it!


Reflecting on my journey to the NPTE

One of the struggles was forcing myself to sit inside all day. I recently learned a new term, FOMO (fear of missing out), and I definitely had it. There were a few unbelievable days this summer, but I buried my nose in the books and drove on. I met with a few classmates during the weeks and we kept each other focused. It made learning the material easier. I forced myself to take at least one day a week to NOT study and allow my brain to recharge.

The problem was that anytime I wasn’t studying I would feel guilty. Sure enough, the opposite was true as well. I felt guilty for always studying and not “doing anything fun” in the beautiful weather, with my even more beautiful girlfriend. I’m lucky to have her support though. In fact, she often encouraged me to study more!

I realized a lot of things during this journey, about myself, my study habits, and, of course, physical therapy!

Lessons learned along the way

Lesson 1:

Support is essential. Surround yourself with people that won’t compete for your attention. Keep your eyes on the prize! Loved ones, true friends, and classmates will keep you focused and understand the importance of what you’re doing!

Since graduating, I’ve had some great opportunities. I received my limited license and I’ve started working part time at Duffy & Bracken. Also, I accepted an offer as an assistant instructor at SUNY Downstate. Palpation is a key skill required for therapists and I feel very privileged and humbled to be passing on what knowledge I have acquired thus far. I’ve found teaching fulfilling and the opportunity to help the first year Physical Therapy students as they embark on this wild road is priceless. This is where my math skills came into play. There are never enough hours in the day! I’ve worked limited hours at the clinic and only teach one day a week. I couldn’t afford to lose any study days. On days that I worked I woke up early to study, for at least three to four hours, before I went in.

The days became long! When I got home reading was the last thing I wanted to do. Instead, I watched videos and one key resource was PT Final Exam. Will, Johnathan, and Reema provided videos that ranged from 60-120 minutes. They discussed essential topics and answered questions. A positive community was created and they provide structure to help manage your time.

For anyone that wants to work while studying, it’s possible. Think of each patient as a case study. Apply the concepts you’re studying. If you add anything to your schedule, be prepared to cut an equal amount out. I’ve had to make sacrifices, such as cutting back on my exercise routine. I miss you exercise.

"Whatever you want to do, if you want to be great at it, you have to love it and be able to make sacrifices for it" - Maya Angelou

Lesson 2:

Prioritize your time. Make sure studying is always your top priority. I sometimes lost track of that, but luckily my “support system” was always there. You should block out time that is dedicated only to studying. For me, I studied for a minimum of three hours, and up to 10 hours some days.

Prometric called, just as I finished typing the paragraph above. It was a reminder for tomorrow.

“Mark, this is just a reminder that you are scheduled for tomorrow at 8:30 AM. You need to show up at least 30 minutes early and bring two forms of valid ID.”

Thanks for the butterflies, lady.

Stay positive.” Perhaps this was an attempt to convince myself. You will get nervous. You may start to doubt yourself. I’ve discussed practice exam scores with classmates to make sure we were in the same range. I’ve googled PEAT scores and O’Sullivan test exam scores to see what people who passed the exam were scoring. In case you’re interested, this is what I found:

135/200 - O’Sullivan

145/200 - Peat & Scorebuilders

That seemed to be the general consensus, if you’re scoring in those ranges you should be alright. Keep in mind, this is hardly scientific and you have to take most of what you read online with a grain of salt (I said most, not all).

It’s alright to be nervous. This is an important exam. You’ve went through three years of school for this. Think about that. You’ve dedicated the last three years to learning and understanding the profession of Physical Therapy. You’ve passed all the exams and practicals, as daunting as those “hell weeks” were, that your professors threw at you. You know the material. Don’t psych yourself out. Pysch yourself up!

Here is a great TED Talk about how the mind affects the body and the ability of the body to affect the mind.

For the big day tomorrow, I'll be sure power pose in the bathroom before I take the NPTE.

Lesson 3:

Everything is hardest while you’re “IN” it. For future students that will take the NPTE. This is going to be an unnerving time in your life. You will feel overwhelmed. Sometimes you’ll answer a string of questions correctly and feel like Eduard Einstein (Albert’s son). You’re not alone in this. Put in the time, learn the concepts not the little details, and know that one day you will look back and tell people “It wasn’t that bad.”

Despite all the good advice, it’s time for me to look over my weak points one last time!

Good luck to everyone taking the exam now! Be sure to read this article on Six Tips for the Night Before.

I hope you found this helpful and that some of you can relate to my journey! If you have any tips of your own to share, be sure to leave a comment below!



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