Physical therapy provides an essential public service by supporting recovery from illness, injury, and disability, and is one of the largest healthcare professions. Over the past century, entry-level educational requirements for physical therapists have increased, culminating in the adoption of the clinical doctorate as the required entry-level degree in 2016. As educational requirements have expanded, so has the financial burden placed on students, while entry-level salaries have not increased at a comparable rate.

The purpose of this qualitative study was to examine the impact of educational debt on early-career physical therapists and to explore how they perceived the value of the degree in relation to their personal, professional, and financial lives. Guided by life course theory, this study sought to understand how educational debt influenced how individuals make sense of their experiences and shapes the direction of their lives as they transition from training into early professional practice.

A phenomenological qualitative design was employed to explore the lived experience of educational debt. Semi-structured interviews were conducted with eight early-career physical therapists who carried average levels of educational debt and represented diverse geographic regions, institutional types, practice settings, and debt amounts. Interpretive phenomenological analysis (IPA), using a double hermeneutic and inductive approach, was applied. Data analysis involved open and axial coding, followed by the development of themes, subthemes, and variations across participant narratives.

Four major themes emerged: The Experience of Becoming a Physical Therapist, The Experience of Early Career Realities, The Experience of Debt, and The Experience of Doctoral Reflections. Participants consistently described deep professional fulfillment and satisfaction in patient care alongside significant emotional and financial strain that emerged at the end of training and persisted into early practice. Educational debt influenced major life decisions and delayed or altered personal and professional milestones.  Participants also reflected critically on their education, often describing themselves as overtrained relative to the realities of clinical practice, and in comparison with colleagues who entered the profession prior to the clinical doctorate requirement. While most participants indicated they would choose physical therapy again, many expressed regrets about the financial cost of their education relative to compensation and noted that they would pursue the path differently.

Four principal findings were identified from the themes. First, a financial and career paradox reflected the coexistence of professional satisfaction and financial distress. Second, financial gatekeeping revealed inequities within the profession. Third, a practice education gap highlighted misalignments between the doctoral training, clinical expectations, and salary structures. Finally, professional silence described a perceived lack of dialogue and collective action regarding the growing gap between educational costs, compensation, and professional well-being. From a life course perspective, educational debt negatively influenced participants’ life trajectories, with implications for physical therapy in workforce sustainability, retention, patient outcomes, and societal health.