Purpose/Hypothesis: The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) accrediting agency reports an increase in the number of programs over the past 10 years. This acceleration in post-professional education correlates with the progressive demand of professional and clinical leadership responsibilities of physical therapists (PTs) in an ever-changing healthcare environment. An exploratory survey study comparing resident and/or fellow-trained to non-resident and/or non-fellow trained PTs with matched work experience revealed that employers perceived fellow-trained employees as attaining superior patient outcomes, and possessing stronger leadership and communication skills than their counterparts. The Fellowship in Orthopaedic Manual Physical Therapy (FOMPT) at a University located in the Western United States is an established post professional program with a professed leadership development component. However, the program has never measured trainee leadership behaviors or implemented an intentional leadership program with individual goal setting and targeted leadership development. Understanding the leadership behaviors, roles and activities of FOMPT trainees upon entry and exit of a program could inform FOMPT curriculum, improve program and patient outcomes and better prepare Fellows for leadership in the profession. The purposes of this study were to: (1) Examine leadership characteristics (behaviors, roles and activities) of Fellows-in-Training (FiTs) in a FOMPT program. 2) Describe leadership development goals of FiTs that might guide the enhancement of an intentional leadership component of the FOMPT program. 3) Compare leadership profiles of FiTs to a national Leadership Practice Inventory®(LPI) database and to LPI data of entry-level DPT students at the same University. Number of Subjects: 48 FiTs Materials and Methods: This study used a mixed methods exploratory design. The Leadership Practices Inventory® (LPI) 360 and Self (LPI) are valid and reliable assessments of perceived frequency of thirty leadership behaviors based on Kouzes and Posner’s The Leadership Challenge, The Five Practices of Exemplary Leadership®. The LPI 360 was administered to 48 FiTs enrolled in the FOMPT program (25% female, mean age= 36, SD= 7.3 (range 27-55 years)). The LPI 360 scores for the Five Practices of Exemplary Leadership®: Model the Way (Model), Inspire a Shared Vision (Inspire), Challenge the Process (Challenge), Enable Others to Act (Enable) and Encourage the Heart (Encourage), were compared to LPI normative data, 210 Regis DPT entry level student data upon graduation using descriptive statistics, 95% confidence intervals. Qualitative data was obtained via an online demographic leadership survey completed by 22 FiTs. Two one-hour Leadership workshops were conducted as training sessions for interpretation of individual LPI results and to facilitate individualized goal setting and leadership philosophy statements. Results: LPI: Mean and standard deviation for self and observer LPI 360 scores from highest to lowest self-ranking were:Observer (53.6 Model -Self (45.29 6.9), Observer (50.85 4.1) Challenge (43.88.0), Observer (51.1; Inspire-Self (40.9.8), Observer (48.10±4.5). There are no overlaps in the 95% CIs around any of the five practices when comparing the Self and Observer LPI scores for the FiTs. The LPI Observer scores were higher than the LPI self-scores. The LPI Self 95% CI's overlapped when comparing the FiTs and the DPT students and the FiTs to the LPI Normative Database scores in all five exemplary practices. Survey: Themes that emerged on the topic of outcome expectations of FOMPT program included: 100% of the FiTs expected advancement in clinical practice skills to improve patient care, 62% expected to expand their role in academic and professional contributions at a local, state, and/or national level and 57% expected an increase their leadership roles within their clinical and professional practice. Eighty-six percent of the FiTs responded that leadership development was an extremely important or a very important component of the FOMPT program and Seventy-one percent of the FiTs expected to have greater job satisfaction without an increase in financial compensation upon completion of the FOMPT program. Conclusions: The results from the LPI 360 demonstrate that FiTs believe themselves to have stronger leadership behaviors in the exemplary practices of Enable and Encourage as evidenced by their ability to develop relationships, facilitate growth in others’ and recognize the contributions of team members. Observers scored the FiTs as not only effective in enabling and encouraging others, they also are proficient in the practice of challenging the process, indicating they see FiTs as capable of implementing new and improved strategies for growth. Despite a difference in years of clinical practice and professional prowess as noted in the leadership survey, FiTs and DPT student’s in their final semester of school had similar self-perceived LPI data in all five exemplary practices suggesting that leadership training needs are much the same for FiTs and the entry level DPT student. An intentional leadership curricula integrated into a formal fellowship education program using a leadership framework and standardized assessment tools may provide the necessary structure, resources and support to further develop leadership based competencies and individualized professional goals necessary for advanced clinical practice and notable contributions to the physical therapy profession. Further research is needed as this study examined a small sample size of FiTs enrolled in a FOMPT from a single institution and therefore limits the ability to generalize the results to other accredited fellowship programs. Clinical Relevance: Leadership is multifaceted and has been recognized as a core competency skill for physical therapists working in today’s complex health environment. By gathering FiTs perspectives and utilizing standardized assessment tools, fellowship education programs can better design standardized curricula to foster leadership development.