I entered my profession in 1987 and at that time a bachelor’s degree was required to practice as an occupational therapist. At the American Occupational Therapy Association's Annual Conference in 1999, the Representative Assembly passed Resolution J, mandating post-baccalaureate education for entry into the profession.
I still have not seen any study that indicates that baccalaureate-trained professionals are in any way less effective than people who enter the profession at the master’s level. The marketplace also never acknowledged the alleged benefit of the master’s degree, as people with advanced credentials did not make any more money than people with bachelor’s degrees.
I summarize from this set of facts that the move to post-baccalaureate education served the needs of educational institutions who were able to get more tuition from students who were trying to enter the profession. Students stay in school longer and educational institutions benefit by collecting more tuition. I do not see any other benefit to any other stakeholder (consumers, therapists, or others). I imagine that the possible intent of OT post-baccalaureate education was to ‘keep up with the Jones’ – that is the PTs and pharmacists who moved in that direction. Still, important decisions should be based on what is good and necessary for the occupational therapy profession, not based on what someone decided was a good idea for some other profession.
Following Resolution J, ACOTE (the educational credentialing agency for OT) began looking at doctoral level education and formed a committee to look into the issues. The ESRC (Educational Standards Review Committee) identified some significant concerns about any move toward accrediting doctoral level programs. It seems that someone didn’t care what ESRC had to say because a different committee was formed (the ACOTE OTD Standards Committee) to develop standards for doctoral degrees despite what ESRC reported. This represented a major switch for ACOTE, who traditionally was always in the business of credentialing PROGRAMS, but now would be granting different credentialing for different DEGREES.
Additionally, the AOTA Representative Assembly was supposed to be the body responsible for making recommendations about the doctoral level of education. They were supposed to finish this work in 2006 but had to extend their process until 2007. Now whatever the RA has to say is a moot point because ACOTE has already made unilateral decisions about doctoral level education.
At this point I imagine that the eyes of many street-level occupational therapists begin to glaze over… but this is an important issue to study. The question I have is this: why does it appear that ACOTE, with the tacit approval of AOTA, is trying to ramrod an entry level doctoral level of training on the profession?? Is there some unpublished study that has been done that identifies how this change will benefit consumers?
Just because other professions have moved to a doctoral level of training doesn’t mean that OT also has to. Just because some people have the IDEA that advanced training is needed for practice doesn’t mean that IN FACT advanced training is needed for practice.
As collective shepherds of our occupational therapy profession we can’t allow major decisions like this to occur without the input of the membership or without careful and thoughtful study of the impact.
What should street-level OTs be concerned about:
1. If it is true that practice is becoming so complex that doctoral training is required, what does this mean for people who are functioning as occupational therapy assistants and only have an associate’s degree?
2. Are there some glaring inadequacies in the skill sets and competencies of associate and baccalaureate and master degree level practitioners that need to be acutely addressed in order to ensure the safety of consumers?
3. If there will be two levels of entry into the profession (from the masters level and from the doctoral level) does this mean that people with degrees below the doctoral level will be restricted from certain areas of practice?
4. If it is true that doctorally trained professionals are practicing at a stratospheric level of competence do they even need to be credentialed for entry level practice? How would they be credentialed and what will state regulatory boards think of multiple levels of certification?
5. Since there was an RA process in place to look at the issue of doctoral level education, does this mean that the RA is irrelevant since ACOTE already acted on this issue?
6. If the RA is irrelevant and if constituent feedback to the ESRC was irrelevant, and since the ESRC report was summarily dismissed, do we even really have a representative membership organization?
So if you managed to read through all of this, contact your RA representative and ask them what they think.
AOTA (11/12/06). Frequently asked questions about the Doctor of Occupational Therapy Degree (OTD). Downloaded 2/3/07 from http://www.aota.org/nonmembers/area13/links/link56.asp
AOTA (July 2006). Background on the development of ACOTE standards for OTD programs. Downloaded 2/3/07 from http://www.aota.org/nonmembers/area13/docs/otd-process-7-06.pdf