On April 30, 2014, the AOTA Board of Directors released the following statement:
In response to the changing demands of higher education, the health care environment, and within occupational therapy, it is the position of the American Occupational Therapy Association (AOTA) Board of Directors that the profession should take action to transition toward a doctoral-level single point of entry for occupational therapists, with a target date of 2025. Support of high quality entry-level doctoral education for occupational therapists will benefit the profession, consumers, and society.
The Board’s goal in issuing this statement was to facilitate a profession-wide dialogue on this critical issue. Over a 9-month period, the Board held 14 face-to-face meetings with AOTA leadership groups, including informal discussions with members of the Representative Assembly, the membership at large via Town Hall meetings at several state conferences, and at AOTA’s Annual Conference in Nashville. Online forums through OTConnections, and email were also used to solicit feedback and discuss the pros and cons of the issue. The following is a summary of the findings and potential next steps.
What is clear from the data collected is that overall, the occupational therapy community is split on this issue, and that the overwhelming majority of participants in the dialogues see both potential threats and opportunities in moving the entry-level degree requirement to the clinical doctorate.
- Decreased diversity
- Decreased number of applicants
- Lack of qualified Fieldwork Educators and sites
- Lack of infrastructure and faculty in many schools to support doctoral level
- Increased student debt load without increased salary
- Impact on OTA
- Lack of distinction between entry-level and post-professional doctorates
- Equating doctoral degree, rather than experience, with better patient care
- Single entry-level degree
- Meet society’s changing expectation that health care professionals hold doctorates
- Better reflect the content and academic workload being demanded by the profession in our entry-level master’s programs
- Some schools that want to transition to the OTD cannot do so without a mandate
- Doctoral degree increases perceived credibility to participate in and influence health policy discussions with payers and legislators
- Increased ways to address changing health care delivery models. For example:
- Quality measures
- Population-based approaches
- Community-based practice
- Greater autonomy
- Primary care delivery
In June 2015 AOTA staff also surveyed the 152 accredited master’s-degree-level programs, with 131 (86%) responding to the survey. Of the 131 programs that responded, 106 (81%) indicated that they had started working on a transition to the doctorate and planned to have this completed within 10 years (86 within 5 years).
In addition to surveying and talking with the members, the Board also reviewed health care professions that transitioned to a doctoral entry-level degree to review the implications, specifically physical therapy (must transition to DPT in 2015), pharmacy (transitioned in 2000), nurse practitioner (must transition in 2015), audiology (transitioned in 2007), and nurse anesthetist (must transition by 2025). In each of these cases the profession has not seen a decrease in applicants, graduates, or diversity. It is likely that student debt will increase, and that continues to be a concern.
As previously stated, the Board’s goal in issuing their statement was to facilitate a profession-wide dialogue. President Ginny Stoffel stated how pleased the Board of Directors is with the thoughtful dialogue that has taken place. “Much was learned, and we heard members’ feedback, both positive and negative, on moving to a single point of entry for the occupational therapist. The potential threats and opportunities are both significant, and the quickly changing health care system makes the dialogue even more important and timely.”
The Board findings from the dialogue will be shared with the Accreditation Council for Occupational Therapy Education (ACOTE®) to better support and inform their discussions. We look forward to learning more from the independent ACOTE survey, being released in August, in which more than 3,000 respondents were asked their thoughts on this important issue.