The Entry-Level Occupational Therapy Clinical Doctorate: Advantages, Challenges, and International Issues to Consider

Abstract

Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

“…more in the military sector within the USA) [33, 114]. The same inter- and intra-national variability exists within educational requirements for licensure: 3-year clinical doctorates are increasingly required for PTs/OTs in the USA, but PTs/OTs can work with lower credentials [25, 115]. …”

Clinician, Educator, and Student Perceptions of Entry-level Academic Degree Requirements in Occupational Therapy Education

“…Results across geographic region were relatively similar, indicating overall consensus across the nation and supporting findings from a 2007 study conducted by Smith. Despite degree confusion being a topic of discussion within the profession (AOTA, 2014;Brown et al, 2015, Wells & Crabtree, 2012, clinicians, educators, and students supported maintaining the current state of multiple degree offerings.…”

“…Vast modifications in occupational therapy educational and degree requirements have occurred over the years (Brown, Crabtree, Mu, & Wells, 2015). Accreditation has served to publicly highlight integrity and quality within the profession as a means of promoting confidence within educational communities and among recipients of occupational therapy services (ACOTE, 2017a).…”

“…Rationale for this decision included a variety of reasons, such as degree confusion between the variety of masters and doctoral degree designations currently present in the field (AOTA, 2014;Brown et al, 2015). Additionally, focus on professional autonomy to meet the needs of practice settings, interprofessional practice, and increased need for scholarship relevant to clinical practice were also highlighted (Brown, Mu, & Crabtree, 2006;Case-Smith, Page, Darragh, Rybski, & Cleary, 2014).…”

Development, Implementation and Evaluation of Entry-Level Occupational Therapy Doctoral Capstones: A National Survey

“…While the occupational therapy (OT) profession has been debating the move from the entry-level master's degree to the entry-level doctorate degree since the 1990s (Fisher & Crabtree, 2009); there has recently been a significant increase in the number of programs offering the degree. Brown et al (2015) discussed this paradigm shift in OT education citing reasons both internal and external to the profession that impact this move toward entry-level clinical doctorate. In 2006, five out of 150 fully accredited entry level programs offered an entry-level doctorate degree (Griffiths & Padilla, 2006).…”