Ami Zusman06 July 2013 Issue No:279
In the past 10 to 15 years, new kinds of doctorate degrees – in fields
that had never had doctorates before – have burst onto the higher
education scene in the United States. These new ‘professional practice
doctorate’, or PPD, degrees have emerged in at least a dozen fields,
ranging from physical therapy to bioethics.
Some of these newly created doctorate degrees are now required for a person to enter a professional practice. In other fields, although they are not (or not yet) required, these doctorates have become the normative degree.
Nor is this just a US phenomenon: new professional doctorate degrees have been created and programmes for them are growing rapidly in Canada, the United Kingdom, Ireland, Australia and elsewhere.
Professional practice doctorates differ from PhDs in several ways; most are shorter than PhDs – in some cases, only slightly longer than the masters programmes they replace. In the US, most do not require original research, but they do include a clinical component.
Beyond this, there is little agreement on what they are or should be. Yet, like PhDs, they use the title ‘doctorate’, require at least some study beyond the masters level and are intended to confirm the highest level of achievement.
Phenomenal growth
The growth of newly created professional practice doctorates in the US has been phenomenal.
Programmes for them skyrocketed from nearly zero a decade ago to more than 500 programmes in at least a dozen fields today, with over 10,000 degrees awarded just in 2012. For example, doctor of nursing practice programmes increased from just two in 2002 to 217 in 2012; nearly 100 more programmes are in the planning stage. What’s driving this growth?
Supporters of the new doctorates state that they are needed to respond to the growing complexity of professionals’ work environments, rapid expansion of knowledge underlying practice, and increases in technological interventions. While there are some indications of these factors, in most fields the evidence is limited.
For example, the difference between masters and doctoral programmes in physical therapy is on average just 12 weeks, and doctorate holders do not have higher licensure pass rates; if increased labour market complexity were the main reason to require doctorates, one would expect greater differentiation between masters and doctoral degrees and greater student success.
Overall, it is not evident that these doctorates have led to higher salaries or career advancement for professionals or significantly better outcomes for clients, although it may be too soon to determine outcomes. Rather, based on my research, I conclude that in most fields professional associations’ and practitioners’ pursuit of greater status, autonomy and control has been the main factor driving the creation of new doctorate credentials.
Once these doctorate degrees are established, institutions have felt pressured to offer doctoral programmes either because accreditation mandated it or because they felt they would be less competitive otherwise. For many formerly non-doctoral institutions, these new doctorates also provided an opportunity to take a long-desired step into doctoral work.
It is important to note that situations do differ among fields, programmes and institutions. Nevertheless, much of the adoption of these doctorate degrees seems driven by credential creep, followed in many cases by mission creep.
Why the growth of PPD degrees matters
The resource implications of the professional practice doctorates are substantial.
First, there seems to be a domino effect in health fields, with the PPD becoming the required or normative degree for entering practice in one field after another. Second, while most new growth in the US has been in health fields, new types of PPDs have been started in a variety of fields.
Third, many of the new programmes are expensive, so even limited expansion requires more resources. At a time when most institutions face shrinking resources, this means either redistribution of resources from other programmes or institutions, a higher workload burden on faculty, or higher tuition fees and higher foregone income burdens on students.
Indeed, partly because of public disinvestment in higher education, students are bearing the brunt of increased programme costs. For example, median total tuition and fee costs for doctor of physical therapy programmes in US public institutions were 63% higher than for masters programmes in 2010; in private institutions, they were 14% higher.
Higher tuition and longer periods of study will likely increase student debt and may reduce access into the profession, especially since financial support for these programmes is meagre in most cases.
PPDs also raise unresolved questions.
For example, what should a ‘doctorate’ mean? Should profession-specific accrediting bodies – which play important roles in setting standards for programme effectiveness – also determine which degrees institutions offer in these fields? Finally, the fundamental issue for public policy is the ultimate impact of new PPDs on clients, organisations and communities. New requirements could lead to fewer professionals, especially in already under-served communities.
On the other hand, if PPD training enables professionals to serve their clients more effectively, meet new and more complex needs and, in the words of advocates, transform the organisations and settings in which they work – and do so without reducing access to services – the added resource costs to individuals and the public may well be worthwhile.
Those outcomes are still unknown.
* Ami Zusman is a visiting scholar at the Center for Studies in Higher Education (CSHE) at the University of California, Berkeley. She formerly directed graduate and professional education planning and student outcomes assessment for the University of California system. This commentary is based on her paper, “Degrees of Change: How new kinds of professional doctorates are changing higher education institutions”, published online as part of UC Berkeley CSHE’s Research and Occasional Paper Series.
Some of these newly created doctorate degrees are now required for a person to enter a professional practice. In other fields, although they are not (or not yet) required, these doctorates have become the normative degree.
Nor is this just a US phenomenon: new professional doctorate degrees have been created and programmes for them are growing rapidly in Canada, the United Kingdom, Ireland, Australia and elsewhere.
Professional practice doctorates differ from PhDs in several ways; most are shorter than PhDs – in some cases, only slightly longer than the masters programmes they replace. In the US, most do not require original research, but they do include a clinical component.
Beyond this, there is little agreement on what they are or should be. Yet, like PhDs, they use the title ‘doctorate’, require at least some study beyond the masters level and are intended to confirm the highest level of achievement.
Phenomenal growth
The growth of newly created professional practice doctorates in the US has been phenomenal.
Programmes for them skyrocketed from nearly zero a decade ago to more than 500 programmes in at least a dozen fields today, with over 10,000 degrees awarded just in 2012. For example, doctor of nursing practice programmes increased from just two in 2002 to 217 in 2012; nearly 100 more programmes are in the planning stage. What’s driving this growth?
Supporters of the new doctorates state that they are needed to respond to the growing complexity of professionals’ work environments, rapid expansion of knowledge underlying practice, and increases in technological interventions. While there are some indications of these factors, in most fields the evidence is limited.
For example, the difference between masters and doctoral programmes in physical therapy is on average just 12 weeks, and doctorate holders do not have higher licensure pass rates; if increased labour market complexity were the main reason to require doctorates, one would expect greater differentiation between masters and doctoral degrees and greater student success.
Overall, it is not evident that these doctorates have led to higher salaries or career advancement for professionals or significantly better outcomes for clients, although it may be too soon to determine outcomes. Rather, based on my research, I conclude that in most fields professional associations’ and practitioners’ pursuit of greater status, autonomy and control has been the main factor driving the creation of new doctorate credentials.
Once these doctorate degrees are established, institutions have felt pressured to offer doctoral programmes either because accreditation mandated it or because they felt they would be less competitive otherwise. For many formerly non-doctoral institutions, these new doctorates also provided an opportunity to take a long-desired step into doctoral work.
It is important to note that situations do differ among fields, programmes and institutions. Nevertheless, much of the adoption of these doctorate degrees seems driven by credential creep, followed in many cases by mission creep.
Why the growth of PPD degrees matters
The resource implications of the professional practice doctorates are substantial.
First, there seems to be a domino effect in health fields, with the PPD becoming the required or normative degree for entering practice in one field after another. Second, while most new growth in the US has been in health fields, new types of PPDs have been started in a variety of fields.
Third, many of the new programmes are expensive, so even limited expansion requires more resources. At a time when most institutions face shrinking resources, this means either redistribution of resources from other programmes or institutions, a higher workload burden on faculty, or higher tuition fees and higher foregone income burdens on students.
Indeed, partly because of public disinvestment in higher education, students are bearing the brunt of increased programme costs. For example, median total tuition and fee costs for doctor of physical therapy programmes in US public institutions were 63% higher than for masters programmes in 2010; in private institutions, they were 14% higher.
Higher tuition and longer periods of study will likely increase student debt and may reduce access into the profession, especially since financial support for these programmes is meagre in most cases.
PPDs also raise unresolved questions.
For example, what should a ‘doctorate’ mean? Should profession-specific accrediting bodies – which play important roles in setting standards for programme effectiveness – also determine which degrees institutions offer in these fields? Finally, the fundamental issue for public policy is the ultimate impact of new PPDs on clients, organisations and communities. New requirements could lead to fewer professionals, especially in already under-served communities.
On the other hand, if PPD training enables professionals to serve their clients more effectively, meet new and more complex needs and, in the words of advocates, transform the organisations and settings in which they work – and do so without reducing access to services – the added resource costs to individuals and the public may well be worthwhile.
Those outcomes are still unknown.
* Ami Zusman is a visiting scholar at the Center for Studies in Higher Education (CSHE) at the University of California, Berkeley. She formerly directed graduate and professional education planning and student outcomes assessment for the University of California system. This commentary is based on her paper, “Degrees of Change: How new kinds of professional doctorates are changing higher education institutions”, published online as part of UC Berkeley CSHE’s Research and Occasional Paper Series.
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