What’s been discussed is now a reality. While changing the educational requirement for entry into O&P from a bachelor’s to a master’s degree has been a possibility for several years, NCOPE has decided to start moving forward with the changes necessary to upgrade O&P education to that of a master’s-level degree.

The change will not impact anyone now certified. However, effective in 2010, any new educational program applying for accreditation will have to apply at the master’s level. NCOPE plans to bring all currently accredited programs to master’s level by 2012. Its goal is that all new students entering an O&P program in 2012 will be working on a professional master’s degree.

Where O&P education began
The history of formalized O&P education can be traced to several landmark meetings on education. In the 1970s, the education conferences Ponte Vedra I and II marked the start of the move toward a bachelor's degree. In 1980, ABC established its requirement for a bachelor's degree for O&P certification. The next meeting on education didn't occur until the Phoenix Conference, held in 1990.

In April 2005, NCOPE, in conjunction with the Academy's federal grant, held a consensus conference on education that resulted in the report "O&P Education Summit: Forecasting the Future." This report concluded that the expanded body of O&P knowledge, education requirements for other allied health professions, market forces and the need for greater accountability all pointed toward establishing a master's degree. In February 2006, NCOPE held a strategic planning meeting to actively plan the move to a master's. 

Why a master's?
NCOPE decided to make this move for several reasons. 

First, the knowledge base for O&P has expanded. NCOPE believes that a master's will provide O&P graduates with the skills, knowledge and ability to criticallly appraise evidence from clinical research and to integrate this evidence with their clinical expertise. This will establish a firm foundation for effective clinical practice. With the O&P curriculum already crowded, a move to a master’s is the best long-term solution.

Second, it seemed unlikely that future schools would want to establish O&P programs at the bachelor’s level. For example, NCOPE is currently in discussions with three potential O&P programs. Representatives from each of these schools indicated that they would want to create a master’s-level program despite the current existence of entry-level bachelor’s programs. Apparently, a bachelor’s-level program is less marketable, since other allied health professions have master’s- or higher-level education programs.

In addition, dialogue with counselors from several universities and colleges indicate that they do not recommend post-baccalaureate certificate programs as much as they recommend master’s-level programs.

The plan
NCOPE proposes that an O&P professional master’s-level program offer additional curriculum on the following topics:

• Evidence-based practice
• Reading and applying research
• Additional ethics curriculum
• Neuroscience
• Clinical pharmacology
• Disability
• Diagnostic study
• Entrepreneurship/business plans

Since two master’s-level programs are already established, the shift to a master’s has already begun. We expect that schools may establish a transitional degree for individuals who have obtained a bachelor’s degree and want to get a master’s. However, this new master’s requirement will apply only to new students. It will not impact an individual’s certification or his or her ability to practice, if he or she is already certified.

Effective 2010, any new program applying for accreditation will have to apply at the professional master’s level. NCOPE is working on a transition plan to bring all currently-accredited programs to master’s-level programs by 2012. Our goal is that all new students entering an education program in 2012 will be working on a master’s degree. 

Some currently accredited programs are already moving to the master’s level well before the deadline of 2012, which in turn will impact programs at the bachelor’s level to move more quickly.

In addition, NCOPE is reviewing the current residency model and how it will be impacted by this movement to the master’s level. Thanks to some funding from the Academy’s grant, one such meeting has occurred. More are needed and will take place as this movement of primary education moves to the master’s level.

NCOPE understands that there will be a lot of questions about the rationale behind this move. Short of having to review all the reports and resources that helped guide this decision, here are the answers to some of the key questions.

Q: What about students who only wish to become orthotists or prosthetists?

A: The current bachelor’s program combines both disciplines. While some students may only be interested in one, they receive education in both and then gravitate toward their preference. We expect the master’s program to do the same. This would provide comprehensive exposure and a broad-based education, but still allow students to specialize after graduation.

Q: Would changing to a master’s program deter more prospective students than it attracts?

A: Since 1999, there has been a general upward trend in the number of graduate-level students. In particular, we are beginning to see a greater number of female students taking graduate education.
Physician assistant programs found that they had an increase in female and foreign student enrollment after moving to a master’s degree.

Additionally, it’s important to remember that current O&P certificate programs get most of their enrollment from accredited post-baccalaureate programs. This suggests that students will be willing to expand their education beyond a bachelor’s.

Q: Has NCOPE conducted a survey to determine the number of individuals interested in a master’s program?

A:  No, but NCOPE did review two survey-based studies. They were “Assessing the Need for Increased Standards in the Field of Orthotics and Prosthetics,” by Alicia J. Davis, MPA, CPO, and “A Web-Based Assessment for the Need to Develop Graduate Degree Programs in Prosthetics and Orthotics,” by Mark Edwards, MHPE, CP.

Edwards’ study found that 62.8 percent of the respondents agreed that the level of O&P education should be raised to a graduate degree. The Davis study showed a lesser amount of support, but did show that the higher-educated the respondent, the higher level of support for a master’s degree.

More details on these studies can be found on www.ncope.org.

Q: What changes would happen with the residency? How would the master’s programs handle two residency requirements and two certification exams?

A: The details of what a residency would look like are still in development. Discussions have ranged from keeping it at 12 months per discipline to a shortened, combined O&P residency. NCOPE will be meeting again about this shortly.

Q: Do the program directors and instructors in O&P programs have master’s degrees?

A: Currently, all but one of O&P program directors (who is currently in a master’s program) have a master’s degree or higher. However, there will be an impact on the instructors, as many do not. The Academy is looking at creating a fund that would assist current faculty in pursuing these degrees.

Q: Won’t a master’s requirement limit job opportunities for those who became certified under the old model, especially in licensure states?

A: When O&P shifted from short-term certificates to bachelor’s education, there was not an impact on job opportunities. Based on this history, NCOPE does not feel that there will be an impact with the shift to the master’s.

Q: What if entry-level master’s degree students find themselves unable to compete for jobs against less-educated practitioners with more experience?

A: There will always be competition for jobs, no matter the person’s education or experience. The profession currently has two accredited master’s programs, and we have not heard any word that graduates of these programs are unable to get hired.

Q: Why is NCOPE making a master’s degree program mandatory for practitioners who do not want to pursue research in O&P?

A: This master’s program is not about creating a researcher. The O&P master’s program intends to educate students to be good consumers of research. Being a good consumer of research creates graduates capable of information-seeking, critical appraisal, and knowledge management skills necessary for effective, evidence-based practice and ultimately better patient care.

Q: Will moving to a master’s degree increase salary demands?

A: Studies from other professions indicate that moving to the master’s level does not significantly increase salary expectations. For instance, a survey of physical therapists and occupational therapists reported that individuals with bachelor’s degrees earned an average salary of $62,084. Physical therapists with a master’s degree reported an annual salary of $64,247. For occupational therapists with a bachelor’s degree, the average salary was $48,342 and those with a master’s degree received (on average) only $194 more.

Q: How does NCOPE justify the added time and expense in obtaining a master’s degree when it appears that there is no apparent change to O&P reimbursement rates?

A: Increasing the education level to a master’s was not predicated on the premise that it would change O&P’s reimbursement rate. The move was in response to the increasing body of knowledge in both the technical and clinical arena.

In addition, there is not an added time requirement if you consider that the majority of students graduate from a post-baccalaureate program.

Q: Would payers eventually limit participation to master’s-level practitioners?

A: There is no evidence to suggest that payers would limit participation to master’s-level practitioners. For years, O&P has had practitioners with various degrees of education, and there have not been limits of payment based on their education. In addition, this does not appear to be a problem with reimbursement for physical therapists, occupational therapists, and physician’s assistants.

Rebecca St. Andrie is managing editor of the O&P Almanac.