Volume 90 - Fall 2005	Download

"Degree Creep" in the Health Professions A Misunderstood Notion by Randall S. Lambrecht, PhD, MT(ASCP) Dean, College of Health Sciences, University of Wisconsin - Milwaukee

A number of health professions have strategically moved towards implementation of advanced degrees - a trend that has been labeled by those skeptical of the motives as "degree creep." From an educational perspective, this phrase is deceptive since it places the focus on educational degrees and not the entry level credentialing process. It also doesn't accurately differentiate motives spurred by professional self-interest, from initiatives driven in response to a rapidly changing, highly technological and sophisticated health care system. Simply put "degree creep" is an unfair label for professions which are responsibly addressing the need for career ladders (advanced degrees), continuing education, and a diverse workforce, while maintaining access to the discipline by not changing minimum entry requirements.

Terminal (education) degrees, which provide opportunities for advanced education/training and lead to the mastery of skills which define a greater scope of practice, is a laudable educational goal. In contrast, the mandating of advanced practice degrees for "entry level" practice, whereby the primary objective is to elevate the profession by increasing eligibility requirements for certification, might more accurately be described as "credential creep." Perhaps a subtle difference, but educational degrees are reflective of the level of formal learning, whereas accreditation and credentialing regulate eligibility for practice based on competencies. While closely intertwined, it is important not to confuse education and credentialing as being synonymous. Increased entry level requirements are a result of mandated credentialing imposed by professional societies and not educational institutions. It should also be noted that accreditation and/or credentialing agencies are simply responding to pressures exerted by their professional disciplines and societies to increase entry level requirements.

When access is limited through increased credentialing, it has its greatest impact on first-generation, underrepresented and disadvantaged students. "Credential creep" also makes it more difficult to provide for a qualified and diverse health care workforce. If health professions would identify "a scope of practice" to coincide with each level (degree) of education and training, "credential creep" could be avoided. It would also alleviate the need to pack an enormous amount of material and training into one curriculum which ultimately gets forced to the doctoral level. A career ladder designed with increasing scopes of practice, can provide access to a particular health discipline for many more students, and allows bridging from the associate degree to the baccalaureate, and to advanced graduate and doctoral degrees.

The creep of entry level credentials has been called into question by many academic institutions, as well as the health care provider industry, often because of the appearance that it is self-serving, controlling of labor market workforces, and contributing to greater health care costs. When health disciplines transition to an advanced entry-level degree (such as a professional doctorate), vulnerable populations are often affected the most and are at greater risk of not being adequately served (e.g., rural populations).

It is incumbent upon educators, health professionals, and administrators to support education and training initiatives that help build career ladders which provide opportunities for advanced degrees and the mastery of clinical practice.

NAACLS is currently studying how best to develop an advance practice doctorate for clinical laboratory science and I have the pleasure of serving on the Task Force reviewing this. At NAACLS there is no intent to consider this an entry level degree.

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			"Degree Creep" in the Health Professions A Misunderstood Notion by Randall S. Lambrecht, PhD, MT(ASCP) Dean, College of Health Sciences, University of Wisconsin - Milwaukee
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			Fall 2005 Site Visits

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