Why Naturopathic Medicine Deserves First-Professional Degree Designation
William J. Keppler, PhD
This missive describes the project and recommendation for reclassifying naturopathic medicine into the first-professional degree category of the U.S. Department of Education Integrated Postsecondary Education Data System (IPEDS). It is instructive to keep in mind that IPEDS is subsumed under the National Center for Education Statistics (NCES), a key component within the Department of Education. A degree’s category has many significant implications politically, economically, and in status.
While degree status of naturopathic medicine is our concern, there are also allied health disciplines that are making a strong case to move from graduate category to first-professional degree classification. For example, both physical therapy and audiology are moving toward a professional doctorate. The audiology profession is going a step further by increasing its entry-level requirement from the master’s to doctorate level, Doctor of Audiology. Audiologists, like optometrists, consider themselves professionals providing independent diagnosis as a part of a healthcare team.
Degree categorization must be carefully examined in light of recent developments regarding the growth and maturation of health disciplines. The Carnegie Commission on Higher Education is reorganizing and restructuring its classification of American accredited institutions of higher learning. This new Carnegie classification, when published, will have a profound effect on American higher education. In our opinion, the Carnegie Commission is arguably the most prestigious and best funded private, independent organization in America. The leading colleges and universities publicly announce their Carnegie Commission rank and status as a way to pronounce their place in American higher education.
The NCES in recent years has had many questions and concerns about the first-professional degree classification. A large number of requests have arisen from professional accrediting organizations, councils and commissions, and institutions of higher learning seeking to have new programs added to the list of accepted first-professional degree programs. Edward L. Delaney, PhD, principal investigator and the chair of the appointed Technical Review Panel made the statement: “Confusion has also arisen about what appears to be an eclectic collection of programs and the definition of first-professional in light of expanding educational requirements, particularly in the allied health fields.”
In early 2005 a series of interviews, focus groups, and analyses were conducted by Dr. Delaney, a nationally recognized biostatistician, to clarify the issues and uses of the IPEDS first-professional degree classification. This was followed by an e-mail survey of the academic officers of the State Higher Education Executive Officers (SHEEO). A similar survey was also conducted using the electronic newsletter of the Association for Institutional Research (AIR) in spring 2005. In May and June 2005, presentation of the issues identified from the surveys and interviews were made at the SHEEO meeting in San Antonio, Texas and the Association for Institutional Research Forum meeting in San Diego, California. At both meetings, additional insights and information were gained from discussions at the sessions with key stakeholders.
A final Technical Review Panel for the First-Professional Degree Policy Project was set up and carried out on December 12-13, 2005 in Washington, D.C., representing the widest variety of stakeholders and scholars by invitation only. Through the lobbying efforts of Mr. David Matteson, a public policy expert and long time advocate for naturopathic medicine, I was invited to join the Technical Review Panel for IPEDS as a representative of the naturopathic medicine profession. As the representative, I respectfully acknowledge and thank the other accredited naturopathic colleges in the U.S. and Canada for their interest and support. This includes Dr. Pamela Snider, ND, a Bastyr University graduate. She generously assisted in formulating my presentation to the Technical Review Panel. The panel generated considerable debate and discussion about the first-professional degree definition and programs approved by the Technical Review Panel.
Following is the approved IPEDS first-professional degree glossary definition:
An award that requires completion of a program that meets all of the following criteria: (1) completion of the academic requirements to begin practice in the profession; (2) at least two years of college work prior to entering the program; and (3) a total of at least six academic years of college work to complete the degree program, including prior required college work plus the length of the professional program itself. First-professional degrees may be awarded in the following 10 fields:
- Chiropractic (DC or DCM)
- Dentistry (DDS or DMD)
- Law (LLB, JD)
- Medicine (MD)
- Optometry (OD)
- Osteopathic Medicine (DO)
- Pharmacy (PharmD)
- Podiatry (DPM, DP, or PodD)
- Theology (M Div, MHL, BD, or Ordination)
- Veterinary Medicine (DVM)
In addition, the Classification of Instructional Programs (CIP 2000) has essentially the same criteria: “An award that requires post-baccalaureate study of the basic knowledge and skills required to function as an entry-level professional in certain fields specified for reporting purposes by the U.S. Department of Education.”
This was the classification and status of the first-professional degree category, before the meeting in Washington, D.C., of the IPEDS Technical Review Panel. Note that prior to this meeting naturopathic medicine was not a member of this august group of 10 professionals. Furthermore, naturopathic medicine has been assigned to the graduate program category of IPEDS. A careful perusal of the ND program and its requirements at each of the four-year accredited naturopathic colleges revealed that the programs clearly meet the established criteria for the first-professional degree category.
This timely opportunity allowed me, as a representative of naturopathic medicine education, to provide pertinent information and to present our case. There was considerable discussion and debate, both formally and informally, during our pre-arranged breaks. Dr. Delaney was particularly skillful in obtaining consensus and final agreement of a challenging and complex multifactorial rift caused by professional “territorial” issues.
It is interesting as a side bar that many of the respondents noted that first-professional degree itself does not seem to have much intuitive meaning to most people outside, and even inside, the higher educational community. Webster’s New World Dictionary (Second College Edition) describes a professional as “a person practicing a profession”, and a profession as “a vocation or occupation requiring advanced education and training, and involving intellectual skills, as medicine, law, theology, engineering, etc.”
Historically, the adjective “first” indicated that it was the initial professional degree required for entry into professional practice through licensure. However, because many of the professional programs have competitive admission requirements, many of the students enrolled already have earned a bachelor’s degree, and in some instances, a master’s degree.
The Technical Review Panel of IPEDS came up with four options after considerable discussion and debate during the first day of our December meeting in Washington, D.C.:
- Revise list of first-professional degree programs
Add doctoral programs and delete master degree programs
Simply report the appropriate degree title
Separate professional degrees from research degrees
- Leave intact
Maintain current list of approved programs
The third option, Reconceptualize, was the overwhelming choice of the 34 panelists who undertook a complex challenge utilizing six classic professions: architecture, education, engineering, law, medicine, and the ministry. Each of these six professions was discussed in some detail and the three IPEDS criteria were ratified and disciplines evaluated. The naturopathic medicine profession met all three evaluative criteria of the Reconceptualize option.
What are the implications and advantages of naturopathic medicine’s inclusion in the revised first-professional degree category? First, it places the ND degree in the same category as the MD, DC, DO, DVM, and DDS, creating a “level playing field” of dignity and respect for the naturopathic medical profession. Second, there are enhanced opportunities for grants from private foundations such as Robert Wood Johnson and governmental granting agencies such as the National Institutes of Health (NIH) and the National Science Foundation (NSF). Third, there is a substantial increase in the Department of Education Title IV Student Loan Program financial assistance for students in good academic standing. Fourth, credits are equitably transferred between professional schools, a privilege not currently allowed naturopathic medical colleges. Other professional schools would treat naturopathic medicine courses and credits, didactic and clinical, with greater respect since they will be in the same first-professional degree category with other medical colleges.
This draft White Paper milestone must be approved by the U.S. Department of Education. From indications given orally by Dr. Dennis Carroll, associate commissioner, Postsecondary Studies Division, U.S. Department of Education, National Center for Education Statistics, who attended all the deliberations, the draft White Paper authored by the Technical Review Panel of 34 participants for first-professional degree category will be approved by the U.S. Secretary of Education. In addition, the Carnegie Commission will incorporate the full recommendations of the Technical Review Panel in its reorganization and reclassification system. Its chief scholar served as a member of the Technical Review Panel in an ex officio role. These changes will not be put into effect until FY 2007, or even FY 2008, since they must become part of the federal budget of the U.S. Department of Education and OMB.
The case for moving naturopathic medicine from graduate category to first-professional degree category has been presented and accepted by the U.S. Department of Education. We have every reason to be confident, because our cause for naturopathic medicine is a most noble one. The public is clearly on our side, and we shall take our place where we rightly belong in providing holistic healthcare for America.
William (Bill) J. Keppler, PhD, holds a doctorate in genetics from the University of Illinois at Urbana-Champaign. He completed 15 years at Florida International University in Miami as dean of the college of health and professor of public health, teaching graduate students in genetics, ethics, and biostatistics. Dr. Keppler has served as a public member of the Council on Naturopathic Medical Education (CNME) and as a long-time senior evaluator for the Northwest Commission on Colleges and Universities (NWCCU). He is currently the President of NCNM.