Post Professional Pathways with Dr. Lindsey Eberman

PhD? DAT? Internship? Residency? You’ve got your degree–What’s your next move?

Post Professional Pathways in Athletic Training

By:  Dr. Lindsey Eberman

You might be asking yourself… with the degree transition, do I need post-professional education and if so… what’s right for me? With the current costs of higher education, some might be asking, “is it worth the cost” or “what is my return on investment?” And that really depends on how you look at opportunity cost. 

Opportunity cost is the potential loss from a missed opportunity. So, what are the lost opportunities for not pursuing post-professional education (post-professional masters degrees, post-professional doctoral degrees, doctor of education (EdD) and doctor of philosophy (PhD) degrees)… the answers are specialized training in a mentored environment, advanced practice clinical skills, scholarship skills, teaching skills, and/or the structure of formal education that promotes lifelong learning.

Now, if you are one of those rare people that can facilitate your own lifelong learning, I want to say, I might not know you, but I’d be proud to know you! Much of the literature in our professional development (or continuing education) space indicates we have skill and knowledge decay and many of the newer curricular content being introduced in education programs are not well known or performed by preceptors and other credentialed athletic trainers in our profession. This suggests, we collectively, aren’t so great at guiding our own professional development opportunities… and maybe some formal structure could help us manage those losses. 

Before I go down the path of talking about each of the post-professional pathways, I want to share honesty. In my experience facilitating professional and post-professional education (MS, DAT, and PhD degrees), I acknowledge employers, particularly those in traditional athletics settings, are placing experience in their setting above all else when hiring. If you ask me, it’s flawed thinking from a healthcare delivery perspective, but it does make sense from a socialization to hellish workplaces perspective. If I wanted people to be prepared to work 80 hours a week for moderate to low pay, I would want them to be really committed to that before hiring them! But, from a patient care perspective, I am less convinced that setting-specific experience trains one to excel in preventing, recognizing, and treating health conditions. So, if you want to work in a particular setting, plan to bide your time, commit to that setting, and eventually you will rise to the position you want. Or, you can accelerate that rise or shift perspective through post-professional education. 

Some athletic trainers have been hesitant to embrace residency and the term specialization because they think if others in the profession are “specialized” in orthopedics, what does that make them… well… the answer is a generalist. The reality is, professional education provides breadth and not depth, and frankly… breadth is a WIN for our patients. They need us to have that breadth, particularly in under-resourced communities where we have a responsibility and duty to be a public health resource as much as the point person for athletic health care. Specialization is what we need in more rare or complex cases and we need specialists in athletic training. According to the BOC, specialization can be developed through mentored clinical practice outside of residency training, making one eligible for the orthopedic specialty certification (more to come in other specialty areas). However, structured residency training can give you both mentored clinical practice in the specialty area (the expectation is that 80% of your practice is in the specialty area) and didactic training that complements that clinical practice. From an efficiency standpoint, residency training is the more efficient way to achieve specialization. Fellowships are soon (and I mean soon) on the horizon and we should expect to see more programs accredited with the CAATE in the coming years. Fellowships are sub-specialty training and again, a faster, more efficient way of achieving sub-specialization. My biggest warning in the residency and specialization space is SEEK A PROGRAM WITH ACCREDITATION. Those programs are assuring quality to external peer review and meeting consumer needs by offering a program to a specific standard. “Other” residencies and fellowships can be harmful workplaces that exploit employees for large volumes of work without the educational training required of residencies and fellowships.

Let’s break down the post-professional masters and doctor of athletic training (DAT) degrees. Typically a post-professional masters degree has served our profession as a transition to practice space, where students were gaining an opportunity to refine their knowledge, skills, and abilities from professional education, while also being introduced to advanced practice clinical skills. These programs also offered opportunities for varying levels of mentored clinical practice experiences, so students could develop that progressive autonomy, we expect of competent athletic trainers. These programs still exist, but are growing fewer with the degree transition. Their greatest strength is in providing students with that place to transition to practice, while also reinforcing and facilitating growth in clinical practice. 

DAT programs are continuing to grow, offering learners and opportunity to develop both advanced practice leadership skills and advanced clinical practice skills. One of the greatest benefits to the consumer is the wide range of program variability. Programs are able to offer curricula that best meets consumer needs, whether it be about developing yourself as an entrepreneur, educator, or clinical supervisor. This variability will continue to allow for consumers to select programs based on their personal and professional development aspirations, versus a specific set of competencies – the clear difference between professional and post-professional education. DAT degrees are serving athletic trainers in all settings, traditional and emerging, as well as in an educational setting. The purpose of a DAT is practice leadership… although the degree has versatility, the purpose is to train practice leaders who can model best practice in healthcare and lead healthcare systems to deliver the highest quality healthcare to their patients.

There has been a lot of talk on social media about the viability of DAT credential holders to secure faculty positions. As an expert in this space, I can assure you, they can, and frankly, they are an often missing piece in our more traditional, research or teaching-focused faculty. Those with a DAT are looked upon to bridge the gap between clinical practice and didactic learning, and their training in practice-based research (like quality improvement and point of care research) has provided educational programs complementary educators to the more traditionally prepared faculty. Yes, I acknowledge, a DAT degree holder is not prepared for independent research. That is not the goal of the degree. So those seeking faculty positions at research intensive universities should consider a research doctorate, like a PhD degree. But if your goal is to maintain clinical relevance, partner with clinicians in practice-based research, and aid students in connecting didactic learning with clinical practice, a DAT can serve you and prepare you for that role. 

Finally, if you wish to pursue research or program administration, an EdD or PhD may be the right choice for you. A research doctorate is intended to help one conduct independent research. The coursework is often in a focused area and upon graduation, the expectation is that one is a steward of the profession, by introducing new data to drive the field forward. Similarly, an EdD, is a specialized degree focused on being a steward of the profession through teaching. This preparation often takes faculty away from clinical practice toward other duties of the faculty (teaching, research, service, administration), and depending on your aspirations as a faculty member may best suit your skills. 

In the end, when considering post-professional education, what seems clear to me, is that the opportunities lost due to not pursuing may be great. But, it all comes down to you… your mission, vision, and values… and how you see yourself contributing to our great profession. Look inward first, to find the path for you.