Preventing brain-drain: Opportunities and challenges for higher education
At Educator Day during the Registered Massage Therapists’ Association of Ontario’s (RMTAO) 2017 Education Conference, moderator Pam Fitch posed the question, “Who in the room has obtained a master’s degree or PhD?” A small number of hands in a room full of educators went up.
By Don Quinn Dillon
With so few attaining this level of education, one might wonder about the opportunities and challenges for registered massage therapists who advance their education.
Donelda Gowan – a doctorally-prepared massage therapist and recipient of the RMTAO’s research award – acknowledges concerns that highly educated RMTs face barriers in sharing knowledge. Gowan is adamant highly educated RMTs must be supported in their efforts to inject the knowledge and perspective they have gained back into the profession – assisting its growth and professional culture.
In her RMTAO research award acceptance speech, Gowan emphasizes, “Massage therapy research must be informed by massage therapists.”
Highly educated RMTs may feel pressure to leave massage therapy practice in pursuit of research and academic positions in related fields. This brain-drain and the limited opportunities for research and knowledge transfer should concern the profession as it limits the growth and potential of the field.
I invited a group of six RMTs with high academic standing – some educators, others researcher or practitioner status – to address the following questions:
- What opportunities exist for RMTs that pursue higher education?
- What are the barriers to advancement in the massage therapy field, particularly in education, research or influencing community health and social policy?
- How can stakeholders in the profession support opportunities for practitioners attaining higher education?
- How can your talents, experiences and education be most effectively used for the advancement of the profession?
Beth Barberree, Trish Dryden, Cathy Fournier, Donelda Gowan, Ania Kania-Richmond, and Martha Menard participated in the conversation.
In response to the question, “What opportunities exist for RMTs pursuing higher education?” Trish Dryden, a RMT and associate vice-president, research and corporate planning at Centennial College advises, “There are very few opportunities to do a degree in massage therapy per se, but there are degrees that would be relatable.”
She goes on to explain opportunities with higher education may not be material currently, but can and do contribute to a desired career path. The issue, as Dryden sees it, is to streamline RMT education, creating an academic ladder for undergraduate and graduate studies.
Martha Menard, who has a PhD in research methods, statistics and evaluation, with a master’s in clinical psychology, laments the fact that massage therapy is not an academically-based discipline in itself, and this provides a barrier to education advancement. A diploma in massage therapy alone would not be considered when applying to a graduate program, for example. Adding a caveat, Menard shares that given current education streams, “I’m not sure we want to go the traditional academic route.”
She suggests creating articulation agreements between massage programs and colleges/universities could be a viable path.
Cathy Fournier, who has a PhD in social anthropology, shares a frustrating personal account of a disincentive to higher education. Fournier trained in Ontario – a province where the practice of massage therapy is regulated – and practiced 24 years before moving to Nova Scotia (an unregulated province) to pursue a masters and PhD in a related field. During that time, she maintained inactive status with the Ontario regulatory college. Upon returning to Ontario, and despite her advanced study, Fournier was informed, as per policy, that she would need to do a refresher course to gain active status again. She followed procedure and made a formal written request to appeal this requirement. After deliberation, the regulatory body lifted the requirement for tutoring. Apparently, the appeal was not granted because of Fournier’s higher education, but because she continued to be active within the profession through teaching continuing education courses and contributing one of the required reading articles in the CMTO’s publication, while still out of province.
“(It appears) higher education is not valued,” Fournier states.
Gowan, who has a PhD in population health science, notes Fournier’s story showcases the negative consequences of the lack of uniform education, training and regulation in massage therapy throughout Canada. She posits this as creating a barrier to practitioner mobility throughout Canada, and meaningful contribution to the profession via advanced education.
Dryden agrees. “Educators have complained for a very long time about the lack of uniformity, and the difficulty of educators to maintain active status given regulatory policy.”
“The (Ontario regulatory body) appears to under-acknowledge the contribution educators make to the field,” she adds.
Gowan notes stakeholders may lack an understanding of the challenges and barriers for RMTs in pursuing higher education or “for contributing their hard-earned knowledge and skills back to the field.”
“What other professions have a better model?” she asks.
Beth Barberree, who has a masters in leadership (health specialization) shares another obstacle. She was reviewing employment positions in Alberta – commensurate with her higher education – that would allow her to influence community health policy. She learned that any job applicant must be a member of the province’s regulatory body, which means these jobs are closed to her because massage therapists are currently not regulated in Alberta.
“The jurisdictional variance (in regulation across Canada) is problematic for us,” Barberree states.
I ask the question, “Is the profession in danger of losing educational and intellectual capital if RMTs are forced to leave the profession and find work related to their higher education?”
Gowan responds, “There are lots of opportunities if you wish to contribute and get a higher education.” She recalls attending a professional conference, yearning to contribute further to the conversations and Trish Dryden, her mentor, telling her, “Good…now go get the formal education so you can do so.”
While admitting there are lots of opportunities to contribute, Gowan offers a tongue-in-cheek riposte to the conversation, “What are the opportunities to make a living?” which generated sympathetic laughter from the group.
Gowan relates how the Massage Therapist Association of Saskatchewan (MTAS), of which she is a member, is dedicated to supporting the conduct and dissemination of massage therapy-related research. The association has been active in facilitating important stakeholder consultations across Canadian provinces to seek feedback and input from experts – a significant aspect of Gowan’s own research. In addition, the MTAS also makes funds available for travel and accommodation to present research methods and findings with posters and oral presentations at research conferences.
Gowan acknowledges that the financial support for expenses related to research is critical to the development and success of every research project, the researcher’s skills, and what can be learned and applied to the profession. She is concerned, however, that many scholars are not compensated accordingly, which may discourage or eliminate their ability to contribute.
“We need to support researchers” she exclaims.
She asks those in the group with faculty education positions who have access to the Massage Therapy Research Fund or similar funds, “How much is available for salary support beyond just funding the research costs?”
Cathy Fournier replies, “Typically, you can pay a research assistant, but there’s not enough to pay yourself.”
Fournier talks about barriers for graduate students attempting to recruit a professor with faculty position to oversee a research project.
Martha Menard adds, “Even if you could get salary support for your research, it assumes you already have a salaried position.”
Gowan shares the story of a fellow researcher – a medical oncologist with a clinical, not a research or academic, position – laughingly refer to their joint research project as a “hobby.” He labelled it as such because none of the researchers were being paid. The difference for the oncologist is that he doesn’t rely on research funding for living expenses as he draws a high salary from his clinical position – a fact that it not typically true for massage therapists.
In addition, Gowan notes that graduate school education can be very expensive. Cash outlay for tuition and fees can easily reach $50,000, while there is reduced income potential imposed by limits of time and energy for practice. As well, undertaking advanced education studies incurs the opportunity costs of forgoing other potential business or industry streams. All these contribute to the lack of good quality massage therapy research.
Dryden confirms the self-employed status of RMTs may limit their proclivity toward an administrative or academic position. When RMTs do obtain these positions, they are full-time, with few resources allotted to do research.
“This speaks to a much larger social question around access to the production and distribution of knowledge,” states Dryden.
Menard explains another unintended consequence: Scholars attracted to academia often come from other disciplines, so any research related to massage therapy will naturally reflect that particular discipline’s viewpoint.
“This is still valuable,” Menard states, “but our profession loses the opportunity to view the research through its own lens.”
She wonders if there is a correlation among the notions of massage therapy as a female-dominated field, women as caregivers in society, and positions of higher education not compensated sufficiently.
“Women, compared to men, face systemic, structural barriers in achieving economic equality, and these barriers are present in academia and clinical health care. Even though women now receive a higher percentage of academic degrees, they still earn an average of $0.80 to every dollar earned by their male counterparts.”
Ania Kania-Richmond, a RMT with a PhD, is the assistant scientific director of the Bone and Joint Health Strategic Clinical Network, Alberta Health Services. She points out the problem may stem from how researchers position their identity in research circles. Sharing insights gleaned from working with established researchers during her PhD, Kania-Richmond advises, “Don’t position yourself as ‘massage therapy researcher’ but rather, identify as a rehabilitation researcher or with an interest in health administration and policy. Once you’re in, then you carve your career path.”
Barberree remarks that the very notion that a RMT must seek advancement in another field only to attempt to weave back in later when established, “supports the observation of the significant barriers facing higher-educated massage therapists.”
Kania-Richmond poses another point: “We may presume the massage therapy profession is open and accepting of injecting new knowledge and research… that’s not necessarily true.”
She shares how some RMTs she’s interacted with in research and practice contexts do not always actively or intentionally engage in professional reflection or partake in new knowledge. Kania-Richmond laments RMTs “may still apply the same methods they graduated with 20 years ago.”
She continues, “We must be innovative and not see massage therapy as a static field – advancements in technology necessitate considering influences on health care and society over the next five to ten years.”
She says of RMTs with higher education, “We are the early adopters, the leaders… we will not find the culture in existence but will have to create it and change it.
“The questions have been the same for the last 10 to 20 years. The struggle hasn’t changed… there’s just more people involved in the struggle.”
Dryden explains academics must often follow recognized degree paths that can then be parlayed into a career. Dialogue must ensue among the profession’s stakeholders to develop a recognized and utilitarian degree. She suggests looking at other disciplines with regard to their higher education status and consider how such education contributes to a profession.
“How has nursing done this,” for example? Dryden affirms stakeholders should ensure RMTs are not penalized in their positions as practitioners when they pursue higher education.
Fournier points out that educators in academia or administration can affect policies that shape education and contribute to professional cultural change.
“Educators can influence (regulatory) policies affecting protection of the public interest,” she says.
Dryden posits, “How will those with higher education stay engaged?”
She suggests it is useful to point out what research is relevant and important. “It’s not helpful to pull out research threads that aren’t being used and picked up by the profession. Part of our responsibility is to influence that.”
Gowan adds, “Culture changes because of exposure to knowledge.” She states those with higher education can assist with the dissemination of research by gelling available knowledge through publication and making presentations at industry conferences.
I asked two questions: “1) Can anyone refer to academics in other disciplines that can describe how their profession supports its scholars, and 2) Have any scholars on the call received offers of support from massage therapy stakeholders?
Fournier, Dryden and Menard all suggest approaching the medical, nursing, midwifery, naturopathic and acupuncture practitioners regarding the trajectory of their professionalization, and ask how their stakeholders and culture support their scholars. Menard points to the updated 100th anniversary of the Flexner report regarding medical and nursing education.
Barberree applauds the support others, like Gowan, have received. Unfortunately, she relays, her experience has been that stakeholders in some provincial associations have not been actively supporting those higher educated practitioners in sharing and translating their knowledge to the rest of the massage therapy community.
Beth continues, “The two Alberta massage therapist associations (there are four) that require members to graduate from a 2,200-hour equivalent program do not, as I understand it, have a research committee. As stakeholders and decision-makers in the profession, I would expect these associations to demonstrate robust support for building research literacy and capacity among their members.”
Gowan laments, “It’s interesting in how the conversation (goes) back to the lack of uniformity in education, training and standards in the profession.”
In her case, Gowan says she has received “stellar” support from the MTAS, other RMT associations and regulatory colleges in helping her with travel and accommodation expenses.
“I’m so grateful for that,” she said. She relayed student support by academia is “awesome” in the profession and wants students to know that.
Gowan suggests stakeholders in the massage therapy field may be looking for direction on how to better help scholars. Donelda recommends that consulting opportunities exist for scholars in helping stakeholders reach these ends.
I ask, “How do we prevent ‘brain drain’ of our higher educated colleagues who have trouble finding work within the field?”
Dryden shares that as her academic career advanced in administration, she was less able to participate in research studies. “My job got bigger and more complicated.”
She adds there is still opportunity to influence policy, but ability to participate in her own research has diminished. However, Dryden believes she has been able to improve student engagement in research through her current role.
Gowan echoes Dryden’s comments. “An administrative position makes decisions, influences education policy and builds bridges between massage therapy and mainstream academia. There’s an integration there that would not have been available before (without Dryden’s advocacy).”
“Stakeholders can create an ‘intentional investment in knowledge.’ Research seeks solutions to problems, and stakeholder investing supports massage therapy in becoming a ‘good quality product’ informed by research,” Gowan concludes.
Donald Q. Dillon is a practitioner, author and adviser to massage therapists. Find him at DonDillon-RMT.com