Chai and Gup Shup over Occupational Therapy education, areas of practice, medical regulatory boards, frameworks, ethical practice, and everything in between!
This blog post is a two part series of FREQUENTLY ASKED QUESTIONS (FAQs) about Occupational Therapy education and practice in India. So, let’s educate and empower our profession the way it needs to!
Part - 2: Understanding Occupational Therapy Practice in India
6. CAN ALL OCCUPATIONAL THERAPISTS USE "DR" PREFIX IN INDIA?
This has been by far the most controversial aspect of OT practice in India!!
Occupational Therapy in India currently has different medical regulatory boards for different states which undertake the responsibility of registering practitioners and one national council AIOTA (All India Occupational Therapy Association) which acts a common board to further expand OT practice through memberships and continuing education courses.
Why did I take the trouble of explaining all of this? This is to highlight that we currently do not have a national medical regulatory board in India for Occupational Therapy because of which there is a difference in the way Occupational Therapists get registered with the prefix.
Occupational Therapy is an allied medical health coursework which by itself DOES NOT award us the prefix of “Dr”. This prefix has been awarded to Occupational Therapists ONLY AFTER REGISTRATION in the state of Maharashtra as of yet. It is illegal and unethical if you use this prefix without being registered as an Occupational Therapist in the state of Maharashtra. Although my baccalaureate degree says “Sakshi A Tickoo”, I’m registered as “Dr. Sakshi A Tickoo” in Maharashtra. This would change if I move to other state which does not have the same provision. So, if you’re still an intern or a new grad who has passed out but not yet registered as an practitioner or reside/practice outside of Maharashtra, you CANNOT LEGALLY use the "DR" prefix! Period.
PS: It doesn’t mean you’re less qualified or unimportant. No prefix, no number of degrees, or certifications can decide the skill set you bring to the table.
7. WHAT ARE THE PREDOMINANT SETTINGS THAT OCCUPATIONAL THERAPISTS ARE WORKING IN?
At the moment, paediatric (outpatient) is the most common setting OTs work in, followed by neurorehabilitation. Hand therapy, Mental Health, and Ergonomics have been focused on in the recent years however, new gads students often find themselves with rare opportunities to pursue the same.
8. WHY IS THERE A LACK OF AWARENESS AND CLARITY ABOUT OCCUPATIONAL THERAPY IN STUDENTS AND HEALTHCARE PRACTITIONERS?
The biggest drawback of OT education and practice in India is that only a handful of us are actually practicing Occupational Therapy the way it’s supposed to. In my personal view, OT has struggled to create its mark in India because OTs are constantly trying to prove that they are different while not knowing what makes them unique. Makes sense? No? I'll try explaining that again- I think we’re trying really hard to tell professionals why are we different from PT when we should actually be discussing how can OT help your client live a better life!
There is a lack of awareness and clarity about OT in India, especially in government hospital settings for a couple of reasons:
a) There is a huge gap between theory and application of concepts. In my experience, there is too much time and energy focused on knowing the condition than understanding the client which does not make our practice client-centered and leaves our client with no distinctive treatment options.
b) Due to heavy caseloads (I’m talking at least 15-70 in a day) and lesser therapists, it becomes practically impossible to deliver our treatments optimally in a hospital setting. Private settings are much more accommodating in terms of caseloads but are equally expensive and non-affordable for the kind of population we treat.
c) We aren’t taught OT! I can only recall a couple of professors in my teaching institution who taught me what OT is. I KNOW RIGHT? I’m NOT scapegoating professors. I think most of them are trying to do their best but it is not in concordance with the foundation of our profession. Hence, most students struggle to understand how OT works and what is it that we *really* do.
d) TOO SCARED TO CHANGE! I’ve hated OT for most of my college years. However, internship was a game changer for me and the time I fell in love with OT. People are too scared to step out and be the change they want to see in this profession. Everyone wants to fit in a box thinking that is how this profession works but it does not.
e) Even if some of us try to bring a change the way OT functions, others do not welcome this change. This is by far the saddest thing I’ve experienced as a student and I continue seeing this with my junior peers in OT School. Moreover, this is one of the biggest reason why OTs stop following OT practice and take away/follow alternate healthcare professions which fall beyond the scope of OT practice.
f) Malpractices: Ethics isn’t the strongest thing in our profession right now. There are only a few workplaces that ask for registration documents when hiring OTs. In fact, some of them hire PTs instead of OTs just to maintain their business revenue which is also one of the reasons why our medical counterparts have a hard time understanding what OT and PT is.
Hopefully in the coming years, there would be a generation of OTs that are aware of the scope of OT and practice it the way it is!
9. WHAT FRAMEWORKS DO WE RELY ON AS A FOUNDATION TO OUR APPLICATION AND TREATMENT?
This is truly subjective but I can enlighten you on what I use as a foundation for my practice.
I have been working in telehealth, home healthcare, and school-based settings for over a year now and I’ve rarely found any evidence for the kind of work I do in Sexuality and Mental Health. Hence, I rely on evidence-informed practice rather than evidence-based practice to support my interventions.
Additionally, I find myself using Kawa Model and Person-Environment-Occupation-Performance (PEOP) Model most often with the dynamic client population I serve (3 years to 65years). I have found them to be the most effective, approachable, and holistic models that can serve both as diagnostic and intervention tools.
10. WHAT OT PRACTICE AREAS CAN GROW IN THE NEXT 5 YEARS IN INDIA?
I honestly believe that Mental Health and Ergonomics could be the two practice areas that could grow in the upcoming years. I’ve come across brilliant OTs who are constantly hustling and trying to shed some light on these areas.
If we stick to the foundations and frameworks of our profession, I think there are great things we can achieve given the dynamic and diverse clientele in India!
This pretty much sums up Occupational Therapy education and practice in India!
All of the views shared here are based on my experience as a student and new grad practitioner. The idea of this post was not to scapegoat or dis my origins and preach western education but to honestly reveal the loopholes, pros and cons when working in country like India.
I’m grateful for my experiences and struggles as a student/practitioner and wouldn’t change a thing about it because that is what makes me a compassionate professional, and a humble person. I meant no harm to anyone through this blog post. However, if I may have hurt your sentiments in anyway, I sincerely apologize for making you feel this way.
If there is anything you’d like to add or enlighten our community on, please comment it below. I’m always interested to hear and connect with our communOT!