Challenges to Education for the Professions

by James L. Morrison and Larry L. Leslie

(reprinted from Morrison, J. L. & Leslie, L. L. (1975). Challenges to education for the professions. Education, 95(4), 386-388.)

Undersupplies of professional workers, "crisis" service modes, and out-moded delivery systems have increased the cost of, and reduced the availability of, many professional services.  Unless professionals can alter their service modes and delivery systems to more effectively meet social needs, there is little hope that our major social problems will be solved.  In this paper it is argued that professional schools must adjust enrollments to meet public needs and must reorganize their curriculums in order to inculcate a broader sense of social responsibility on the part of neophyte professionals and thereby assist in altering existing service modes and delivery systems.

Challenges to Education for the Professions

Newspapers, popular magazines, and professional journals are currently devoting a great deal of attention to problems in the education of disadvantaged children, the chaotic state of our welfare system, the pollution and exploitation of our natural resources, the shortages of physicians, the high cost of medical services, and the jamming of court dockets.  These are problems which not only depress the standard of living of our population, but may also serve to threaten the stability of our society.  People feeling, and thereby knowing, that they are not getting good education for their children or the proper medical care and legal services they deserve, become increasingly frustrated with their lot in life and with the legitimacy of the social order.  These frustrations, combined with unemployment or underemployment and real or perceived discrimination, were no doubt in part responsible for the tragic and extensive civil disturbances experienced in the last decade.

It is the authors' contention that the under-supply of professional workers and outmoded delivery systems of many professions have added to societal problems in America. At present we simply do not have a sufficient number of physicians to render health care to everyone.  We are the last industrial nation in western society without universal health care.  We have slipped from the sixth ranked nation in infant mortality in 1950, to fifteenth in 1961, and eighteenth in 1967.  The proportion of pregnant women receiving prenatal care is declining by about two percent per year.  These statistics can only be explained by a broad inequality of medical treatment; poor people simply do not receive health care.

According to a recent article in U.S. News & World Report, we presently have 155,000 fewer nurses than needed, and by 1975, it is expected our deficiencies will be nearly 200,000. Medicare and Medicaid programs are certain to aggravate our present situation as are plans to convert nurses to physicians' surrogates.  Further, one half of all children reach age 15 without having visited a dentist; and it takes little imagination to speculate about extant dental services for the poor.

For the first time in generations the teaching profession is no longer one of insufficient numbers.  To the contrary, it appears that one important task now is to encourage colleges and schools of education to reduce the number of candidates they admit.  The immediate employment situation is such that teacher oversupplies are the case within most secondary fields everywhere, and in elementary education in all but the remote geographic areas.  In spite of this, there is little evidence that education faculties are curbing enrollments even though to do so would be a relief to the hard-pressed higher education dollar.

After the question of quantity comes that of quality.  Educational research has made possible a new "enlightened era," and within a few colleges of education, a handful of scattered school districts, a few individual schools and some isolated classrooms, the enlightened age seems surely to be finally upon us.  However, away from these centers of enlightenment and innovation, the picture does not appear to have changed in the past 50 years.  Across the nation, in by far a majority of cases, the typical classroom remains one of neat rows of chairs, all facing the front, where a dominant teacher is delivering her lecture- if she is one of the more ambitious individuals.  Otherwise, students are involved in "individualized instruction" which means, as applied in the typical case, they are reading the chapter on their own and answering the questions at the end.

In the disadvantaged school the situation is no better and no worse except that here students will not survive in spite of the ineptitude of the teacher.  Here the teacher is unlikely to have any understanding of and less tolerance for the culture of the disadvantaged student.  She has almost certainly not been schooled in the psychology and sociology of the disadvantaged, and cultural pluralism is a concept beyond her wildest imagination.  In sum the situation is in desperate crisis.

The prevailing service mode and delivery system of the medical services field is as dysfunctional as that in the teaching profession.  Physicians are trained in the diagnosis and treatment of diseases, and are not specifically trained in preventive and community medicine.  Yet it may be argued that preventative medicine is better suited to the health needs of the poor.  Personal hygiene instruction, massive inoculation programs, and health education would probably do more for the health of America's poor citizens than proper diagnosis and treatment of diseases.  There is no assurance that a person who fails to understand his malady or the potential of prescribed drugs will care for his person as specified by a physician; in fact, far from there being assurance, most poor people are known not to follow their physician's instructions.

In social work, it appears that we have abetted a process of "welfare colonialism" by which the social worker serves to “get the people adjusted so they will live in hell and like it too." In less dramatic terms this statement means that we have rendered many of the poor of this nation to a position of dependence from which they can never escape.  Yet, few issues surrounding welfare controversies have gained as much bipartisan support as has the principle that welfare should enhance personal independence.

To the "man on the street," attorneys appear preoccupied with protecting criminals from the public, even though the single, original purpose of law was the opposite of this.  To many, the adversary system seems to have become a game.  Even when the attorney knows his client to be guilty, his goal seems to be merely "winning." The "ambulance chaser" is perhaps only a popular stereotype of the practicing attorney, but it is a stereotype symptomatic of a very real problem within the legal system.  It is a well-known fact and a national crisis that our courts are jammed to the point whereby the guarantee to a speedy trial cannot be met.  Civil cases often require two or three years to come to trial.  Even criminal cases are seriously delayed; persons accused of criminal offenses are imprisoned for months, or worse yet for subsequent victims, they are freed for months pending trial.

What we are briefly arguing here, is that undersupplies of professional workers, "crisis" service modes, and outmoded delivery systems have increased the cost of, and reduced the availability of, many professional services.  Unless professionals can alter their service modes and delivery systems in such ways as to demonstrate their responsibility for the health care needs of the central cities and rural poor, for the protection of the rights of the general public as well as of the accused, for the needs of the disadvantaged school child, for the great need for human dignity and for the protection of the environment, there is little hope that our major social problems will be solved.

What role do the professional schools bear in altering professional service modes and delivery systems and in inculcating a sense of social responsibility on the part of neophyte professionals?  First, they can address the problem of supply of professionals by adjusting enrollments to meet public needs.  It appears that professional schools in the past have been doing little more than maintaining a balance in supply and demand favorable to their profession.  However, even if applicants in sufficient numbers would apply and could meet the standards of professional schools, the problem of supply would still not be fully resolved.  For what is needed is a supply of professionals sensitive to the, social problems of our society and the relationship of these problems to the professions.

This requires that professionals increasingly be made socially aware.  The most obvious means to this end and that most often employed has been to require additional elective courses in the humanities and in the social sciences.  Unfortunately, however, these courses are often taught as first courses toward the Ph.D. in the respective disciplines.  Often, the least tasteful of all teaching assignments is the elective, service course.  It would be much more reasonable to teach such electives in an applied fashion in which the implications of the humanities and the social sciences to professional service could be developed.  To realize this objective, these courses should be taught within the professional school by members of the profession involved rather than by members of parent disciplines.  These persons should be generally concerned about the various social problems and, if possible, possess relevant experience and formal training.  For example, physicians who have worked in the public health service or in central-city clinics, teachers who have taught in poor disadvantaged schools, and engineers who have worked in pollution control should be the teachers of such electives.  Formal pre-professional education in the disciplines is "frosting on the cake."

Secondly, organizational changes must be made in professional schools.  We recommend that formal departments or programs be established in such areas as family and community medicine, educating the disadvantaged, environmental engineering, etc.  Regardless of inherent dangers, departmentalization is probably necessary to legitimate the basic philosophy which such departments represent.

We also recommend that professional internships take place in agencies located where social problems exist.  Internship locations have often been selected to insulate neophyte professionals from experiences that might be trying and frustrating.  Teaching internships, for example, have characteristically avoided central-city schools, and similar evasions have often been the rule in other fields.  If carefully designed, reversing such practices could facilitate the development of social sensitivity, and generate a sense of responsibility among many young professionals. When professional schools begin to produce such professionals in large numbers, the prospects for altering service ends.