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Physio graduates in limbo as clinical competency exams nixed, but still required for licensure

Since the beginning of the pandemic, the licensing process for new physiotherapists across Canada has been an endless saga of technical glitches, last-minute cancellations and disappointment for candidates. 

On Wednesday, the Canadian Alliance of Physiotherapy Regulators — the body responsible for the administration of the exams — announced that the clinical component of the Physiotherapy Competency Examination (PCE) will no longer be offered, citing the pandemic and its inability to offer large-scale competency exams in person. 

“It feels like the weight I’ve been holding around these past 16 months has been worthless,” said Eric Bennett, a physiotherapy graduate in Langley, B.C.

He says careers have been stalled for many like him, and their mental health impacted over the past two years due to the failure of CAPR to administer the exam.

The recent announcement brings further uncertainty over the future of physiotherapy licensing in Canada, he adds.

“It’s just exhausting. To have to consistently fight and feel like our voices haven’t been heard. It just sucks.”

Last year, CAPR developed an online version of the exam that was plagued with technical issues. 

The exam’s postponements and cancellations over the last two years have created a backlog of thousands of physiotherapists waiting to get fully licensed. 

Although graduates who pass the written exam may work as interim physiotherapists, the role comes with restrictions, including lower salaries and the inability to specialize.

Exam no longer offered, but still required

CAPR’s decision to stop offering the clinical component is also the result of “a major effort to review and re-conceptualize evaluation services for entry-to-practice physiotherapy in Canada,” they said.

physio graduates in limbo as clinical competency exams nixed but still required for licensure
Physiotherapy graduates say their careers have been stalled by the failure of the industry’s licensing body to offer a clinical exam during the COVID-19 pandemic. (Jeff McIntosh/The Canadian Press)

However, while the clinical component of the exam is no longer being offered, it is still a requirement to practice as a fully licensed physiotherapist.

In B.C., a candidate cannot become a full member of the College of Physical Therapists of B.C. until they complete a competency exam or an appropriate alternative.

“We’re in a far worse position than we were before,” said Bahram Jam, a Toronto-based physiotherapist and member of the Physiotherapy Advocates of Canada.

“They simply passed the buck onto the regulatory bodies to take care of it.”

Jam says this will create a patchwork system of licensing across Canada, as local provincial colleges either develop their own exams or alter their bylaws to remove the requirement for a clinical exam.

He says Canada’s physiotherapy regulatory bodies have failed new graduates.

“The sad part is … we are the only ones who have this issue. Chiropractors, physicians, nurses, they’ve never had the issue during the pandemic. They don’t have this licensing crisis,” Jam said.

Unified interim measures

Amanda de Chastelain, president of the Canadian Physiotherapy Association, says there’s concern this will simply mean candidates will continue to be forced to wait while local colleges figure out their next move.

“What we need to address pretty immediately, is getting those candidates who have waited up to two years or more [to move] forward,” she said.

physio graduates in limbo as clinical competency exams nixed but still required for licensure 1
Many in the industry are calling on physiotherapy colleges to remove the clinical examination component for licensure. (Submitted by Jeremy Lynn)

She says the lack of a national exam will also create inequity among candidates based on where they live as each local college develops its criteria for licensure.

The association is calling on the colleges to develop a cohesive and unified solution that offers equitable interim measures for all candidates.

UBC offers clinical exam

B.C.’s college of physical therapists has teamed up with the University of British Columbia to offer clinical exams.

After waiting for nearly a year and a half, Bennett was finally able to take his exam last weekend.

The college is holding another round of exams this weekend, but it’s an interim step as it decides how to proceed.

“The Registration Committee and Board of Directors require time to discuss the CAPR announcement,” said the college in an online statement.

“The College will also discuss the impact of the cancellation with the Ministry of Health and other physiotherapy regulators in Canada.”

Bennett, Jam and the Canadian Physiotherapy Association are all calling for the clinical examination requirement to be nixed completely in Canada, even at the local level — but because it is written into most college bylaws, doing so could be a lengthy process.

In B.C., the college must apply for a bylaw amendment to the Ministry of Health, which includes a three-month notification period — meaning the careers of many physiotherapy graduates could linger in limbo for longer.

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