As a result of a system failure causing the cancellation of the Physiotherapy Competency Examination (PCE) clinical component for March 20 and 21st, 2021, the Canadian Physiotherapy Association (CPA) is calling for a suspension of the requirement for candidates to complete the clinical component of the PCE in order to obtain their license and an immediate return of all candidates’ fees related to the clinical component of the PCE.
The health care system in Canada needs physiotherapists. Physiotherapy care, whether delivered in the ICU, in clinics, in long-term care facilities, through virtual care, in homes or in outpatient clinics, is essential care. There is demand for physiotherapy across the country and COVID-19 has made that more apparent than ever:
- As the number of long haul COVID-19 cases continues to increase, mounting evidence points to the long recovery and debilitating impacts that follow infection. Physiotherapy is a key member of the core team required to address the significant and long-term disability that arises as a result of long COVID.
- COVID-19 has disproportionately affected women, who have experienced greater job losses and caregiver responsibilities due to the pandemic. More than 75 percent of all physiotherapists are female, suggesting there may be a significant impact on the profession, heightening the need for new qualified physiotherapists to be entering the profession at this time.
- There is a backlog of surgical cases, cancelled due to the pandemic, requiring rehabilitation services to either delay or decrease the need for surgical intervention, or provide post-operative care leading to patients recovering and returning home more quickly.
- There is an unquantified toll that continued lockdown has had on the physical well-being of Canadians which will need to be addressed by the health care system with physiotherapists playing a prominent role.
- Due to the COVID-19 quarantine and physical distancing measures, many long-term care residents will have experienced diminished cardiovascular function, muscle wasting due to inactivity, decreased mobility and range of motion and may be at an increased risk for falls, fractures or permanent mobility loss which will result in more intense and costly daily care. Physiotherapy access now can mitigate these effects and allow residents to regain and maintain function and to avoid hospitalization.
Creating incremental barriers preventing Canadians from accessing physiotherapy is unacceptable.
The role of the PCE is to test the essential competencies of physiotherapy practice, in order to ensure that reliable, high-quality care that meets the established standards is delivered to Canadians. The PCE is not the only way to assess that competency. We are calling on CAPR and the provincial Regulators to be innovative, nimble and creative in their approach to ensure that not only the public safety is upheld – but prioritized. Canadians need access to physiotherapists – many of the current candidates have been working under supervision by licensed physiotherapists for over a year. We need a new solution – rescheduling the virtual exam is not an acceptable answer. There is evidence that exemptions can be developed, other relevant Colleges have been nimble and addressed the ongoing pandemic by changing regulation (for example changes to the Ambulance Act) as needed – we’re calling on the regulatory colleges across the country to consider this action.
Further, candidates of the PCE have substantial training to ensure they meet the competencies required of a physiotherapist:
- Each of the 15 Canadian Universities offering physiotherapy education provide a professional, entry-level program at the Master's level – all programs are rigorously reviewed every six years by Physiotherapy Education Accreditation Canada (PEAC), the body that conducts accreditation reviews of Canada's Physiotherapy education programs.
- National Curriculum Guidelines set out by the Canadian Council of Physiotherapy University Programs (CCPUP) stipulate that all Canadian physiotherapy university programs prepare graduates for safe and effective entry-level practice as generalists. Patient safety is embedded into every Core Knowledge stage of training to ensure entry-to-practice proficiency.
- Physiotherapists practicing in Canada are autonomous self-regulated primary health care professionals bound by a code of ethics. Physiotherapists have an ethical obligation to practice in a safe, competent, accountable and responsible manner during the provision of services.
- Candidates eligible for the clinical component of the PCE who have been educated at an accredited university physiotherapy program have completed: 6+ years of university, numerous exams (written and practical), completed over 1000 clinical hours where they have been evaluated and deemed safe by numerous registered physiotherapists and have completed the written national licensing exam.
Patient safety is a priority, well established, through the rigorous education that a physiotherapy candidate must undertake to be eligible for the clinical component of the PCE.
Beyond the fact that the health of Canadians relies on physiotherapists – the emotional and financial toll this has taken on candidates cannot be justified. Candidates from every walk of life, across the country have been thousands of dollars out of pocket, have been experimented with as new materials and approaches were considered, and had their examination cancelled with little or no notice three separate times. Treating our future physiotherapy professionals this way is unacceptable.
The CPA is committed to addressing this. We have spent the last year in a collaborative, supportive manner working with CAPR to address the implications of COVID-19 on the PCE. With that said, enough is enough.
As a result the CPA is calling for the following:
- CAPR to immediately return all fees collected from candidates who are waiting on the clinical component of the PCE
- The provincial Regulators (Colleges) to immediately suspend the requirement for a completion of the clinical component of the PCE to be eligible for licensure in every province
In addition, the CPA is asking the provincial Regulators to use this as an opportunity to reevaluate the PCE including current requirements, viability of the testing, the efficacy of the test to meet the required standards, and more. As an Association, we continue to stand, willing to support the profession as it navigates these challenges and potential changes. However, navigating these challenges can not be done on the back of the candidates currently waiting for this exam.
COVID-19 has been a challenge. But, it is no longer an excuse. The CPA expects more from the profession as we move forward, and expects more from the way we treat our physiotherapists.
To our members, the candidates and the profession writ-large who are all frustrated by these events. We hear you and share in your frustration. We appreciate your candor, open dialogue and your support. The CPA is committed to taking action and will continue to share information and our next steps this week.
Please know the CPA including its Board of Directors, staff, Divisions, Branches and Assemblies are working tirelessly to address this issue on your behalf.
Please continue to be in touch with the CPA by emailing email@example.com.
 The pre-pandemic unemployment rate among physiotherapists was 0.3 per cent (2014).