Physio graduates fed up as clinical exams cancelled for 4th time during COVID-19

The Canadian Alliance of Physiotherapy Regulators (CAPR) has cancelled all of its clinical exams scheduled for 2021.

It's the fourth time exams have been cancelled since March 2020, leaving new graduates in B.C. and across Canada unable to become fully registered physiotherapists.

It was devastating but not surprising news for candidate and interim physiotherapist Evan Wilton.

"No one was particularly shocked," said Wilton.

"Given how the whole last year has gone on, it's more just disappointment and frustration."

Back in March 2020, the final exam was cancelled as the country adapted to the realities of the COVID-19 pandemic. The November 2020 exam was then cancelled as CAPR worked to develop a pandemic-proof alternative.

The alternative materialized as an online exam at the end of March, but the platform crashed while some students were in the middle of the exam.

Wilton says it has cost graduates money, time, clients and the development of their careers, while also restricting patients from accessing treatment as the province continues to deal with a physiotherapist shortage.

Graduates who pass the written exam may work as interim physiotherapists, but it's a position that also comes with restrictions. Interim physios often earn less, aren't able to specialize, and deal with the stigma attached to their perceived skill level.

Exams cancelled as investigation continues

On its website, CAPR wrote that the investigation into the online clinical exam's failure in March is still being investigated and it "cannot guarantee the success of another virtual exam."

"The risk of another negative experience for candidates is too high," it wrote.

It said it can't offer in-person exams due to the third wave of the COVID-19 pandemic.

Following the failure of CAPR's online clinical exam in March, the College of B.C. Physiotherapists sent a proposal to B.C.'s Ministry of Health suggesting an alternative solution.

It proposed that a cohort of 81 interim physiotherapists be classified as fully registered physiotherapists without having to complete the clinical portion of the competency exam.

The majority of the candidates have between 10 and 24 months of supervised clinical practice in B.C., it said.

"Many are no longer entry-level practitioners while the exam is fit for purpose at entry-level," it wrote.

Dianne Millette, registrar at the College of Physical Therapists of British Columbia, says the college understands how difficult this has been for new graduates.

"We felt like they have put in a lot of time and have waited a long time," she said.

But ultimately, B.C.'s Ministry of Health decided against the proposal because the clinical exam requirement is written into the college's bylaws.

"[The ministry's] position is that proceeding with the proposals we had put forward would put us in a position of being unlawful and not complying with our bylaws," said Millette.

Potential changes to the bylaw

The ministry did, however, give the college the option of applying for a bylaw amendment, despite a current moratorium on amendment applications in the province.

With an amendment, the college would have the flexibility to add language that would allow the board of directors to approve an alternative form of evaluation.

"The upside is that it would solve our problem in the longer term. The downside is that it takes time," said Millette.

It likely won't help the candidates who have been waiting months to complete the clinical exam, she adds.

Need for physiotherapists

The Physiotherapy Association of B.C. previously told the CBC there's a shortage of physiotherapists both in the private and the public sectors.

Many patients aren't able to access physiotherapy services due to long wait lists.

Wilton, who works as an interim physiotherapist at UBC Hospital, says the shortage has been exacerbated by the pandemic as hospitals experience greater demand.

"When there's a shortage of physios available, you see a lot less access to preventative services to stop people from coming to the hospital," said Wilton.

And when patients do arrive at the hospital, he says they need more assistance and sometimes don't return home and, instead, end up in long-term care homes.

Millette agrees the work of physiotherapists has been an important tool to rehabilitate COVID-19 patients.

Wilton says he chose physiotherapy to help people and he's frustrated that more than a year into a pandemic, there are still barriers keeping him from fully doing that.

"At this point, I'm just frustrated that we haven't had a solution," he said.