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How the pandemic is disrupting the lives of people seeking their Canadian physio licences

National clinical exam for physiotherapists has not been successfully held since November 2019

Sampada Keluskar at her job as an interim physiotherapist at a walk-in clinic in Grande Prairie, Alta.

Sampada Keluskar at her job as an interim physiotherapist at a walk-in clinic in Grande Prairie, Alta.

Photo:  (Submitted by Sampada Keluskar)


Sampada Keluskar moved from Toronto to northern Alberta because of an exam. 

Keluskar is one of at least 2,000 physiotherapist candidates across Canada who have been unable to get their full licence because of ongoing issues with the national clinical exam, which has been cancelled five times since the start of the COVID-19 pandemic. 

As a foreign-educated physiotherapist and newcomer to Canada working on a post-graduate work permit, Keluskar says she was worried that her interim licence would expire before she could successfully pass the clinical exam, potentially putting her permanent resident application in jeopardy. 

She said dealing with the uncertainty in Ontario, where an interim licence previously lasted a year, was taking a toll on her mental health. In Alberta, interim licences last two years. 

Considering the exam situation, the COVID situation and my immigration situation, all of these three together, I think Alberta was a better option for me, said Keluskar. 

The Canada Alliance of Physiotherapy Regulators (CAPR) last held (new window) a full clinical exam in November 2019, leaving 832 people in Ontario with only an interim licence. The backlog comes at a time of increasing demand for physiotherapists as people recover from COVID-19. It's also making life difficult for physiotherapist candidates left in limbo, prompting some, like Keluskar, to make drastic changes to cope in the meantime. 

Starting everything from scratch in Grande Prairie was a really daunting experience for me, said Keluskar, who knew no one when she moved to the city in December 2020. 

The CAPR exam has two parts, a written component and a clinical exam. Those who pass the written component receive an interim licence and can practise with restrictions, such as working under a supervisor, but they cannot specialize or take certain courses and often earn less money. 

The College of Physiotherapists of Ontario ultimately extended interim licences indefinitely due to problems with the exam, but Keluskar had already moved to Alberta.

Clinical exam repeatedly cancelled

At the onset of the pandemic, CAPR cancelled its June 2020 in-person clinical exam. It was rescheduled for November 2020, but was cancelled when sites could not safely accommodate people during Canada's second wave of COVID-19. 

A pandemic-proof virtual exam crashed while people were taking it in March 2021, leading to another cancellation. 

A month later, CAPR cancelled all scheduled exams for this year because it could not relaunch the virtual exam and an in-person exam was impossible during the third wave. 

The virtual exam was later rescheduled for September, but again, ran into technical difficulties, with many unable to complete it. CAPR posted on Facebook that only 14 out of 48 people did not have technical problems and announced on Sept. 14 that all clinical exams would be cancelled indefinitely. 

The repeated cancellations have left many questioning (new window) the validity of a national licensing exam. 

study (new window) from Western University noted that among 17 countries with well-developed regulations for physiotherapists, Canada is the only country to require a licensing exam in addition to a degree.

Some unable to practise since late 2019

In Ontario, those who fail the clinical exam lose their interim licences and cannot practise as a physiotherapist, which concerned Keluskar, who emigrated from India in 2017, as she must work full-time for a year in order to apply for permanent residency. 

According to the Ontario College of Physiotherapists, 70 people failed the November 2019 clinical exam and lost their interim licences. Sameena Shaikh, a foreign educated physiotherapist with seven years of experience in India, was one of them. 

I had lost my mother also during that time, so a lot of things were running in my head, Shaikh said, adding that she failed by a few points.  

Without a Canadian licence, she currently works as a physiotherapy assistant in a long-term care home in Scarborough. 

Sameena Shaikh frequently helps patients exercise with walkers outside the long-term care residence she works at in Scarborough, but she says she's limited in her duties as a physiotherapy assistant. (Katie Swyers/ CBC)

Sameena Shaikh frequently helps patients exercise with walkers outside the long-term care residence she works at in Scarborough, but she says she's limited in her duties as a physiotherapy assistant. (Katie Swyers/ CBC)

Photo: (Katie Swyers/ CBC)

As a widow and single mom, she says not being able to retake the clinical exam for almost two years has affected her emotionally and financially. 

I'm doing everything, all the responsibilities I am taking up, all by myself. I have nobody to help, said Shaikh.  

As a fully licensed physiotherapist, she could earn three times the amount she makes as a physiotherapy assistant.

With her current salary, Shaikh says she is struggling, but manages because she and her daughter live in Toronto community housing.  

When her seven year old asks when they can buy a car or a house, she feels like crying. 

I keep telling her, 'Yeah, I will.' Sometimes certain things take time, said Shaikh. I'm doing my best. I'm on the right track. 

Once she passes the clinical exam and receives her full licence, she said, life will change for the better, like 360 degrees, especially for my daughter.  

Shaikh has invested close to $20,000 in preparing for the clinical exam and felt confident she would pass before the most recent cancellation. 

We aren't able to move forward in our careers, she said. 

She's frustrated that she and others can't do the work they are trained for at a time when they are needed.

Shortage of physiotherapists in long-term care

Shaikh's boss, Toula Reppas, a physiotherapist and CEO of Achieva Health, says she has had trouble finding fully licensed physiotherapists. 

There's definitely a shortage of physiotherapists in Ontario, she said. 

As soon as there's [a COVID-19] outbreak in a long-term care home, that's when the need arises for more physiotherapists, said Reppas. It was really an issue during the first and second wave.  

As soon as Shaikh is fully licensed, Reppas plans to hire her as a physiotherapist. 

Keluskar plans to move back to Toronto once she passes the clinical exam and has her full licence. 

In the meantime, with all her friends back in Toronto, she says: The days here pretty much go by prepping for the exam.

Katie Swyers (new window) · CBC News