This letter is intended to bring to your notice the new discriminatory action taken by Federation of State
Boards of Physical Therapy (FSBPT) against Physical Therapists of certain nationality including Philipines,
India, Egypt and Pakistan.
FSBPT is a board formed in 1986 intended to protect the public health and safety by acting as a common
organization for various boards for regulating physical therapy practice in the US. The Board regulates
the licensing of physical therapists from different countries who intend to practice inside any of the
states inside the US. The Board administers the National Physical Therapy Exam (NPTE) for the licensing.
A lot of therapists take the Board exam conducted at various prometric centers across the US
throughout the year. It requires a lot of administrative and evaluative procedures before one can sit for
the exam. And it takes lot of time, effort, money and energy before a physical therapist can get through
the process, sit for the exam and have a license in hand.
It is shocking, dismaying, to hear about the latest order passed by the FSBPT which after careful
consideration of the whole matter can be only but termed as aberrant, discriminatory, unconcerned,
This is what the FSBPT website has to say, “In response to pervasive, ongoing security breaches by
significant numbers of graduates of physical therapy schools from certain foreign countries, the
Federation of State Boards of Physical Therapy (FSBPT or Federation) will suspend National Physical
Therapy Examination (NPTE) testing for all graduates of schools located in those countries, pending the
development of a separate, secure exam for those graduates (to be called the NPTE-YRLY). The affected
individuals will include all graduates of physical therapy schools in Egypt, India, Pakistan and the
“This necessary security measure is in response to compelling evidence gathered by the Federation
reflecting systematic and methodical sharing and distribution of recalled questions by significant
numbers of graduates of programs in the affected countries, as well as several exam preparation
companies specifically targeted to these graduates. This evidence was obtained through extensive
forensic analyses of exam performances, as well as a variety of legal actions brought by the Federation in
the United States and abroad. Most notably, this includes the raid and seizure of evidence from the St.
Louis Review Center in Manila, Philippines, and its alleged owners/operators, Gerard L. Martin, Roger P.
Tong-An and Carlito Balita, which revealed the widespread sharing of hundreds of live test items. In
response, the Federation is pursuing criminal copyright prosecution against St. Louis Review Center and
its owners, has invalidated the scores of several individuals believed to have unfairly benefitted from
advance access to test questions, and has removed the compromised items from the exam.
The Federation’s ongoing investigative efforts have revealed that the sale and sharing of recalled test
questions extends beyond this single test preparation company, and that the sharing of test items has
continued despite its past efforts to ensure the security of the exam. “The National Physical Therapy
Examination is a key element in assisting jurisdiction licensing boards and the Federation in assuring the
public that licensed physical therapists and physical therapist assistants are competent and safe
practitioners. We view the security of the NPTE as the highest priority in our mission of public protection
and, therefore, have used the best forensic and investigative techniques available to identify the problem
and the perpetrators. Given the pervasive and continuing use of electronic technologies by graduates of
these schools and some examination preparation companies - in spite of the harsh penalties imposed by
the Federation - we believe that the NPTE-YRLY is the best solution to ensure the validity of all NPTE test
results,” stated Federation President E. Dargan Ervin. “The Federation recognizes the significant
consequences of this policy decision, but feels that it needs to be made clear to all candidates that the
Federation will not tolerate security breaches. We will continue to use and add security measures to
protect against possible future breaches and will not hesitate to add other groups to the list restricted to
the NPTE-YRLY if we obtain sufficient evidence that members of additional groups may be obtaining an
unfair advantage on the NPTE or otherwise jeopardizing the integrity of the exam.”
It is always fair on the board to take action against anyone who is caught cheating the board and
thereby protecting fellow candidates and the public by that. It is very much important to maintain strict
standards to prevent the American public from reckless and incompetent persons providing medical
care. It also prevents injustice to fellow candidates who had been training and preparing hard genuinely
for a Physical therapy License in the US.
But what is strikingly standing out in this present order from FSBPT in response to the breaches in exam
conduction or material is that it is trying to generalise a particular population for the mistake of some
which is no way understandable nor justifiable. The Board still is unable to provide facts on how it has
come to terms of prohibiting certain sections from taking the test. The intelligence and forensic tests
described by the Board if conducted should be able to pinpoint the persons who might have gained an
advantage and the Board should be able to take an action against them. If the Board has found the
culprit agent then they should find those candidates who have enrolled with the agent for exam
preparation. If the Board feels that the questions have leaked beyond that agency, they should also be
able to provide facts and figures about how it would have leaked out of Philippine agency to other
candidates who are not enrolled with the agency, or to those beyond the border to 3 other particular
countries Egypt, India and Pakistan. The Board website points to facts that online discussion forums
have taken it to different places and if that is the case it is ridiculous and immature for the board to
assume that the WWW is accessible only to those nations and not to the whole world.
Discriminating the PT aspirants from few countries in the name of protecting the American public is a
cheap tactic which was a trademark of the bygone times. If the preparatory material leaked out was
available to whole world, assuming each and every aspiring PT’s from few countries alone would have
used it to gain any unfair advantage is goofy and hilarious in a sense but very dangerous a precedent. It
brings about the memories of the olden days of racial discrimination in the American society.
Notable facts in the situation are that the same FSBPT had been in the same situation against cheaters
earlier in 2002, 2007 and in 2008 in Texas and another one firm in New Jersey. It was the same situation
and the Board did find the culprits and case were registered and they were found guilty in case. The
Board should come out and say what action did they take then? The Board didn’t cancel any license
approved after taking test through those agencies, the Board did not prevent PT’s from taking a test
from those two states in the US, the Board did not change the way exam was conducted for all or for
those from the two states, the Board did not change anything then even after having more evidence in
hand then and presumably having more options to track all those candidates who might have gained an
unfair advantage. Does not a question arise here? Was it because there were lot of American PT’s
involved directly then and not many in the present situation? Is this plain discrimination or does it have
a racial background or just plain immature decision on behalf of the Board? Anything it may be but it can
be nothing but excessive an action!
A Physical therapist spends an average of 2000-2500$ in preparation for an NPTE examination not
including the airfare and accommodation needed to take the test which is conducted only inside the US.
This is a considerable amount of money considering the average monthly earnings of a PT in countries
like India is 100-150$. The present action by the Board does not consider the amount of money and time
each candidate has put into preparing for the Board exam.
The proposal by the Board to conduct a yearly exam separately for the candidate from the four named
countries itself lacks any uniformity in the exam conduction. This is certainly not a level playing field
where one group of PT aspirants gets a different set of examination and evaluation which can be done
many a time throughout the year while few others get a different presumably difficult examination and
evaluation standards conducted just once a year just because being of a particular nationality. There is
no justification for this sort of an action by any board. It would be fair if the examinations for all
candidates were halted and restarted once the problems were sorted out without singling out
candidates from any particular countries. The Board is free to and is justified in an action against a
candidate or agency is taken who is found of any misdoing.
It should also be noted that the FSBPT is answerable to the PT’s not just because it is a PT licensing
board, it is answerable because it represents a professional field in the medical fraternity where callow
thoughts and decisions are dangerous to the particular field, to the medical industry as well as to the
career of lot of people who never would have imagined such a reputable board to come out with such
primitive decisions to handle common situations. It is more answerable to the general public as well
since it represents a government, a nation where the human rights and freedom have much more value
than most other nations around. As qouted from former US President Jimmy Carter, “America did not
invent human rights, Human rights invented America”. What would the Board answer to those PT’s who
have already spend a lot of time, energy and money, moreover their careers elsewhere to get a license
in the US? Where are the rights of those young people? Where is the trust they placed on the Board to
be responsible and equipped?
The Board can never be right in blaming a section of PT’s geographically determined for some fault, the
Board can never be unbiased by providing two different responses in same type offense because
geography or race is involved, the Board can never be societal by not being concerned about the
sacrifices made by the genuine candidates!
Two different sets of exams, different sets of evaluations for the same License among PT’s based on the
boundaries of countries can only be considered here as discrimination against certain nationals unless
and until the Board is ready to come out in the public and answer to the public and every PT including
me. Until then the Board has a racial discrimination flag flying high over it, and let it also be clear that
the rights of every individual here in the US stands higher than the Board and will take every step to
keep it so and make the Board answerable to all these unnecessary situation brought forth.
The Board should take actions if it feels there was a mistake in such a decision made, if not should take
actions which are non discriminatory, equally applicable to all nationals or races who aspire to take up a
PT license in the US. The board should follow the Agriculture ministry and the US government in taking
steps to recover in the Shirley Sherrod case where immature, improper and hasty decision was made
initially on assumption based on available data’s.
I am a PT graduate from India having a permanent residency status in the US. I left my practice of 10
years back in home town looking for a better opportunity to show, deliver and update my skills in the
field of physical therapy. I professionally represent an online community of Physical therapists at
www.physioblasts.org and personally represent those physical therapists who chose US for the
opportunities it presents, the culture and value it upholds and have already spent a good amount of
money and time preparing to sit for the NPTE exam besides leaving out the career made back in their
homelands. I consider myself representing many more unspoken physical therapists from these
countries those residing already in the US as well as those who are not here but have already have
spend a fortune for a PT license in the US.
I hope everyone concerned including the FSBPT will understand the situation and the injustice in the
whole matter and take actions to address the issue in the right manner.
Robin Robert Varghese, PT.