Call To Action: Help Displaced Graduates in California

(from Elizabeth Bruckner, future punk at Bluegreen Community Acupuncture)

On August 7th of this year, hundreds of acupuncture graduates entered a massive exam room to take their state board’s licensing exam.  I was one of those graduates.  After years of study, 5 months of review courses and intense memorization, I felt prepared for the 200 question exam that, upon passing, would grant me the right to practice acupuncture in California.
I received a score of 74%.  For many exams in the history of the California Acupuncture Licensing Exam (CALE), the passing score hovered between 68-70%.  This exam, however, the passing score was set at an all -time high of 76%.  My dreams of opening a community acupuncture clinic in my neighbor came to dead halt.
I did what any graduate student would do.  I took a few days to grieve and began to study again for the next exam which is set for February 2013 while figuring out a way to make my very little savings last through 6 more months of unemployment.  A few days later, one of my teachers called me to say that something might have been wrong with the exam.  Colleges throughout California were noticing that the number of students who failed this exam was much higher than past exams.  Things didn’t add up.
Graduates and college representatives asked the California Acupuncture Board (CAB) for explanation.  We called and left messages but our calls were not returned.  We sent hundreds of letters but received only one response via mail.  It read, “There were no errors in the exam results, so the score that you received in the first exam letter is correct.”
Concerned patients, graduates, students and college representatives sent more letters to the Department of Consumer Affairs only to be told that our letters were merely forwarded to CAB for review.  Once again, we received no response.  We loaded our worn out, unemployed selves into cars and delivered our message directly to the CAB at their quarterly meeting in November.  “We are hungry.  We are tired.  We are angry and we are not going to take it anymore.”
The board agreed to investigate the exam.  No deadline was set except one; the February exam fees are due on December 21st.  The day after the meeting, we emailed and called CAB asking them to set a deadline for the investigation.  They told one staff member from the Senate Committee that they hope to have an answer for us at the February board meeting.  WHAT?!?
CAB has had over four months to investigate their mistakes; mistakes which cost 61% of the people who took the exam to fail and be forced into 6 more months of unemployment.  Hundreds of graduates are unable to work because CAB set the passing score higher than ever before.  Yes, you read that correctly.  Due to the all-time high passing score, 61% of the people who took the exam failed!
What exactly are the colleges and graduates asking for?  It’s simple.  We want the passing score to be changed to a customary 70% before the next exam’s fees are due on December 21st.  We want to be able to work in the field for which we were trained.  We want what is rightly ours – a passing score of 70% and the right to practice medicine like all those that went before us.
Our patients are waiting for us.  They deserve to be offered affordable acupuncture in their neighborhood.  This increased passing score doesn’t protect patients.  It merely lowers the number of new acupuncturists entering the workforce.
We need your help.  Just a few hundred unemployed graduates sounds like a buzzing mosquito in the ears of the CAB.  We need your voices to rise up with ours.  We need people who care about getting a fair exam for all to speak up for those of us who are being ignored.  This is not just for this exam.  We need the insanity of a select few deciding who gets to practice acupuncture to stop!
Do you want to be part of the solution? Here are 2 things you can do RIGHT NOW.
1. SIGN and CIRCULATE our petition link by emailing it to friends and posting it on friend's Facebook pages. A sentence as simple as “Please help me and other displaced graduates” usually does the trick.
Here's the link;
https://www.change.org/petitions/california-acupuncture-board-reform-re-evaluation-of-california-acupuncture-licensing-exam-cale
2. MAKE THREE CALLS & CIRCULATE our telephone campaign information (copy/paste info below) via Facebook and email.  The telephone calls are continuing to flow throughout next week.  If you haven't made a call yet, please do so.  It's easy, it's supporting displaced graduates and let's be honest, it's fun to kick up a little dust in Sacramento.
Here’s what you can share about the telephone campaign.
***
Friends, we need your help. While the CAB has agreed to investigate the acupuncture exam many of us took in August, they are dragging their feet. We want to be sure they stay focused on the task of fixing their mistakes BEFORE exam fees are due on 12/21/12 for the next exam.
 So, we are asking you to make 3 calls this week to help us get a fair exam for everyone.
Please use the script below or speak your mind freely while calling these three people;
 1. James Westbrooks  # (213)745-6656 at Senator Price's office
 2. Bob Holmgren  # (916) 575-7273 at Office of Professional Examination Services
 3. Governor Jerry Brown # (916) 445-2841 at his office
“Hello, my name is _____. I am calling to request California Acupuncture Board (CAB) finish their investigation on the August California Acupuncture Licensing exam (CALE), and re-score it to a fair and reasonable passing score of 70% by December 7th. Please reference the letter and petition emailed to you on Tuesday, 11/27/12 from CALE Takers United Front. Thank you!” [end of script]

POCAGuestBlog
Author: POCAGuestBlog

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Responses

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  1. EVERYTHING about this profession is a scam. EVERYTHING. They did this on purpose to collect fees twice is my guess. I have nothing really constructive to say but I just wanted to vent the fact that this does not surprise me and that is sad.

  2. thanks for your kind words, racheline. and many thanks for posting my article. here’s an update;

    the california acupuncture board sent us a letter stating that they are aware of our concerns and currently investigating the issue. no timeline was set for getting to the bottom of this. no comment was made about how hundreds of graduates who can’t figure out a way to pay for rent are to afford the february exam fees due on 12/21/12. sigh.

    and so, we are continuing our telephone and petition. please consider calling, signing and supporting a fair exam for all.

    we’ve got a few new actions planned but won’t be rolling them out until next week.

    all i want for xmas is my license to poke.

  3. This is the response I got back from my e-mail:
    ” Thank you for sharing your input in writing. It is very helpful to have your
    > written comments and perspective as a licensed member of the profession.
    >
    >
    >
    > I sympathize with your frustrations expressed in your comments. However,
    > your comments reflect a fundamental misunderstanding about the role of the
    > Acupuncture Board. The Board’s role is to regulate the practice of
    > acupuncture to ensure competency and protection of the public’s safety. In
    > that role we set minimum core curriculum standards that acupuncturists must
    > complete to be considered minimally competent to practice. That role also
    > includes developing a licensing exam that evaluates minimum competency as a
    > condition of issuing licenses. We also oversee education and enforcement in
    > our regulatory role. None of these roles are meant to promote the
    > acupuncture profession. It is the role of organizations or schools to
    > promote and support the profession of acupuncture.
    >
    >
    >
    > As for your concern about the exam, the licensing is constitutionally
    > required to be administered by a state agency in order to ensure that public
    > safety is protected and it accountable. NCCAOM is not a government agency;
    > it is an organization that serves the acupuncture profession. Serving the
    > acupuncture profession and regulating it are roles that need to be separated
    > and not mixed. You must seek support from the various acupuncture
    > organizations or start your own.
    >
    >
    >
    > Sincerely,
    >
    >
    >
    > Terri Thorfinnson”
    >
    >

  4. thanks for the update, roppie. i am extremely grateful that you took the time to contact terri on behalf of us.

    i believe terri’s response may have a few holes in it. i forwarded terri’s repsonse to a seasoned colleague of minm. here’s the email my colleague just sent to terri as a follow-up.

    roppie, would you be willinng to forward me the email from terri? i’d like to keep it for my records. we have a few surprises for the cab and that email might prove helpful. thanks SO much! my email is bluegreenacu@gmail.com .

    “Dear TerrI:

    This e-mail is to inform you that you are inaccurate re: the California Acupuncture Board’s ability to contract with the NCCAOM if it so chooses. All other states that license and regulate acupuncturists use the NCCAOM exam as the main exam required for licensure. All other states that license/regulate acupuncture have excellent safety records.

    You are correct when you state that the main purpose of the CAB is to protect patient safety. The role of the CAB is in fact not to create an exam or micromanage the colleges. No other licensing boards – to our knowledge do this and that is why the CAB is always facing problems.

    California is the ONLY state that has it’s own exam in our field. All the other 44 states plus DC that license/regulate acupuncture use the NCCAOM exam as the main exam required for licensure. Also, for your information, NCCAOM requires graduation from an program that is recognized by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), which is an accreditation agency recognized by the US Department of Education. In addition, NCCAOM is recognized by NOCA (the National Organization for Certification Agencies), is already computerized and is very well-respected in all other states. NCCAOM is a non-profit organization and has been in existence since the 1980’s and has never had the exam problems that the CAB has had doing its own exam. In addition, the NCCAOM has evolved over many years and is now a very strong exam and we believe absolutely tests appropriately for entry-level competency, which is what a licensing exam should do. Clearly, the last CALE exam did not do this. We are convinced that the OPES did not properly oversee the pass rate, which was placed too high for an entry-level exam. For your information, virtually all other health care licensing boards throughout the USA, including California, use their field’s national certification exam boards as the main exam as a criteria for licensure. They are all non-profit as is the NCCAOM. The CAB is one of the few – if not the only – health care boards that does NOT contract with their field’s national boards. Some states also require an ethics and jurisprudence exam, but the main exam used to show competent entry level is the national certification boards. MD’s, ND’s, DC’s, etc. all use their national examination boards. This is how practitioners are able to move state to state. The CAB insisting on using its own exam also prevents us from moving state to state unless we also take the NCCAOM exam, which is a very unfair economic burden. So, you are incorrect in your statement below. We agree with you – that the CAB should focus on patient safety. But, the CAB should not the state licensing exam, as clearly the CAB’s history indicates that the CAB is not competent to do so. If you really wish to ‘clean up’ this board, the best thing you personally could do is have the CAB contract with the NCCAOM which would then also include that the programs must be recognized by ACAOM as NCCAOM has that requirements. Then, the board could truly focus on its main role – patient safety.”

    thanks,
    elizabeth

  5. thanks SO much for your calls and emails letting me know that you support our movement for a fair exam.

    i’m sure a few of you are wondering what we’ve been up to since the telephone campaign. thanks to all of you that made calls for us. it certainly helped perk up the ears of those who can help us in sacramento.

    here’s what we’re doing now;

    LATEST DEVELOPMENT! We have hired an attorney to pursue legal action against the California Acupuncture Board.

    If you would like to be a part of what comes next, keep reading:

    1. August 2012 CALE test takers who did not pass the CALE and would like to be included in legal representation MUST COMPLETE AND SUBMIT the attorney’s retainer by December 28, 2012. (for those of you still reading, please share this post with every tcm graduate you know. we want to everyone to have the right to representation!)

    2. August 2012 test takers are being asked to contribute whatever amount they can toward legal fees by December 28, 2012 (e.g., sliding scale $1-20). NO ONE will be turned away for lack of funds. Please know that we are securing the majority of the retainer fee from outside sources.

    3.Please mail your signed retainer and contribution by December 28, 2012 to (checks only, payable to Robert H. Sulnick Esquire):
    CTUF
    c/o 609 East Buffalo Avenue
    Santa Ana, CA 92706

    You can obtain copy of the retainer by emailing us.

    If you have questions, you can call Esther Moux, one of the CTUF coordinators at 619-549-6376; or email Elizabeth Bruckner, one of the CTUF coordinators at bluegreenacu@gmail.com, or Kimberley Woo one of the CTUF coordinators at kimberleywoo@sbcglobal.net. Questions will not be answered via facebook.

    Please remember, we’re all volunteers and busy studying and juggling responsibilities. We’ll respond as soon as we can.

    There is hope for positive change!

  6. I would like to address two issues regarding the Aug 2012 CALE outcomes: (1) the cut score vs the pass rate and explosive testimony at the Nov 2012 CAB meeting not mentioned here that has bearing on the low pass rate; and (2) the NCCAOM exam and licensing across states. I will do this in two posts. The first issue is pretty straightforward. The second is more complicated. Elizabeth makes good comments but misses one thing on which I will focus.

    The Aug 2012 CALE exam: The cut score was 76%. That is the number of questions a test taker needed to get correct in order to pass. If I got 74% right I would also be disappointed. If 76% was the highest CUT SCORE it was by a point. The usual cut score on the CALE is around 75%. The PASS RATE is the issue. The typical percentage of test takers who pass the CALE is ~60%. The Aug 2012 PASS RATE was 39%. This is very low. How can this be explained. The Director of the group (OPES) that assembles the CALE testified at the Nov 2012 meeting that they had discovered years of copies of the CALE in the offices of study seminar services. The OPES was tipped that these services advertised a guaranteed passing score on the CALE. Upon removing these copies the OPES then REMOVED all the items on those copies from the next CALE – Aug 2012. The students and school reps in the audience booed. The testimony was devastating to thoughts about a CAB scam. The scammers are the study services and the schools and former students that support them. The CAB is conducting a full investigation. Of course, the culprits have already been identified. This will prove to be the beginning of a sea change in AOM training programs and much needed reform.

  7. Licensing and licensing/certification exams: California is the only state with its own licensing exam – the CALE. There are good reasons for this including ~35% of all LAcs and 40% of all Chinese and Korean LAcs reside in CA; the ed requirements in CA are greater (more hours) than other states (if we used the NCCAOM exam it would have to tweaked to fit); and the majority of AOM schools are in CA. Every other state includes passing the NCCAOM certification exam as a condition for APPLYING for licensure. Each state that licenses LAcs has its own regs or code. Just like MDs, PAs, RNs, etc. licensed providers cannot just set up shop in any state without applying for a license in that state. The CAB approves schools whose graduates may sit for the CALE. There ~30 schools on that list; 20 from CA. Fees for the CALE are half the NCCAOM exam. A licensure exam is higher order than a certification exam because it is an essential component in protecting the scope of practice. Cert exams cannot. The USMLE (doctors) is a national licensing exam. The NCCAOM is not. PAs also have a national licensing exam. Nurses do not. Finally, the main reason I do not support using the NCCAOM as a licensing req in CA is that the NCCAOM is NOT a TRANSPARENT org. They DO NOT reveal any information on exam outcomes, esp at the school level. This policy effectively contributes to sustaining long-standing educational problems. The CALE is completely transparent and provides a platform for ed reform in AOM training. If the NCCAOM decided to become transparent I would reconsider my view. Hope this helps.

  8. steven,

    in response to your first post, the cut score has varied from as low as 68% to the all time high score of 76%. you stated the cut score is always around 75%. um, 68% is not oh so close to 75%.

    the investigation was prompted by test takers and college representative that believe there is a problem in the development and scoring of the exam. up until a college representative suggested the cab formally investigate the august exam, the board told us that the exam was fair and didn’t need further investigation.

    the cheater book that bob from opes referenced was one that he bought in los angeles. he said that he then deleted questions in the august exam with those key words. ah, yet another reason we need the more transparency regarding the development of this exam.

  9. ***CALL TO ACTION***CALL TO ACTION***

    Wonderful news! Our attorney sent a letter to CAB today via email & snail mail. We’ve attached a link to this letter for your review. Once again friends, we need your help TODAY and if you can’t do it right now, AS SOON AS POSSIBLE. The more emails, the more seriously the CAB will take our requests. If you read this in a few days, send your email then. This will be one of the last actions you can do to support positive change for the displaced graduates and future graduates. Thank you for helping our voices be heard!

    Please send an email to the email addresses below stating something to this effect,

    “I am writing on behalf of the letter sent by Robert Sulnick, attorney for CALE Takers United Front. I support the candidates’ position. All points in his letter are correct. Please let me know what you will be doing to be sure their requests are met in regards to the August 2012 California Acupuncture Licensing Exam.”

    Here is the list of email addresses to copy/paste into the TO section of your email;

    governor@governor.ca.gov, Anna.Caballero@scsa.ca.gov, Denise.Brown@dca.ca.gov, Tracy.Rhine@dca.ca.gov, Reichel.Everhart@dca.ca.gov, Sonja.Merold@dca.ca.gov, Bob.Holmgren@dca.ca.gov, LeOndra.Clark@sen.ca.gov, kimberleywoo@sbcglobal.net, senator.price@senate.ca.gov, bluelotushealth@gmail.com, james.westbrooks@sen.ca.gov, bluegreenacu@gmail.com, terri.thorfinnson@dca.ca.gov

    here is the link to read our attorney’s letter;

    https://docs.google.com/file/d/0B9AFci390MdrM1VVaHdOVXFzbkE/edit

  10. Elizabeth – Congrats on getting the letter out. I support ed reform in acupuncture. The CAB has a long history of being a tool of the schools to the detriment of students and the public. I have been bringing much of the info in Sulnick’s letter before the CAB since 2008. I am very glad the pressure is mounting from multiple sides. We (the Guild) made our greatest impact with the Sunset Review Committee (SRC). Issues we raised were repeated throughout the SRC Background Paper. We sent the same paper to the CAB prior to sending it to the SRC. The CAB ignored us.

    The CAB has a new Exec Ofcr as of Nov 2012. She did not write the letters which stirred up the students. The new EO is a JD and is much better to understand the issues than the former. I believe the new EO is also motivated to do the right things. More than ever before this CAB may actually be ready to work according to its mission.

    I expect the CAB to head in a new direction with the next meeting in Feb. The BIGGER issues have to do with transparency and accountability of the schools. The CAB has been a problem because it let the schools run it for decades and the schools acted in their interests. This is not in the interests of students or the public/consumers.

    Not passing the CALE has been a long standing problem for the 40% of all students who on average over the past 12 years do not pass. What can we do for them? One low cut score does not make a trend nor is it evidence that 76% is out of bounds as a cut score. The real issue is substandard training.

    Setting the cut score is based on an outmoded process that Sulnick describes very simply: “judges predict how many minimally-qualified candidates would answer the question correctly. The average of the judge’s predictions for a test question becomes its predicted difficulty.” In other words, the cut score is set on an average of opinions. This the problem: the way the cut score is set. Believe me when I tell you there are much better ways to do it. Another problem is the low pass rates across all schools. As a health profession acupuncture has the lowest pass rates on licensing exams by far. Nursing, PA, MD – all above 85%. This bothers me.

    These wider issues are part of ed reform. Visa scam schools and student loan mills bother me. These issues are embedded in Sulnick’s letter and the Aug 2012 pass rate. The cut score is not the issue. I support the letter and its demands.

  11. I also wanted everyone to know that the Nov CAB meeting was webstreamed. The OPES rep testifies about the back copies of the CALE bought in “Koreatown” in LA. He testified copies of exams going back for years were also supplied. He was booed when he suggested that the low scores may have been a function of removing items from the CALE that were on the back exams. The Aug 2012 CALE was the first exam to “suffer.” What do you think will be the pass rate on the next CALE? The obvious implication is that the cheater books lost their value and that in turn resulted in the low pass rate. If you have any info on how many and what items were removed from the Aug exam in the form of a letter or otherwise I would love to see it. The webcast is here…the OPES testimony on the cheat book starts around 1:40.

    https://www.youtube.com/watch?v=dtuzWBtMsrM&feature=youtu.be

  12. steven, are you a licensed acupuncturist? have you sat for a california acupuncture licensing exam? have you spent 6 months of your life studying for an unfair exam?

    if the answer is, “no” to any of these questions, i highly recommend taking the cale. it would definitely enlighten you.

    are you still a consultant for the guild? i can’t help but wonder what your motives are. however, i don’t have time to speculate.

    here’s something to chew on; the cab has been negligent in its fiduciary responsibility with examinees that paid $550 to take the cale in august 2012. there is currently no appeals process available to examinees.

    graduates, teachers, csoma and numerous concerned citizens have been asking the cab to investigate the ridiculously low pass rate of 38.5% and the all time high cut score for over 4 months now. our requests have been met with delayed responses, unreturned phone calls and dismissive form letters.

    comments like yours have been used for years now to shame examinees into shutting up and retaking the exam. fortunately, that won’t work forever. cale takers united front (a group of motivated and fed up graduates, students and patients) want to ensure that this atrocity never happens again.

    there’s still hope for positive change.