I am writing on behalf of the nearly 1,700 chiropractic students I have been elected to represent. They are more than concerned, as they should be, over the National Board of Chiropractic Examiners' decision for an increase of over 30 percent in the cost of taking the national boards.
Where is this money going, gentlemen? You have expressed how thoughtfully this was considered, but have not given effective answers. Have you been moving toward computer-based testing? Have you increased the number of testing sites? Will we be receiving our scores in a more timely manner? Is it fair to increase the cost of a product or service with no increase in its value? Does the NBCE feel it is ethical to take advantage of its monopoly to raise the price of the national boards (which are already high compared to the rest of professional education)?
If my letter seems a bit pointed, I cannot apologize. Mine is the tone of the students who are being extorted in this situation. We are the ones truly being hurt at this point, as we have no choice in the matter; we must pay or we cannot practice. During a recent forum, one student stated that this situation is every bit as sinister as the extortion practiced by crime syndicates. A furious round of applause followed this.
The increase also smacks of an unchecked monopoly. It is my stance that if the boards were to treat their consumers, the students, in a more appropriate manner they would avoid many of the problems they would be sure to face if they continued to mistreat and abuse the future of the chiropractic profession.
I look forward to a mutually beneficial resolution to this problem and appreciate a chance to work together in the best interest of all parties. Thank you for your time and consideration.
Shawn Neff Student Body Presiden Palmer College of Chiropractic
NBCE President Dr. Peter Ferguson Responds
November 19, 2001
Shawn Neff Student Body President Palmer College of Chiropractic 1000 Brady Street Davenport, IA 52803-5287
Dear Mr. Neff:
It was with puzzlement and concern that the National Board received your letter of November 7 voicing concerns of the Palmer student body about the increase in exam fees.
Given the tone of your letter, I too will be as direct as possible in my reply. While our Board was diligent and resourceful in its deliberations relative to fee increases, I was somewhat surprised by your multiple questions which have been addressed previously on a number of occasions.
As president of the Palmer College student body, I am sure that you are aware that leaders must at times make difficult decisions. When I became president of the National Board of Chiropractic Examiners, I advised the profession that our Board would be reviewing all aspects of our operations.
While not a reason to raise fees, it should be noted that National Board Written Exams fees have not been increased since 1992. It should also be noted that the Board provided notice of an impending fee increase in the attached July 9, 2001, open letter to all chiropractic college students. Mention was also made of the impending possibility of fee increases during National Board Day Forums that were held on all college campuses in early 2001.
The exact amounts of the increased fees were announced and distributed as quickly as possible in order to give prior notice to students before application deadlines for the March and May exams in 2002. See the attached open letter to students of September 18, 2001. Both the July 9 and September 18 letters were also posted on our web site.
Since 1997 enrollment in chiropractic colleges has declined approximately 18 percent. Unfortunately, just as it costs more to attend chiropractic college now than it did in 1992, it now costs more to develop, more to produce and more to administer our tests, for appropriate state board use in protection of the public.
You should also be aware that the National Board has operated on a deficit basis for the past three years now, including 2001, while attempting to hold the exam fees in check. The fact of the matter is that this could not be justified any longer. Please see the actions taken by the board to cut costs of NBCE operations, as outlined in my letters to students, college presidents and state board members.
You ask:
"Where is this money going, gentlemen?"
We have published "where the money goes" in our annual report to state board delegates, and on our website. The annual report provides full disclosure of our annual independent audit as appropriate, and also be aware that we are chartered to serve the prelicensure testing needs of state boards, and must be financially able to test eligible students, those just now entering chiropractic college, as well as those in their final semesters.
"Have we been moving towards computer-based testing?"
Computer testing continues to be analyzed. Over the past year the Computerization Committee, which includes the president and immediate past president of chiropractic colleges has reviewed many different scenarios all of which will ultimately increase fees while reducing the reporting of exam scores minimally which, by the way, has been reduced over the past year. As always our Board with counsel from our constituents will review findings and make its judgment accordingly. The Special Purposes Examination for Chiropractic (SPEC), which is not for initial licensure, will be available by computer beginning in February 2002.
"Have we increased the number of testing sites?"
If you are speaking of written exam sites, we test on every college campus in the United States except one. In reference to the Part IV Practical Examination, we had increased the number of sites to include all U.S. schools except four. However, with the decline in examinee numbers, we closed one test site for the November 2001 exam and with applicants continuing to decline, we plan to close two additional sites in May 2002 to contain the costs. As enrollments increase, I am committed to re-opening sites as appropriate.
"Will we be receiving our scores in a more timely manner?"
Scores have been released at least one week to ten days ahead of our published schedules for several administrations, and we will continue to do so as our processing of scores allows. We are also exploring releasing score reports via the web.
"Is it fair to increase the cost of a product or service with no increase in value?"
In reference to your comments regarding "value": In 1968 when I graduated from the National College of Chiropractic, I sought and obtained licensure in nine states. This required completion of all course work and graduation prior to testing, travel to each individual state, and paying for each separate exam. Currently, the battery of NBCE tests can be completed up to six months prior to graduation from chiropractic college, and presently allows for licensure in 45 separate states, obviously reducing travel costs, stress, state exam fees and the ability to immediately enter practice following graduation. Additionally, the cost of the NBCE exams represents a small part of one's individual educational investment.
"Does the NBCE feel it is ethical to take advantage of its monopoly to raise the price of the National Boards (which are already high compared to the price of the rest of professional education)?"
The National Board was formed out of the preparedness for the exams in each of the subject areas of the Part I, II, III and Physiotherapy exams. We hope to have these sample exams posted by the end of August.
As you can see, there is a lot of change taking place at the National Board, and I am committed to keeping you up-to-date as we address the challenges that lie ahead. As well, I want to assure you that the National Board is exploring every avenue to make the exam-taking process a beneficial tool that validates your education and proves to the public that you are indeed ready to practice chiropractic health care.
The Board joins me in wishing you a very successful year.
Most sincerely,
Peter D. Ferguson, D.C. President PDF/kkl Enclosures
cc
NBCE Board of Directors Don Petersen, Publisher, Dynamic Chiropractic Guy F. Riekeman,DC, President, Palmer College of Chiropractic Terry A. Rondberg,DC, President, World Chiropractic Alliance
NBCE President Dr. Peter Ferguson Responds to the Student Body
July 9, 2001
Dear Chiropractic Student:
Since I became president of the National Board of Chiropractic Examiners last year, with the Board's complete support, we have provided national board updates to students four times a year via the NBCE Journal, which is distributed to your campus, as well as posted directly on our web site: www.nbce.org.
However, challenges lie before us that I feel must be communicated quickly to you. You may know that at the National Board's annual meeting in April we addressed the budget ramifications of declining enrollments in chiropractic colleges across the nation and the rising costs of administering exams. In response to these problems, the national Board voted to look internally for savings and has implemented these cost-saving measures:
decreased the directors' honorarium by 20 percent
dramatically cut travel
reduced the number of meeting days for Executive Committee and full Board meetings
postponed expanding NBCE headquarters facilities
closed a Part IV practical test site for November 2001
significantly reduced the budget of the Professional Relations and Communications Department
Despite these cost saving measures, at its June meeting the executive committee felt it necessary to consider raising exam fees.
As you know, the NBCE has not increased fees since 1992 and, of course, this is not a decision that was considered lightly. Nonetheless, we did decide to increase fees in 2002. We are still evaluating the amount and timing of the increase. I want to assure you that we will pay special attention to students' concerns.
At the same time, we want to note that the national board is continuing its fee waiver program. Introduced in 1997, this program allows each chiropractic college to name one student recipient for each of the Part I, II, III, and IV exam fee waivers. In 2000, fee waivers were offered to more than 100 chiropractic candidates at 18 chiropractic colleges.
Additionally, we are currently working on a sample exam to be added to our web site. For a nominal fee, you will be able to assess your preparedness for the exams in each of the subject areas of the Part I, II, III and Physiotherapy exams. We hope to have these sample exams posted by the end of August.
As you can see, there is a lot of change taking place at the national board, and I am committed to keeping you up-to-date as we address the challenges that lie ahead. As well, I want to assure you that the national board is exploring every avenue to make exam-taking a beneficial tool that validates your education and proves to the public that you are ready to practice chiropractic health care.
The board joins me in wishing you a very successful year.
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