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Oral Exam: Rite of Passage, Road Block, or Vital Requirement
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EARLY CAREER + STUDENT

 

 

Oral Exam: Rite of Passage, Road Block, or Vital Requirement to Assess Competency to Practice Psychology

 

 

 

Kyle A. McCall, B.A.
Director of Communications, Texas Psychological Association Student Division

The profession of Psychology is strictly regulated under the Psychologists’ Licensing Act (3 Tex. Occ. Code § 501, 1999).  Only those who meet the standards set forth by this Act, and the standards of the Texas State Board of Examiners of Psychologists (TSBEP), are eligible for licensure.  Becoming a Licensed Psychologist is no easy feat.  According to a document produced by the Texas Psychological Association, licensees are required to obtain a doctoral degree [4-6 years of organized graduate study in psychology in an American Psychological Association (APA)-accredited program], pass the Examination for Professional Practice in Psychology (EPPP), pass the Jurisprudence Examination, obtain at least 3,500 supervised practice hours (one must be after conferral or completion of the doctoral degree), and pass an oral examination (“Steps to Becoming a Psychologist,” n.d.) with the goal of protecting the public against unqualified psychologists.  Is the training for psychologists sufficient?  Are there unnecessary requirements preventing new psychologists from entering the pipeline?  The State of Texas 85th Legislature Sunset Advisory Commission addresses these concerns with proposals for new legislation (“Sunset Advisory Commission: Staff Report,” 2016) that may affect the standards for psychologists to be licensed in the State of Texas.  One specific step they are trying to eliminate is the oral examination by removing the statutory authority of the TSBEP to administer oral examinations (“Texas Psychology Board Under State Scrutiny,” 2016).
 

 

Rite of Passage

The oral exam has been a time-honored tradition since 1987 (“Sunset Advisory Commission: Staff Report,” 2016) in the competency evaluation of psychologists in the State of Texas.  Even experienced psychologists from other states must meet the same license requirements to be licensed as a psychologist in Texas (3 Tex. Occ. Code § 501.262) which means an oral examination is required to be taken either in Texas or in the state where the individual holds their license.

Speaking with psychologists in a variety of settings, I found that many see this portion of the process as a rite of passage.  They were required to go through this requirement, therefore, others should be as well.  In addition, it was largely expressed that every psychologist should be held to the same standards as psychologists before them to ensure continuity of high standards which is the hallmark of the profession.

Although this sentiment is understandable, is it enough to say, “We’ve always done it this way so why change it?”  Unfortunately, it is not.  In rebuttal, I have heard psychologists argue that the current way of evaluating competency is not broken, so why try to adjust it?  Although this is believed by many, others argue to the contrary (“Sunset Advisory Commission Email,” 2016; “Texas Psychology Board Under State Scrutiny,” 2016; “Another blow to ASPPB-driven board in Texas,” 2017; “Decision Meeting Material,” 2017).

 

Road Block

The Modern Psychologist reports in their article, “Texas Psychology Board Under State Scrutiny, Recommends Eliminating ASPPB Anti-Competitive Practices” that the TSBEP unnecessarily limits psychologists from entering the pipeline (2016).  They argue in the same article that psychologists already go through rigorous training and multiple levels of screening that are fair, whereas, the oral exam creates a “bottleneck entry into the profession” citing number of exams offered per year (“Important Dates,” n.d.), issues with staffing the exams (“Urgent: Oral Examiners Needed,” n.d.), and concerns about fairness and consistency in the administration of the exam. The Chief of Operations for the Modern Psychologist said in an email to the Sunset Advisory Commission, regarding the TSBEP, that “the Oral Exam is an extremely outdated practice that only protects incumbent psychologists from the competition by delaying entrance to the market, to otherwise well-qualified providers,” (2016).  The individuals supporting change desire a fairer and more consistent process, removing hurdles that psychologists face when entering the field.

In a 2016 Sunset Advisory Commission Staff Report, the Commission also argued that candidates have already met “rigorous educational, training, and testing requirements” arguably making them qualified to be licensed.  In addition, they found that the “oral exam does not consistently evaluate entry-level competency” and has “minimal value” due to the high passage rates (90% over the past four fiscal years) and inconsistency in the examination practices despite protections that have been put in place over the years such as pre-formulated questions and TSBEP work-groups.  Overall, the exam is inconsistent, relying on the examiners judgement of candidates’ responses in an exam that requires non-standardized answers.  Another fear of the examination is that candidates are only interested in achieving the minimal passing score (Goldberg & Young, 2015) because there is no benefit to achieving the highest possible score or demonstrating highest level of competency.  By taking risks and going above and beyond, they risk negative marks on an evaluation which could lower their score.

Furthermore, in the same aforementioned report, the Sunset Advisory Commission suggested removing the barrier of the oral exam to make the licensing process fairer, remove undue barriers to entering the profession, and increase reciprocity and mobility for psychologists interested in practicing in Texas.  The Sunset Advisory Commission found that in 2013 half of the states used oral exams in their licensing process.  Since then, 11 states removed this portion of the licensing process leaving 14 states remaining.  Of those states, only eight test the candidates’ competency to practice whereas the other six only use the exam to test jurisprudence. Removing the oral exam requirement would increase reciprocity and address the mental health workforce shortage in Texas.

The Texas Psychological Association said in their 2017 article, “How Psychologists Can Help Alleviate the Texas Mental Health Workforce Shortage” that “there are not enough licensed mental health professionals to meet the needs of Texas citizens”.  The Texas Department State Health Services (DHHS) found in their 2014 report that in 2013 there were 566 active, licensed psychologists in the State of Texas indicating a clinical specialty with an average ratio of 47,111 Texans per clinical psychologist in the state.  This report also indicated that over two-thirds practiced in Harris, Dallas, Tarrant, Bexar, and Travis counties (the five most populous) making the average citizen-to-clinical psychologist ratio 1:36,232 in those counties leaving the rest of Texas at a 1:86,277 ratio.  In addition, DHHS found that “21.0% of Texas’ clinical psychologists were 65 or older while another 27.2% were between 55 and 64 years of age.  Thus once more, a sizable proportion of the profession (48.2%) will be of retirement age by 2023.” 

In response to the need for more psychologists to enter the field, and the rationale given by many sources to eliminate the oral board exam, the recommendation from the Sunset Advisory Committee can be understood.  After speaking to a small number of students currently in APA-Accredited Clinical Psychology programs (12 total), I found that their feelings were consistent with the Sunset Advisory Committee and all agreed this requirement should be eliminated.

 

Vital Requirement

Despite such heavy opposition from many sources, the Texas Psychological Association is holding steadfast with their position to keep the oral board examination as it is currently (“TPA Legislative Alert,” n.d.).  The TPA’s official position in the ‘alert’, along with talking-points given to their members, is that the, “TSBEP needs to continue to utilize this competency exam as a requirement for licensure” rationalizing that “psychology is a profession that requires
face-to-face interaction.  It is important that qualified licensed psychologists be required to take this competency exam as it tests a candidate’s ability to successfully interact with clients.” 

The TPA’s stance is not unfounded.  In Goldberg and colleagues’ 2011 evaluative article, they found that California School of Professional Psychology (CSPP) “model permitted interns to demonstrate important competencies that had not previously been sufficiently appreciated by their clinical rotation supervisors.”  Supervisors, professors, and other colleagues cannot always evaluate every necessary aspect of someone seeking licensure as a psychologist.  Goldberg and Young (2015) suggest that it is the responsibility of the professionals in the field to not merely rely on status of educational achievement, but provide as much proof of possible that this license candidate is ready to practice.

The TPA’s efforts and concern for the field is admirable.  They desire that the psychologists in the State of Texas are held to the highest standard making them some of the most elite mental health professionals in the field today.  They fear that by removing the oral exam, the individuals entering the field may not be as qualified and could present a risk to the public.  Oral exams in psychology were developed to identify people who have mastered skills needed at an entry level and are competent enough so the public may be protected from unsafe practices (Novy & Kopel, 1996).  Even though many oppose, most can agree that protecting the public is of the utmost importance, as is ensuring that each licensed psychologist is competent in their practice.

Furthermore, although there may be faults with the oral exam, the TSBEP is continually improving the process and implores everyone to understand that licensing boards face limited resources, but it is their responsibility is to ensure reliability, validity, and fairness in their processes and hope that as they complete ongoing program and psychometric checks there will be more improvements and increased validity (Novy & Kopel, 1996) and desire “nothing less than a psychometrically adequate examination to be acceptable.” The TPA joins with the TSBEP to encourage others to trust the oral exam and assist with its implementation and development (“Why You Should be an Examiner for the TSBEP Oral Exam,” n.d.; “Urgent: Oral Examiners Needed,” n.d.).  They are requesting members to reach out to the legislature and inform them they are willing to be a part of the solution.  By offering more qualified examiners and members to assist the TSBEP in improving the oral exam process, many arguments for removing the exam are stripped away.

 

Conclusion

Although I am a student that is not experienced in the field, I desire the best outcome for our profession that enables mobility of psychologists, allows a fair and consistent entry into the pipeline for license candidates by removing undue burdens, and, in the process, to allow psychologists to come together regardless of the outcome.  If the oral exam is taken away, Texas will join other states not requiring this exam.  It is the responsibility of everyone in the field, student or professional, to be an advocate for the profession and desire the best outcome. Everyone may not always be in agreement, but we can still work together for our common goal of serving the public regardless of the outcome.

 

 

References


Another blow to ASPPB-driven board in Texas. (2017, January 7). Retrieved from http://www.modernpsychologist.com/another-blow-asppb-driven-board-texas-good-news-us/

Decision meeting material. (2017, January 11). Retrieved from https://www.sunset.texas.gov/public/uploads/files/reports/Decision%20Meeting%20Material_January%202017.pdf

Goldberg, R. W., & Young, K. R. (2015). Oral Case Examinations for Assessing Intern Competence. Training & Education In Professional Psychology, 9(3), 242-247. doi:10.1037/tep0000081

Goldberg, R. W., DeLamatre, J. E., & Young, K. (2011). Intern Final Oral Examinations: An Exploration of Alternative Models of Competency. Training & Education In Professional Psychology, 5(3), 185-191. doi:10.1037/a0024151

Important dates. (n.d.). Retrieved from https://www.tsbep.texas.gov/important-dates
How psychologists can help alleviate the Texas mental health workforce shortage. (2017). Retrieved from http://c.ymcdn.com/sites/www.texaspsyc.org/resource/collection/2536697A-22D4-4CE8-96AC-765DE02314D1/2017%20RxP%20Talking%20Points.pdf

Novy, D. M., & Kopel, K. F. (1996). Psychometrics of oral examinations for psychology licensure: The Texas examination as an example. Professional Psychology: Research & Practice, 27(4), 415.

Psychologists’ Licensing Act, 3 Texas Occupations Code § 501 (1999).

Mental health workforce shortage in Texas. (2014, February). Retrieved from http://liberalarts.utexas.edu/iupra/_files/pdf/Mental%20Health%20Workforce%20Shortage%20Texas.pdf

Steps to becoming a licensed psychologist. (n.d.). Retrieved from http://c.ymcdn.com/sites/www.texaspsyc.org/resource/collection/2536697A-22D4-4CE8-96AC-765DE02314D1/Steps_to_Licensure_Psychologist.pdf

[Sunset advisory commission email]. (2016, November 28). Retrieved from https://www.sunset.texas.gov/public/uploads/Modern%20Psychologist_12-2_0.pdf

Sunset advisory commission: Staff report. (2016). Retrieved from https://www.tsbep.texas.gov/files/agencydocs/Budgets%20and%20Reports%20Published%20Online/Sunset/2016-2017%20Staff%20Report.pdf

Texas psychology board under state scrutiny, recommends eliminating ASPPB anti-competitive practices. (2016, November 20). Retrieved from http://www.modernpsychologist.com/texas-psychology-board-state-scrutiny-recommends-eliminating-asppb-anti-competitive-practices/

TPA legislative alert: TPA sunset advisory commission talking points. (n.d.). Retrieved from http://c.ymcdn.com/sites/www.texaspsyc.org/resource/collection/2536697A-22D4-4CE8-96AC-765DE02314D1/Legislative_Handout_Awards_Lunch.pdf

Urgent: Oral examiners needed. (n.d.). Retrieved from http://www.texaspsyc.org/page/OralExaminersNeeded/Urgent-Oral-Examiners-Needed.htm

Why you should be an examiner for the TSBEP oral exam. (n.d.). Retrieved from http://www.tsbep.texas.gov/files/agencydocs/New%20Developments%20and%20Requirements/Oral%20Examiner%20Solicitation.pdf
 
 
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