Professional- licensure, reimbursement, other

During the recent CEPA webinar Matt Thomas identified reasons contributing to poor compensation for CEP's in cardiopulmonary rehab. One of these was confusion due to a multitude of job titles for similar positions.

It seems that the leadership of CEPA are also creating a similar problem. The credentials of the CEPA leaders are listed in a variety of different ways on the CEPA website, their LinkedIn pages, journal articles, etc. These include ACSM-CEP, ACSM-RCEP, ACSM EP-C, ACSM-EP, RCEP, CEP. This just contributes to the confusion surrounding our profession.

The ACSM has retired the RCEP, so why do members of the CEPA leadership continue to list this as their credential? The ACSM has indicated that we are to now list our credential as ACSM-CEP and ACSM-EP. I think these are a lot of letters to put after our names, but we need to be listing our credentials in the same manner.

The leaders of CEPA should lead the way by listing their credentials appropriately.

I totally agree with you, Brian. I do have a couple of thoughts, though. Is it possible that these CEP's are using RCEP because they are registered with CEPA? I am a dietitian, in addition to a CEP and we use RDN (Registered Dietitian Nutritionist) as the credential indicating that we are registered with the "Commission on Dietetic Registration", the CDR, which is the credentialing agency for the Academy of Nutrition and Dietetics. Once a dietitian passes the exam, they automatically go into a list of people at CDR and then receive a bill every year to maintain that registration with CDR. If you don't pay the bill, you can't say you're a RDN, which then means that most states won't allow you to be licensed. So, needless to say, people pay their bills! Since CEPA is now an affiliate of ACSM, I understood that RCEP was to be used in a similar manner. That is, to indicate that the user had officially passed the ACSM-CEP exam. The confusion may stem from the fact that you have to sign up for CEPA individually, which means there are people who can call themselves CEP because they passed the ACSM-CEP exam, but who aren't part of CEPA. I believe that shouldn't be allowed. CEPA should automatically receive info from ACSM as to who has passed the exam and then RCEP could/should be used ONLY if the individual pays an annual fee to be a part of CEPA. That's a lot of organizational hoops to jump through, as well as adding an annual fee. But if CEP's have a goal of being respected and appropriately acknowledged by the medical community (and perhaps move toward licensure), then things need to be tightened up. We shouldn't have to write the name of the exam we passed after our name, just like a dietitian or a physical therapist doesn't have to. We should be able to write RCEP and everyone would know that we passed the necessary exam. I know there are other organizations, like ASEP, offering exams for exercise physiologists, but they use ECP for the certification credential, not CEP. So, I don't quite understand the whole idea of why ACSM is insisting on having their name as part of the credential. And, correct me if I'm wrong, but as far as I know no other organization has a Registration (not a certification) like CEPA.

Brain- Thanks for brining up this important issue. As a past-president of CEPA, someone who has managed the website since CEPA's launch (minus those years as president), and helped launch CEPA's journal, I consider myself one of those CEPA leaders. In those roles I've tried to be consistent with the credentials we report. See About>CEPA Leadership on the website. As you mentioned, there is a lot of inconsistency. Lets be clear about what credentials people use and why... After an individual passes ACSM's Clinical Exercise Physiologist exam they have earned the right to use ACSM-CEP. Some CEPA leaders have also earned additional certifications, such as ACSM's Certified Exercise Physiologist (ACSM-EP) or a certification outside of ACSM. The similarity between the ACSM-CEP and ACSM-EP is unfortunately. ACSM discontinued the Registered Clinical Exercise Physiologist (ACSM-RCEP) exam and merged those individuals with the ACSM-CEP. At the same time, ACSM & CEPA started the CEPA Registry for clinical exercise physiologists as a way to acknowledge those individuals who had earned the ACSM-RCEP and future ACSM-CEPs based on criteria. Those in the CEPA registry could use RCEP today. Because you have to earn the ACSM-CEP to be recognized as RCEP, I think it is redundant to list both and personally prefer just RCEP. Not everyone agrees with me. Interestingly, individuals outside the US have not been allowed to be recognized in the CEPA registry, so I can appreciate that they might continue to use ACSM-RCEP. They did earn it. I still list both my ACSM-CEP and ACSM-RCEP under certifications on my CV. To add to the registry confusion, when you are certified by ACSM (all ACSM certifications) you are listed in the US Registry of Exercise Professionals (USREPs; http://www.usreps.org/Pages/default.aspx). I've heard chatter about considering USREPs as the newest "registry." Doesn't make sense to me, because you are automatically added to it. There are no additional criteria or board review, etc.

I also attended Matt Thomas' webinar. I thought he did an excellent job with it. What he didn't touch on is the reasons different programs might use the various titles to describe similar professionals. ACSM initially only offered the Exercise Specialist (ES) and Program Director (PD) certifications. Both were focused on cardiopulmonary rehabilitation. I earned the ACSM-ES in 1993. Since then, ACSM sun-set the PD. And they renamed the ES to Clinical Exercise Specialist (CES) and later to CEP. I bore you with this history because it might be one of the reasons for differing titles. Add to this the confusion the individual who may have preferred to use the title Exercise Physiologist over Exercise Specialist. I think the latter is the best description for most. Oh... lets not forget the additional title challenge when ACSM renamed the Health Fitness Specialist, which originally was Health Fitness Instructor, to Certified Exercise Physiologist. Despite these names changes, I can appreciate that employers might not change the title for these professionals because it may be easier said than done to rename positions through human resources.

In summary, we all need to be attentive to this issue. We all play a role in advocating for the profession. Personally, I think the most important thing to do is distinguish clinical exercise physiologists from non-clinical exercise physiologists.

Best wishes. -CAB

Hi, Clinton.

Thanks for the info on the USREP. I never knew any such thing existed. I did check it out. Once again, it is a situation where ALL exercise professionals are lumped into the same group. I think this is actually harmful to the most-well prepared, most-educated exercise professionals. Someone, such as yourself, with a PhD is in the same registry as a personal trainer from ACE?!?! How is that helpful to you? The big beneficiary is the ACE personal trainer, who gets to be in a registry with a PhD! I am not saying that personal trainers are unprepared or uneducated. Some may even have a PhD. But, they shouldn't be in the same registry with those who work/have worked or have passed an exam which indicates that they have the skills and knowledge to work in clinical settings. I have to say, I question why ACSM would even agree to populating such a registry. I would love to know your thoughts on all of this.

Karen- I think USREPS was intended to model the European equivalent (https://www.ereps.eu/). The purpose for the European registry is portability of the credentials between countries. I think USREPS is more focused on being a source to confirm/validate that an individual's credentials are current, which is a good thing. Although I earned and maintained both the Clinical Exercise Specialist and the Registered Clinical Exercise Physiologist certifications (until it was ended), I don't know that we need a "registry" for CEPs. The additional recognition might add confusion. We need to promote who CEPs are and what they can do.