Philippine nursing licensure examination results from June 2006

Philippine Nursing Licensure Examination in June 2006

REPUTATION AND THE FUTURE AT STAKE

The Philippine Nursing Law

Republic Act 9173, or the Philippine Nursing Act of 2002, provides for a more responsive nursing profession. Article IV on examination and registration states that all applicants for license to pass nursing are required to pass a written examination (Congress of the Philippines, 2002). The Board of Nursing, or BON, of the Professional Regulation Commission or PRC shall determine the scope of the examination. The scope shall include the objectives of the curriculum, broad areas f nursing and related disciplines and competencies (Congress of the Philippines).

According to the Philippine Overseas Employment Administration, 7,768 nurses left the country in 2005 and 12,822 in 2001 to work overseas (Rodis, 2007). They find competition with Philippine doctors who study to become nurses and get higher-paying jobs abroad. A typical doctor in a government hospital earns only $446 a month while a job as a nurse abroad can pay $8,000.00 (Rodis). This is the context in which the 2006 Philippine Licensure exam scandal occurred.

The 2006 Leakage Scandal Timeline

June 11-12 - On these days, 42,000 nursing graduates took the exam, conducted by the PRC (GMA News Research, 2006). Of this number, 17,800 passed.

June 21 -- Some examinees filed a complaint that answers to 500 actual questions to Tests III and V were distributed to other examinees at three nursing review centers (GMA News Research, 2006). These were the Gapuz, INRESS, and Pentagon nursing review centers, two of which were located in Baguio City. Some examinees filed a complaint against former Board of Nursing members who supplied the actual test questions to students of the mentioned review centers. They said that the leakage stained the outcome of the exam and questioned the qualification of passers. In response, the PRC and the BON conducted an investigation. They found that two former members of the Board copied and distributed test question manuscript to enrolled students at the three review centers before the actual exam. One of them claimed that she accidentally left copies in a copier shop in Baguio City while photocopying her 500 questions. They were also accused of receiving bribes from the review centers for the questions and their answers. Of the 500 "raw" questions, 20 were for Test III and 90 were for Test V (GMA News Research).

The Culprits and their Crime

These two former Board members were Anesia Buenafe-Dionisio and Virginia Diolola-Madeja (Torres, 2007). On June 1, 2007, the Ombudsman filed criminal charges against them for violating Section 15a of Republic Act 8981 and Republic Act 3019. Republic 8981 is an Act Modernizing the Professional Regulation Commission. Republic Act 3019 is the Anti-Graft and Corrupt Practices Act. The Board also filed charges against Ray Gapuz, owner of the Gapuz Nursing Review Center. Madeja was the assigned examiner for Test III on Medical Surgery Nursing while Dionisio was assigned for Test V on Psychistric Mental Health. The complaint filed said that the examinees enrolled at the RA Gapuz Review Center in Baguio City finished the exam much earlier than others. Investigation showed that keywords to 56 questions in Madeja's manuscript were written down and distributed to enrollees at the Gapuz Review Center. Of these 56, 23 were actually included in Test III. Of the 100 questions actually asked in Test V, 90 were leaked out by Dionisio in handwritten notes and computer printouts to enrollees at the Gapuz Review Center in Baguio City, the Institute for Review and Special Studies or INRESS in Manila and other review centers elsewhere in the country. The National Bureau of Investigation or NBI also found Madeja and Dionisio as responsible for the leaks. The accused failed to overturn the charge that the only sources of those questions leaked out were those who prepared and submitted these questions. Investigators did not believe Dionisio's claim that she had lost her manuscript or that of Madeja that the computer shop she frequented reproduced her manuscript (Torres).

July 17 - In response to the problem, the PRC passed Resolution number 31 (Rodis, 2007; Marcelo, 2002) The Resolution invalidated the 20 leaked questions and recomputed the combined scores in the un-affected Tests I, II and IV and averaged them to make a retake unnecessary. It then announced that 17,781 out of 42,000 examinees had passed. The Resolution elicited loud objections from nursing students, their families, nursing schools and organizations. Those who favored a retake argued that it was the only way to erase the shame created by the leakage on the nursing profession. On the other hand, those who opposed it complained of the added expenses and delay in issuance of licenses it incurred (Rodis, Marcelo)..

July 26 - The University of Santo Tomas' College of Nursing Faculty Association, through its president Rene Luis Tadle, urged the PRC to defer the oath-taking of those announced exam passers. At first, the Office of the President ordered a retake of the exams.

August 15-16 and 18- the PRC and the BON announced that the oath-taking would proceed for those who passed the recomputed scheme. Tired of government inaction, the UST College of Nursing Group petitioned the Court of Appeals to stop the implementation of Resolution number 31 and order a retake. The Court of Appeals issued a temporary restraining order against the implementation of Resolution number 31 and the scheduled oath-taking (GMA News Research, 2006; Marcelo).

DOJ Indictments

August 23 - A Presidential Task Force on the Licensure Exam was formed for the retake of the affected Tests III and V (GMA News Research, 2006). In the meantime, the Department of Justice indicted the owners of the two nursing review centers for violating Republic Act 8981 (Canlas, 2007). The Department found probable cause against the owners of the centers for giving handouts of tests questions to examinees, which came out in the exam. The accused owners were Ricarte Gapuz, Elena Gapuz-Altajeros and Jonna Bucudall of the Gapuz Review Center and George Cordero of the INRESS Review Center. The contents of the handouts given by the Gapuz Review Center to its enrollees were identical to the test questions, which later came out in the exam. The Department resolution also said that Jonna Bacud, a scholar and drill master of the Gapuz Review Center, would testify against her employer. She said that the test questions circulated between Baguio and Manila. The Department likewise added the name of another respondent, George Cordero, as an accomplice. A witness said Cordero assured him that 100 questions out of the 500 in psychiatric nursing would surely come out in the exam (Canlas).

August 28 and September 27 -- Philippine President Gloria ordered the revamp of the Board of Nursing and expressed favor for a retake (GMA News Research, 2006; Marcelo, 2002).

October 13 and 26 - the Court of Appeals voided Resolution 31 and ordered a retake of the exam by those whose names were merely added to the list of successful examinees. Un-affected successful examinees could go ahead with the oath-taking and secure their licenses. It later ruled that no these un-affected and successful examinees did not have legal impediments to the oath-taking (GMA News Research).

The Court of Appeals ordered the 1,687 enrollees of the review centers to retake the exam (Marcelo, 2002; Canlas, 2007). But those who passed and did not attend these centers would be given their licenses immediately. The decision for a partial retake was heavily criticized as something that would not redeem the credibility of Filipino nurses. The president of the UST College of Nursing Faculty Association said that the indictments were insufficient to recover lost international reputation of Filipino nurses. Rene Luis Tadle was also the spokesman of the UST Nursing Leakage Ad Hoc Committee and one of those who exposed the 2006 leakage. He emphasized that there should be concerted effort in assuring the prosecution of the violators in order to restore trust in the reputation of Filipino nurses (Marcelo, Canlas).

CGFNS Sanction

February 14, 2007 - the Commission on Graduates of Foreign Nursing Schools or CGFNS announced that Filipino nursing graduates involved in the scandal would not be eligible for a VisaScreen Certificate (Pinoy Abroad, 2007). It required the examinees to re-take and pass Tests III and V in order to qualify for the Certificate, which is a requirement for nursing or related jobs in the U.S. It announced that the decision to disqualify the examinees was reached after careful deliberation and in pursuit of the critical mission of CGFNS. Upon learning about the leakage, the Commission sent a fact-finding mission to the Philippines in September 2006. The Commission found that the competencies of passing examinees who received licenses became questionable on account of the irregularity. It reasoned that the integrity of foreign licensing systems could not be compromised. Such integrity affects the health and safety of patients in the U.S. This is a primary criterion in evaluating candidates under the U.S. immigration law, according to the Commission. The CGFNS is an internationally recognized entity in evaluating and verifying the credentials of nurses and other healthcare professionals. It has been performing this role for more than three decades as an immigration-neutral and non-profit organization. To-date, it has evaluated more than 450,000 internationally educated nurses and other healthcare workers for jobs (Pinoy Abroad).

February 16,19 and 24 -- President Arroyo ordered the Philippine Department of Labor and Employment to formally appeal the decision made by the CGFNS (GMA News Research, 2006). A task force was created for the purpose and was headed by PRC chairperson Dr. Leonor Rosero. In a telephone conversation on February 24, CGFNS head, Dr. Barbara Nichols, confirmed with Dr. Rosero that the panel's decision was final as well as unanimous. Dr. Nichols also said that the CGFNS did not have a provision for appeal or reconsideration. She explained that the Commission is a private organization but it follows the U.S. immigration law. Its decision to require a retake of the affected tests was based on that law. Despite this, Dr. Rosero insisted on making a personal appeal for reconsideration on March 3 at the CGFNS offices in Philadelphia, Pennsylvania (Filipino Nurses 2 U.S., 2007).

In the meantime, the Department of Labor and Employment set up rules for the retake, which would be on a voluntary basis and offered only once (Filipino Nurses 2 U.S., 2007; Sun Star, 2007). Secretary Arturo Brion assured that the exam would be conducted in a way that would avoid questions of validity of the licenses issued to passers of the June 2006 exam. At the same time, it was intended to enhance the employability of Filipino nurses (Filipino Nurses 2 U.S.). At least 4,000 nursing graduates who participated in the controversial exam registered for the second Special Nursing Review classes offered by the Department of Labor and Employment (Sun Star, 2007). They were to retake the disputed Tests III and V. About 10,000 f the 17,000 affected passers from all over the country registered for the retake (Aning, 2007; Sun Star).

March 5 - CGFNS officers explained to the Philippine panel team that their decision to deny VisaScreen Certificates to the involved passers was not subject to re-negotiation or review (Filipino Nurses 2 U.S., 2007). They emphasized that they had been fair and transparent in presenting facts on the issue from the start. Their fact-finding team determined that the Philippine nursing licensure exam held in June 2006 did not come up to the standards of the U.S. nursing licensure. They also expressed awareness and concern with media exaggerations, misinformation and confusion as a result. But they stood firm on their decision (Filipino Nurses 2 U.S.).

March 31 -- The Philippine government allocated P20 million - approximately $420,000,00 - for a one-week review by the voluntary examinees Aning, 2007; Sun Star, 2007). They did not have to pay an exam fee. The exam was conducted with the regular exams in June and December during the year. Of the 17,000 nursing graduates who took the June 2006 exam, more than 1,687 were ordered to retake. Only about 1,2000 took the exam again and around 1,000 passed (Aning, Sun Star).

June 1 -- The Philippine Ombudsman, Merceditas Gutierrez, filed criminal charges against two members of the Board of Nursing involved in the leakage scandal (GMA News Research, 2006). In addition to the two, 17 other officers in the test review centers would be brought to court to answer the charges, according to the chief of the anti-fraud and computer crimes division of the Philippine National Bureau of Investigation. Reports said that there were 420 nursing review centers in the Philippines, many of which are listed as "undesirable" by the PRC (GMA News Research).

Stiffer Penalties for Violators, but Damage Done

Philippine education authorities proposed stiffer penalties and preventive measures against a repeat of the leakage in the future (Sun Star, 2006). These measures would avoid doubts on the integrity of all licensure examinations and procedures and insure the excellence of Filipino professionals, according to President Arroyo (Sun Star).

But the damage cannot be undone. Before the scandal, the Philippines was lobbying with the U.S.-based National Council Licensure Examination or NCLEX to include Manila as an exam site (Marcelo, 2002). It would have been a big boon and savings if Filipino nurses could take the exam without needing to travel to Singapore or Kuala Lumpur. Deputy Executive Director of the Commission for Overseas Filipinos also announced that the first testing center was to be established within six months at that time. But when the leakage became global news, Manila was stricken out of consideration (Marcelo).

The Philippines has been the largest supplier of foreign-registered nurses in U.S.

hospitals and other healthcare settings (Filipino Nurses 2 U.S., 2007). Almost 26,000

nurses received immigrant visas and work permits to work in the U.S. between 1988 and May 2006. The country sent nurses also to Canada and Saudi Arabia. The demand would increase with the lifting of the limit on the number of nurses a hospital can hire. But as a consequence of the leakage, the Philippine image was tarnished. American recruiters began turning down the applications of passers involved the controversial licensure exam. The prejudice extends to others in the Philippines who find it difficult to land nursing jobs. Their competence and integrity have been questioned. Nurses from India have been selected to fill in the need in the U.S. And other countries who share the same sentiment. The Philippines' place has been threatened (Filipino Nurses 2 U.S.).