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National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM®) Fact Sheet:
Meeting National Standards through its Examinations and Certification Process


This fact sheet is prepared for NCCAOM stakeholders to become more familiar with the NCCAOM examination system, certification process and the organization’s long standing partnership with state regulatory boards/agencies for the regulation of acupuncture and Oriental medicine (AOM) throughout the United States. For additional questions, please contact the Executive Office.

Q (1). Are there national standards for the practice of acupuncture and Oriental medicine?

A. Yes. Since 1982 the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) and the NCCAOM have established national standards leading to programmatic accreditation and certification, respectively. There are over 60 accredited programs for AOM in the USA and the NCCAOM currently provides examinations for licensure as an acupuncturist in 43 states plus the District of Columbia. Every acupuncture regulatory board in the U.S. except California accepts the NCCAOM certification examinations as a measure of competency for an acupuncturist to ensure the safe and effective practice of AOM.  More information on NCCAOM certification standards can be found in the NCCAOM® Certification Handbook.

Q (2). Does this mean that the NCCAOM provides the national examination(s) for the practice of AOM?

A. Yes, 98% of the states that regulate AOM require NCCAOM examinations or full certification as a prerequisite for licensure. All of the states, except California, that regulate AOM require NCCAOM examinations or certification. There are six states: Oklahoma, Kansas, Alabama, South Dakota, North Dakota and Wyoming that currently do not have an AOM practice act. NCCAOM is currently working with Kansas, Wyoming, South Dakota and Alabama on the creation of legislation to regulate AOM in those states. Please see the Map of States that Accept NCCAOM Exams. Currently, California is the only state that administers its own licensure examination. This means that AOM practitioners who pass the NCCAOM required examinations and/or become NCCAOM certified in Acupuncture or Oriental Medicine (and have also met state specific requirements) can enjoy reciprocity in all states that regulate acupuncture except for California. Please note that applicants for licensure may have to complete additional requirements in some states in addition to achieving NCCAOM certification or passing NCCAOM examinations. It is advised that applicants for licensure check with the state agency that regulates acupuncture in the state they wish to practice to ensure that they have met all state designated requirements. For more information, please visit the NCCAOM website for a listing of state exam requirements and state regulatory contact information.

Q (3). How does the NCCAOM examination process meet the criteria of a national exam for the practice of AOM?

A. The content of NCCAOM’s examinations is linked to extensive role delineation studies (also known as a job, practice, or occupational analysis studies) which are conducted minimally every five years. NCCAOM’s previous job task analysis surveys represent the only nationally verified job analysis regarding the practice of acupuncture, Chinese herbology, Oriental medicine and Asian bodywork therapy. The 2008 NCCAOM Job Task Analysis: A Report to Acupuncture and Oriental Medicine Profession is the most recently published survey, which represents AOM practitioners from all states in the U.S. including California. Currently, at least one-third of all newly certified acupuncturists in California also take the NCCAOM certification exams.

Q (4). Has the NCCAOM national examination system ever been legally challenged?

A. No. The assurance of long-standing defensibility of NCCAOM’s examinations is one of the multiple reasons why 98% of the states in the U.S. that regulate acupuncturists use the NCCAOM national examination system as a prerequisite for licensure. Legal action has never been brought against the NCCAOM with regard to its examinations; therefore, states who adopt the NCCAOM examinations as one of the prerequisites to licensure as an acupuncturist rely on the NCCAOM for legal defensibility of the exam or exams used for licensure. All NCCAOM certification programs for the AOM profession are accredited by the Institute for Credentialing Excellence’s (ICE) National Commission for Certifying Agencies (NCCA). This means that the NCCAOM examination development and certification processes for each of its certification programs have met all the essential elements of a nationally accredited certification program.

Q (5 ).
What are the other reasons, besides legal defensibility, why the states in the U.S. that regulate acupuncturists use the NCCAOM national examination system and how are NCCAOM examinations administered?

A. There are multiple reasons for the AOM regulatory boards in the U.S. to use the NCCAOM examinations as a prerequisite for licensure. The NCCAOM examinations are administered in highly secure professional test centers, around the U.S. and throughout the world. These professional test centers are identical and are owned and operated by Pearson VUE®. Candidate identity is confirmed by means of palm vein readings and photo identifications. Tight internal test administration processes, which include camera surveillance of each test taker, prevent cheating during the examination process. The NCCAOM also administers computer adaptive tests (CAT) which not only improve examination reliability, but also further reduces the potential for cheating (memorizing test questions) by minimizing test question exposure since every examinee receives a unique set of examination questions based on the test specification requirements and the tester’s response to each new test item on the exam. The CAT administrative model is not only a more reliable measure of competency, but also it is a very desirable administrative test model for candidates since each examination completed by the test taker can be scored in real time, and thus a preliminary “pass” or “fail” screen” is generated once the test taker completes the examination. The NCCAOM follows up with an internal quality control procedure; however, and the final test results are sent to the examinee within 5 to 10 business days. The NCCAOM generates official exam results reports which are sent directly the state regulatory boards upon the examinee’s request. The CAT exam administration model, therefore, allows for year-round testing with a location convenient to examinees. The 2012 NCCAOM® Certification Handbook and the 2012 NCCAOM Examination Study Guides provide more detailed information about the examination development and administration process.

The NCCAOM is also assisted by Schroeder Measurement Technologies (SMT®), a national research and psychometric services corporation that conducts professional competency assessment research, and provides examination development services and scoring of examinations for a number of credentialing programs nationwide. The NCCAOM has demonstrated over the last 30 years with its issuance of over 25,000 certificates of certification that it is well equipped to handle the challenges associated with the development and administration of a credible, valid and legally defensible examination system for the acupuncture and Oriental medicine profession.

Q (6). How does NCCAOM establish itself as a national standard setting organization and how does this benefit the states?

A. NCCAOM partners with state regulatory boards when they are developing a practice act for AOM. The NCCAOM also works with the legislature and regulatory agency staff to establish regulation that includes a national assessment tool that effectively measures the knowledge, skills and abilities required to safely and effectively practice AOM. States recognize and accept the ACAOM and NCCAOM national standards of education and competence as established requirements for the growing profession of acupuncture and Oriental medicine. The AOM state regulatory boards rely on these national standards to protect their consumers from the unsafe practice of AOM by unqualified practitioners. Each of the 44 states plus the District of Columbia that require the NCCAOM examinations for AOM practitioners as a measure of competency to practice safely and effectively recognize the financial and administrative benefits of requiring the NCCAOM certification or passing of the examinations as a prerequisite for licensure of acupuncturists. This is due to the fact that all examination development and administration costs, as well as legal defensibility, are assumed by the NCCAOM.

The NCCAOM offers each of the state regulatory boards that accept its examination system the security of having all of its certification programs and its examinations nationally accredited. NCCAOM’s certification programs (Acupuncture, Oriental Medicine, Chinese Herbology, and Asian Bodywork Therapy) are accredited by the National Commission for Certifying Agencies (NCCA). Accreditation assures that NCCAOM’s examinations are psychometrically validated for content and construct. All regulatory boards that rely on the NCCAOM examinations enjoy the advantages of state-of-the-art examination development and administration security and lessened legal liability. Refer to Q (5) above for more details.

The NCCAOM’s highest priority is its commitment to the public to ensure the safe practice of acupuncture and this is manifested through its mission, which is to promote nationally recognized standards of competency and safety in acupuncture and Oriental medicine for the purpose of protecting the public. As such, NCCAOM fulfills its mission by 1) establishing national standards of competency for the safe and effective practice of acupuncture; 2) evaluating each applicant’s qualifications through a robust eligibility process; 3) assessing candidates for certification based on valid, reliable and legally defensible examinations; and 4) requiring candidates for certification and Diplomates to adhere to the NCCAOM® Code of Ethics, as well as 5) ensuring that certified practitioners maintain their competency to practice through a mandated recertification process in which certificate holders must provide documentation of professional development activities.

Q (7). How can a national examination system such as the NCCAOM satisfy the variety of practice acts and scopes of practice for each state that regulates AOM? 

A. NCCAOM’s modular examination system allows each state to adopt the exams that are tailored to its AOM practice act requirements, statues, rules and regulations. NCCAOM offers four exams for the AOM profession: Acupuncture with Point Location, Foundations of Oriental Medicine, Biomedicine and Chinese Herbology. States either require all or a portion of these examinations depending on their practice act and whether their state accepts the practice of Chinese herbology. Candidates that successfully pass each of the required exams have then demonstrated competency in each of the core areas of AOM. These candidates can then move on to completing the other licensing requirements as requested by the state. As always, the NCCAOM does have a process for offering unique examinations, if requested by a state regulatory board.

Q (8). What is the difference between states that require the NCCAOM examinations and states that require full NCCAOM certification as a prerequisite for licensure?

A. The value of NCCAOM’s certification and its examinations is demonstrated by its acceptance in 28 states that require full certification (or passing of all required NCCAOM exams for Certification in Acupuncture) as a prerequisite for licensing acupuncturists. More and more state licensing agencies are now recognizing the importance of relying on the NCCAOM’s robust certification process to ensure that the licensed acupuncturists in their state have met and will continue to meet the necessary requirements to practice acupuncture and Oriental Medicine safely and effectively. States that require full certification by the NCCAOM as indicated on this map will best ensure that licensed AOM practitioners in their state meet recognized national standards of competence and safety in the AOM profession as set forth by the NCCAOM and have maintained their certification in good standing via the NCCAOM recertification process.

Q (9). How do we know that every candidate who sits for the NCCAOM exams is qualified to take the exams?

A.  NCCAOM has developed an in-depth process to verify each applicant’s education and training to make sure that each candidate has met ACAOM’s academic standards and professional competencies as set forth by the ACAOM Accreditation Manual as well as other requirements such as the Council of Colleges for Acupuncture and Oriental Medicine’s (CCAOM) Clean Needle Technique course, if applicable for the particular certification program. The eligibility qualification process includes a thorough verification of educational transcripts for domestic and foreign-educated applicants. All candidates must meet the same nationally-set requirements in order to become eligible to sit for the NCCAOM exams. NCCAOM requires all internationally educated applicants to first have their academic transcript authenticated through one of NCCAOM’s approved foreign transcript review agencies to include American Association of Collegiate Registrars and Admissions Officers (AACRAO) and World Education Services (WES).

Q (10). Can candidates take the NCCAOM exams in their own state and are their exam sites secure?

A.  Candidates for the NCCAOM examination(s) can schedule and take their examinations as soon as they are approved to test by the NCCAOM, any day, year-round at over 230 locations throughout the U.S. and abroad to include exam sites in Europe, Canada and Asia. NCCAOM examinations are offered in a computer adaptive format, which minimizes testing error as mentioned in Q. (5) of this fact sheet. In addition, computer adaptive testing (CAT) provides candidates with a preliminary pass/fail screen after completion of the examination giving them a preliminary indication of how they performed on the examination. The NCCAOM is able to offer these premier exam administration services because it is assisted in its examination administration by Pearson VUE, one of the leading testing services in the United States and the world. In addition, candidates are ensured a safe and secure examination site thanks to Pearson VUE’s state-of-the-art security systems, which has virtually eliminated cheating by test-takers. Since contracting with Pearson VUE, the NCCAOM has had zero incidents of cheating or examination compromise owing to the extremely secure systems that exist at the Pearson VUE Professional Test Centers.

Q (11). What about candidates who wish to take the exams in another language

A.  The AOM certification examinations are available in three languages: English, Chinese and Korean. Please check with the NCCAOM website for specific administration dates. To date there have been no challenges to the translation of the NCCAOM foreign language examinations. The NCCAOM takes great pride in the proper translation of its examinations. In fact, the NCCAOM has a separate Translation Exam Development Committee who provides the quality control checks for the exams translated by a third party vendor. In 2011, the NCCAOM’s psychometrician and CEO were invited to make a national presentation, at the Institute for Credentialing Excellence’s (ICE) national conference, about how our organization provides the translation and equating of the translated examination items so that fairness of testing in the foreign languages can be assured.

Q (12). Are there nationally recognized continued competency (recertification) requirements for the AOM profession?

A. NCCAOM has an extensive and highly developed recertification process that emphasizes core competency maintenance and the demonstration of professional development. Core knowledge and skills in safety, professional ethics and CPR are absolute requirements of the recertification process. The NCCAOM recertification program relies heavily on its own professional development activity (PDA) program which has its own unique continuing education approval standards. NCCAOM requires its Diplomates to document 60 PDA points (1 PDA point is equivalent to 1 hour of active learning) every four years. For more information see NCCAOM Recertification at a Glance. The NCCAOM Certification Services Department reviews every application for renewal of certification and verifies each piece of documentation for each application. In addition, NCCAOM staff also performs internal quality audits to assure compliance.  Turnaround time for processing a recertification application is 4-6 weeks. More and more states are recognizing NCCAOM’s recertification program and accept or require all continuing education courses to be an approved PDA course. This way a state regulatory board can rely on the NCCAOM’s services to ensure the continued competency of existing licensees and to alleviate the financial and administrative burden to their state and their licensees.

Q (13). What about the practitioners who cross the boundaries of safe and/or ethical practice? Each state has its own disciplinary procedure, but how can we ensure that these practitioners do not move from state to state without recognition?

A. One of the most important functions of the NCCAOM is to establish and enforce the standards of ethical practice for the AOM profession as stated in the mission of the organization.

By partnering with the states to discipline certified practitioners who have violated the NCCAOM®Code of Ethics and preventing them from moving to another state that might be unaware of their violations, the NCCAOM’s Professional Ethics and Disciplinary Committee (PEDC) has the authority to evaluate complaints against Diplomates (from states, patients, or other practitioners), issue decisions and impose sanctions. This action allows states that require NCCAOM certification to further protect their consumers from the unsafe practice of acupuncture since acupuncturists who have been disciplined by the NCCAOM for ethical and/or criminal violations cannot renew their license to practice acupuncture until those sanctions have been lifted by the NCCAOM.

The NCCAOM® Code of Ethics and related disciplinary process is the only one of its kind in the AOM profession. The disciplinary process allows individuals to report professional misconduct directly to the NCCAOM. The PEDC and NCCAOM staff continuously meets its policy of the reviewing and determining cases within 60-90 days of the initial complaint. This disciplinary procedure ensures that states will be fully apprised of any disciplinary action taken against a NCCAOM certified practitioner and the public will be also be readily informed.

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