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The Future of Health/Fitness and Clinical Exercise Professionals

Where Are We Headed?

Paternostro-Bayles, Madeline Ph.D., FACSM

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ACSM's Health & Fitness Journal: March 2010 - Volume 14 - Issue 2 - p 40-41
doi: 10.1249/FIT.0b013e3181cff80d
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In Brief

Licensure, particularly of allied health professionals, is often motivated or initiated out of a desire to ensure a safe environment for the client/patient interaction to occur. The process of a profession becoming licensed involves the development of a standardized curriculum (body of knowledge) and related practical experiences along with the development of an examination to test the minimum competency of the professional.

Recent nationwide legislative activity might make the health/fitness professional or clinical exercise physiologist think that licensure is right around the corner, but in reality, for many professions, state-by-state licensure may take 20 years or more. Although there have been several proposed bills, currently, only one state in the nation - Louisiana - licenses exercise physiologists. Other legislative activity proposing licensure has been developed in Massachusetts, North Carolina, and Utah, but none of these efforts has been successful thus far. In the United States, personal trainers also are not currently licensed. Legislative language to regulate the activities of personal trainers has been proposed in the last several years in New Jersey, Georgia, the District of Columbia, and California. However, none of these efforts has gotten very far through the legislative process, and most were initiated out of a concern for client safety.

There are many steps to be taken before a profession can move toward licensure. One of those steps includes professional examinations to test for minimum competency. ACSM certifications are widely recognized as meeting or exceeding rigorous industry standards. All of the current ACSM certifications - Certified Personal Trainer, Health Fitness Specialist, Clinical Exercise Specialist, and the Registered Clinical Exercise Physiologist - are undergoing a process of review, which involves updating the major activities within the jobs and the required knowledge and skills. This process follows industry best practices and ensures that our certification examinations evaluate the knowledge and skills required by currently practicing professionals. This periodic reassessment also provides an avenue to incorporate new skills or cutting-edge technology into the profession.


Another critical component to the future development of the health/fitness and clinical exercise profession is the expanded role of academic preparation programs accredited by third-party agencies. The Committee on Accreditation for the Exercise Sciences, under the larger umbrella of the Commission of Accreditation of Allied Health Education Programs (CAAHEP), accredits undergraduate and graduate academic programs in the exercise sciences. In addition, academic program accreditation tracks outcomes, one of which is typically the attainment of a national certification at the end of an undergraduate or graduate degree program. The steady expansion of the number of CAAHEP-accredited undergraduate and graduate programs will strengthen the credibility of the profession and will connect academic preparation to the attainment of a certification. This connection between a more standardized undergraduate curriculum and a culminating certification to examine and ensure minimum competency is a critical link in the licensure process.

Recently, the first university-based personal trainer program was accredited; in addition, 20 undergraduate exercise science programs and 5 graduate programs in exercise physiology have been accredited by CAAHEP. A substantial number of pending applications will steadily increase the total programs accredited in 2010.

Being part of a profession means advocating for that profession. For the clinical exercise professional, the Clinical Exercise Physiology Association (CEPA) is an organization dedicated to advancing the profession of clinical exercise physiology ( Its mission is advocacy, education, and career development of the clinical exercise physiologist.

Perhaps one of the most exciting developments to take place recently is the relationship formed with CEPA, through ACSM, with Lewis-Burke Associates, LLC. Lewis-Burke, LLC, is a full-service government relations firm, with a significant history of success in influencing government policy-making decisions. Lewis-Burke Associates, LLC, will be working with CEPA to develop a strategic plan to educate politicians regarding CEPA and the profession of Clinical Exercise Physiology as well as to develop relationships with important government officials. Lewis-Burke Associates, LLC, has already partnered with ACSM directly to advocate for the organization and work closely with the Exercise is MedicineTM initiative on legislative policy regarding physical activity.

ACSM can assist its members with state-by-state efforts toward professional licensure by providing legislative tool kits. These tool kits can assist health/fitness and clinical professionals as they work with their representatives to develop sample language for licensure. A tool kit to assist clinical exercise professionals with licensure efforts has already been developed jointly by ACSM and CEPA, its affiliate organization. A similar tool kit to assist health/fitness professionals is currently being developed.

Most legislations to regulate the practice of health/fitness and clinical exercise professions include requirements for professionals to have a minimum level of education, professional certification, and knowledge and skills. ACSM-certified professionals are well prepared to meet those requirements and already have knowledge and skills required to perform their jobs. Couple that with academic preparation that meets third-party standards through CAAHEP, and health/fitness and clinical exercise professionals are prepared for licensure!

With the current developments in play and the existing knowledge of our certified professionals, all of the pieces of the licensure puzzle are falling in place. These efforts and developments can help shape the future of ACSM-certified health/fitness professionals and clinical exercise physiologists as they move forward on a state-by-state basis toward licensure.

© 2010 American College of Sports Medicine