Mutual Recognition Agreement - Frequently Asked Questions


Many of you are wondering how the decision to withdraw from the current MRA came about.  Below is some background to help provide context.

Important update about the future of the MRA

Its important for members to know that CATA has not closed the door on negotiating the 2021 MRA; we remain open to continuing discussions with the partners provided we’re working towards a beneficial arrangement and outcome.  On November 13, 2019, CATA’s Board of Directors sent a letter to the U.S. Board of Certification (BOC) and Athletic Therapy Rehabilitation Ireland (ARTI) stating:

The CATA remains dedicated to the promotion of athletic therapy and training globally as well as the portability of the profession across borders in a reciprocal fashion. We welcome the opportunity to continue to participate in discussions for the next iteration of a mutual recognition agreement.

We plan to meet soon with the MRA partners and will provide an update when there is something to share.

What is the history and purpose of the MRA?

In 2005, CATA and the BOC signed the first Mutual Recognition Agreement which allowed CATA Certified Athletic Therapists and BOC Certified Athletic Trainers to challenge each other’s exams.  In 2015, ARTI joined CATA and the BOC in a new Mutual Recognition Agreement.

The intent of the MRA was portability of the profession, giving certified professionals the opportunity to practice in another jurisdiction.  It does not grant or infer work visa or immigration rights to the individual; each individual is responsible for meeting immigration requirements and acquiring the appropriate immigration and work visa documents to be eligible to work in another country.

Opportunities to work in other countries are predicted to decrease: immigration requirements are tightening and, according to the National Athletic Trainers Association (NATA), the U.S. graduate assistantship programs will likely be phased out within the next 5-7 years once the U.S. Athletic Training programs become a master’s degree program.

Why did CATA decide to withdraw from the current MRA?

Last year, CATA, ARTI and BOC began the process of negotiating the next MRA which starts January 2021.  

In February 2019, the MRA partners learned that the Commission on Accreditation of Athletic Training Education (CAATE) - the organization that accredits Athletic Training programs in U.S. universities and colleges - plans to accredit universities in Spain, with the first cohort starting in 2019.  Under the current MRA, anyone graduating from a CAATE-accredited program can automatically challenge the BOC exam then automatically challenge the CATA exam. At the time we negotiated the original and subsequent MRAs, CAATE had not expressed plans to accredit international programs. CATA felt the definition of CAATE-accredited programs was being expanded beyond the terms of the original agreement.

By accrediting countries outside of the MRA, it enables professionals in non-MRA countries to take advantage of the MRA but without any opportunity or reciprocity for CATA members – and no way of achieving reciprocity.  We can’t invite Spain to the MRA table because the athletic therapy profession doesn’t exist in Spain; it isn’t established or recognized and there is no certifying body or professional organization.  A health professional in Spain can become a CAT(C) and practice as an AT in Spain without any professional framework or oversight in place – and they can practice as an AT in Canada, if eligible, without the opportunity for CATA members to do the same in Spain.  

Our understanding of the intent of the MRA was that the opportunity to challenge exams is limited to professionals in the MRA countries.  CAATE is looking at accrediting programs in many other countries, possibly even Canada, and we believe this alters the essence of the agreement and has larger precedent-setting implications for the profession globally and here at home. 

CATA sought to amend the current MRA to enable graduates from only MRA countries to challenge the CATA exam. From March through August 2019, the MRA partners met frequently to discuss options and negotiate amendments to the agreement. One option proposed was the inclusion of a deferral period, but CATA felt it didn’t address the fundamental issues and could impact the next MRA. Subsequently CATA proposed the following motion, which was defeated in late August:  “In order to be eligible to attempt writing the Canadian Athletic Therapists Association (CATA) National Certification Examination as a Temporary International Candidate (TIC), you must have graduated from an accredited institution approved by the partners of the Athletic Training and Therapy International Mutual Recognition Agreement, that is physically located in Canada, Ireland or the United States of America. You must also have maintained your status / remain in good standing with Athletic Rehabilitation Therapy Ireland (ARTI) as a CAT, or Board of Certification, Inc. (BOC) as an ATC, and the CATA as a TIC to be effective immediately upon approval of ARTI, BOC and CATA.” Unfortunately, the partners did not find a solution and with CAATE accrediting internationally starting September it left a short window of time to respond.

After announcing the withdrawal on October 1, we heard from concerned stakeholders. When considering the decision to withdraw, we looked at the number of applicants over the years and the overall low program growth; we didn’t know how many people intended to challenge an MRA partner exam in the future.  Based on member concern, CATA responded by introducing a grandfathering clause enabling individuals to challenge the CATA exam for up to three years after graduating from an accredited institution (see below). Unfortunately, the grandfathering clause was not reciprocated by the partners for students enrolled in Canadian-accredited Athletic Therapy programs.

The impact of CAATE accrediting internationally and lack of reciprocity were the key factors in the decision.  A secondary factor was the consideration of what we believed to be the impact of the MRA relative to the time and resources required to manage it. In 2018, members ranked ‘building international opportunities and reciprocity’ as #8 of 9 strategic priorities. The ranking does not mean the international program isn’t important to members – it’s important – it simply shows members prioritizing their professional needs.  CATA is committed to building international relationships, collaboration and opportunity, but we also have a responsibility to balance those efforts with members’ needs and priorities, the time and people resources required to deliver programs, and the overall impact to advancing the profession.

Where did the 60-day notification of withdrawal come from?

The 60-day notification clause in the MRA states any organization wishing to withdraw from the agreement must give the MRA partners 60-days notice and must, within 10 days of that notification, inform their members. CATA gave all stakeholders 60-days notice.  We recognize the short notice period and hope this will be re-considered in the next MRA so as to give more advance notice. CATA acted sooner than we would have liked because, within the current MRA, we would be required to accept graduates from this altered definition of CAATE-accredited institutions as early as September 2019.

What about students currently enrolled in accredited institutions outside Canada, or holding the ATC or ARTI credential?

Individuals currently enrolled in CAATE-accredited institutions in the U.S. or accredited institutions in Ireland as of October 1, 2019, are eligible to attempt the CATA National Certification Exam within 3 years of graduating from the program, provided all other requirements are met, including submitting:

  • Proof of full-time enrollment, prior to October 1, 2019, at a CAATE-accredited institution in the U.S. or an accredited institution in Ireland;
  • Proof of certification in good standing with the Board of Certification (BOC) or Athletic Therapy, Rehabilitation, Ireland (ARTI)
  • Official transcripts
  • Proof of current First Aid and Basic Life Support, or First Responder
  • Copy of registration (federal and state), if applicable
  • Applicable registration fee

Individuals currently holding the ATC or ARTI credential and wishing to challenge the CATA National Certification Exam had until November 29, 2019 to apply for and be approved as a CATA Temporary International Candidate.  This message was previously circulated.

What kinds of international programs and activities is CATA currently involved in?

The MRA was one element of CATA’s international program. We are continuing to promote the profession and expand opportunities through partnerships with the National Athletic Training Association (NATA), the World Federation of Athletic Training and Therapy (WFATT), and others.  Ongoing activities include: 

  • CATA and NATA research reciprocity program to facilitate presentation opportunities;
  • Founding member and supporter of WFATT, including collaborating in the upcoming 2020 strategic planning meeting. Currently the WFATT President and a Vice President are CATA members;
  • Sponsor speakers at WFATT World Congress and international conferences;
  • International ambassador program to connect members with CAT(C)s living abroad;
  • George Borden International Bursary: $500 annually for CAT(C)s to pursue international opportunities;
  • Build relationships and share information with international partners at CATA, NATA (annual) and WFATT (bi-annual) conferences;
  • International candidate liaison to support international candidates through the exam process;
  • CATA Honorary Member Award; though not international it is typically awarded to international partners;
  • Ongoing collaboration with multiple sports medicine and health organizations in Canada and the U.S. and promoting international positions and programs such as the World Anti-Doping Association (WADA) and the International Concussion in Sport Group (CISG).

CATA remains committed to building international relationships, collaboration, and opportunity for members.