The Board of Directors of the National Board of Osteopathic Medical Examiners (NBOME) has accepted the Report of the Special Commission on Osteopathic Medical Licensure Assessment.
The Board appreciates the work of the Commissioners for over 16 months on this important task. Based on this report, and as a follow-up on two of the four themes, the Board has made the following statements and endorsed specific action items:
Theme 1: Long-term solutions to assess clinical skills competencies for osteopathic medicine in the COMLEX-USA program: Class of 2024 and beyond
Recommendation 1: Establish COM-based COMLEX-USA national standardized assessment which includes an in-person, hands-on evaluation of fundamental osteopathic clinical skills including interpersonal and communications skills and OMT, with quality assurance.
- The NBOME will extend the enhanced attestation guidelines for Level 3 eligibility through the Class of 2025. Graduates in the classes of 2024 and 2025 (similar to the classes of 2022 and 2023) will need to have their college of osteopathic medicine (COM) dean provide verification that the graduate has demonstrated competency in osteopathic clinical skills necessary for graduation.
- The NBOME has approved closure of the NBOME’s two National Centers for Clinical Skills Testing and the formal discontinuation of the centrally administered COMLEX-USA Level 2-PE. We have committed funding and resources to develop and pilot a core competency capstone for osteopathic medical students. This project will include funding for partner colleges of osteopathic medicine that are interested in participating in this initiative to deliver a new clinical skills exam on campuses at the COMs. We anticipate a request for proposal (RFP) period to begin no earlier than September 30, 2022, with further details regarding the core competency capstone available at that time. The prototype in development will assess patient-physician communication skills and hands-on physical exam and OMT skills in a multi-station OSCE model using standardized patients that is designed for entry into residency program level. The model would be competency based, in that a candidate could have multiple opportunities to successfully complete the assessment. Only the final achievement of competency would be recorded on a transcript. Finally, minimizing overall costs to candidates will remain a key consideration.
- The NBOME will also create a task force, comprising individuals from across the osteopathic medical education and licensure spectrum, to advise on the pilot project and resulting capstone assessment. These task force members will be selected based on their expertise in developing, administering, and validating performance assessments of clinical skills. There will be representatives from organizations including the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, and the American Association of Osteopathic Examiners.
Theme 2: Diversity, Equity, and Inclusion in Assessment (DEI)
- The NBOME Board appreciates the tone of inclusivity in Theme 2, and would like to commend the commission for their recommendations for equity for and inclusivity of all persons, including those specifically mentioned in the report and individuals with disabilities.
“The mission of the NBOME is to protect the public by assessing the competencies of osteopathic physicians,” said NBOME Board Chair Richard J. LaBaere, II, DO, MPH. “Osteopathic clinical skills are important competencies for our patients and our profession. Through the work of the Special Commission, we have taken feedback from multiple stakeholders, and intend to develop a method of supporting a standardized, profession-wide assessment delivered in a distributed administration model. We believe that this will take advantage of the gains made over the past 17 years of national osteopathic clinical skills assessment, but also provide a trustworthy benchmark for use in medical licensure for DOs. We believe this path forward also takes into consideration stakeholder concerns about the previous assessment model and addresses the public concerns that all individuals demonstrate minimal competence.”
“We listened to everyone: patients and patient safety advocates, students and residents, educators including deans, residency program directors and faculty, and those in the licensure, accreditation and medical regulation community,” said NBOME President and CEO John R. Gimpel, DO, MEd. “What we heard was that each of those constituents believe that assessing fundamental osteopathic clinical skills is essential for our patients. Many shared that this could be done on COM campuses, which would help reduce travel and financial burdens for students.”
He added, “I believe the Special Commission’s guidance and the NBOME Board’s decision will allow us to do just that, and will allow the NBOME to maintain the licensure community’s trust, by ensuring our COMLEX-USA exam series continues to help protect the public. This underscores our profession’s emphasis on the patient and patient safety.”