Position Statement on Reintroducing a National Clinical Skills Examination

The Student Osteopathic Medical Association supports the indefinite cancellation of the COMLEX Level 2-PE clinical skills examination and strongly opposes the re-introduction of such an exam into the osteopathic physician licensure pathway. In late February, SOMA conducted a survey regarding pre-medical student, medical student, and physician opinion on the future of the COMLEX Level 2-PE. In this survey, over 95% of the 3,209 respondents called for the permanent cancellation and discontinuation of the COMLEX Level 2-PE. Of the 1,628 respondents who provided testimonies, our organization found general themes regarding osteopathic student concerns with:

  1. Safety with travel and interactions at testing sites between students and standardized patients
  2. Limited number of examination centers and their locations near densely populated metropolitan centers
  3. Redundancy created by assessing clinical skills are often tested by trained faculty at COMs
  4. Osteopathic students bearing additional financial burden due to this exam and associated travel fees
  5. Additional testing burdens for osteopathic students as compared to their allopathic counterparts 6. The current requirement to take the Level 2 PE before Level 3 for the Class of 2022 and beyond

Since the survey was conducted, SOMA has stayed in constant communication with our members and has worked to advocate for their concerns to stakeholders such as the AOA, NBOME, and COCA. Apparent from continuous feedback collected by SOMA, our members value the competency and patient safety standards assessed through examinations that ensure students are equipped for future clinical practice as resident physicians and beyond. However, our members only ask they be assessed in a way that does not place themselves or other osteopathic medical students under unnecessary financial, safety, or testing strain. SOMA stands by the position of our members and while we supported the NBOME decision to indefinitely suspend COMLEX Level 2-PE, given the circumstances regarding the upcoming decisions on the future of skill examinations, SOMA believes it is vital we clarify our stance regarding a national clinical skills examination. Based on continuous alumni, medical student, and pre-medicine student feedback, we believe reinstatement of a national clinical skills examination would result in inadvertent, long-term negative impacts on the future of osteopathic medicine, including the placement of additional undue financial and testing burdens onto osteopathic medical students.

SOMA believes COCA has a foundation that future COM-level standardized skills examinations can be built upon. Per COCA Accreditation Standard 6, osteopathic medical schools must create a curriculum that meets COM program objectives and demonstrates student competency on, “[…] statements of the knowledge, skills, behaviors, and attitudes that osteopathic medical students are expected to demonstrate as evidence of their achievement prior to successful completion of the program.” Further, COCA standards currently outline osteopathic clinical examination requirements, as seen in Element 5.4 that requires osteopathic clinical skill examinations have “[…] appropriate supervision by a licensed healthcare professional.” Many COMs meet and exceed COCA’s standards by conducting longitudinally tested, standardized clinical skill examinations throughout students’ first, second, and third years of medical school (e.g., OSCEs). We believe these longitudinal, COM-level skill assessments offer osteopathic medical education stakeholders a more formative evaluation on osteopathic clinical skill progression of students than any one snapshot captured by a one-time licensing exam could. In-line with this view, SOMA asks osteopathic medical education stakeholders to direct their efforts to developing formative, COM-level assessments instead of focusing on the continuation of a one-time national skills examination.

While SOMA believes the NBOME’s goals to assure proper licensure and public safety are aimable pursuits, it is currently unclear how reinstating a national clinical skills examination will uniquely benefit the students, our profession, or patients. It is the opinion of SOMA that clinical skill examinations should continue to be solely overseen by COCA. Further, SOMA petitions NBOME to move to indefinitely cancel the COMLEX Level 2-PE, halt any plans to reintroduce a similar exam within the national osteopathic licensure pathway, and that NBOME seek collaboration with COCA and AACOM to ensure COM-level clinical skill examinations are conducted to a standard comparable to Level 2-PE.

SOMA’s National Secretary is the point of contact for all public statements and can be reached by email at secretary@studentdo.org.

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