UGRC 2021 recommendations on GME transition: pros and cons, opportunities and limitations.

The Coalition for Physician Accountability's Undergraduate Medical Education-Graduate Medical Education (UME-GME) Review Committee (UGRC): Recommendations for Comprehensive Improvement of the UME-GME Transition final report includes a total of 34 recommendations and outlines opportunities to transform the current processes of learner transition from a US-based MD- or DO-granting medical school or international medical education pathway into residency training in the United States. This review provides a reflection on the recommendations from the authors, all members of the UGRC, describing the pros and cons and the opportunities and limitations, in the hopes that they might inspire readers to dig deeper into the report and contribute to meaningful improvements to the current transition. The UGRC Recommendations highlight the many opportunities for improvement in the UME-to-GME transition.

CATALYST: Piloting a Longitudinal Assessment and Learning Program for Board Recertification and Continuous Professional Development.

Context: As a proposed alternative to the traditional recertification examination, CATALYST is a longitudinal formative assessment platform created on cognitive learning principles. CATALYST was designed by the National Board of Osteopathic Medical Examiners to encourage more complex and durable practice-relevant learning and demonstration of ongoing competencies.

Objective: To investigate the value of the CATALYST platform using board diplomates' subjective feedback and comparison of performance on CATALYST questions with performance on board examinations.

CATALYST: Piloting a Longitudinal Assessment and Learning Program for Board Recertification and Continuous Professional Development.

Context: As a proposed alternative to the traditional recertification examination, CATALYST is a longitudinal formative assessment platform created on cognitive learning principles. CATALYST was designed by the National Board of Osteopathic Medical Examiners to encourage more complex and durable practice-relevant learning and demonstration of ongoing competencies.

Objective: To investigate the value of the CATALYST platform using board diplomates' subjective feedback and comparison of performance on CATALYST questions with performance on board examinations.

2019 United States Osteopathic Medical Regulatory Summit: Consensus, Recommendations, and Next Steps in Defining Osteopathic Distinctiveness.

Background: Osteopathic distinctiveness is a result of professional education, identity formation, training, credentialing, and qualifications. With the advancement of a single graduate medical education (GME) accreditation system and the continued growth of the osteopathic medical profession, osteopathic distinctiveness and professional identity are seen as lacking clarity and pose a challenge.

Summit: To achieve consensus on a succinct definition of osteopathic distinctiveness and to identify steps to more clearly define and advance that distinctiveness, particularly in professional self-regulation, a representative group of osteopathic medical students, residents, physicians, and members of the licensing, GME, and undergraduate medical education (UME) communities convened the 2019 United States Osteopathic Medical Regulatory Summit in February 2019.

An Investigation of the Relationship Between COMLEX-USA Licensure Examination Performance and State Licensing Board Disciplinary Actions.

Purpose: Passing the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) serves as a licensing requirement, yet there is limited understanding between this high-stakes exam and performance outcomes. This study examined the relationship between COMLEX-USA scores and disciplinary actions received by osteopathic physicians.

Method: Data for osteopathic physicians (N = 26,383) who graduated from medical school between 2004 and 2013 were analyzed using multinomial logistic regression to assess the relationship between COMLEX-USA scores and placement into one of 3 disciplinary action categories relative to no action received, controlling for years in practice and gender.

Association Between Performance on COMLEX-USA and the American College of Osteopathic Family Physicians In-Service Examination.

Background: The primary goal of residency programs is to select and educate qualified candidates to become competent physicians. Program directors often use performance on licensure examinations to evaluate the ability of candidates during the resident application process. The American College of Osteopathic Family Physicians (ACOFP) administers an in-service examination (ISE) to residents annually.

Evidence-Based Redesign of the COMLEX-USA Series.

To ensure that the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) reflects the evolving practice of osteopathic medicine, the National Board of Osteopathic Medical Examiners has developed new content and format specifications for an enhanced, competency-based examination program to be implemented with COMLEX-USA Level 3 in 2018. This article summarizes the evidence-based design processes that served as the foundation for blueprint development and the evidence supporting its validity. An overview is provided of the blueprint's 2 dimensions: Competency Domains and Clinical Presentations.

The Use of COMLEX-USA and USMLE for Residency Applicant Selection.

Background: The Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) and the United States Medical Licensing Examination (USMLE) are recognized by all state medical licensing boards in the United States, and the Federation of State Medical Boards has supported the validity of both examinations for medical licensure. Many osteopathic medical students take both examinations.

Objective: The purpose of this study was to investigate performance on COMLEX-USA Level 1 and USMLE Step 1 of students from colleges of osteopathic medicine where the majority of students took both examinations.

Preparation Strategies of Osteopathic Medical Students for the COMLEX-USA Level 2-PE.

Context: Since 2002, osteopathic medical schools have made curricular changes to further enhance the clinical skills of their students, to prepare them for residency training, and to pass the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE).

Objective: To report how students at osteopathic medical schools prepare for the COMLEX-USA Level 2-PE, and to investigate the effect of these techniques on examination performance.

Methods: A standardized survey was given to students before the beginning of their examination to assess the preparation of osteopathic medical students for the COMLEX-USA Level 2-PE, such as coursework, orientation materials, and standardized patient (SP) encounters.

Relationship between COMLEX-USA scores and performance on the American Osteopathic Board of Emergency Medicine Part I certifying examination.

Context: Few studies have investigated how well scores from the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) series predict resident outcomes, such as performance on board certification examinations.

Objectives: To determine how well COMLEX-USA predicts performance on the American Osteopathic Board of Emergency Medicine (AOBEM) Part I certification examination.

Methods: The target study population was first-time examinees who took AOBEM Part I in 2011 and 2012 with matched performances on COMLEX-USA Level 1, Level 2-Cognitive Evaluation (CE), and Level 3.

Using standardized patients to assess the communication skills of graduating physicians for the comprehensive osteopathic medical licensing examination (COMLEX) level 2-performance evaluation (level 2-PE).

Background: Standardized patients can be trained to assess the communication and interpersonal skills of medical students and graduates.

Purpose: The purpose of this study is to present data to support the psychometric adequacy of the communication ratings provided by standardized patients.

Methods: Using the data from testing of 3, 450 examinees over a 1-year period, a number of psychometric analyses were undertaken.

Patient note fabrication and consequences of unprofessional behavior in a high-stakes clinical skills licensing examination.

Background: The National Board of Osteopathic Medical Examiners (NBOME) administers the Comprehensive Osteopathic Medical Licensing Examination USA Level 2-PE (COMLEX-USA Level 2-PE) and has developed a process that links the competencies of written communication and professionalism by tracking fabrication in the postencounter SOAP (Subjective, Objective, Assessment, Plan) note exercise.

Method: A process used to identify potential SOAP note fabrication was implemented in the 2007-2008 test cycle for the COMLEX-USA Level 2-PE.

Results: A total of 3,753 candidates took the COMLEX-USA Level 2-PE in the 2007-2008 test cycle.

The use of standardized patient assessments for certification and licensure decisions.

Although standardized patients have been employed for formative assessment for over 40 years, their use in high-stakes medical licensure examinations has been a relatively recent phenomenon. As part of the medical licensure process in the United States and Canada, the clinical skills of medical students, medical school graduates, and residents are evaluated in a simulated clinical environment. All of the evaluations attempt to provide the public with some assurance that the person who achieves a passing score has the knowledge and/or requisite skills to provide safe and effective medical services.

Standardized patients and mechanical simulators in teaching and assessment at colleges of osteopathic medicine.

Context: A 2001 survey of 19 colleges of osteopathic medicine (COMs) revealed that standardized patient programs (SPPs) are increasingly used in osteopathic medical education. However, no new data have been published since.

Objectives: To evaluate current SPP and mechanical simulator use at COMs compared with previous survey results.

Getting "beyond the barriers" in reforming osteopathic medical education.

As the healthcare needs of the United States change, some leaders at colleges of osteopathic medicine and osteopathic graduate medical education programs have embraced one very important and timeless goal: to prepare future physicians to meet society's health needs. These medical educators have made significant strides toward moving "beyond the barriers" to effect curricular reform and quality improvement at their institutions. Some of the barriers to osteopathic medical education reform are addressed in this article, which recommends allowing curricular evolution and faculty development; expanding clinical learning and teaching; breaking down departmental walls; integrating osteopathic principles and practice; reevaluating admission requirements of colleges of osteopathic medicine; and eradicating the unspoken and, ironically, often detrimental culture of medicine, which can be contrary to compassionate patient care and healing.

Survey on the clinical skills of osteopathic medical students.

As part of the standard-setting methods used by the National Board of Osteopathic Medical Examiners for its Comprehensive Osteopathic Medical Licensing Examination clinical skills performance evaluation (COMLEX-USA Level 2-PE), a self-administered survey was distributed electronically and by mail to deans of colleges of osteopathic medicine, directors of graduate medical education programs, osteopathic medical students, and experts chosen demographically to represent osteopathic physicians in the United States. Groups were asked to rate fourth-year osteopathic medical students and interns on their clinical skills and acceptable pass rates and expected pass rates on the COMLEX-USA Level 2-PE. The surveys were not used systematically to compute the passing standards but to provide additional support for their validity.