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NBOME

COMLEX-USA | Level 2-PE

UPDATED OCTOBER 2, 2020

This update is in follow-up to the announcement on September 1, 2020 on NBOME’s exploration of a temporary contingency satellite testing site for COMLEX-USA Level 2-PE in the western region of the United States.

This update is in follow-up to the announcement on September 1, 2020 on NBOME’s exploration of a temporary contingency satellite testing site for COMLEX-USA Level 2-PE in the western region of the United States.

We have continued to listen to the feedback from students, particularly from the Class of 2021, including the many stressors they have encountered with taking or planning to take their licensure exams. We understand these students have been faced with numerous uncertainties and challenges with their clinical learning/clinical rotations, applications for GME/residencies, etc. Providing access to safe testing that remains valid, reliable and defensible has remained our priority, for those students who feel they are ready to test and would like to have the opportunity to do so in the upcoming months. We have surveyed Colleges of Osteopathic Medicine and DO students and have found an interest in availability to take Level 2-PE in 2021 in a temporary satellite testing location near Fresno, CA. In addition, our team has been working to identify a partner that would be able to work with us to assure that the additional availability for testing in this temporary satellite site would ensure the same NBOME standards for everyone’s safety, test security, and standardization for the valid, reliable, defensible assessment of fundamental osteopathic medical competencies.

At present, it is anticipated that Level 2-PE testing availability at this satellite site would begin in March of 2021 and run through July 2021, adding opportunities to the NBOME’s two National Centers for Clinical Skills Testing in Chicago and Philadelphia for those ready to test. We anticipate that once eligible candidates with graduation dates in 2021 (or earlier) have been provided priority-opportunity to test, availability would be offered to eligible students in the Class of 2022. As previously described, the NBOME has frozen COMLEX-USA exam fee increases and eliminated any rescheduling fees to support the continued flexibility and choice of when to test, leaving that in the hands of the students and their schools.

We will continue to provide updated communications regularly and are committed to providing another more comprehensive update on Level 2-PE test availability and the contingency planning for clinical skills testing delivery on or about November 2, and further details and possibly the opening of test center appointment dates at a temporary satellite testing site as early as December 15, 2020.

SEPTEMBER 2, 2020

In response to the COVID-19 pandemic, the NBOME has accelerated research, development and piloting of temporary contingency test delivery options for NBOME assessments -- including the COMLEX-USA Level 2-PE examination which assesses fundamental clinical skills including physical exam skills and OMT. Since exam suspension in March of 2020, we have been working hard to implementing procedures for everyone’s safety such as rigorous and frequent cleaning protocols and health screens for both candidates and staff, and are also investigating the potential role for SARS-CoV-2 testing. External public health and infectious disease consultants have been integrally involved in our plans for test resumption, currently targeted for November 1, 2020 at both NBOME National Centers for Clinical Skills Testing (NCCSTs; Chicago and Philadelphia.)

We understand and appreciate the ongoing concerns related to travel to test. Approximately 56% of the DO students the Class of 2021 are enrolled at a college of osteopathic medicine located within an 8 hour drive of one of our current testing locations, and 25% of the anticipated graduating DO Class of 2021 have already passed the exam. While considerable capacity remains in our two NCCSTs to test the remaining graduating seniors, our team is actively exploring options for a temporary satellite testing center located in the western portion of the country, potentially for a testing window in 2021.

Our objective is to provide candidates the opportunity to complete their COMLEX-USA examination and demonstrate their competency for licensure, when they are ready to do so, as promptly and as safely as possible. As COMLEX-USA is a licensing examination, it is imperative that we maintain the integrity of the examination program, and that the administration of the exam remains valid for this purpose, and preserves the reliability, defensibility and fairness of the examination. COMLEX-USA is entrusted in every state for medical licensure for DOs, therefore the integrity of the examination is of paramount concern. We have appreciated the overwhelming support of the colleges of osteopathic medicine and other stakeholders in sharing constructive feedback and ideas for administration solutions, in particular appreciating the concerns and input from DO students and student organizations. We have reached out to residency program associations including the Organization of Program Director Associations (OPDA) and the Assembly of Osteopathic Graduate Medical Educators (AOGME) and received formal statements from both that they understand that many residency program applicants in the Class of 2021 will not have results of COMLEX-USA Level 2-PE (DO applicants) or USMLE Step 2-CS (MD applicants) when they apply, and that applicants should not be held accountable for results of exams they have been unable to take due to exam suspensions and the pandemic. We have advocated for other organizations across the house of medicine to acknowledge this reality in 2020-2021.

NBOME has continued to work tirelessly to assist exam candidates, colleges of osteopathic medicine (COMs), and other stakeholders since the pandemic emerged in March, when we implemented COMAT-Self-Proctored test form options for COMs, and launched COMSAE Phase 2 (self-assessments) on our CATALYST longitudinal assessment platform. In late July the first satellite testing center for administration of COMLEX-USA Level 1, Level 2-CE, and Level 3 opened on the campus of the University of North Texas Health Science Center-Texas College of Osteopathic Medicine, Fort Worth, TX and in mid-August a similar center opened at Michigan State University College of Osteopathic Medicine, East Lansing, MI. These strategies and Prometric test center-delivered exams have put COMLEX-USA testing totals over the 16,000 mark since testing resumed in May.

In conjunction with identifying a potential contingency site for clinical skills testing, we continue to listen and collaborate with organizations and individuals in the medical education and medical regulatory communities to address this disruption and its effects, both professionally and personally, on candidates. We empathize with the unique circumstances of osteopathic medical students and residents, and indeed all of us in healthcare, medical education, and our world. Your support and input remains critical to our ability to meet our mission, relied upon by the state medical and osteopathic medical licensing boards and the patients in the communities we serve.

We will continue to provide updated communications regularly, and are committed to a formal update on the contingency planning for clinical skills testing delivery by October 1.


JULY 23 2020

As we monitor evolving challenges related to the pandemic, we are concerned with the surge in disease activity across the county and the impact this has on safe candidate travel. While we believe we can ensure a safe testing experience once students are onsite, we are not able to ensure their safety during travel. The health and safety of our candidates and staff continues to be of the utmost importance. As such, exams up through October, 2020 have been cancelled and we anticipate resuming testing on November 1, 2020. Candidates directly impacted by this cancellation decision will be notified directly and we will assist them with any rescheduling needs.

We realize the stress this decision creates and know that everyone is facing significant challenges at this time. We apologize for the inconvenience but ask for your understanding during this time of uncertainty. Once we return to normal operations, we will add additional exam sessions in an effort to provide as much opportunity to access the exam.

We continue to monitor the situation daily and will make informed decisions about resuming testing and impact on the exam based on how the pandemic evolves. Thank you for your patience as we all look for signs of hope in the public health crisis improving.

Our portal is open to reschedule exams at this time. The NBOME is very committed to assisting students as much as possible with testing opportunities while looking to monitor safety.

Score release dates for all November and December examinations will now be included in the February 1-9, 2021 window. All score release dates for 2021 are unchanged at this time.

For information on travel advisories or making changes to your current travel itinerary, please contact your airline or rail service directly. If any alteration in your travel plans results in a change fee, please reach out via our client services system for assistance.

We will continue to update this site as the situation evolves. Please contact the NBOME directly if you have any additional questions or concerns.

P: 866.479.6828
E: ClientServices@nbome.org


JULY 16 2020

On July 11, infectious disease epidemiologists from the Johns Hopkins School of Public Health were onsite to review NBOME’s enhanced safety policies and procedures for the administration of the COMLEX-USA Level 2-Performance Evaluation. This was the second infectious disease expert NBOME has engaged related to our plans to resume testing.

This latest group of experts reviewed both candidate and staff processes from the standpoint of the examination day and provided notes regarding the safety policies and procedures to be used once we resume clinical skills testing. They expressed confidence that our interventions are grounded in sound medical knowledge and provide risk mitigation for the exam. We anticipate receiving their full report within the next few weeks.

We are also looking forward to sharing our new safety video with you early next week. This video provides a visual overview of the myriad modifications and enhancements NBOME has made to protect candidates, staff and standardized patients. Stay tuned!


JUNE 25, 2020

As osteopathic medical schools begin to resume educational activities, including clinical rotations, the Clinical Skills Testing Department at the NBOME is also preparing for the resumption of the COMLEX-USA Level 2-PE, currently slated for September 1.

With a keen sensitivity to the pressures and challenges of testing during these uncertain times, we are taking every precaution to ensure a safe and comfortable testing experience for candidates, as well as for our staff and standardized patients.

We have taken a methodical approach to analyzing the exam administration process, looking critically at each onsite step of the exam experience, from the moment a candidate enters the building until they depart. Our commitment to the health and wellness of our candidates guides us as we identify opportunities for improvement, and as we adjust our processes and procedures to address any safety gaps that may exist - all while maintaining the validity and reliability of the clinical skills exam.

We will be sharing our comprehensive safety measures more fully in the next few weeks, as well as guidelines for candidates regarding the exam encounters with standardized patients. In the meantime the following items serve as a starting point:

  • Candidate and Staff health screening. Exam staff will assess candidates during the check-in process and conduct thermal screenings of all candidates.
  • Social distancing. These protocols will be rigorously enforced throughout the NCCST. However, patient encounters will still require direct contact / interaction.
  • Staggered exam start times. On days with more than 1 exam scheduled we will stagger times to start about an hour apart. Start times will be communicated via email received in the weeks leading up to their exam.
  • Larger capacity rooms. Large rooms have been reserved for registration and breaks to further support social distancing protocols.
  • Hand sanitizer. This will be available in all common areas throughout the NCCST, in all examination rooms, and at all SOAP note terminals.
  • Clear face masks issued to all candidates and standardized patients. These masks provide protection from spreading respiratory droplets while allowing viewing of the full face. Please note, these are not face shields, but actual face masks that fully cover the nose and mouth of the wearer.
  • Enhanced cleaning procedures. Hospital-grade disinfectant will be used to periodically wipe down high-touch surfaces both in exam rooms and at SOAP note terminals, plus daily deep-cleaning before each testing session.

Risk Management. Scenario Planning. Pilot Testing. Independent Review. Incredible thanks go out to the students, residents and attending physicians who joined us on Saturday June 13 as part of our first Level 2-PE pilot exam with COVID-19 protocols in place. The intent of the pilot was to pressure-test the various physical distancing and safety modifications put in place and to gain further insight on what else needs to be done to prepare for a safe and successful exam re-start.

We were also joined on-site by a local board-certified infectious disease specialist with training in hospital epidemiology and investigating outbreaks. She monitored the pilot exam from candidate and staff wellness screening, to physical distancing implementation, to enhanced cleaning protocols. She provided valuable feedback on our processes and expressed confidence in the steps we have taken to make the exam a safe experience. The pilot provided us clearer insight on the integrity of our enhanced health and safety policies and procedures and reassured us that we are on the right track as we prepare to relaunch the exam.

As a follow-up to the pilot, NBOME will be hosting a team of public health officials from Johns Hopkins University on July 11. This group will provide further review of the exam and our approach to enhanced safety.

While the input and recommendations received from subject matter experts in the public health sector will directly guide our path forward, we also feel it is important to engage the student community to ensure they feel safe in this environment. As such, we have invited a fourth-year DO student leader who has already completed the clinical skills exam to visit our NCCST, review the safety enhancements we are putting in place, and provide their thoughts as it relates to the comfort level of incoming candidates.

Once this 360-degree analysis is complete, we will incorporate our learnings into a safety report and video that will be available on our website in mid-July.

Our re-start plan will continue to evolve as we monitor the rapidly growing medical knowledge surrounding the virus and the implications of public health and safety guidelines in the Chicago and Philadelphia regions where our NCCSTs are located, as well as other key regions. While we are optimistic about our plans to safely resume testing on September 1, and are looking forward to again engaging with candidates, please be assured that we do not plan to resume testing until we have made the testing environment as safe as possible, given the unique circumstances. We also encourage students to continually evaluate their own personal circumstances regarding location and personal situations. We currently have exam openings through June 2021 for those who would feel more comfortable coming at a later time.

We remain dedicated to the importance of assessing the fundamental clinical skills of DO candidates and support the safe return of clinical learning opportunities as we all move forward during these uncertain times, together.


JUNE 5, 2020

The American Association of Colleges of Osteopathic Medicine (AACOM), American Osteopathic Association (AOA), Commission on Osteopathic College Accreditation (COCA) and the National Board of Osteopathic Medical Examiners (NBOME) have been working together on numerous challenges presented by the COVID-19 crisis. Read our joint statement in support of COMLEX-USA Level 2-PE and COCA’s temporary modification of graduation.


JUNE 3, 2020

We appreciate all of the students who have very professionally provided their feedback and made us aware of their concerns. We heard your views about availability and access to testing as well as the safety of testing and travel to testing centers since the challenges with COVID-19 emerged. We have continued our considerable efforts to listen to the opinions of DO students, but particularly over the past several months in the COVID-19 era. And we continue to hear you, and share in your frustrations and anxieties caused by this pandemic. In addition to countless information sessions with other stakeholder groups, we have held multiple videoconference meetings with the Council of Osteopathic Student Government Presidents (COSGP), their Executive Board, and two open Webinars for DO students in the past 2 months. We have also held a similar number of updates and Question and Answer sessions for COM Deans, who often reflect the concerns expressed by their students.

Specifically related to COMLEX-USA Level 2-PE and clinical skills testing in our two National Centers for Clinical Skills Testing, we initially suspended all testing back in March, and have not given a test since March 6, 2020. We did so out of concern for the health and safety of students, staff and our communities, and in compliance with local, state and federal expert and governmental authorities. We continue our outreach for further input from the licensure and medical regulatory community, the leadership of the AOA and the AACOM, and others across the patient advocacy community. They all reiterate the importance of the examination as a part of the licensure examination series and of our mission to protect the public- the patients we have the privilege to serve.

We had announced a suspension of Level 2-PE test sessions until July 1 and we were on track with examination modifications that could have made this possible. However, out of an abundance of caution we have elected to further suspend resumption of testing until September 1, 2020. We have engaged external public health/infectious disease experts on the significant modifications to test administration that would enhance safety. We will continue to monitor local and state opening guidelines, travel restrictions, and guidelines for return to campuses and clinical rotations. We will continue to use these indicators to help guide the safe resumption of testing, and will be sharing further detailed materials and a video tour of the modified testing center environment and test administration features. We have reached out to student leaders who will be visiting our National Centers for Clinical Skills Testing to walk through a center and see the examination and physical center modifications.

We know there will be different circumstances for each candidate. Some will more easily be able to come to take the examination at first- those who can travel more easily to the locations, for example. We continue to suggest that anyone who would like to postpone testing for any reason, be it personal safety, that of loved ones, travel concerns, etc., that they do so. Candidates who have been impacted with this further suspension have been personally notified, and we apologize for the inconvenience and frustrations exam cancellations cause. For any additional cancellations, we will supplement our normal systems and processes with telephone access to client services support who can help to troubleshoot rescheduling challenges. As always, candidates who are impacted with additional financial hardship due to travel cancellation fees are also encouraged to contact NBOME Client Services at Clientservices@nbome.org or 866.479.6828.

These decisions are not made by the NBOME in a silo, but with the input of many stakeholders, including medical regulatory and educational organizations in the osteopathic medical community. Our collective decision to further suspend the examination and not provide testing opportunities until September 1 may not be a popular one, but we continue to do everything we can to provide safe testing opportunities for students and residents to meet licensure requirements and demonstrate their competencies. At the same time, we will honor our commitment to the patients and communities who entrust us with the responsibility of professional self-regulation that ultimately helps to keep them safe.


MAY 18, 2020

In an effort to assist candidates impacted by cancellations of the COMLEX Level 2-PE examination due to the ongoing COVID-19 pandemic, we are releasing additional testing sessions for later this year and early 2021.  New sessions have been made available on the NBOME portal and more will be released once we resume normal operations.

NBOME continues to evaluate recommendations related to how long social distancing will be in effect to determine when additional opportunities for more sessions might best be added. Currently almost 3200 candidates have been impacted by exam cancellations and we appreciate your understanding as we look to offer rescheduling options. Our portal is open and remains the fastest means to reschedule exams.

We often hear student and school concerns about residency program applications and the desire to have Level 2-PE results before applying in ERAS. Please know residency program directors are well aware that many applicants in the Class of 2021 will not have a chance to receive a test score by the new October 2020 ERAS opening. We appreciate your understanding during this stressful time and please be assured we are very cognizant of the importance of providing ample opportunities for this exam.

Once the National Centers for Clinical Skills Testing resume exams, we will be able to determine the best avenues for the additional sessions.  We hope you are staying safe during these challenging times.


MAY 14, 2020

The health and safety of our staff and candidates is of the utmost importance to the NBOME. Governors in both states (PA and IL) have mandates in place that have made it impossible to deliver the June exams. Therefore, NBOME has extended our COMLEX-USA Level 2-PE hiatus through June 30 and hope to resume testing on Wednesday, July 1. We apologize for the inconvenience this creates but ask for your understanding during this time of national emergency and uncertainty. Candidates scheduled in June will be notified individually and we will work with them to assist with rescheduling their exam. Once we return to normal operations, we will add a considerable number of additional exam sessions in an effort to provide as much opportunity to test and receive results in a timely manner.

We continue to monitor the situation daily and will make informed decisions about testing and impact on the exam based on how the pandemic unfolds. We will resume testing when it is as safe as possible to do so. Prior to resuming, we will provide information regarding any impact COVID-19 has on how the exam unfolds, including modifications to exam administration for social distancing and accounting for this novel disease in the context of exam cases. The NBOME remains committed to a valid, reliable, defensible and fair assessment of the fundamental clinical skills required for licensure as an osteopathic physician and by residency program directors. Thank you for your understanding during this stressful time.

Our portal is open to reschedule exams and at this time, score release dates are unchanged for exams taken from July 1 onward. The NBOME is very aware of the need to have Level 2-PE results in a timely manner for rotation, residency application, and graduation requirements. As circumstances, guidelines and governmental mandates continue to vary across the nation, we recommend that those uncomfortable with travel for a July, August or September test session (or any time) reschedule their session. There will be sessions added to accommodate candidate demands through the winter and spring months of 2020-2021.

We often hear student and school worries about residency program applications and the desire to have Level 2-PE results before applying in ERAS. Please know that residency program directors are well aware that many or most applicants in the Class of 2021 will not have had a chance to receive a test score by the new October 2020 ERAS opening. We appreciate your understanding during this stressful time and please be assured we are very cognizant of the importance of providing ample opportunities for this exam.

We will continue to update schools, accreditors, and residency program director groups, reminding them that many 2021 graduates will not have Level 2-PE results by the new ERAS opening date in October 2020 or even by rank order list submission deadlines in February 2021, helping to advocate for students so they are not held accountable for test results of examinations they were unable to complete due to the pandemic.

We will continue to update this site as the situation evolves. Please contact the NBOME directly if you have any additional questions or concerns.

P: 866.479.6828
E: ClientServices@nbome.org


APRIL 8, 2020

The health and safety of our staff and candidates is of utmost importance to the NBOME. With this in mind and in order to carry out our mission of protecting the public, NBOME has extended our exam hiatus through May 31 and hope to resume testing on Monday, June 1. We apologize for the inconvenience this creates but ask for your understanding during this time of national emergency and uncertainty.

Our portal is open to reschedule exams and the score release dates are unchanged for exams taken from June 1 onward. The NBOME is very aware of the need to have Level 2-PE results in a timely manner for rotation, residency application, and graduation requirements.  We are committed to assisting students as much as possible during this challenging time.

Once we return to normal operations, we will add exam sessions in an effort to provide as much opportunity to access the exam.  We continue to monitor the situation daily and are looking to make informed decisions based on how the pandemic unfolds.  Thank you for your understanding during this stressful time.

For information on travel advisories or making changes to your current travel itinerary, please contact your airline or rail service directly. We will continue to update this site as the situation evolves.  Please contact the NBOME directly if you have any additional questions or concerns.

P: 866.479.6828
E: ClientServices@nbome.org


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