Addressing PE

  • Thread starter Thread starter AnatomyGrey12
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
msnbc2020 said:
View attachment 328725

Initial License | Arizona Osteopathic Board

The Board currently has three pathways to licensure as an Osteopathic Physician in the State of Arizona: License by Examination, Licensure through the Interstate Medical Licensing Compact (IMLC) and Universal Licensing Recognition (Applicants for Universal Recognition do not qualify for...
www.azdo.gov www.azdo.gov

So a DO gets licensed using USMLE sequence in Arizona. The same DO then decides to move to California and is turned down for a license. Would this not be an illegal restraint of trade?
Click to expand...
Sorry no. The licensing of professionals is an essential part of the sovereign police powers of each state. Just ask the lawyers who have to re-take the bar exam if they move to certain states. While many states will license lawyers with a certain number of years experience, or at least limit your test taking to a small exam of state specific procedures, others will give you no credit whatsoever and treat you the same as recent law school graduate. CPA's, engineers and other professionals also can have licensing hoops to jump through. My dad is a CPA and he has told me there are certain states that his license would not be recognized for a reciprocal license. This is due to variations in the standards for number of accounting classes, other requirements such as specific classes in law or ethics, and whether CPA firm work experience is required vs corporate accounting/auditing experience.
 
Last edited:
sunshinefl said:
I can't tell by the wording of "must have MD or DO" if you have to wait to actually have your degree to register or just abide by entering an eligibility period after graduation.
Click to expand...
I believe you have to produce your graduation docs before they authorize you to pick a date. That is, you must be a DO/MD by the time you even initially apply to get a test date.
 
unexpectedcomplications said:
Dean said it was an honor to be considered by the NBOME and that he will keep us updated on this "exciting news" -_-
Click to expand...

Wow. Actually gagged there. Probe your clinical skills department if any headway was made since. If he's genuinely excited, I wouldn't trust him to keep you updated. Communications skills took a backseat when everything went online.
 
They will fight to keep this test to the bitter end, but it will eventually be dropped, hopefully by the end of the year
ChicagoBear said:
Sorry no. The licensing of professionals is an essential part of the sovereign police powers of each state. Just ask the lawyers who have to re-take the bar exam if they move to certain states. While many states will license lawyers with a certain number of years experience, or at least limit your test taking to a small exam of state specific procedures, others will give you no credit whatsoever and treat you the same as recent law school graduate. CPA's, engineers and other professionals also can have licensing hoops to jump through. My dad is a CPA and he has told me there are certain states that his license would not be recognized for a reciprocal license. This is due to variations in the standards for number of accounting classes, other requirements such as specific classes in law or ethics, and whether CPA firm work experience is required vs corporate accounting/auditing experience.
Click to expand...
Reciprocity applies to all 50 states for a professional engineer liscense. It is a national test, so It does not matter where you were liscensed originally. All 50 states will recoginize your liscense. However, certain states have unique requirement such as seismic/earth quakes, sub-zero temperature, high winds/tornado/huricane, etc.. you will only need to take and pass the portion of the exam that uniquely applies to that state. A national liscensing approach should be applied to the medical profession whether MD or DO in my opinion. They should also combine the MD and DO liscensing under one system, but that is a pipe dream because some DO orginizations have too much to lose. These are the people that are making the lives of DO students way harder when they should be helping students succeed. not saying anything that everyone on this board already knows.
 
msnbc2020 said:
View attachment 328725

Initial License | Arizona Osteopathic Board

The Board currently has three pathways to licensure as an Osteopathic Physician in the State of Arizona: License by Examination, Licensure through the Interstate Medical Licensing Compact (IMLC) and Universal Licensing Recognition (Applicants for Universal Recognition do not qualify for...
www.azdo.gov www.azdo.gov

So a DO gets licensed using USMLE sequence in Arizona. The same DO then decides to move to California and is turned down for a license. Would this not be an illegal restraint of trade?
Click to expand...
States are free to set their own medical licensing requirements. Medicine is not an interstate business so rules regarding interstate trade do not apply
 
MDMechEngr said:
They will fight to keep this test to the bitter end, but it will eventually be dropped, hopefully by the end of the year

Reciprocity applies to all 50 states for a professional engineer liscense. It is a national test, so It does not matter where you were liscensed originally. All 50 states will recoginize your liscense. However, certain states have unique requirement such as seismic/earth quakes, sub-zero temperature, high winds/tornado/huricane, etc.. you will only need to take and pass the portion of the exam that uniquely applies to that state. A national liscensing approach should be applied to the medical profession whether MD or DO in my opinion. They should also combine the MD and DO liscensing under one system, but that is a pipe dream because some DO orginizations have too much to lose. These are the people that are making the lives of DO students way harder when they should be helping students succeed. not saying anything that everyone on this board already knows.
Click to expand...

If you have any means to do so, we would sure love to have your public support in all this.
 
msnbc2020 said:
Actually medicine is very much an interstate business.

A bill introduced by U.S. Rep. Ted Yoho, R-Fla., would imperil funding for states that do not join the Interstate Medical Licensure Compact within three years.
The compact, which currently includes 29 states, as well as Washington, D.C. and Guam, was formally introduced in the fall of 2014 in recognition of the fact that physicians will increasingly practice in different states via telehealth.
Yoho's legislation would make funding from the Bureau of Health Workforce conditional on adopting the compact.

WHY IT MATTERS
The Interstate Medical Licensure Compact became operational in 2017.
Physicians can qualify to practice medicine in multiple states, receiving separate licenses for each, via one application within the compact. The licensing is still state-based, but the application process is streamlined.
"States that participate in the Compact are able to streamline licensure by using an expedited process to share information with each other that physicians have previously submitted in their State of Principal License – the state in which a physician holds a full and unrestricted medical license," reads the compact's website.
To be eligible, physicians must hold a full, unrestricted medical license in their state of primary residence, where they also practice at least 25% of their business. They must also have graduated from an accredited medical school and not have any history of disciplinary actions toward their license, among other requirements.
The compact is administered by the Interstate Medical Licensure Commission, which has two representatives from each participating state medical board. In addition to the 29 states already participating, Ohio, New York, New Jersey, Georgia and Oklahoma have taken steps to join the compact.
House bill would compel states to join the Interstate Medical Licensure Compact
Click to expand...
The Compact is currently voluntary and largely doesn't do a thing to help with licensing. Having a license in a Compact state can make it ever so slightly faster to get one in another state but you still need to pay and be vetted by the new state, making the compact functionality meaningless. Furthermore, the compact does not make medicine a domain of interstate trade and in fact protects the rights of states to regulate their own markets as they see fit. Interstate trade is a very specific thing in legal terms. Professions, by legal definitions in the United States, are the domain of States and not the federal government. For further clarification:

jaoa.org

Home - Journal of Osteopathic Medicine

jaoa.org

"Physicians seeking entry into the IMLC will be evaluated by the board in their state of principal license against specific criteria as laid out in the IMLC’s definition of physician.8 In addition, Section 5 of the IMLC8 specifically details that it is the state board, not the Commission, that determines the eligibility of any physician to participate, which includes that board completing a federal and state criminal background check on the applicant. Only state boards can issue licenses and discipline physicians under the IMLC, just as it is today. In reality, by employing the Compact Clause of the US Constitution, the IMLC protects states’ rights and strengthens the ability of medical boards to protect the public."
 
msnbc2020 said:
I am sorry but I really do not think you understand the compact.

1) You do not need to "vetted by the new state".

Before the compact was established, each state would determine its requirements for medical licensing, which meant they were all different. The IMLC was established by local state medical boards in an effort to streamline this process. Participating states came together and agreed to accept each other's vetting processes for medical licenses.

Recently, we were working with a physician who worked in Wisconsin but wanted to take a locum tenens assignment in Minnesota. In the past, he would have had to go through Minnesota's normal medical licensing process, which usually takes around seven weeks. However, because both Wisconsin and Minnesota are IMLC-participating states, he was able to get his license in just 13 days.

www.physicianspractice.com

Medical Licensure in Multiple States Made Easy

Everything physicians need to know about the Interstate Medical Licensure Compact and how it can further their career.
www.physicianspractice.com www.physicianspractice.com

2) Joining the compact is done through legislation that is passed in each state.

These licenses are still issued by the individual states – just as they would be using the standard licensing process – but because the application for licensure in these states is routed through the Compact, the overall process of gaining a license is significantly streamlined. Physicians receive their licenses much faster and with fewer burdens.

The licensing is all state-based. Physicians do not receive a “Compact license” or a nationally recognized medical license through their participation in the Compact.

Approximately 80% of U.S. physicians meet the criteria for licensure through the Compact.

Only states that have formally joined the Compact can participate in this streamlined licensure process. In order to participate in the Compact, states must pass legislation authorizing it.
www.imlcc.org

States Information | Interstate Medical Licensure Compact

Information of participating U.S. states for the physicians licensing process. Contact Interstate Medical Licensure Compact for licensure.
www.imlcc.org www.imlcc.org
Click to expand...
The Compact is an additional, optional program for physicians to engage in. You have to specifically apply to it, and at that point you are held to both the standards of the compact and the standards of your home state board. It is *not* a true interstate integration of Licensure, but rather allows *certain physicians that meet certain requirements within a given state expedited Licensure in others.* As an example, half of psychiatrists in each of the given States would not be Compact eligible, as half of psychiatrists, give or take, are not board certified. Their license, despite being issued by a Compact state, is not Compact eligible, as they do not met Compact Licensure requirements. Furthermore, aside from speeding licensure, there are other steps in obtaining a license that can still be enforced that fall ourside of the compact, as allowed in Section 24:

Section 24. Binding effect of compact and other laws
A. Nothing in this compact prevents the enforcement of any other law of a member state that is not inconsistent with this compact.

This is the area where some states with more notorious boards and legislatures have some leeway. Pennsylvania, for instance, has certain educational requirements enshrined in state law with regard to opioid and child abuse training that one will still have to complete before being considered for a Compact license, because these laws are legislatively enshrined and not decisions of the medical board.

Regardless, this all kind of goes back to my point that the compact isn't what it should be- one national license that you apply for and get that works in every state in the Compact. It is an additional framework that allows some physicians within a state to apply for additional rights on top of their current license. You still need to pay all the fees of each state for each license, you still are held to legislative laws unique to each state, and you may well qualify for a license in one or even every state in the Compact and not be eligible for the Compact yourself. That's why it's not a true instate commerce agreement, but rather a special process that speeds the issuance of some licenses for some physicians under some circumstances of they choose to participate.
 
Hi everyone,
it seems like the best way forward is to get other organizations outside of the NBOME involved in the effort to cancel Level 2 PE. I've drafted a letter to the Osteopathic Medical Board of California that I plan to send to them on Tuesday. I'm hoping to get signatures from both attendings as well as students. Please circulate, especially to sympathetic attendings and faculty. Thank you for your solidarity!
Link to form: Letter to Osteopathic Medical Board of California: Help Cancel COMLEX Level 2 PE
 
yumpopink said:
Hi everyone,
it seems like the best way forward is to get other organizations outside of the NBOME involved in the effort to cancel Level 2 PE. I've drafted a letter to the Osteopathic Medical Board of California that I plan to send to them on Tuesday. I'm hoping to get signatures from both attendings as well as students. Please circulate, especially to sympathetic attendings and faculty. Thank you for your solidarity!
Link to form: Letter to Osteopathic Medical Board of California: Help Cancel COMLEX Level 2 PE
Click to expand...
Throw in PA as well.
 
yumpopink said:
Hi everyone,
it seems like the best way forward is to get other organizations outside of the NBOME involved in the effort to cancel Level 2 PE. I've drafted a letter to the Osteopathic Medical Board of California that I plan to send to them on Tuesday. I'm hoping to get signatures from both attendings as well as students. Please circulate, especially to sympathetic attendings and faculty. Thank you for your solidarity!
Link to form: Letter to Osteopathic Medical Board of California: Help Cancel COMLEX Level 2 PE
Click to expand...
Can we make a Florida one too? This is perfect.
 
I always thought the NBOME's purpose was to preserve that DO identity post-merger. Or maybe they think the PE will show that we can treat the whole person?

They do care about our progre$$
 
j4pac said:
So as an attending, what can I do to help?
Click to expand...
Would you consider signing a petition to the Osteopathic Medical Board of California and perhaps sending it to other attendings? Support from fully licensed physicians would go a very long way to convince regulatory boards that eliminating Level 2 PE would not jeopardize public safety.
forms.gle

Letter to Osteopathic Medical Board of California: Help Cancel COMLEX Level 2 PE

Dear Members of the Osteopathic Medical Board of California, We write this letter as concerned trainees and physicians regarding the NBOME’s recent decision to require COMLEX Level 2 PE for DO licensure following the NBME’s announcement that USMLE Step 2 CS will no longer be required for MD...
forms.gle forms.gle
 
msnbc2020 said:
Sorry. The letter does not make sense imo. The California board does not require the PE exam. Any physician that graduated before 2004 never took the PE exam and they can still apply and obtain a license in California. The California code makes no mention of the PE. It does mention completing Part 3 (Level 3). It also does not mention accepting the USMLE series for DOs.
View attachment 328826

The NBOME and NBME did not add Level 2 PE and Step 2 CS by getting laws changed in 50 states.

How was the NBME able to make their new test a requirement for licensure? Aren’t licensing requirements determined by individual state medical boards?​

Yes, they are.

And though the NBME had the support of the FSMB in introducing Step 2 CS, it still wouldn’t have been easy to get the legislature in every single state to amend their medical practice acts and require the CS exam.

So they didn’t. They did something far more clever.

The NBME/FSMB simply required passing Step 2 CS in order to register for USMLE Step 3. Because existing state regulations typically required completion of Step 3 for licensure – poof! – just like that, Step 2 CS became mandatory for all medical students.

thesheriffofsodium.com

Step 2 CS, Part Two: The Resistance

Welcome to the second part of our trilogy on the USMLE Step 2 Clinical Skills (CS) exam. In Part 1, I reviewed how the Step 2 CS examination came to be. We traced the history of the test from its r…
thesheriffofsodium.com thesheriffofsodium.com
Click to expand...

It does require the PE exam as, like you said, PE is required to take Level 3. While the CA Board itself may not have the power to eliminate the requirement, they are certainly a stakeholder whose opinion the NBOME will take into account.
 
Prehealth1011 said:
FL laws seem to indicate you can take the COMVEX to fulfill the level III requirement according to this:

Osteopathic Medicine Full Licensure - Florida Board of Osteopathic Medicine

floridasosteopathicmedicine.gov floridasosteopathicmedicine.gov
Is something like that possible in California?
Click to expand...
According to what I could find on the COMVEX, it seems the NBOME has to individually approve people to sit for it. I would guess they would not approve someone who was trying to use it to get licensed via the USMLE.
 
fldoctorgirl said:
According to what I could find on the COMVEX, it seems the NBOME has to individually approve people to sit for it. I would guess they would not approve someone who was trying to use it to get licensed via the USMLE.
Click to expand...
yeah The Osteopathic Medical Board of Florida would have to petition NBOME for a candidate to be able to take it.
 
Deecee2DO said:
Just got off the phone with a PD at a mid tier academic program in the south who is a DO. He said he could care less if you took PE or not to rank/Interview/match at his program. He said with no CS it means squat. Hes 100% for cancelling it. n=1 but still lol
Click to expand...
It’s more likely n=the entire population of PDs in the country.
 
yumpopink said:
Would you consider signing a petition to the Osteopathic Medical Board of California and perhaps sending it to other attendings? Support from fully licensed physicians would go a very long way to convince regulatory boards that eliminating Level 2 PE would not jeopardize public safety.
forms.gle

Letter to Osteopathic Medical Board of California: Help Cancel COMLEX Level 2 PE

Dear Members of the Osteopathic Medical Board of California, We write this letter as concerned trainees and physicians regarding the NBOME’s recent decision to require COMLEX Level 2 PE for DO licensure following the NBME’s announcement that USMLE Step 2 CS will no longer be required for MD...
forms.gle forms.gle
Click to expand...

Maybe post on Twitter as well? Idk
 
released by AMA today.

www.ama-assn.org

AMA guiding principles to protect learners responding to COVID-19

The AMA and other educational organizations issue principles to support and protect medical students if their institutions put them in physical contact with patients and/or offer early graduation during the COVID-19 pandemic.
www.ama-assn.org www.ama-assn.org
 
Noisewater-TDX said:
released by AMA today.

www.ama-assn.org

AMA guiding principles to protect learners responding to COVID-19

The AMA and other educational organizations issue principles to support and protect medical students if their institutions put them in physical contact with patients and/or offer early graduation during the COVID-19 pandemic.
www.ama-assn.org www.ama-assn.org
Click to expand...
EA0B1E4F-0040-405E-BE12-7C9D67A3DD16.jpeg
 
I want to ask one question before I finally request a refund for PE and it might have been answered in previous page. Sorry for asking again. For class 2021, if I decide to practice in 1 of the 44 states, (WA/NY/NV in my case), I can just do Step 1, 2, 3 to get my license. (have already taken Step 1 and 2). I think WA requires to take WA state OPP exam as DO. Just want to make sure that I don't need to go back to pay NBOME and Gimpel and take the ****ty PE and level 3. Thanks again
 
AiRBagel said:
I want to ask one question before I finally request a refund for PE and it might have been answered in previous page. Sorry for asking again. For class 2021, if I decide to practice in 1 of the 44 states, (WA/NY/NV in my case), I can just do Step 1, 2, 3 to get my license. (have already taken Step 1 and 2). I think WA requires to take WA state OPP exam as DO. Just want to make sure that I don't need to go back to pay NBOME and Gimpel and take the ****ty PE and level 3. Thanks again
Click to expand...
Yes you can use Step in WA. You'll just need to take whatever the state OPP exam is.

Edit: my phrasing was confusing.
 
I have decided to request a refund and use that money to register for and take Step 1 and Step 2CK after match but before residency start. Even though I'll be studying more than I wanted to, I feel like it's the right thing to do: hurt the NBOME where they feel it most, in the wallet.

I have no desire to live in any of the weird 5 states, and I will now be depriving Gimpel of almost $2,000. Now please pray that I pass Step 1 as a post-match 4th year lol
 
Anyone know what these state OMM exams are like? Is it basic soft tissue, FPR type stuff or do they expect you to do cranial and spinal HVLA?
 
I feel for you guys, this test was always a money grab. I called BS on this exam when I took it. Were constantly evaluated throughout medical school on omm and PE skills, there is zero reason for this exam to exist.

Id recommend going full usmle route if you are allowed by your state/med school. As far as advocacy goes, if your state allows you to get licensed via usmle, then focus advocacy efforts on your school if they require comlex. If your state requires comlex, focus efforts there. AOA, NBOME, COCA etc dont care one bit what students think. No point wasting energy there, they wont change.

Hit em where it hurts, get licensed through usmle,MD route.
 
msnbc2020 said:
Here is PA:

STUDY MATERIALS All protocols are referenced in the Foundations for Osteopathic Medicine, current edition. Sponsor is the American Osteopathic Association. Publisher is Williams and Wilkins. Executive Editor is Robert C. Ward.

RECOMMENDED PRACTICAL DEMONSTRATION CHAPTERS:
54 Soft Tissue Techniques
56 High-Velocity Low-Amplitude Thrust Technique

Additional Recommended Chapters:
Thrust Techniques: An Introduction
Muscle Energy Technique Procedures

Techniques M Muscle Energy H HVLA (high-velocity low-amplitude) S Soft Tissue

Body Regions C Cervical: Upper (OA-C7) T Thoracic: Upper (T1-T4), Lower (T5-T10) L Lumbar (L1-L5) P Pelvis (pelvic bones and sacrum).
View attachment 328947
Click to expand...
This made me nauseated... I haven't read anything omm related since level 2.
 
Jackaleauxpe said:
@Goro have you heard anything more about the situation in the last week?
Click to expand...
We're having a faculty meeting about this in a week or two
sylvanthus said:
I feel for you guys, this test was always a money grab. I called BS on this exam when I took it. Were constantly evaluated throughout medical school on omm and PE skills, there is zero reason for this exam to exist.

Id recommend going full usmle route if you are allowed by your state/med school. As far as advocacy goes, if your state allows you to get licensed via usmle, then focus advocacy efforts on your school if they require comlex. If your state requires comlex, focus efforts there. AOA, NBOME, COCA etc dont care one bit what students think. No point wasting energy there, they wont change.

Hit em where it hurts, get licensed through usmle,MD route.
Click to expand...
Do not underestimate the belief system of the True Believers in the "we're special" mindset.

Advocating is the way to go, as mentioned above.
 
Jack Donaghy said:
I have decided to request a refund and use that money to register for and take Step 1 and Step 2CK after match but before residency start. Even though I'll be studying more than I wanted to, I feel like it's the right thing to do: hurt the NBOME where they feel it most, in the wallet.

I have no desire to live in any of the weird 5 states, and I will now be depriving Gimpel of almost $2,000. Now please pray that I pass Step 1 as a post-match 4th year lol
Click to expand...
I commend your decision. If It makes you feel better I'm a 4th year and I took Step 1 in August and Step 2 CK in January. You will have to study some especially for step 1 since you're further removed, but you should pass. I didn't even bother trying to relearn biochem or finer basic science points and I achieved my personal goal.
 
sunshinefl said:
I commend your decision. If It makes you feel better I'm a 4th year and I took Step 1 in August and Step 2 CK in January. You will have to study some especially for step 1 since you're further removed, but you should pass. I didn't even bother trying to relearn biochem or finer basic science points and I achieved my personal goal.
Click to expand...
Thanks. What resources did you use? I was planning on just buying a month of Uworld. I am considering adding B&B, but I scored fairly high on both Levels so I don't think too much re-learning should be necessary.
 
@Jack Donaghy I’ll say one awesome thing about uworld step 2 is that even though it’s ~3500 questions, a lot of them are repeats from uworld step 1. Since you’re doing them back to back, I think you’ll have less re-learning than we did
 
You must log in or register to reply here.

Similar threads

wxman
COMLEX Level 2 PE
Replies
9
Views
2K
EDThoracotomy
EDThoracotomy
J
NBOME - COMLEX PE
Replies
8
Views
2K
PandaBaer
PandaBaer
D
The return of the Level 2-PE in a year?
Replies
4
Views
1K
Goro
Goro
W
How is your school addressing aways?
Replies
17
Views
2K
Scrubs101
Scrubs101
C
Permanent Address for Residency Application
Replies
4
Views
717
Coltuna
C
Top