Addressing PE

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cbc86 said:
Omg please stop. If you want to be an NBOME apologist go do it in another thread.
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Bru.

She said "And, lastly, we are seeing REAL patients and being evaluated by preceptors on the daily. Any discussion is useless until someone is able to ask these questions in a public setting and get an answer."

And I responded to that that she can get her answers/opportunity to ask that.
 
In case anyone was curious to see NBOME salaries as reported in their tax filing, John Gimple reported earning $600,000 dollars from NBOME compensation for a reported 37.5 hours worked per week. Can look for yourself and draw your own conclusions, but it is a little crazy to me that for every 60 dollars the NBOME receives in revenue, the man takes a dollar of it. For every $1300 PE exam, he pockets 22 dollars of it, or about 140k for the 6,500 students who take this exam every year.

projects.propublica.org

National Board Of Osteopathic Medical Examiners Inc - Form Form 990 for period ending Dec 2019 - Nonprofit Explorer - ProPublica

Since 2013, the IRS has released data culled from millions of nonprofit tax filings. Use this database to find organizations and see details like their executive compensation, revenue and expenses, as well as download tax filings going back as far as 2001.
projects.propublica.org
 
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0100010001001111 said:
In case anyone was curious to see NBOME salaries as reported in their tax filing, John Gimple reported earning $600,000 dollars from NBOME compensation for a reported 37.5 hours worked per week. Can look for yourself and draw your own conclusions, but it is a little crazy to me that for every 60 dollars the NBOME receives in revenue, the man takes a dollar of it. For every $1300 PE exam, he pockets 22 dollars of it.

projects.propublica.org

National Board Of Osteopathic Medical Examiners Inc - Form Form 990 for period ending Dec 2019 - Nonprofit Explorer - ProPublica

Since 2013, the IRS has released data culled from millions of nonprofit tax filings. Use this database to find organizations and see details like their executive compensation, revenue and expenses, as well as download tax filings going back as far as 2001.
projects.propublica.org
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Heh. In 2010 he started off with just over $300,000. As the total revenue doubled so did his salary. VPs have hovered around the $200,000 ever since. Nothing to see here. Nope.
 
Does anyone know if the NBOME is still waiving cancellation fees? I know the original plan was to waive those fees thru December 31, 2020. Another tactic would be for the class of 2022 to all register for early dates and cancel at the last minute, effectively worsening the backlog.
 
throwaway199 said:
Guys so just got done with the web call...

1. I asked if there was any plan on waiving PE as requirement to level 3 for c/o 2021 and he said as of right now there is no plan to do that. Now if for some reason they can't resume PE or c/o 2021 wont be able to take it by end of this year then they will rethink about this.

2. I asked what does he think of people taking Step 1 --> Step 2 --> Step 3 for licensing purposes in majority states that allow it (since most of us take Step 1&2 anyways) and he said that he cant stop us from doing that but we should be loyal and proud to be DO as we prepared for this profession for the past 4 years and just take Level 3 since we have be preparing for it anyways.

3. I think licensing before 2004 was very weird... every state that their own exams and what not you had to take... with COMLEX (and Step) the process became more streamlined and you can apply for license in all 50 states without worrying about taking more exams. And he said if you pass all Levels (1, 2, 3) you can practice down under (Australia)

3.1 Currently if you look at pharmacist they have to take new exams everytime they decide to practice in new state... so its better that we don't have to do that.

4. NBOME is non-profit org and the salaries/other dialogues going on social media is not true.


I messenger don't kill me
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I know you are the messenger but that is absolutely NOT what being a "non-profit" means in 2021. He thinks we are ****ing idiots, guys.

My hospital is a non-profit and the hospital doesn't make a profit but the exes get huge salaries and bonuses so they are directly affected by decrease in "profits" before accounting magic happens. Any extra money is a employee salary expense that just happens to go to executives and therefore hospitals revenues did not exceed expenses. He is the executive in this case making a lot of money. I don't give a single **** how they label the money. His conflict of interest still exists as an employee in a non-profit organization.

I mean, damn...
 
National SOMA is collecting testimonies on the PE Issue. They're due Feb 1 at 5 pm EST.

docs.google.com

COMLEX Level 2 PE Testimony

The National Student Osteopathic Medical Association (SOMA) plans to use the below responses to both aggregate an official organizational opinion, and to provide personal insights/stories on the COMLEX Level 2 PE. In order to amplify the student voice to stakeholders effectively and in a timely...
docs.google.com docs.google.com

1611961469987.png
 
What makes me more concerned is that rank lists are opening up Monday. A PD who has to have a DO resident complete PE AND Level 3 is going to need more time off than an MD resident. NBOME is actually making DO's the least competitive we've ever been for this match by not removing PE.

EDIT: I'm not saying none of us are going to match or anything like that, but I could see how this could be a factor in a programs rank list.
 
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msnbc2020 said:
Dear DO Medical Students and Residents:

In light of USMLE’s announcement (1/26/21) that MD medical students would no longer need to take “Step 2 CS”, the USMLE national clinical skills exam, we have heard from many DO medical students that they would like us to discontinue the COMLEX-USA Level 2-Performance Evaluation (Level 2-PE) clinical skills exam for DO medical students. We hear you. We had heard from both the Student Osteopathic Medical Association (SOMA) and the Council of Osteopathic Student Government Presidents (COSGP), two osteopathic medical student organizations, about student concerns particularly related to the pandemic and safety as well as costs and concerns about secondary uses (residency applications) of exam scores.

Our public statement describing our position and short term and longer-term initiatives in regards to national standardized clinical skills testing for licensure and Level 2-PE can be found here. The Level 2-PE measures the ability to demonstrate core and fundamental competencies and values for DOs, including communication skills and connection, empathy, hands-on physical diagnosis/OMM and OMT. These are qualities state licensure boards value in seeking to protect their patients. We understand that NBOME’s position is an unpopular one amongst DO medical students. However, entrusted with a role in professional self-regulation, at this time we remain committed to both the importance of this examination for DO licensure and its impact on teaching, learning and patient care, and the feasibility of delivering this examination safely as planned. We will continue to provide you with updates in this regard, as well as continue to reach out to DO medical students and student organizations for additional feedback, as we always have.

The NBOME remains dedicated to the valid assessment of osteopathic competencies, promotion for the excellence of the osteopathic credentials of our students and physicians, and the protection of the public whom we all have the privilege to serve. The pandemic has certainly caused many temporary disruptions in how we do things, but it does not change who we are as a caring, professional osteopathic community and what we value as osteopathic physicians for our patients.
Sincerely,

John R. Gimpel, DO, MEd
on behalf of NBOME, its Board of Directors, National Faculty and Staff

It appears to me that the NBOME does not have any empathy for 2021 graduating students that are facing the upcoming match.
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They only have EMPaThY pockets. That's all they care about, their bottomline.
 
EMTAB said:
What makes me more concerned is that rank lists are opening up Monday. A PD who has to have a DO resident complete PE AND Level 3 is going to need more time off than an MD resident. NBOME is actually making DO's the least competitive we've ever been for this match by not removing PE.

EDIT: I'm not saying none of us are going to match or anything like that, but I could see how this could be a factor in a programs rank list.
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Yes I agree! Say that on the SOMA testimony link. Twitter. Both.
 
The single most effective thing that could be done is a national boycott of the PE -- we all cancel our dates and demand refunds from the NBOME. Their will would be broken very quickly if that could be organized. I don't believe that it can, aside from us organizing to boycott their other revenue streams such as the COMQUEST and COMSAE exams. Those are unnecessary to get a good score anyway. Likewise, we aren't r/wallstreetbets. We probably lack the resources and numbers to initiate a class action lawsuit unless we could somehow get a large number of attendings onboard. Though if anyone reading this has friends in the legal field, by all means contact them.

Dr. Carmody's ideas with outreach are the most viable: We do have the numbers and collective outrage to get the attention of key people with influence if we reach out to them as a single mass and all at once: State legislators, city representatives and media in the relevant places, program directors, faculty of our respective schools, members of the AOA and COCA, etc. Perhaps even the AMA given how large their audience is. We could also plead with attendings, especially DO attendings, to put pressure on the AOA and COCA. If a large number of DO residents and attendings are outraged by what is happening and the AOA's own streams of income are put at risk, their leadership may be pushed to act on our behalf.

Dr. Carmody is certainly right about one thing: The NBOME absolutely WILL NOT budge. They are more than likely teetering on bankruptcy and the PE is their last stand. They probably will not exist in 10 years. We know it. They know it. These efforts popping up to organize a response directly to them will be fruitless. They are sanctioned by the State and by COCA and they don't need to listen to us. We need to go above and outside of them, and we need to start getting it together now.

Any other ideas are welcome.
 
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throwaway199 said:
He said main mission for NBOME is to protect public and their trust in the process and hence they are reluctant to change the process. ¯\_(ツ)_/¯
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Let's be honest, the public doesn't know anything about the NBOME or the COMLEX PE so how could it existing or not impact the public's trust in the process? It's a garbage excuse.
 
I filled out that soma survey thing. don't know if it will help, but this is what I said:

1. My #1 Rank residency requires completion of Level 3 ideally before starting and latest December of Intern Year.

2. There are no 2021 PE dates available.

3. I don’t know when I will have PTO to study for and travel for the PE during residency.

4. Time off in intern year is precious and you are making it so I have to use it for the PE.

5. You will be pulling me from real patients to travel in the middle of a pandemic in the middle of residency to see fake patients.

6. Our clinical competence is already evaluated by our schools and our hospitals.

7. You have said class of 2021 is being prioritized, but your own organization told me there was no mechanism to enforce this when I suggested it months ago.

8. Class of 2022 is holding most of the PE dates in 2021.

9. Class of 2022 and beyond will be log jammed by prioritizing Class of 2021, but we need to take it to move forward with licensing.

10. MD students now have no such exam. Neither do DOs from prior to 2004. Are all of those group of physicians a danger to the public?

11. By requiring PE of DOs, you are saying that we can’t be trusted to be as competent as MDs, and neither can our osteopathic medical schools, hospitals, and preceptors be trusted in judging clinical competence.

12. The PE exam also introduces another hurdle that costs time and money, only affecting DO students.

13. The PE exam also introduces another opportunity for a board exam failure, only affecting DO students, and thus handicapping them in The Match.

14. DO students already have to spend extra time, money, and board failure risking by taking Step 1 and Step 2 CK alongside Level 1 and Level 2 CE to be competitive for residency.

15. PE results take 2.5 months, and only then can you schedule your Level 3 which again depends on availability of PTO from your residency as well as Prometric availability, further delaying Level 3 for people who are forced to take PE during residency.



***The best resolution would be to cancel the Level 2 PE.

***The 2nd best resolution would be to waive the Level 2 PE entirely for class of 2021 to prevent licensing disruptions and a back log of testing on 2022 and beyond.

***The 3rd best resolution would be to at least allow Class of 2021 to take Level 3 in any order, including before Level 2 PE.
 
I switched my date to December today but I really want to just cancel all together and get my money back. As a third year, most of my classmates are scheduled for later this year but some are still holding out on scheduling at all. Should I cancel or just hold onto my date and hope they change their minds by then? I don't have any faith in them waiving PE for my class for graduation.
 
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EMTAB said:
What makes me more concerned is that rank lists are opening up Monday. A PD who has to have a DO resident complete PE AND Level 3 is going to need more time off than an MD resident. NBOME is actually making DO's the least competitive we've ever been for this match by not removing PE.

EDIT: I'm not saying none of us are going to match or anything like that, but I could see how this could be a factor in a programs rank list.
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I mean in 44/45 states we can simply take step 3 and skip the hassle so I don’t necessarily think it’ll be held against us in those states. Honestly by making a huge stink about it publicly I can see it raising concern to PDs who otherwise wouldn’t have given it a passing thought. Not saying we shouldn’t be making a stink, but it could possibly backfire
 
GoCards05 said:
I switched my date to December today but I really want to just cancel all together and get my money back. As a third year, most of my classmates are scheduled for later this year but some are still holding out on scheduling at all. Should I cancel or just hold onto my date and hope they change their minds by then? I don't have any faith in them waiving PE for my class for graduation.
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Cancel.
 
RamsFan&FutureDO said:
I mean in 44/45 states we can simply take step 3 and skip the hassle so I don’t necessarily think it’ll be held against us in those states. Honestly by making a huge stink about it publicly I can see it raising concern to PDs who otherwise wouldn’t have given it a passing thought. Not saying we shouldn’t be making a stink, but it could possibly backfire
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This is how nothing changes......
 
RamsFan&FutureDO said:
I mean in 44/45 states we can simply take step 3 and skip the hassle so I don’t necessarily think it’ll be held against us in those states. Honestly by making a huge stink about it publicly I can see it raising concern to PDs who otherwise wouldn’t have given it a passing thought. Not saying we shouldn’t be making a stink, but it could possibly backfire
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I see what you're saying, but there's a strong percentage of students who don't/didn't take Step 1/2 because they were applying to DO friendly specialties, didn't have the funds, believed it when their school/NBOME said "they're equivalent exams now", only took Step 1, knew they needed to take the full COMLEX series to go back to their hometown, etc. You're right that taking the Step series is a smart move, but we can use this talking point to advocate for ALL DO's while at the same time sticking it to the NBOME's wallet by choosing to take Step 3.
 
EMTAB said:
What makes me more concerned is that rank lists are opening up Monday. A PD who has to have a DO resident complete PE AND Level 3 is going to need more time off than an MD resident. NBOME is actually making DO's the least competitive we've ever been for this match by not removing PE.

EDIT: I'm not saying none of us are going to match or anything like that, but I could see how this could be a factor in a programs rank list.
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Do you think PDs are even paying attention to the PE at this point? Because with this logic you could argue a PD would prefer a c/o 2022 applicant who ends up taking the PE and passing in August vs. someone scheduled for November or December that is still an unknown. This is such a cluster f**k.
 
RamsFan&FutureDO said:
I mean in 44/45 states we can simply take step 3 and skip the hassle so I don’t necessarily think it’ll be held against us in those states. Honestly by making a huge stink about it publicly I can see it raising concern to PDs who otherwise wouldn’t have given it a passing thought. Not saying we shouldn’t be making a stink, but it could possibly backfire
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Thousands of DOs only take comlex. They can’t just take step 3. The laws say you have to complete the USMLE or COMLEX 1/2/3
 
fldoctorgirl said:
Do you think PDs are even paying attention to the PE at this point? Because with this logic you could argue a PD would prefer a c/o 2022 applicant who ends up taking the PE and passing in August vs. someone scheduled for November or December that is still an unknown. This is such a cluster f**k.
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I'm sure they're aware, but they have a full plate to begin with and are probably waiting to see what happens. Twitter has had a few PD's tweet about the PE and how they think it's useless.

Edit: You bring up a good point too about class of 2022 and preferring those who have it done over those who don't. I think that was talked about a few dozen pages ago here IIRC.
 
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Yaldabaoth said:
Would a petition to the host cities to block the congregation of students under COVID precautions be a possibility?
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Honestly, unless the current situation takes a rapid turn for the worse, the current trend is a good excuse for the NBOME to bulldoze on. Steps to distribute the vaccine properly are finally being taken and we're among the first to get it. People have stopped caring about their safety and are calling for fewer restrictions. Any strategy involving making a stink with the public won't work anymore. Only option is to cancel and jab away at them financially while contacting sympathetic organizations outside NBOME's influence, but who might be affected by their interference. I for one contacted AAFP and its presidents, individually, while I tinker for ideas or something presents itself.
 
GoCards05 said:
I switched my date to December today but I really want to just cancel all together and get my money back. As a third year, most of my classmates are scheduled for later this year but some are still holding out on scheduling at all. Should I cancel or just hold onto my date and hope they change their minds by then? I don't have any faith in them waiving PE for my class for graduation.
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Cancel for now.
 
RamsFan&FutureDO said:
I mean in 44/45 states we can simply take step 3 and skip the hassle so I don’t necessarily think it’ll be held against us in those states. Honestly by making a huge stink about it publicly I can see it raising concern to PDs who otherwise wouldn’t have given it a passing thought. Not saying we shouldn’t be making a stink, but it could possibly backfire
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PDs do not give a **** about our plight. They do care about an intern needing to go take this test.
 
Alkaidius said:
Honestly, unless the current situation takes a rapid turn for the worse, the current trend is a good excuse for the NBOME to bulldoze on. Steps to distribute the vaccine properly are finally being taken and we're among the first to get it. People have stopped caring about their safety and are calling for fewer restrictions. Any strategy involving making a stink with the public won't work anymore. Only option is to cancel and jab away at them financially while contacting sympathetic organizations outside NBOME's influence, but who might be affected by their interference. I for one contacted AAFP and its presidents, individually, while I tinker for ideas or something presents itself.
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Start with your classmates. Gather support and reach out to your state osteopathic people. Send a letter to the AOA. Send a letter to your senator. Focus on the discrepancy between MD and DO training. Undue burden.
 
j4pac said:
So as an attending, what can I do to help?
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Start by stating your opinion on social media if you use it. Ask close colleagues to do the same. Next reach out to state osteopathic organizations directly and express your concern, as well as the AOA. And finally, DM me your contact info if you are comfortable with that.
 
Alkaidius said:
Honestly, unless the current situation takes a rapid turn for the worse, the current trend is a good excuse for the NBOME to bulldoze on. Steps to distribute the vaccine properly are finally being taken and we're among the first to get it. People have stopped caring about their safety and are calling for fewer restrictions. Any strategy involving making a stink with the public won't work anymore. Only option is to cancel and jab away at them financially while contacting sympathetic organizations outside NBOME's influence, but who might be affected by their interference. I for one contacted AAFP and its presidents, individually, while I tinker for ideas or something presents itself.
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The AAFP isn't a bad place to start y'all:

The AAFP has provided feedback to the parent organizations of this exam regularly as changes--including last year's effort to move the USMLE Step 1 to pass/fail scoring--were considered and the AAFP has advocated for elimination of the challenges with Step 2 CS, including limited testing sites, high cost to students, and unproven correlation between exam performance and future performance in residency, specialty Board exams, and clinical practice. In this letter the AAFP calls on these organizations to, "monitor and rapidly correct situations in which USMLE exams negatively impact medical students, resident career options, holistic admissions, workforce diversity, and professional development. The results should lead to quick and timely action on an ongoing basis."

In its announcement, the exam parent organizations share intentions "to take this opportunity to focus on working with our colleagues in medical education and at the state medical boards to determine innovative ways to assess clinical skills." The AAFP plans to continue its advocacy and thought leadership, representing you, all our members in undergraduate and graduate medical education and in practice."
 
morningmedicine said:
The AAFP isn't a bad place to start y'all:

The AAFP has provided feedback to the parent organizations of this exam regularly as changes--including last year's effort to move the USMLE Step 1 to pass/fail scoring--were considered and the AAFP has advocated for elimination of the challenges with Step 2 CS, including limited testing sites, high cost to students, and unproven correlation between exam performance and future performance in residency, specialty Board exams, and clinical practice. In this letter the AAFP calls on these organizations to, "monitor and rapidly correct situations in which USMLE exams negatively impact medical students, resident career options, holistic admissions, workforce diversity, and professional development. The results should lead to quick and timely action on an ongoing basis."

In its announcement, the exam parent organizations share intentions "to take this opportunity to focus on working with our colleagues in medical education and at the state medical boards to determine innovative ways to assess clinical skills." The AAFP plans to continue its advocacy and thought leadership, representing you, all our members in undergraduate and graduate medical education and in practice."
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Could you put up a link to this?
 
I honestly don't know if this is feasible, but why doesn't the NBME just meet with a couple of DO's and create an OMT portion? Make it a separate 1-2 hour written exam like a COMAT that costs an additional $100, lobby the school to allow USMLE OR COMLEX as graduation requirement, and just push NBOME out? It sounds like most of the laws require completion of the "USMLE or COMLEX series", and this would just be part of the series. Isn't that why the CS was able to be removed without having to change any state medical laws? Perhaps someone more knowledgeable about that could let me know.

Edit: COCA accreditation element 6.12 States that all students must successful pass COMLEX-USA Level 1, Level 2 CE, and Level 2 PE prior to graduation.
 
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cbc86 said:
PDs do not give a **** about our plight. They do care about an intern needing to go take this test.
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Which is an argument that could be made to the leadership of the schools, COCA and the AOA, because it would mean that the class of '22 would be by far the least competitive class ever.
 
Jackaleauxpe said:
Which is an argument that could be made to the leadership of the schools, COCA and the AOA, because it would mean that the class of '22 would be by far the least competitive class ever.
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Exactly. I don’t think Class of 2022 even realizes how screwed they are. They probably won’t realize until it’s far too late.
 
cbc86 said:
PDs do not give a **** about our plight. They do care about an intern needing to go take this test.
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Exactly my point about it possibly backfiring. I’m doing everything I can to match into a state that I can take step 3 and not give the NBOME another penny, but right now when programs are making their rank lists us screaming about the PE not being cancelled COULD have a negative impact that otherwise wouldn’t have been on their minds. I’m not trying to stop the momentum of the cancel the PE movement online just pointing out it might have unforeseen consequences for us in the immediate time period. Also might not idk I’m a cynic lol
 
RamsFan&FutureDO said:
Exactly my point about it possibly backfiring. I’m doing everything I can to match into a state that I can take step 3 and not give the NBOME another penny, but right now when programs are making their rank lists us screaming about the PE not being cancelled COULD have a negative impact that otherwise wouldn’t have been on their minds. I’m not trying to stop the momentum of the cancel the PE movement online just pointing out it might have unforeseen consequences for us in the immediate time period. Also might not idk I’m a cynic lol
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Fear is the mind killer.
 
cbc86 said:
Fear is the mind killer.
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If you’re not at least apprehensive about this possibility then kudos to you. I’ll continue to be weary of the prospect of possibly getting knocked down some rank lists for something I have no control over that was until this week a big nothing in most PDs minds
 
cbc86 said:
Exactly. I don’t think Class of 2022 even realizes how screwed they are. They probably won’t realize until it’s far too late.
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Can you expand further on this? I'm kind of confused because y'all advised us to take later test dates and/or cancel but are now saying we'll be uncompetitive/screwed if we don't have a score? Maybe I am misinterpreting what you're saying.
 
The OMT our OMM/NMM professors (you know, the ones who actually know and practice OMM regularly?) assess during school practicals/exams is much more valid than the PE. We partner up with a classmate, diagnose each other, and then perform OMT while verbalizing what we are doing. They actually check our diagnoses and reassessments to make sure we're doing it right. On the PE, we're literally just making up a diagnosis that no one checks and should have already been treated by the x number of examinees prior to us if, you know, we were actually doing real OMT. By the the x number of examinees, that standardized patient shouldn't have any more somatic dysfunction. So basically, the PE just encourages us to fake OMT. How is this helping to protect the public???
 
RamsFan&FutureDO said:
If you’re not at least apprehensive about this possibility then kudos to you. I’ll continue to be weary of the prospect of possibly getting knocked down some rank lists for something I have no control over that was until this week a big nothing in most PDs minds
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It’s a dune reference.
 
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