My school just had the call with the NBOME. It was pretty interesting. Dr. Gimpel expressed his frustration at his words being "taken out of context" on the internet, so I will try my best to give my own impression of what was said instead of quoting him. That said, there is a video recording of the meeting for accountability that I’ve requested a copy of from my school.
He mentioned several times how hurt he was that people were being so mean to him online about Level 2 PE when there hasn’t been a Level 2 PE exam administered in a year. He said the NBOME was shocked by the decision to end Step 2 CS and that his own announcement that Level 2 PE was going to continue was a response to him being inundated with questions about it. I’m not sure how that explains the content of the letter, but I got the sense that he was trying to explain why it might have been tone-deaf, especially about the part that says “we hear you,”. One of my brilliant classmates very clearly spelled out why the message is being perceived poorly, and his response to that was something along the lines of: we are better verbal communicators than writers. I found this funny considering that this whole mess is about being competent communicators.
He also mentioned how hurt he was that our petitions mentioned that a bunch of students flying in and out of Fresno might be a safety concern in a pandemic, and (in a somewhat insultingly beside-the-point-way) cited how safe the other COMLEX exams have been. I explained that as the writer of the petition, pointing out safety concerns re: the new site was not intended to make him feel bad, but to show that the timelines the NBOME itself has provided (resuming testing in April 2021 and starting a new location in Fresno in May 2021) is risky in terms of a slow vaccination effort and the emergence of new strains. He didn’t really argue with this except to repeat that they are being very safety minded.
He also attempted to reinforce over and over the idea that this is all because of patient safety, so addressing that point became my main line of questioning. I asked whether he believes that by discontinuing Step 2 CS, the NBME is endangering the public. He said yes.
I asked him if the NBOME had any plans to communicate their belief to the public that incoming MD residents would be endangering patients (I think I literally used these words because I couldn’t believe he would admit to something so outrageous). He said yes, but that they have to be diplomatic about it. As rationale for this belief, he mentioned that after the announcement of Step 2 CS discontinuation, he knows that some MD schools are cutting clinical education funding. I don’t understand why that would impact the class of 2021, though I do agree that would be concerning trend. Still, it should be up to accreditation boards to determine if there is sufficient clinical education in any given program.
He explicitly stated throughout that Step 2 CS and Level 2 PE are very different exams, and pointed to
this list of research re: Level 2 PE efficacy. I felt like he was implying that Step 2 CS wasn’t as well validated, which would be hilarious if true. It would be great if someone could go through the PE specific articles and determine how strong these studies actually are (Dr. Gimpel is a co-author on a large number of them, which already presents a conflict of interest).
I hope I can get access to the recording because his answers to some of my other questions were kind of difficult to follow. For example, he kept mentioning that some states require all physicians undergo a clinical skills exam for licensure, but then said the standards are different for MD and DO since they are licensed by different boards, as if the NBOME and the osteopathic licensing boards don’t work together on creating these standards. So I’m still confused about that.
But my suggestion right now would be for everyone who hasn’t yet to ask for refunds for Level 2 PE, to lobby any state boards that have disparate licensing requirements for DOs and MDs, and to take the USMLE series once you find out where you matched and it’s allowed for licensure in your state, and to reach out to Chicago, Philadelphia, and especially Fresno municipal leadership to inform them about the situation and how people feel about it. I will be sending the mayor of Fresno the letter to the state osteopathic board + signatures collected so far (272, with multiple attendings) so that they know how practicing physicians feel about the risk-benefit ratio of opening a testing site there.
www.aaemrsa.org
