NBOME Town Hall

[Cornfed101]

So I was just reading this Q&A from the recent NBOME town hall and it is kinda depressing how removed from reality these folks are. Here are a few gems:

• In response to how p/f COMLEX will affect residency matching, they said now there is even less incentive to take USMLE, and they are working on a better conversion tool between COMLEX and USMLE because I'm sure PDs will use that.
• In response to the financial burden of the PE and the "new format," the NBOME is considering (they didn't say exactly what that would be). They said "fee increases that had been announced for July 2020 were postponed in the pandemic, and all exam change fees were eliminated in 2020 as well" Oh, how generous of you
• In response to why they are considering an alternate to PE when NBME is not, they talked some BS about patient safety (cause every osteopathic physician uses OMM all day every day) and they also said many state licensing boards require OMM skills testing for licensure, which I've never heard of, but I guess I could be wrong.

They ended with this quote, which in my interpretation says "don't compare yourselves to MDs because we are better" super, but you kinda have to convince PDs of that or it doesn't mean anything

"Let us not fall into the error that we may so easily- that of consoling ourselves that on average we are as good diagnosticians as our medical brothers. That is not the yardstick by which to measure. Our standard must be a new one - that of the needs of the hour and of humanity." -S.V Roebuck DO, President of the National Board of Examiners for Osteopathic Physicians and Surgeons 1948-1963 (as published in the JAOA in 1923).

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[InternistDO]

• In response to why they are considering an alternate to PE when NBME is not, they talked some BS about patient safety (cause every osteopathic physician uses OMM all day every day) and they also said many state licensing boards require OMM skills testing for licensure, which I've never heard of, but I guess I could be wrong.

This one is unfortunately true. Pennsylvania, at least, has this requirement though they're discussing removing it based on the PE cancellation this year and the potential for a permanent cancellation.

 

[DrZoidbergDO]

This one is unfortunately true. Pennsylvania, at least, has this requirement though they're discussing removing it based on the PE cancellation this year and the potential for a permanent cancellation.

i think FL as well, but i'm not 100% on that

 

[DrStephenStrange]

This one is unfortunately true. Pennsylvania, at least, has this requirement though they're discussing removing it based on the PE cancellation this year and the potential for a permanent cancellation.

There are only 6 states I think that actually have some sort of OMM requirement for DOs (PA, FL, OK, CA, MI, WV). They could easily get rid of those requirements if they wanted.

 

[AlbinoHawk DO]

I talked to a president of one of the COMs. He told me OMM departments ate adamant to bring back the test with stronger OMM focus. If you guys don't fight, it'll be back

Honestly, this OMM garbage needs to end. Sure, some of it is okay, but they bash it over the head so much that people grow to hate it. It's time we eschew these people from the profession

 

[Cornfed101]

I talked to a president of one of the COMs. He told me OMM departments ate adamant to bring back the test with stronger OMM focus. If you guys don't fight, it'll be back

Honestly, this OMM garbage needs to end. Sure, some of it is okay, but they bash it over the head so much that people grow to hate it. It's time we eschew these people from the profession

Really it should be an elective, not sure if that will ever happen though.

 

[Tragal Pointer]

There are only 6 states I think that actually have some sort of OMM requirement for DOs (PA, FL, OK, CA, MI, WV). They could easily get rid of those requirements if they wanted.

I don’t think these states have an “OMM requirement”. Whatever that is. I believe these states simply have an osteo board that requires the COMLEX series. PA is an exception as they do have an actual OMM test. And remember Class of 2021, as far as state licensing boards are concerned, the schools have vouched for our clinical skills through a special exemption made by the NBOME.

 

[Prehealth1011]

There are only 6 states I think that actually have some sort of OMM requirement for DOs (PA, FL, OK, CA, MI, WV). They could easily get rid of those requirements if they wanted.

I remember Anatomygrey saying OK is off the list

In any case, I’m gonna try to take level 3 and get my state license ASAP before they think of some sht

 

[DOVinciRobot]

I believe WA has some form of OMM expectation.

What states have what isn’t important, as it is literally less than a handful that have an OMM requirement. They are using that simply as a smoke screen.

I also want to emphasize for any student still in the early years that the need to take USMLE is greater than it ever has been. To not have a P on the USMLE exam will make it SO EASY for a residency program to throw your app straight in the trash. It will be a massive red flag to not take USMLE once the bar is simply to pass.

 

[scoopdaboop]

Wait you actually have to show OMM in some states? LMAOOOOOOOOO. The DO leadership be drunk on the OMM Kool-aid

 

[Doc_Ock]

Really it should be an elective, not sure if that will ever happen though.

Sooner than you think.

 

[deleted1081396]

There are only 6 states I think that actually have some sort of OMM requirement for DOs (PA, FL, OK, CA, MI, WV). They could easily get rid of those requirements if they wanted.

How can we start lobbying for this if we want to practice in those states? Who do we write?

 

[Goro]

Really it should be an elective, not sure if that will ever happen though.

Ahh, NBOME never fails to disappoint.

Cornfed, it CAN happen, but it will take you and your peers to do something about it.

And that is two-fold. First, lobby your faculty (meaning, the non-True Believers) who have any input with NBOME about this.

Then once you're an attending, join AOA, and lobby from the inside to do what you want to do.

IF you say, "**** all that. Once I graduate, I'm done", things will never change, because the True Believers will still be running things.

 

[deleted1081396]

Ahh, NBOME never fails to disappoint.

Cornfed, it CAN happen, but it will take you and your peers to do something about it.

And that is two-fold. First, lobby your faculty (meaning, the non-True Believers) who have any input with NBOME about this.

Then once you're an attending, join AOA, and lobby from the inside to do what you want to do.

IF you say, "**** all that. Once I graduate, I'm done", things will never change, because the True Believers will still be running things.

Is there a realistic possibility/probability that the AOA, NBOME, and all the professional certification orgs will be extinct in 25 years? I don't see how any of them, especially the professional certification orgs (AOBFP, AOBS and the like) will still be around once the older generation of DOs dies off.

 

[hohxil_fr]

I had a random idea that AOA, NBOME could merge with their MD siblings and all medical schools in the US could confer a joint MDDO degree, like the UK's MBBS, after all, MDs have been taking the "holistic" ideas from DOs, right? Just small random proposals from a premed...

 

[Goro]

Is there a realistic possibility/probability that the AOA, NBOME, and all the professional certification orgs will be extinct in 25 years? I don't see how any of them, especially the professional certification orgs (AOBFP, AOBS and the like) will still be around once the older generation of DOs dies off.

It's possible in the future that there might be some sort of merger between COCA and LCME and NBOME and NBME (these are two very different sets of organizations). But the AOA itself? Have no idea.

 

[hohxil_fr]

I can't wait to see MDs being awarded the DO degree after COCA-LCME merger.

 

[Tragal Pointer]

As long as there is the potential for money to be made, there will exist a divide between the DO and MD degree.

 

[DOVinciRobot]

I had a random idea that AOA, NBOME could merge with their MD siblings and all medical schools in the US could confer a joint MDDO degree, like the UK's MBBS, after all, MDs have been taking the "holistic" ideas from DOs, right? Just small random proposals from a premed...

I can't wait to see MDs being awarded the DO degree after COCA-LCME merger.

I think you don't realize just how much bigger and more powerful the MD orgs are. The DO organizations have power only in the DO world. That's it. Anything they have in the MD realm is purely because those organizations allow them to have it and it's not enough to actually matter.

 

[deleted1081396]

It's possible in the future that there might be some sort of merger between COCA and LCME and NBOME and NBME (these are two very different sets of organizations). But the AOA itself? Have no idea.

How will the AOA survive if no one new is filling their ranks? Especially now that you don't have to pay their extortion fees to keep your licensure? I think they'll eventually meet the same fate as their professional board certification orgs since there is now literally no reason whatsoever to choose them over their allopathic equivalents.

 

[Goro]

How will the AOA survive if no one new is filling their ranks? Especially now that you don't have to pay their extortion fees to keep your licensure? I think they'll eventually meet the same fate as their professional board certification orgs since there is now literally no reason whatsoever to choose them over their allopathic equivalents.

True Believers

 

[DrZoidbergDO]

True Believers

How many are there though? At my school it's only a handful

 

[deleted1081396]

True Believers

That demographic gets smaller with each passing class.

 

[Tragal Pointer]

How many are there though? At my school it's only a handful

It only takes a few.

 

[getfat]

I don't think LCME would want to merge with COCA anytime soon.

How many DO schools meet LCME standards maybe 3-4.

So they either go through the hassle of shutting down most DO schools or reduce their standards to DO schools.

Can only imagine the PR stunt AOA would go through to prevent shut down a single DO school.

 

[PandaBaer]

I don't think LCME would want to merge with COCA anytime soon.

How many DO schools meet LCME standards maybe 3-4.

So they either go through the hassle of shutting down most DO schools or reduce their standards to DO schools.

Can only imagine the PR stunt AOA would go through to prevent shut down a single DO school.

Where and by how much do LCME and COCA standards differ?
Perhaps it would be possible to raise COCA standards to be in line with LCME over time? If it can be done with the ACGME merger, with some attrition, it could theoretically be possible for COCA.

 

[getfat]

Where and by how much do LCME and COCA standards differ?

Clerkship years mostly. Expectations for USMD students vastly different. Opportunities in non-primary specialties completely different. Consistency in education completely different.

Perhaps it would be possible to raise COCA standards to be in line with LCME over time?

Maybe. I think its possible the schools that have established a regional presence already. They could convince a hospital to be a teaching hospital for a couple students.
I think maybe 2-3 DO schools could do it for 100-200 students.
Do we really think 10-20 DO schools could reduce their class size to 40 ? Doubtful.

 

[ohmanwaddup]

Clerkship years mostly. Expectations for USMD students vastly different. Opportunities in non-primary specialties completely different. Consistency in education completely different.


Maybe. I think its possible the schools that have established a regional presence already. They could convince a hospital to be a teaching hospital for a couple students.
I think maybe 2-3 DO schools could do it for 100-200 students.
Do we really think 10-20 DO schools could reduce their class size to 40 ? Doubtful.

my school prides itself on being one of the biggest medical schools in the country class size wise

 

[deleted1081396]

Can you reach this income level by doing tele with a full-time job as just a general neurologist without any fellowship?

 

[Konigstiger]

Expectations for USMD students vastly different.

I was also curious about the difference in standards between LCME and COCA. Do you have a source which lists the numerical aspects of this? All I could find was the LCME's "12 Standards" on their website along with a few documents which just list some pretty basic, qualitative things.

 

[getfat]

I was also curious about the difference in standards between LCME and COCA. Do you have a source which lists the numerical aspects of this? All I could find was the LCME's "12 Standards" on their website along with a few documents which just list some pretty basic, qualitative things.

I do not. Looked for a second on the google as well and couldn't find it either :shrugs:

 

[Cornfed101]

I was also curious about the difference in standards between LCME and COCA. Do you have a source which lists the numerical aspects of this? All I could find was the LCME's "12 Standards" on their website along with a few documents which just list some pretty basic, qualitative things.

Well for one thing, RVU MT was just approved by COCA even though the state of Montana doesn’t want them there

 

[FutureInternist]

“.....but they bash it over the head so much that people grow to hate it. .....”

Good thing we ALL know several Cranial techniques that can help with that 🤪

 

[BorntobeDO?]

How will the AOA survive if no one new is filling their ranks? Especially now that you don't have to pay their extortion fees to keep your licensure? I think they'll eventually meet the same fate as their professional board certification orgs since there is now literally no reason whatsoever to choose them over their allopathic equivalents.

They have been stronger against mid levels than AMA is/was and have been doing it longer. Quite frankly between the two Org’s I would rather support AOA. I have been considering joining.