Only One Medical Licensure Examination Series Instead of Two? AMA Resolution 325.

To practice medicine, licensure is a must! In order to become a licensed physician, medical students must pass a series of licensure examinations (e.g. USMLE, COMLEX). The determination of which licensure exams ("boards") must be taken depends upon whether a school is accredited by the Liaison Committee on Medical Education (LCME) (which graduates MD [allopathic] students) or by the Commission on Osteopathic College Accreditation (COCA) (which graduates DO [osteopathic)]students).

Up to now, osteopathic medical students have been required to sit for and pass Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) examinations in order to meet COCA requirements (and often in order to graduate from DO schools). DO students often elect to take the United States Medical Licensing Examination (USMLE) to enhance their competitiveness for residency matching, especially in specialties or residency programs that are more selective/competitive. Of note, many osteopathic medical students successfully match into excellent specialties and programs without taking the USMLE. As I have guided hundreds of osteopathic medical students through the decision-making process regarding whether or not to sit for the USMLE in addition to the COMLEX, I have, however, seen the stress and impact of making such a critical decision. Of note, this is not a one-time decision. The COMLEX series includes Level 1, Level 2CE, (Level 2PE - ceased due to COVID-19), and Level 3 (taken during residency). Similarly, the USMLE series includes Step 1, Step 2CK, (Step 2CS - ceased due to COVID-19), and Step 3 (taken during residency).

In response to various different factors (e.g. student stress, financial parity), the American Medical Association (AMA) has put forth Resolution 325. The resolution provides the rationale and intent to shift from two series of licensure examinations to a single modified examination that would incorporate a section specifically designed for DO student candidates. The resolution can be read at https://www.ama-assn.org/system/files/a22-325.pdf. Of note, the osteopathic medical community has provided their rationale for not supporting the shift and their perspectives can be found at https://www.nbome.org/news/osteopathic-community-joint-statement/ with concerns including, but not limited to, uncertainty regarding the composition of a modified exam. It will be important to follow this process as such a decision will have a tremendous impact not only on DO (and MD) medical students but also on the osteopathic medical community and organizations including the COCA, NBOME, AOA, AACOM, and individual osteopathic medical schools.

With an evolving UME landscape, modifications in the UME-GME transition, and a continued need for GME growth to accommodate an increasing number of medical students, it will be interesting to see how medical education will adapt and mold into the future! A reminder that needs to stay in place throughout is the need to maintain the mental, physical, and spiritual health of our future physician workforce. Hopefully, as changes in medical education occur, medical trainee wellness will improve to ultimately parallel the health and wellness that we wish for our patients.

Wishing all students well, as always,

Sincerely,

Dr. Vora

P.S. Feel free to reach out to me if you are a premed student, DO/MD/IMG medical student, or resident considering a career pivot and would like support and guidance. I would love to help in any way that I can :).