Clinical Skills Assessment
Quick Links
About Clinical Skills Assessment
Osteopathic clinical skills—such as building a patient history, performing physical examination, structural examination and osteopathic manipulative treatment (OMT), physician-patient communication and interpersonal skills, clinical decision making, and others—are essential to the practice of osteopathic medicine. Assessment of these competencies remains fundamental for professional self-regulation and for protecting the health of the public.
New Options for Clinical Skills Assessment
In June 2025, the NBOME announced two new pathways for candidates to demonstrate their proficiency in clinical skills as part of their eligibility for COMLEX-USA Level 3.
Beginning with the Class of 2029, candidates must do one of the following:
For candidates in the classes of 2026-2028, clinical skills proficiency has been and will continue to be determined by attestation from their COM dean.
A History of Clinical Skills Assessment
COMLEX-USA Level 2-Performance Evaluation (Level 2-PE) was administered from 2004 to 2020 and was designed to measure competencies in fundamental osteopathic clinical skills within two scored examination domains: the Humanistic Domain and the Biomedical/Biomechanical Domain.
The exam included 12 encounters with standardized patients, and candidates were assessed on their abilities in areas including: physician-patient communication; interpersonal skills; incorporating hands-on physical exams and building a patient history; performing osteopathic manipulative treatment; and documentation in a SOAP note format. COMLEX-USA Level 2-PE was suspended indefinitely in February 2021 and formally discontinued in June 2022.
Frequently Asked Questions
We’ve compiled answers to some of the most commonly asked questions about the NBOME, our products, and services. If you can’t find the information you’re looking for, please feel free to reach out to us.