Clinical Skills Assessment

Beginning with the Class of 2029, the NBOME will offer two pathways for candidates to demonstrate their proficiency in clinical skills as part of their eligibility for COMLEX-USA Level 3:

C3DO

The Core Competency Capstone for DOs (C3DO) provides an assessment of osteopathic clinical skills competencies to a national standard. These are evaluated through participation in a multi-station, modified Objective Structured Clinical Examination (OSCE) standardized patient-based assessment. It utilizes standardized assessment tools with training protocols, a centralized pool of certified osteopathic physician examiners, and a national case bank aligned with the COMLEX-USA Blueprint. C3DO is developed through a national collaboration and is delivered locally at participating colleges of osteopathic medicine.

Learn More

CCV

Comprehensive Competency Verification (CCV) is the alternative pathway for Level 3 eligibility that includes documentation and certification of a student’s competency achievement in osteopathic clinical skills as part of the COMLEX-USA examination series. It is a standardized pathway through which a COM can certify that a student has demonstrated competency in these skills.

Learn More

Through participation in either C3DO or CCV, every DO student will have the opportunity to demonstrate that they possess the osteopathic clinical skills necessary for licensure in the COMLEX-USA examination pathway for licensure.

The Value of CCV and C3DO

CCV and C3DO both offer pathways for eligibility for COMLEX-USA Level 3 that document achievement of competency in osteopathic clinical skills in the following ways:

Aligned content: Both pathways include assessment of the following osteopathic clinical skills:

• History building and hands-on physical examination skills
• Osteopathic clinical reasoning
• Interpersonal and communication skills, professionalism, and compassion in patient care
• Performance of OMT

Aligned structure: Each pathway requires direct observation of and demonstration of osteopathic clinical skills, in six encounters, with the requirement of OMT assessment in three encounters.  

Recognized achievement: C3DO provides a formal credential on the NBOME/COMLEX-USA transcript, while CCV enables consistent certification of student competency by COMs.

Actionable insights and stronger programs: Both can deliver meaningful performance data to support competency achievement and program feedback, while C3DO also advances faculty and staff development through participation in the national assessment program activities.

The Critical Role of Clinical Skills in Osteopathic Medical Licensure Assessment

Explore how the osteopathic community is responding to this call and why preserving clinical skills is essential to the future of our profession:

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.