Written by Kiyana Harris, MS, OMS-IV

We had the good fortune of meeting Kiyana on Twitter during Match week when she celebrated matching to Morehouse School of Medicine’s Psychiatry Residency Program. As she prepares to graduate from Philadelphia College of Osteopathic Medicine, she shared her thoughts for Mental Health Awareness Month.

One of the biggest osteopathic principles I carry with me on a daily basis is a person is a unit of body, mind, and spirit. I love this because it emphasizes the holistic approach that osteopathic physicians have when caring for patients. It relates to the intersectionality theory which emphasizes the idea that there are often multiple facets of one’s identity that pose intersecting challenges. Approaching a patient from all angles transforms your relationship with them, builds the trust they have in you, and aids in their overall care.

Considering someone’s mind is truly astonishing because without a healthy mind, how can you utilize your body? And vice versa! This is what ultimately led me to fall in love with psychiatry.

During my clinical rotations, I witnessed how someone’s mental health affected almost every other aspect of their lives. It affects their physical state, the relationships they form, their careers, and more! Seeing a psychological transformation in patients and how it positively impacts their physical state was life-changing for me. I love how in psychiatry you are able to peel back the layers of a person, which is an honor because you are trusted with someone’s most vulnerable moments.

As a Black woman, I saw so many opportunities to help people from my community within psychiatry, such as raising awareness of the barriers people face pertaining to psychiatric conditions and changing the negative perceptions of seeking care. Psychiatry excited me every single day and I was so sad when my rotation ended. I knew in my heart there was no other specialty that would make me feel as accomplished and fulfilled.

As a future psychiatrist, I feel that mental health for DO students is something that is extremely important to address!

Medical school has many challenges and is filled with sacrifices, stress, and exhaustion. It can be hard to have grace with yourself and learn how to achieve a work-life balance. I personally experienced a loss during my medical school journey when my grandfather passed away. It was incredibly heavy for me, since he was one of my biggest supporters in becoming a doctor. This became a pivotal moment for me regarding mental health. I experienced regret for not being with him during his final moments, and I felt as if I needed to suppress my sorrow to push through exams. However, I was fortunate enough to have classmates and faculty from my school that helped me catch up on missed lectures. I look back on that experience with such gratefulness because it taught me about self-awareness, mourning, and being kind to yourself. Pay attention to what you are feeling and give your body and mind what it needs to refuel.

As a medical student, having grace with yourself and knowing how to achieve a work/life balance can be hard. I also feel that the mental health of DO student minorities and people of color is crucial. Many of these students struggle with imposter syndrome and microaggressions.

My initial driving force for not taking the USMLE was financial. I was fortunate to know an alumnus from my school who matched into psychiatry and only took COMLEX and succeeded. Knowing that someone else was able to do that and achieve great things made me feel inspired! I made the right decision too because I was blessed to receive a great number of residency interviews even after only taking COMLEX!

My advice to others is don’t feel pressured to take both exams. However, do your research and make sure you have all the requirements needed for the specialty you are applying to. For example, some residency programs may incorrectly list that they require USMLE. If you’re unsure, always check NBOME’s program outreach page or fill out the advocacy contact form if it looks like they don’t accept COMLEX. I also would advise making sure your application is well-rounded by having a strong personal statement, letters of recommendation, and other experiences.

My advice for dealing with the stress of board exams is to reward yourself. Celebrate small wins and give yourself something to look forward to! One piece of advice I received from a mentor that helped me was to make sure you do not isolate yourself. It’s so easy to separate yourself and solely focus on studying, but having human interaction is needed. Humans are not meant to be alone for days and days. You should still attend dinners with friends because it will help you from burning out. I have learned many tools to help me get through stress, anxiety, and imposter syndrome. It isn’t easy and even I still have days where I experience it.

It’s important to remember it’s okay to not be okay and find those tools that work best for you.

For me, it was working out; it is a great way to release stress and ease your nerves—just another reminder of how much the mind and body are connected. I also love utilizing essential oils, such as peppermint and lavender on exam days when I may be nervous. I’ll dab a few drops on my bracelet or wrist and smelling the oils is so calming! I also have a group text with my closest classmates, and we always vent and uplift each other! It’s impossible to get through medical school alone so do not be afraid to lean on others.

Be aware of your own self-talk. What are you saying to yourself? Are you saying positive statements such as, “I am intelligent and I can do this” or are you saying negative statements such as, “I do not feel prepared, I don’t think I can do this”? You may not even be aware of what you tell yourself, but if you feed your mind positivity, you will be surprised how your outlook changes.

There are many situations during your clinical DO years that you may feel unprepared for, such as a patient passing or feeling overwhelmed from moving from the classroom to a clinical setting. Finding what works for you may be trial and error, but seeking mentorship and support from others is helpful. Having a mentor whom you can confide in and share your fears or stresses with can make a world of difference. They may also be able to offer tips on response tools that helped them. Having a therapist is also amazing, especially if you are fortunate enough to receive one through your school. Talk to residents during your rotation. I loved meeting DO residents who understood our process and could relate to what I was going through.

I know that transitioning from being a medical student to a resident will be challenging but I can’t wait to look back on my journey and say, “Wow, look at how far you’ve come!”

I am so excited to become immersed in psychiatry and learn all that I can so that I can be an excellent psychiatrist. I am even more excited to be able to use the tools I gained to help underserved communities. I also can’t wait to attend more conferences, which was something I didn’t have as much time for as a student, and volunteer to serve on speaker panels for medical students. I want to be a resource to others and share my experiences with the hope to inspire them.

Be sure to also check out the American Association of Directors of Psychiatry Residency Training (AADPRT)’s supporting statement on COMLEX, and the NBOME’s Mental Health and Wellness Toolbox.

The NBOME works to accelerate research focusing on the validity and fairness of the COMLEX-USA series, and how it can evolve to meet the changing needs of the profession.

At Educating Leaders (EL) 2023, the annual conference of the American Association of Colleges of Osteopathic Medicine, NBOME staff will present on some of this research:

Predictive Validity of MCAT Scores and Undergraduate GPA for COMLEX-USA Licensure Exam Performance
April 26 | 1:45 – 2:15 pm ET
With Erik Guercio and Mark R. Speicher, PhD, MHA, AACOM; Kenneth Royal, PhD, MS, Christian Meyer, and Cynthia Searcy, PhD, AACOM; and Jeanne M. Sandella, DO, NBOME vice president, professional development initiatives & communications, Joseph Flamini, MBA, vice president for administration/COO, and Tsung-Hsun T. Tsai, PhD, associate vice president for assessment services & research, NBOME
This study examines MCAT predictive value for osteopathic medical schools, specifically, how well they predict performance on COMLEX-USA Level 1 and Level 2-CE and how that performance is broken down by sex, race, ethnicity and socioeconomic status. Learn more.

A Study on the COMSAE Phase 3 Usage
April 27 | 7:30 – 8:30 am ET
Poster Presentation by Xia Mao, PhD, director for psychometrics and research
This study investigates the characteristics of the population of the COMSAE Phase 3 test-takers since 2018 when the new blueprint was implemented, and the relationship between the scores of the COMSAE Phase 3 and COMLEX Level 3 for this population. Learn more.

COMSAE Phase 2: Patterns, Preparation and Expectations for COMLEX-USA Level 2-CE
April 27 | 7:30 – 8:30 am ET
Poster Presentation by Rong Jin, PhD, senior psychometrician
This study explores COMSAE Phase 2 use by candidates and its impact on COMLEX-USA Level 2-CE performance. Learn more.

NBOME Update: Building Momentum for the Value of Osteopathically Distinctive Assessment
April 27 | 2:45 – 3:45 pm ET
With John R. Gimpel, DO, MEd, NBOME president and CEO; and Richard J. LaBaere, DO, MPH, NBOME board chair
At this session, Gimpel and LaBaere will discuss the various accomplishments of the NBOME over the last year, including the continued support of and advocacy for DOs and their COMLEX-USA credential; the transition to Pass/Fail scoring for COMLEX-USA Level 1; the transition to Pearson VUE for COMLEX-USA administration; the work of the Core Competency Capstone for DOs (C3DO) Task Force, and much more. Learn more.

We encourage you to attend these sessions, or view them virtually, during EL 2023. The NBOME is proud to be a platinum sponsor of EL 2023, and staff members will be onsite at booth #301 to answer questions about enhancements to COMLEX-USA, the progress of C3DO, advocacy and education resources, and more.

For more information, visit: aacom.org/programs-events/educating-leaders.

Please see the statement below from NBOME President and CEO John R. Gimpel, DO, MEd, on the use of Performance Profile Pages that accompany COMLEX-USA Level 1 Pass/Fail Score Reports:

We have been made aware that staff at several clinical rotation sites have requested that osteopathic medical students share the formative performance profile pages that accompany the COMLEX-USA Level 1 Pass/Fail Score Reports. They reportedly were unaware that this information is only shared with the osteopathic medical student and their dean for continuous professional development proposes and to foster a growth mindset, and is not intended to be shared outside of that purpose/relationship. They were also unaware that this places the student in a difficult position in that students are discouraged from sharing this information for other purposes.

To that end, we have drafted a memo for any clinical rotation site staff or programs who request this formative information to clarify its purpose.

View the memo

Click here for more information on COMLEX-USA Level 1 pass/fail score reporting.

Please note that registration closes 40 days prior to the start of the next testing window. See below for dates.

Testing Window	Scheduling Deadline
January 18 – February 11, 2023	December 9, 2022
March 6 – March 25, 2023	February 1, 2023
April 10 – April 29, 2023	March 1, 2023
May 15 – June 10 2023	April 5, 2023
June 26 – July 22, 2023	May 17, 2023
August 7 – September 9, 2023	June 28, 2023
September 18 – October 14, 2023	August 9, 2023
October 30 – November 18, 2023	September 20, 2023
December 4 – December 23, 2023	October 25, 2023

On November 30, the National Resident Matching Program (NRMP) released the results of the 2022 Medicine and Pediatric Specialties Match, the first year that combines the former Medical Specialties Matching Program, Pediatric Specialties, and Adolescent Medicine Fellowship Matches.

Of the 7,648 individuals who matched to a position, 1,093 were DO graduates who matched at rate of 81 percent. DOs matched to 39 subspecialties in internal medicine, pediatrics and addiction, and multidisciplinary specialties. The number of DO graduates that matched increased by 10.6 percent compared with the 2021 matches.

DO applicants filled 14.2 percent of all positions in the Match, at the folllowing rates:

• Internal Medicine Specialties – 13.5%
• Pediatrics Specialties – 14.7%
• Addiction Specialties –18.1%
• Multidisciplinary Specialties – 17.8%

In Medicine Specialties, DOs filled more than 20 percent of all positions in Critical Care, Oncology, Pulmonary and Sleep Medicine.

In Pediatric Specialties, DOs filled more than 20 percent of all positions in Academic General Pediatrics and Child Abuse.

Read the full 2022 Medicine and Pediatric Specialties Match Report for additional findings and key data on the MSMP fellowship appointments.

February 11, 2021
*Note: this article originally appeared in the COVID-19 section of the website.

PHILADELPHIA, PA—The NBOME Board of Directors held a special session earlier this week and has made the following decisions related to the global pandemic and COMLEX-USA:

1. The COMLEX-USA Level 2-PE is postponed indefinitely and will not resume on April 1, 2021.

2. We are deferring work on a temporary clinical skills testing site in California.

3. For the Class of 2021 (and earlier), we are developing a temporary alternative pathway to meet the eligibility requirements for the COMLEX-USA Level 3 examination.

This new pathway will allow for the verification of the competencies assessed in Level 2-PE without the need to travel to an NBOME National Center for Clinical Skills Testing.

We are working diligently to determine exactly what this temporary alternative pathway will look like for the Class of 2021 (and earlier) including options for those who have not yet taken Level 2-PE and others. We expect to release additional details within the next 4 weeks.

4. For the Class of 2022, we are convening a Special Commission that will review the future of Level 2-PE and determine potential alternative pathways. Detailed information about alternate pathways will be available by April 30, 2021.

5. The Special Commission and its charge will be expanded to consider and identify new ways to evaluate fundamental competencies currently assessed in the Level 2-PE. This will include a full review of the COMLEX-USA program, to ensure it continues to provide a defensible pathway to osteopathic medical practice and licensure. The Special Commission will include members from across the UME-GME-Licensure continuum, including student representatives and public members/patient representatives. This work will occur in two phases:

PHASE 1 will address points number three and four above and will include structured feedback opportunities from all stakeholders, from students to educators to licensing authorities to professional organizations, and public members/patient representatives.

PHASE 2 will focus on long-term solutions to assess competencies for osteopathic medicine in the COMLEX-USA program, with an eye on our collective duty to ensure quality care for the public and our patients.

We have carefully considered all of the feedback we have received from students during this pandemic year and are grateful for the input. While we are sorry for the widespread misinformation that circulates, we understand the extraordinary challenges we have all faced in the global emergency. Enthusiasm regarding the COMLEX-USA and the importance of osteopathically distinctive assessment is a testament to how much we all care about the osteopathic profession, its learners and physicians, and our patients.

We at the NBOME have always been, and continue to be, committed to maintaining the excellence of our profession through high-quality assessment and professional self-regulation. Given the unique circumstances presented by the pandemic, we have the opportunity to continue to evolve COMLEX-USA in a manner that meets the changing practice of osteopathic medicine and its physicians.

Our focus on COMLEX-USA includes input from stakeholders across the osteopathic medical profession to ensure its continued excellence for our patients, and we don’t take these decisions lightly. Decisions made by the NBOME as part of this process and outcomes related to our testing methods continue to be made carefully and with valued input from all of our stakeholders and are not to be meant as commentary about assessment and testing decisions made by other organizations or professions.