We are excited to share with you the much-anticipated release of the NBOME’s Fundamental Osteopathic Medical Competency Domains 2026 (FOMCD 2026): Guidelines for Assessment for Osteopathic Medical Licensure and the Distinctive Practice of Osteopathic Medicine. Developed with an evidence-based approach by the NBOME and our esteemed 1,000-member National Faculty, the FOMCD 2026 continues to shape the COMLEX-USA blueprint and NBOME assessments.
Several significant enhancements have been introduced in FOMCD 2026 to better align the COMLEX-USA examination series with the evolving needs of patients, evidence as to impact on patient outcomes, and the practice of osteopathic medicine. For instance, Competency Domain 6 has been renamed “Professionalism and Compassion in the Practice of Osteopathic Medicine” and now includes expanded requirements related to compassion, humanistic behavior, and the consideration of spirituality and belief systems in healthcare. This change reinforces the compassionate, whole-patient approach to patient care established by our profession’s founder, Andrew Taylor Still, DO.
One of the standout features of the FOMCD 2026 is the explicit integration of osteopathic principles and practices (OPP) across all seven competency domains. This integration emphasizes the interconnectedness of OPP within each domain and underscores the distinctive osteopathic focus that profoundly impacts patient care by DOs.
Additionally, the FOMCD 2026 places a greater emphasis on social determinants of health, health systems science, and nutrition and diet in patient care and disease prevention—key components of Dr. Still’s original philosophy and areas of growing interest across health professions today. The guidelines also delve into skills related to digital health, telehealth, and augmented intelligence, while significantly codifying fundamental person-centered competencies in clinical skills such as physical examination, physician-patient communication, medical interviewing, and patient education.
The FOMCD 2026 is the culmination of two years of dedicated work by many individuals and builds on the NBOME’s pioneering efforts in physician competency frameworks over the past two decades. We hope you find the expanded FOMCD 2026 to be illuminating, informative, helpful, and perhaps even inspiring. We eagerly anticipate your feedback as we strive to keep pace with the exciting developments in osteopathic medicine and upholding our commitment to compassionate care of each patient, in body, mind, and spirit, and to improving the health of the public.