The National Board of Osteopathic Medical Examiners (NBOME) is making significant strides to ensure that concepts and competencies related to diet and nutrition are even further integrated into national assessment programs in osteopathic medicine.
The recently revised Fundamental Osteopathic Medical Competency Domains 2026 (FOMCD 2026) framework expands the focus on diet and nutrition across the seven competency domains and aligns with leading frameworks and accreditation standards or elements from the American Association of Colleges of Osteopathic Medicine, the Accreditation Council for Graduate Medical Education, the Commission on Osteopathic College Accreditation, and other evidence-based resources.
This move underscores the NBOME’s commitment to ensuring that future osteopathic physicians possess the knowledge, skills, and attitudes to address nutrition as a key component of patient care. To further these goals, NBOME is developing the COMAT Nutrition in Patient Care examination, slated for release in August 2027. This new assessment will evaluate knowledge and skills in nutrition and its impact on patient outcomes.
Concurrently, 2027 enhancements to the COMLEX-USA Blueprint will align with FOMCD 2026 competencies. Notably, nutrition-related concepts—including nutritional science, metabolism, health promotion and disease prevention, growth and development, dietary and lifestyle counseling, and nutrition-informed patient care and management—are integrated throughout COMLEX-USA examination content across all three levels, reflecting the integral role of nutrition in osteopathic medical practice. These concepts may be represented in nearly one-quarter of test questions across the series.
In addition, the NBOME’s Core Competency Capstone for DOs (C3DO) assessment will utilize OSCE formats to evaluate real-world application of nutrition knowledge with standardized patients. These encounters assess dietary history-taking within a patient encounter; physician-patient communication, particularly as it relates to patient understanding of physician counseling; social and structural determinants of health; and osteopathic clinical reasoning. The post-encounter questions provide the opportunity to test that a candidate can integrate diet and nutrition into patient care and identify appropriate nutritional counseling opportunities and content.
Performance reporting for COMLEX-USA will also evolve, with reports to colleges of osteopathic medicine (COMs) and candidates scheduled for release in 2027-2028 for the series of examinations. This will provide valuable feedback for COMs and examinees related to competency elements focused on diet and nutrition.
Through these initiatives, the NBOME is further enhancing nutrition competency in osteopathic medical assessment, ensuring tomorrow’s osteopathic physicians have the skills to deliver comprehensive, nutrition-informed care to their patients, and continue to provide comprehensive, compassionate, whole person-centered care for patients in body, mind, and spirit. We anticipate that this will help to contribute to improving patient care and the health of the public.