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SOARING: A message from Board Chair Lori A. Kemper, DO, MS, and President & CEO John R. Gimpel, DO, MEd

(from left) John R. Gimpel, DO, MEd, President And CEO; Lori A. Kemper, DO, MS, Chair, Board Of Directors

The majestic eagle and the adept sailplane pilot know how to maintain lift and soar successfully above the fray. They use the invisible forces of nature—sun and wind—to guide and support them. They respect the factors that may hinder their flight, whether that may be obstacles on the earth or the force of gravity itself.

But still, they skillfully maneuver above, gracefully and forcefully. We know that it must take a lot to stay up there, seemingly effortless against the clouds. This is SOARING.

In 2023, the NBOME continued to soar to success in its mission of protecting the public through assessment for osteopathic medicine and related healthcare professions. Among those successes were the transition of COMLEX-USA administrations to Pearson VUE testing centers, which elevated the test-taking experience for COMLEX-USA candidates and many of our client organizations. In addition, we delivered several enhancements to the COMAT examination program, including launch of the new COMAT-Self-Evaluation tool. You’ll read more about both in this report.

We also launched Phase 1 of the Core Competency Capstone for DOs pilot program. Deans and faculty from over two dozen colleges of osteopathic medicine, graduate medical education programs, and the licensing community are involved in shaping this program. Over 800 students participated in this clinical competency assessment that includes evaluation of communication and interpersonal skills, hands-on physician examination skills, and osteopathic manipulative treatment. Read more about this in the “Test What Matters” section of this report.

The NBOME’s advocacy efforts continued to soar, and six additional specialties joined family medicine in 2023 to support the value of DOs in residency programs, the importance of holistic review of applicants, and the inclusion of DO qualifications such as COMLEX-USA in that review. This success expanded throughout the year, as the NBOME and other leaders in the osteopathic medical profession gained support for DOs and osteopathic physician qualifications in licensure and registration internationally. Several of those efforts are detailed herein.

The eagle and the pilot will maneuver to make the flight longer, the altitude higher, the speed faster. Soaring high, the NBOME is well positioned to explore the exciting future of osteopathic education, training, and licensure. We remain propelled by our passion and dedication to the mission of protecting the public and appreciate the many of you who support that mission.


Board Awards
Item Contributor Awards
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For nearly 90 years, the NBOME has paved the way for innovation and excellence in the development and administration of assessments for osteopathic medical students, residents, physicians, and related healthcare professionals. The members of our NBOME Board of Directors and National Faculty—who are some of the foremost thinkers in osteopathic medical practice, medical education, clinical training programs, and licensure—are crucial in meeting our mission of protecting the public with fair, valid, and reliable assessments that ensure that DOs and other healthcare professionals demonstrate their competencies to a national standard for safe and high quality practice.

board of directors

In 2023, the Board of Directors installed new officers:
Lori A. Kemper

Lori A. Kemper, DO, MS

Glendale, Arizona Board Chair
David Kuo

David Kuo, DO

Blue Bell, Pennsylvania Board Vice-Chair
John L. Goudreau

John L. Goudreau, DO, PhD

East Lansing, Michigan Board Secretary-Treasurer
In addition, six new members were elected to the NBOME Board: Gregory E Harris, DO, Robert W. Hostoffer, DO, MBA, MEd, Janie L. Myers, DO, Julieanne P. Sees, DO, MBA, David J. Stephen, DO, and Barbara E. Walker, DO; and the NBOME said goodbye to five invaluable members who completed their terms: Peter B. Ajluni, DO, Jed G. Magen, DO, MS, Michael F. Oliverio, DO, Richard A. Ortoksi, DO, and Geraldine T. O’Shea, DO. Previous Board Chair Richard J. LaBaere will continue to serve as immediate past-chair through 2025.

The NBOME also honored three individuals for their tireless commitment to the NBOME: Dana C. Shaffer, DO, received the Santucci Award, the NBOME’s highest honor; R. David Henderson, JD, received the Clark Award for Patient Advocacy; and exiting Board members received Meritorious Service awards. To learn more, view the NBOME Award Recipients 2023 video above.

national faculty

The National Faculty (NF) added more than 100 new members in 2023 in areas of highest need such as surgery, pediatrics, psychiatry, and obstetrics and gynecology. These additions brought our total number of NF numbers to 853 as of December 31. This years’ highlights included a pilot mentoring program, which will offer incoming National Faculty members the opportunity to gain institutional knowledge from established members and guidance in becoming better contributors, and another successful annual National Faculty Chairs Conclave , which offers an opportunity to present findings, exchange ideas, and develop plans for bolstering the National Faculty program and NBOME assessments. The National Faculty also named new Chairs and honored the Item Contributors of the Year.

Learn more about the 2023 National Faculty committees and exam contributors.

Learn more about our Item Contributors of the Year in the NBOME Exam Contributors of the Year video above.

Reproductive Health Task Force
DEI efforts
Student Feedback
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The NBOME is committed to advancing valid, distinctive assessments across the continuum of the evolving practice of osteopathic medicine and related health care professions. In 2023, the NBOME was proud to launch several initiatives toward meeting this goal.

Transition of Pearson Vue

This year, the NBOME completed transitioning the administration of its COMLEX-USA, COMVEX, and client examinations to Pearson VUE, the global leader in test delivery. This has led to improvement in several key areas for the candidate experience at professional testing centers.

Recommendations from Reproductive Health Task Force

The NBOME established the Reproductive Health Task Force (RHTF) to determine the impact of Dobbs v. Jackson on its national exams. The RHTF met regularly throughout the year and released recommendations, approved by the NBOME Board, to support fairness and validity in the examinations.

Learn more in the Reproductive Health Task Force video above.

Launch of Mindful Language Guide

In April 2023, the NBOME announced the development of a new Mindful Language Guide to assist National Faculty members in considering diversity, equity, and inclusion (DEI) in NBOME assessments when writing or editing test questions. This created unprecedented interest in a public version, which was shared in October 2023 and highlighted the NBOME’s commitment to ensuring bias-free language in its item content. The NBOME remains committed to eliminating stereotyping and bias in assessments.

Learn more about the Mindful Languaege Guide and other DEI efforts in the Diversity, Equity, and Inclusion Initiatives video above.


When COMLEX-USA Level 2-PE was suspended indefinitely and then formally discontinued, the NBOME began to explore ways to assess the clinical skills that are integral to the practice of osteopathic medicine. Feedback from across the profession indicated that demonstrating competency in these key areas--including patient-physician communication skills and hands-on physical exam and OMT skills--was incredibly important to osteopathic medical students, residents, colleges of osteopathic medicine alike.

This became the impetus for the launch of the Core Competency Capstone for DOs (C3DO) Program, a series of pilot studies to investigate establishing a national standardized osteopathic clinical skills assessment delivered at COMs.

In late 2022, the NBOME launched Phase 1 of C3DO with the announcement of its four partner COMs: Campbell University School of Osteopathic Medicine (CUSOM); Marian University College of Osteopathic Medicine (MUCOM); Midwestern University – Arizona College of Osteopathic Medicine (AZCOM); and Rocky Vista University College of Osteopathic Medicine (RVU-COM).

Learn more in the C3DO Pilot: A COM Perspective and the Exploring the Student Experience with C3DO videos above.

“The four selected COMs were excellent partners,” said Jeanne M. Sandella, DO, vice president of professional development initiatives and communications. “All of them have dedicated staff and reflect the diversity of locations and class sizes at COMs across the country.”

In the first half of 2023, the NBOME and the C3DO Task Force worked tirelessly to develop clinical cases to be tested at each COM site and refine scoring rubrics and training materials, and collaborated closely with its COM partners on any site-specific needs to ensure pilot testing could be launched as smoothly as possible. A broader C3DO Advisory Panel was also established to provide oversight and input on the project and help to shape the assessment and keep stakeholder including patient advocates and osteopathic medical students and residents involved.

As testing was completed, the NBOME began analyzing data and feedback collected at each site. Initial findings showed promising results regarding the feasibility of on-campus standardized assessment of fundamental osteopathic clinical skills of osteopathic medical students. One highlight was the remarkable reliability estimates for scoring of doctor-patient communication, interviewing, and respectfulness skills.

“These findings were encouraging, to see a real possibility in collaborating with COMs on these important assessments,” said Sandella. “The feedback and information we gathered from Phase 1 will be invaluable as we prepare for Phase 2.”

Student Feedback:

Overall, this was a great experience and very comfortable being in my home institution. Feel that this format was a formal and very thorough assessment of my clinical knowledge and skills up until this point in clinical training. Highly recommend.

COM Faculty Feedback:

Thank you so much! This has been an amazing experience. Your team has been wonderful to work with throughout this Pilot. We truly believe in the importance of this work and look forward to all that we learn. We look forward to feedback and improving our process. It is a great time to be a DO!

NBOME Assessments


The NBOME continued acceptance of the attestation by deans of colleges of osteopathic medicine (COMs) for clinical skills competencies through the Class of 2027. In addition, several improvements were made to score reporting, including an increase in the number of score release dates for Level 2-CE prior to ERAS application deadlines; providing an interim percentile score converter for Level 2-CE prior to the cycle end; providing continuous Level 1 cohort reporting for COMs; and revising the format and content of the Level 1 Formative Performance Profile to better identify candidates who may be in need of academic assistance. The passing standard for COMLEX-USA Level 2-CE was also updated.


COMAT Self Evaluation (COMAT-SE) on CATALYST was launched on November 2, 2023. After responding to each COMAT-SE question, candidates are shown the correct answer in real time, the rationale for why that answer is correct, and additional references for further study. COMAT-SE is currently only available in COMAT-Osteopathic Principles and Practices, but is expected to expand to other disciplines in the future.

Learn more in the COMAT-SE video above.


Joyce A. Brown, DO

Joyce A. Brown, DO

Wayne R. Carlsen, DO

Wayne R. Carlsen, DO

Brett Stecker, DO

Brett Stecker, DO





Professionalism Course


In 2023, the NBOME continued with numerous innovations in assessment and aspiring to be the global leader in assessment for osteopathic medicine and related health care professions.


In particular, the Learning Center hub for continuous professional development at NBOME added several additional resources for incoming and established National Faculty members alike. One such resource is the “Professionalism in Patient Encounters,” online module, launched in 2023 to help medical students, medical educators, and physicians recognize professional behaviors in physician-patient encounters, understand how professionalism benefits patient care, and learn to remediate lapses in professionalism.

Learn more in the Professionalism in Patient Encounters Course video above.

That course, along with many others, relied on the contributions of the National Faculty, providing even more ways for these subject matter experts to share relevant and current findings related to their disciplines.

The NBOME presents research at AACOM Educating Leaders 2024
NBOME President and CEO John R. Gimpel, DO, MEd, presents at the AOA Board meeting
NBOME Board Chair Richard J. LaBaere II, DO, MPH, presents at the Ottawa

Researchers at the NBOME conducted 73 presentations to various professional conferences and meetings across osteopathic medicine and the entire house of medicine. Topics included the impact of pass/fail score reporting on student performance and stress; the use of COMSAE in assessing readiness for COMLEX-USA; equity in assessment; predictive validity of MCAT scores and GPA for COMLEX-USA; advocacy for DO students and their credentials in GME applications; natural language processing in analyzing candidate comments, and AI applications in examination operations.


The NBOME continues to carefully steward resources directed to its mission and to benefit our many stakeholders. Growth in examinee numbers across the NBOME’s largest assessment programs and careful expense management yielded good financial performance from operations for 2023. The operating gains were further supported with an employee retention credit and a good year for a conservatively invested equity and bond market portfolio.

The organization also reduced its leased space in the Philadelphia and Chicago offices in 2023 as both national centers of clinical skills testing have been closed, resulting in a considerable reduction in ongoing lease-related expenses.

Investing in Enhancements

The NBOME continued to invest in enhanced technologies with the goal of meeting our strategic priority of enhancing the test-taking experience for stakeholders.

The transition of assessment administration a new professional test center partner, Pearson VUE, provided stakeholders with an enhanced test-taking experience at a larger pool of locations. We continued the two-year, no exam fee COMAT Foundational Biomedical Science Targeted promotion. Read more in the “Test What Matters” section of the Annual Report.

The investment into Phase 1 of the C3DO pilot in 2023 provided encouraging data in the pursuit of a COM-based national assessment of osteopathic clinical skills. Included in this pilot were grants to the four participating institutions and considerable in-kind NBOME contributions. Learn more about these COMs and Phase 2 in the “Test What Matters” section of this report.

Investing in the Profession

In 2023, the NBOME served as the platinum sponsor for the American Association of Colleges of Osteopathic Medicine Educating Leaders Annual Conference, and as a sponsor of the Federation of State Medical Boards Annual Meeting, supporting continuous learning across the osteopathic and healthcare professions. NBOME also sponsored the A.T. Still Fit for life Fun Run 2023, which supports the Advocates for the American Osteopathic Association, a non-profit aimed at championing osteopathic students, residents, and physicians, and the osteopathic profession at-large.

The NBOME also delivered more than a dozen in-kind seminars on best practices in assessment and test question item writing, and more than 150 hours of additional faculty development. Many of these were par to the 20 on-campus COM visits in 2023.

Investing in DO Students and Residents

In 2023, the NBOME further supported osteopathic medical students and resident scholarships through donations and support of the American Osteopathic Foundation. The NBOME Candidate Assistance Fund supported numerous COMLEX-USA candidates who experienced extraordinary financial hardships encountered relating to taking their exams. The most common example is for weather-related COMLEX-USA cancellations necessitating rescheduling that add expense.

Through efforts such as the “How DO You Love Yourself?” social media campaign, the NBOME continues to support candidate continuous learning through the giveaways for COMSAE and WelCOM.

Investing in a Better Workforce

Through NBOME assessments, patients are assured that their osteopathic physician has met a national standard of competency to practice of osteopathic medicine. COMLEX-USA provides a credential that enables DOs to be considered for licensure throughout all US licensing jurisdictions and in several abroad (though many countries will require any US physician, DO or MD, to take a new credentialing exam from that country).

In the United States, this nationally trusted standardized assessment program for osteopathic medicine saves state governments and taxpayers millions of dollars annually that would be required to replicate efforts for valid, reliable, defensible and fair assessments pf physician licensure.


The NBOME puts a high priority on the wellbeing of all of its stakeholders, including staff, National Faculty, Board members, and exam candidates. See some of the areas of focus for 2023:

Employee Wellness

In 2024, the NBOME hosted a six week wellness challenge for employees, designed to help find time for daily physical activity in a fun, engaging way. Throughout the year, the Human Resources department also implemented updated anti-harassment, anti-discrimination, and anti-bullying training to ensure a continued open and welcoming workplace. Employees also engaged in several fellowship activities such as a multicultural potluck, an opportunity to learn more about the NBOME’s Mindful Language Guide, and celebrations to observe the winter holidays.

National Faculty

Joining the National Faculty offers osteopathic physicians, educators, and researchers the chance to enhance their professional wellbeing through its various contributions to NBOME examinations, events such as item-writing and case-development workshops, and more.

Candidate & Physician Wellness

A particular focus of the NBOME is to serve as a wellness resource for candidates as they prepare for the high-stakes COMLEX-USA exams. Now in its 4th year, the Road to DO Licensure on NBOME’s website provides numerous wellness and mentoring resources for DO students and residents, including a Spotify study playlist.

The social media campaign “How DO You Love Yourself?” asked osteopathic students to share their tips and advice on managing mental health, and that information was shared on the NBOME’s social media for other students. At a ceremony held on September 28 by Ragan PR Daily, the NBOME received an honorable mention in the Social Media category of the Nonprofit Communications awards.

In addition, the NBOME partnered with more than 115 patient care and health education organizations—including the Accreditation Council for Graduate Medical Education, the American Medical Association, and the Coalition for Physician Wellbeing—to recognize September 17 as National Physician Suicide Awareness Day.

Diversity, Equity, and Inclusion (DEI)

In an effort to make candidates feel as represented as possible, the NBOME made updates to the online Portal demographics section for candidates to self-report their gender, race, and ethnicity information. Test-takers can choose more than one descriptor and/or self-describe. With these new options, the NBOME offers candidates the ability to identify in the manner that best aligns with who they are, and makes another step toward meeting its strategic goal of reviewing examination content and processes with an eye towards DEI.

In May, the Test Development team created a DEI Video Task Force to develop new videos with diverse and inclusive patient and physician representation in examinations across the COMLEX-USA examination series.

COM Visits
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Collaborating with exam candidates, osteopathic organizations including the American Osteopathic Association, the American Association of Colleges of Osteopathic Medicine, and the American Association of Osteopathic Examiners, and licensure, accreditation, and education communities, is integral to meeting our mission of protecting the public. The NBOME uses these relationships to garner and integrate input from diverse groups across the profession and the house of medicine. Here are some of the groups with whom the NBOME partners. Public members and patient advocates play key roles on NBOME’s Board, committees and task forces.

Osteopathic Medical Students

The NBOME regularly works with student groups such as Council of Osteopathic Student Government Presidents and Student Osteopathic Medical Association to answer questions and gather important feedback on NBOME’s assessment tools and resources. Representatives from these groups serve on the NBOME Liaison Committee as well.

The Student Experience Panel comprises a diverse group of osteopathic students, meets throughout the year and provides a vital way for the NBOME to hear about their experiences first-hand, as well as their feedback on NBOME products and services.

Learn more in the Student Experience Panel video above.

Colleges of Osteopathic Medicine (COMs)

The NBOME visited 31 COMs in 2023, including inaugural in-person campus visits to Kansas Health Science Center - Kansas College of Osteopathic Medicine, Rocky Vista University College of Osteopathic Medicine-Montana, Sam Houston State University College of Osteopathic Medicine, and Philadelphia College of Osteopathic Medicine-South Georgia. Each of these visits provides an important opportunity to give updates on important issues and hear direct feedback from students, faculty, and leadership about the NBOME’s products and services.

Learn more in the COM Visits video above.

Student Feedback from Visits in 2023:

OMS2—I wanted to thank Dr. Gimpel for attending [our COM] this afternoon. It was a pleasure getting to hear directly from the NBOME’s President and CEO about all that goes into helping to produce the best osteopathic physicians possible.

Client Organizations

The NBOME partners with numerous osteopathic medical and related healthcare organizations to develop, administer, and manage assessments that ensure the competency of osteopathic physicians and other healthcare professionals.

In 2023, the NBOME worked with the American College of Diabetology (ACD) to launch the first-ever certification examination in diabetology, following a partnership started in 2022. In this partnership, the NBOME provides services including item writing and editing, test development, publishing, program management and administration support, as well as psychometric services and recommendations to ACD to ensure the quality, reliability, and fairness of the ACD certification exams.

Educational Outreach and Advocacy

Advocacy outreach efforts in graduate medical education have doubled, resulting in 128 programs or organizations making positive changes regarding COMLEX-USA acceptance and/or website and FREIDA updates. The NBOME also participated in meetings with the Electronic Residency Application Service Advisory Committee, the National Resident Matching Program® Annual Transition to Residency Meeting, the Residency Explorer Tool Strategy meeting, and the Internal Medicine Education Advisory Board meeting.

Activity by the numbers: Doubled outreach efforts in 2023 128 programs/organizations that have made a positive change Presented at medical education meetings for:

NBOME Advocacy efforts led to public support from six additional specialty organizations with consensus statements supporting holistic review in GME, the value added by DOs, and equivalent inclusion of COMLEX-USA when licensure exams are used in residency applications. Along with Family Medicine in 2022, these seven total specialties represent a little over 60 percent of where DOs apply to in recent graduating years.

These specialties are: Emergency Medicine; Obstetrics and Gynecology; Anesthesiology; Pediatrics; Physical Medicine and Rehabilitation; and Psychiatry. The NBOME is working on similar initiatives for 2024 with Internal Medicine, Surgery, and more specialties.

Learn more in the GME Advocacy video above.

In November, the International Association of Medical Regulatory Authorities (IAMRA) gave osteopathic physicians global recognition when it approved a resolution that highlighted the equivalent competencies of U.S.-educated osteopathic physicians and MDs around the world. The NBOME was proud to be a supporting organization in this initiative, tracing advocacy efforts with the international medical regulation community back almost 20 years. The AOA, the American Association of Osteopathic Examiners, the Federation of State Medical Boards, and the Oregon Medical Board are to be applauded for their efforts in this initiative.

In 2023, additional advocacy gains for full practice rights for DOs included those in India and several Canadian provinces. Like the IAMRA initiative, each were the result of many years of work from the AOA, the NBOME, and numerous other advocates for the osteopathic medical profession and the patients we serve.