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An Investigation of the Relationship Between COMLEX-USA Licensure Examination Performance and State Licensing Board Disciplinary Actions

Roberts, William L. EdD; Gross, Gretta A. DO, MEd; Gimpel, John R. DO, MEd; Smith, Larissa L. PhD; Arnhart, Katie PhD; Pei, Xiaomei PhD; Young, Aaron PhD

doi: 10.1097/ACM.0000000000003046
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Purpose: Passing the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) serves as a licensing requirement, yet there is limited understanding between this high-states exam and performance outcomes. This study examined the relationship between COMLEX-USA scores and disciplinary actions received by osteopathic physicians.

Method: Data for osteopathic physicians (N = 26,383) who graduated from medical school from 2004–2013 were analyzed using multinomial logistic regression to assess the relationship between COMLEX-USA scores and placement into one of 3 disciplinary action categories relative to no action received, controlling for years in practice and gender.

Results: Less than 1% of physicians in this study (n = 187) had a disciplinary action(s). Controlling for all COMLEX-USA levels, years in practice, and gender, higher Level 3 scores were associated with significant decreased odds for all action categories: revoked licensed (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.36, 0.72; P < .001), imposed limitations to practice (OR = 0.59, 95% CI 0.41, 0.84; P < .01), and other action imposed (OR = 0.48, 95% CI 0.33, 0.69; P < .001), relative to not receiving an action. In these same models, higher Level 2 Performance Evaluation Biomedical/Biomechanical Domain scores decreased the odds for an action that revoked a license (OR = 0.75, 95% CI 0.58, 0.98, P < .05) and imposed limitations to practice (OR = 0.64, 95% CI 0.49, 0.84, P < .001).

Conclusions: These findings provide evidence that the COMLEX-USA delivers useful information regarding the likelihood of a practitioner receiving state board disciplinary actions.

W.L. Roberts is director, Psychometrics/Research, Clinical Skills Testing, National Board of Osteopathic Examiners, Conshohocken, Pennsylvania; ORCID: https://orcid.org/0000-0001-6175-8059.

G.A. Gross is vice president, Clinical Skills Testing, National Board of Osteopathic Examiners, Conshohocken, Pennsylvania.

J.R. Gimpel is president and chief executive officer, National Board of Osteopathic Examiners, Conshohocken, Pennsylvania.

L.L. Smith is senior psychometrician, Clinical Skills Testing, National Board of Osteopathic Examiners, Conshohocken, Pennsylvania.

K. Arnhart is senior research analyst, Research and Data Integration, Federation of State Medical Boards, Euless, Texas.

X. Pei is senior research analyst, Research and Data Integration, Federation of State Medical Boards, Euless, Texas.

A. Young is assistant vice president, Research and Data Integration, Federation of State Medical Boards, Euless, Texas.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: On July 31, 2018, the Center for the Advancement of Healthcare Education and Delivery Institutional Review Board (IRB) approved this study being exempt from IRB review because of minimal risk to study participants.

Data: Not applicable.

Correspondence should be addressed to William L. Roberts, National Board of Osteopathic Medical Examiners, Inc., 101 West Elm Street, Suite 150, Conshohocken, PA 19428-2004; telephone: (610) 825-6551; email: broberts@nbome.org.

© 2019 by the Association of American Medical Colleges