BC EDUCATION
Saved by @ThomassRichards

You asked. So here are my thoughts on how osteopathic medical students should respond to the NBOME.

(thread)

 Look, even before the Step 2 CS cancellation, my DMs and email were flooded with messages from osteopathic medical students who are fed up with the NBOME.

There is *real* anger toward this organization. Honestly, more than I even heard about from MD students and the NBME.
The question is, will that sentiment translate into action?

Amorphous anger on social media is easy to ignore. But if that anger gets channeled into organized efforts to facilitate change, then improvements are possible.
This much should be clear: begging the NBOME to reconsider their Level 2-PE exam is a waste of your time.

Best case scenario, you’ll get another “town hall” meeting, a handful of platitudes, and some thoughtful beard stroking before being told that they’re keeping the exam.
Instead of complaining to the NBOME, here are a few things that are more likely to bring about real change.
1) Vote with your wallets: take USMLE Step 3.

Almost all states allow DO licensure by completing the USMLE series. If you aren’t required to engage with the NBOME, don’t.
2) Lobby the state boards that don’t allow the USMLE.

As an MD who has passed the USMLE, I could practice in any state. Why shouldn’t a DO who passed the USMLE be able to do the same?

(State boards that prop up the NBOME with a COMLEX requirement are listed in the Tweet below.) https://t.co/stace4lMjD
If you intend to practice in one of these states, talk to your state representative. Explain how the medical board is providing a deterrent to DOs serving patients in their state.

The board may be friendly with the NBOME, but they’re still accountable to the legislature.
3) Lobby the AOA to change the COCA accreditation requirements that compel schools to require COMLEX-USA.

It’s ultimately the COCA requirement that keeps the NBOME in business.
The AOA is the professional body ultimately responsible for securing the success of the osteopathic profession.

They should think carefully about whether, at this point in history, a “separate but equal” licensing exam hurts DOs more than it helps.

https://t.co/pFwaAx01oB
As a sidenote:

The LCME’s accreditation standards for MD schools are more stringent than COCA’s for COMs - and even they never mandated the USMLE.

(Still, most schools did - since the requirement gave access to student loans to cover registration fees).

Let the schools decide.
Last thing:

Don’t feel guilty about pursuing these tactics. None of them are underhanded. Market forces and political action are how things are supposed to work in America - and they’ll be needed to move an entrenched, monopolistic bureaucracy that ignores its constituents.

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Reduction in the amount of content was important. What used to be 2 x 1 hr in-person lectures/week had to be condensed down into 6 x 10 minute prerecorded videos (aka aynchronounous content) with 1 x hr live zoom session (synchronous). Even that was too much.

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Our studies are crap. We haven't put appropriate resources into studying this. Merging "in-person school" v "remote school" across the country makes little sense since there's so much heterogeneity in what "in-person school" looks like. 🧵

A teacher in Louisiana in an area with high rates of covid & in-person school, has a class with just 2 students in it. The entire school has 37 students and 12 staff, in a building that can hold hundreds.
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2/ The government's last guidance to universities was issued on 3 February. It instructed HE providers not to offer any face-to-face teaching - outside exempt subjects such as medicine, dentistry and veterinary science - until at least 8 March.

3/ By the time the guidance was issued, 12 universities and colleges had already announced that they were keeping non-exempt teaching online until the end of this term or semester. Since then 3 more have done so, and another is keeping teaching online until at least 26 April.

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An appallingly tardy response to such an important element of reading - apologies. The growing recognition of fluency as the crucial developmental area for primary education is certainly encouraging helping us move away from the obsession with reading comprehension tests.


It is, as you suggest, a nuanced pedagogy with the tripartite algorithm of rate, accuracy and prosody at times conflating the landscape and often leading to an educational shrug of the shoulders, a convenient abdication of responsibility and a return to comprehension 'skills'.

Taking each element separately (but not hierarchically) may be helpful but always remembering that for fluency they occur simultaneously (not dissimilar to sentence structure, text structure and rhetoric in fluent writing).

Rate, or words-read-per-minute, is the easiest. Faster reading speeds are EVIDENCE of fluency development but attempting to 'teach' children(or anyone) to read faster is fallacious (Carver, 1985) and will result in processing deficit which in young readers will be catastrophic.

Reading rate is dependent upon eye-movements and cognitive processing development along with orthographic development (more on this later).
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#ஆதித்தியஹ்ருதயம் ஸ்தோத்திரம்
இது சூரிய குலத்தில் உதித்த இராமபிரானுக்கு தமிழ் முனிவர் அகத்தியர் உபதேசித்ததாக வால்மீகி இராமாயணத்தில் வருகிறது. ஆதித்ய ஹ்ருதயத்தைத் தினமும் ஓதினால் பெரும் பயன் பெறலாம் என மகான்களும் ஞானிகளும் காலம் காலமாகக் கூறி வருகின்றனர். ராம-ராவண யுத்தத்தை


தேவர்களுடன் சேர்ந்து பார்க்க வந்திருந்த அகத்தியர், அப்போது போரினால் களைத்து, கவலையுடன் காணப்பட்ட ராமபிரானை அணுகி, மனிதர்களிலேயே சிறந்தவனான ராமா போரில் எந்த மந்திரத்தைப் பாராயணம் செய்தால் எல்லா பகைவர்களையும் வெல்ல முடியுமோ அந்த ரகசிய மந்திரத்தை, வேதத்தில் சொல்லப்பட்டுள்ளதை உனக்கு

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குழப்பங்களையும் நீக்குவது, வாழ்நாளை நீட்டிப்பது, மிகவும் சிறந்தது. இதயத்தில் வசிக்கும் பகவானுடைய அனுக்ரகத்தை அளிப்பதாகும்.
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