The following sections provide an overview of the current policies and procedures of Liberty University College of Osteopathic Medicine pertaining to clinical rotations¹ and will primarily be referenced and utilized by students approaching or engaging in the OMS-III and OMS-IV curriculum. Important supplemental information such as critical dates, deadlines, or milestones to guide students’ progress will be communicated to students via e-mail (see Student Responsibility to Obtain Information).

Contact information for the Office of Clinical Education:

Phone: (434) 582-4100
E-mail: LUCOMClinicalEducation@liberty.edu

Communications between LUCOM and the student which require immediate resolution should be directed by telephone whereas other needs can be facilitated through e-mail.

Treatment of Students

Students are referred to as “Student Doctor” in clinical settings. As a group, students are referred to as “Student Physicians.” If students have a doctorate in any field, they cannot use this title while in any clinical settings related to their education whether in a student environment or not.

Students should expect to be treated as professionals by all clinical personnel, and students must in turn act professionally, ethically, and respectfully toward all clinic and hospital personnel they come in contact with. Courtesy and a professional demeanor are essential traits for a physician.

Students should be treated with respect as health care professionals, to receive quality education and input from the COM, its faculty and preceptors, to have their rights and obligations as detailed in student and faculty manuals and College catalog respected.

Students should be challenged to learn, but should not be belittled, humiliated, verbally or physically abused. Students should not be sexually harassed, either verbally or physically. Students should not be discriminated against on any basis including age, gender, race, religion, ethnicity, and national origin.

Students should be a participant in patient care decisions whenever possible.

Students should have their health care related education take priority over routine menial tasks.

If a preceptor feels a student lacks adequate knowledge or skills, the preceptor has the responsibility to inform and instruct the student so they can improve their performance. The instructor should provide timely, fair, and accurate evaluations and completion of the student’s evaluation and curriculum requirements.

If a student feels that a preceptor has committed infractions against the above standards, they have the responsibility of informing that preceptor, whether by direct contact or by way of an honest preceptor evaluation at the end of a rotation, of such feelings so that the preceptor can improve their performance. If they do not feel that the issues are addressed appropriately, they are to notify the Office of Clinical Education.

Retaliation and False Claims

Retaliation against a person who reports, complains of, or provides information in a mistreatment investigation or proceeding is prohibited. Alleged retaliation will be subject to investigation and may result in disciplinary action up to and including termination or expulsion.

Any person who knowingly makes false allegations of mistreatment, or who knowingly provides false information in a mistreatment investigation or proceeding, will be subject to disciplinary action and, in the case of students, will be considered a violation of the Honor Code. Any complaints anonymously reported will not be investigated.

Code of Conduct

This code of conduct² is designed to guide ethical behavior in hospitals, community clinics, research facilities, and various rotation sites included as clinical practice experiences.

This code of conduct represents general standards of behavior and illustrates ideals for which to strive; however, specific infractions reported by students, preceptors, Office of Clinical Education, or faculty to the Chair of the Student Progress Committee may be investigated by this Committee with respect to both the magnitude and chronicity of incidents considered. These general standards may not afford guidance in every conceivable situation or anticipate every possible infraction.

While participating in Clinical Rotations, students enrolled at LUCOM will:

• Demonstrate respect and concern for the welfare of patients
• Treat patients and their families with respect and dignity both in their presence and in discussions with others
• Recognize when one’s ability to function effectively is compromised and ask for relief or help
• Recognize the limits of student involvement in the medical care of a patient and seek supervision or advice before acting when necessary
• Refrain from the use alcohol, tobacco, or other drug in any manner that could compromise themselves or patient care
• Respect the rights of others
• Interact with members of the health care team in a considerate manner and with a spirit of cooperation
• Act with an egalitarian spirit toward all persons encountered in a professional capacity regardless of race, age, religion, gender, sex, ethnicity, or socioeconomic status
• Respect the patient’s modesty and privacy
• Respect the rights, opinions, and input of the patient and family in health care decision- making
• Be trustworthy
• Be truthful in communication to others
• Maintain confidentiality of patient information.
• Admit errors and not knowingly mislead others to promote one’s self at the expense of the patient
• Participate responsibly in patient care or research to the best of their ability and with the appropriate supervision
• Undertake clinical duties and persevere until they are complete
• Notify the responsible person if something interferes with their ability to perform clinical tasks effectively.
• Report on time and be in attendance at clinical site until released by preceptor or supervisor. Absence without notice can be construed as patient abandonment.
• Have professional demeanor
• Maintain a neat and clean appearance, and dress in attire that is consistent with LUCOM dress code and accepted as professional to the population served.
• Be thoughtful and professional when interacting with patients and families.
• Strive to maintain composure during times of fatigue, professional stress, or personal problems.
• Avoid offensive language, gestures, or inappropriate remarks.

Medical Malpractice Insurance

LUCOM provides medical malpractice insurance for students that are currently enrolled and participating in LUCOM approved clinical rotations, contributing to course completion, and under direct supervision of a fully licensed clinical preceptor.

Practicing Medicine³

A Liberty University College of Osteopathic Medicine student doctor has yet to earn a license to practice medicine. Therefore, the student is neither legally nor ethically permitted to practice medicine. A student may be involved in assisting in the care of a patient, but only under the direct supervision of a licensed physician or clinician with privileges to provide the required level of care. The attending physician is responsible for the medical care of the patient and for the content and signing of all orders, progress notes, and other notes written or entered electronically by the student. A student may not administer treatment, including OMT, except under the direct supervision of a licensed physician or clinician.

Students are prohibited from engaging in any activities (from the time of admission to the University until graduation or other termination of student status) that might be construed as the practice of medicine, or any phase thereof, without the proper supervision and direction of designated members of the faculty. Students who are alleged to have engaged in the practice of medicine, or any phase thereof, and are not in compliance with the requirements above, will be required to meet with the SPC and may be subject to disciplinary action including, but not limited to dismissal from the COM.

Pre-Established Qualifications in Health Care

Students seeking or holding employment or voluntary activity in a medical field, while enrolled as a student at LUCOM, are advised as follows:

Students who matriculate into LUCOM as a licensed practitioner, and who earned such licensure or certification prior to admission to medical school or during their time in medical school (i.e., medical doctor, dentist, podiatrist, chiropractor, or other licensed health care professionals) may desire to continue that work or volunteer role while enrolled (such as during breaks or on weekends). Students seeking or holding outside employment/voluntary activity in the health care field must not represent LUCOM in the role (do not wear LUCOM-issued badge or white coat, do not self-identify as a student-doctor, etc.).

The individual should be in good academic standing and should be careful to prioritize his/her educational and programmatic goals. The individual’s care/service provided during such employment or voluntary work must be restricted to his/her current active licensure or certification. While working or volunteering in the healthcare field under a certification earned outside of LUCOM, the individual will not be covered by any of LUCOM’s insurance policy including any medical malpractice or professional liability coverage. Furthermore, the paid or voluntary work will not be overseen, considered for academic credit, or regulated by LUCOM.

Students with a license/certification in other health care professions may not exercise the rights and responsibilities of their license while simultaneously performing their duties and responsibilities as a medical student on clinical rotations or during other LUCOM-sponsored experiences.

Clinical Shadowing

Shadowing affords students exposure to various medical practice settings and may enhance students’ motivation to complete the degree and become a physician. Whenever a student is seeking shadowing opportunities outside of course requirements outlined in a course syllabus, students will be expected to adhere to the principles outlined in this policy.

Some core sites do not permit clinical shadowing; students should consult the Office of Medical Education before contacting core sites with clinical shadowing requests. Students seeking shadowing opportunities must adhere to the following principles:

1. Because the shadowing experience does not provide course credit and is completed on a voluntary basis, it is not protected by or covered under malpractice insurance provided by LUCOM for clinical coursework.

2. Shadowing experiences are to be observational only. Students must not perform any procedures (inclusive of osteopathic manipulation) or provide medical advice while on shadowing experiences.

3. Students must not wear their LUCOM white-coat nor their University-issued ID badge while shadowing.

4. Students must follow all hospital, facility, ambulatory, etc. policies when shadowing. Knowledge of and adherence to these policies is the student’s responsibility.

5. It is the student’s ethical and professional duty to fully explain their level of training and to serve only in an observational capacity while shadowing.

6. Any student delivering unsupervised medical care is engaging in unauthorized treatment in violation of College policy, is not insured by the College malpractice carrier, and may be subject to disciplinary action including dismissal.

7. Shadowing experiences are to be reported to the LUCOM Office of Medical Education.*

The physician who oversees the student’s shadowing experience should:

1. Establish how the student will be introduced to patients (e.g., “this medical student aspires to enter anesthesiology”).

2. Establish a protocol for establishing the patient’s informed verbal consent for student observation.

3. Establish boundaries and expectations as to when the student’s questions are to be asked and answered.

*Students engaging in shadowing opportunities are encouraged to complete and submit the Extra Curricular Shadowing Form  in advance of the experience to the LUCOM Office of Medical Education (LUCOMMedEd@liberty.edu) including information about the physician who will oversee the shadowing experience. If the experience will be intermittent over several weeks or longer, enter the range of dates on the form to ensure the entirety of the experience is accounted for. The form and the information it provides will be retained for documentation and referential purposes, and will also serve to reiterate expectations for the supervising physician. Completion of the form facilitates data analysis, communication with the site and supervising physician, and fosters relationship development across clinical sites.  

Student Health Policies and Procedures

All students at LUCOM, including third- and fourth-year students, are required to be in compliance with student health policies and procedures published within the LUCOM Academic Catalog and Student Handbook. Students should be aware that individual rotation sites may have additional requirements related to student health, immunizations, and/or insurance coverage, which supplement the expectations enforced by LUCOM. All vaccination requirements beyond those listed by LUCOM and required by the clinical rotation sites, are the responsibility of the student to either receive and/or apply (through the site) for exemption. Documentation of all vaccination information must be on file with LUCOM Student Health prior to participation in any patient contact.

Firearms and Concealed Weapons Carry Permits

Under no circumstances is a student doctor permitted to carry a firearm or weapon of any kind on the premise of a clinical rotation site. This policy extends to all sites in which the student is receiving clinical education including, but not limited to, hospitals, clinics, laboratories, seminars, conferences or any other venue for which the student doctor is engaged in clinical education or training.

Responsibilities and Duties

The student on a rotation service will be responsible at all times to the LUCOM clinical faculty and administrative personnel in charge of the rotation. In addition, all students will be expected to comply with the policies and procedures established by the hospital, clinic, or facilities at which they are being trained.

Student Attendance

OMS-III Attendance

LUCOM students are expected to be present for all days of a clinical rotation as assigned by the preceptor, site coordinator, DSME, or LUCOM Office of Clinical Education (OCE). Students must obtain approval for any absence from the LUCOM Office of Clinical Education and must complete and submit an Excused Absence Request Form. Students must have this form signed by those designated on the form to be considered for an excused absence. Excused absences are considered on a case-by-case basis. Typically, OCE will not approve a student for more than 2 excused absence days off of a four-week rotation, or 1 excused absence day off of a two-week rotation.

Students requesting to be excused from a clinical rotation or examination must submit the request to the OCE prior to the date of absence, at least 30 days for pre-planned events (i.e., professional meetings, weddings). The excused absence request must be submitted via the Excused Absence Request Form. A request is not considered approved until the student receives an email confirmation from the OCE. Likewise, the OCE will communicate if a request has been denied. LUCOM does not grant excused absences retroactively except in dire emergencies, but it does grant reasonable excused absences for requests made in advance. Unavoidable absences (i.e., illness, death of an immediate family member, motor vehicle accidents, etc.) may be excused as determined by the OCE. In addition to the form, for unavoidable absences, students must contact the OCE, their preceptor, and site coordinator by phone and/or in writing by 8:00 a.m. and/or prior to the start of their shift of the day they will be absent.

Supplemental documentation may be required by the OCE to substantiate the excused absence requests (e.g. doctor's note indicating the patient was seen/treated at a date in close proximity to the absence, obituary, wedding program, etc.). Students making requests to attend professional meetings should be detailed and specific in their requests. These requests must include the meeting/conference name, location, meeting dates, travel dates, method of travel, what the student hopes to learn/how they will benefit from the meeting, and if they are presenting or otherwise representing LUCOM (e.g. as a leader of a student organization).

Excused absences may need to be made up. In these cases, students may be required to submit proof that days they were required to make up were completed by signature from the preceptor or email from the preceptor and/or coordinator from the site.

Unexcused absences or tardiness may result in administrative action, including referral to an appropriate dean or to the Student Progress Committee for disciplinary action. A student may receive a failing grade for the clinical rotation if he or she has an unexcused absence.

As a member of the healthcare team during core or elective rotations, there is no guaranteed time off for holidays, traditional observances, or major days of religious significant. Students are expected to follow the holiday practice of the clinic or hospital at their site.

OMS-IV Attendance

LUCOM students are expected to be present for all days of a clinical rotation as assigned by the preceptor, site coordinator, or LUCOM Office of Clinical Education (OCE). Students must obtain approval for any absence from the LUCOM Office of Clinical Education and must complete and submit an Excused Absence Request Form. This includes any time away for residency interviews. Students must have this form signed by those designated on the form to be considered for an excused absence. Excused absences are considered on a case-by-case basis. Typically, the OCE will not approve a student for more than 2 excused absence days off of a four-week rotation, or 1 excused absence day off of a two-week rotation.

Students requesting to be excused from a clinical rotation or examination must submit the request to the OCE prior to the date of absence, at least 30 days for pre-planned events (i.e., professional meetings, weddings). The excused absence request must be submitted via the Excused Absence Request Form. A request is not considered approved until the student receives an email confirmation from the OCE. Likewise, the OCE will communicate if a request has been denied. LUCOM does not grant excused absences retroactively except in dire emergencies, but it does grant reasonable excused absences for requests made in advance. Unavoidable absences (i.e., illness, death of an immediate family member, motor vehicle accidents, etc.) may be excused as determined by the OCE. In addition to the form, for unavoidable absences, students must contact the OCE, their preceptor, and site coordinator by phone and/or in writing by 8:00 a.m. and/or prior to the start of their shift of the day they will be absent.

Supplemental documentation may be required by the OCE to substantiate the excused absence requests (e.g. doctor's note indicating the patient was seen/treated at a date in close proximity to the absence, obituary, wedding program, etc.). Students making requests to attend professional meetings should be detailed and specific in their requests. These requests must include the meeting/conference name, location, meeting dates, travel dates, method of travel, what the student hopes to learn/how they will benefit from the meeting, and if they are presenting or otherwise representing LUCOM (e.g. as a leader of a student organization).

Excused absences may need to be made up. In these cases, students may be required to submit proof that days they were required to make up were completed by signature from the preceptor or email from the preceptor and/or coordinator from the site.

Any reported unexcused absences or tardiness may result in administrative action, including referral to an appropriate dean or to the Student Progress Committee for disciplinary action. A student may receive a failing grade for the clinical rotation if he or she has a reported unexcused absence.

As a member of the healthcare team during core or elective rotations, there is no guaranteed time off for holidays, traditional observances, or major days of religious significance. Students are expected to follow the holiday practice of the clinic or hospital at their site.

Report on Time

OMS-III clinical rotations begin the first Monday of each block and generally end the fourth Friday of the block unless an alternate schedule specifies differently. OMS-IV selective and elective rotations may have alternate begin and end dates. It is the student’s responsibility to contact each site at least one week prior to arrival to obtain instructions regarding any required orientation and information about the service. Generally, OMS-III students report to the rotation site at 7:00 a.m. on the first day of each block rotation and as directed by the preceptor or DSME for subsequent days. Students are to arrive on time every day at their clinical site.

Duty Hours

Clinical rotations begin at 7 a.m. on the first Monday of the clerkship. In-hospital clinical rotations typically begin at 7 a.m. daily, and the typical student day is no longer than 12 hours. Out-patient rotations are typically 8 a.m. to 5 p.m. Monday – Friday. OMS-III clinical rotations end at 6 p.m. on the last Thursday of the rotation.

Students are to contact their preceptor prior to their first Monday of the clerkship to know what hours they will be working. Students should be prepared to work 60-72 hours per week on average. The workweek is typically 5 days and shall be limited to a minimum of 40 hours and a maximum of 80 hours. Examples of accepted hours may include but are not limited to clinical hours, community activities required by a course, didactic hours by the clerkship director or attending, and distance learning lectures. Students may not “compress” their clerkship schedule, working extra hours some weeks to complete the clerkship in less than the required weeks.

A four-week rotation should include a minimum of 160 hours per rotation. A two-week rotation should include a minimum of 80 hours per rotation.

A maximum workday is 16 hours and must be followed by 24 hours off. A student’s night duty should follow a typical night float schedule, which includes 24 hours of rest before start of a day shift.

Departure

Students are not to leave their designated rotation prior to the last day of the rotation. If they are assigned to a different site for end-of-rotation testing, they may be released on the last Thursday of the rotation at the completion of their shift to allow them to be present the following morning for end-of- rotation testing. Students may leave their assigned rotation site prior to the designated time only with the prior consent of LUCOM Office of Clinical Education, the DSME, and the supervising preceptor. Consent should be obtained no less than 14 days in advance unless an emergency requires the alteration. The LUCOM Office of Clinical Education must be provided the details of necessity in order to provide the approval for the early departure.

Unprofessional Behavior

The preceptor or DSME has the authority to dismiss a student from any rotation for violations of the student code of conduct, policies or procedures, threat to public health or safety, or as deemed appropriate for the continued operation of the clinical site. Such a dismissal will constitute a grade of incomplete until such time as the student appears before the Student Progress Committee (SPC). The SPC may find that the student shall receive a failing grade for the rotation, the student shall be allowed to repeat the rotation, or shall be subject to other disciplinary action up to and including dismissal from LUCOM. Any problems affecting students that are not quickly or adequately resolved at the site should be referred to the Dean and the LUCOM Office of Clinical Education. If a student is suspected of having a substance abuse or mental health problem that could affect patient care, the preceptor should report this situation to the appropriate clinical dean to expedite evaluation and further action.

Student Evaluation of Rotation

All rotation requirements, apart from the end-of-rotation exam, are due by 6:00 p.m. on the 4th Thursday of the rotation unless specified differently in the syllabus.

End-of-Rotation Examinations

Students take their examination the last Friday of the rotation. The student may need to travel and will prepare to take the COMAT exam. The COMAT exam is a standardized, specialty-specific examination prepared by the National Board of Osteopathic Medical Examiners (NBOME) and will correlate with the rotation they just completed.

The end-of-rotation examination, COMAT, is offered for all Core 3^rd Year Clinical Courses.

The COMAT will be administered on the fourth Friday of the rotation at the core site or at LUCOM, if within the travel limitations.

The COMAT is a proctored exam. All NBOME and COMAT policies will be in effect. The COMAT will be given one time for each rotation. There will be no options available to re-take the exam. If approved by the Dean and the LUCOM Office of Clinical Education, make-up tests may be scheduled by the LUCOM Office of Clinical Education at a time that is convenient to the required LUCOM personnel. It may be given at the next fourth Friday, requiring the student to take two COMAT exams in one day. It may be scheduled on weekends or in the evening. The student is required to contact the LUCOM Office of Clinical Education and schedule a time to make up the COMAT examination.

Rotation Schedule Time Off Requests

OMS-III and OMS-IV students seeking to take time off for personal, medical, or other reasons must contact the LUCOM Office of Clinical Education with his/her request. All requests must be submitted to the LUCOM Office of Clinical Education at least 30 days prior to the date the requested break is to begin, unless due to a medical or other emergency. All requests are considered on a case-by-case basis and are subject to denial based upon the timeliness of submission and the circumstances surrounding the request. Additional documentation including, but not limited to, proof of need, medical documents, and request forms, may be required for request approval and/or return to rotations.

A rotation change request may impact financial aid. Students are encouraged to contact the LUCOM Office of Financial Aid and the LUCOM Office of the Registrar when considering rotation drops or withdrawals.

Students requesting a schedule change, which would alter the student's anticipated graduation date, may constitute a Leave of Absence. 

Rotation Changes for OMS-IV

Changes to the rotation schedule by fourth-year students are generally not allowed to assure all requirements are met for graduation. An audition or elective clinical rotation acceptance represents a commitment by the student that he/she intends to be present during the scheduled rotation time period. This commitment demonstrates a level of professionalism that all members of the osteopathic profession must understand and honor.

It is advised that rotations not be cancelled within 30 days of the start of the rotation. Any request for a change in a rotation must be submitted to the LUCOM Office of Clinical Education (OCE) in advance of the start date of the rotation. Failure to show up for a scheduled rotation may result in an “F” grade for that rotation. Changes to a rotation schedule may potentially delay the student’s graduation, may affect the student’s ability to obtain financial aid, could adversely delay the student’s ability to begin residency on time, and may result in the student being referred to the Student Progress Committee (SPC) for an evaluation of the student’s professionalism and ethics.

The cancelling of clinical rotations outside of these guidelines could negatively impact our educational partners and could adversely affect the opportunity for students to rotate at those sites in the future.

Affiliation Agreements

OMS-IV student-doctors have the option to do selective or elective rotations at institutions other than our Core Hospital Affiliates by rotating at institutions with a fully executed affiliation agreement.

LUCOM provides an updated listing of affiliated sites for students to choose for rotations on the CORE platform. If a site is not listed, students may submit an Affiliation Request on CORE to begin the affiliation process.

The Office of Affiliations will only accept agreement requests that are submitted via the CORE platform. 

Submitting a request for an affiliation agreement does not guarantee that an agreement will be finalized with the requested institution. New agreement requests may take 4-6 months or longer to process. Students should plan to have backup rotations in place with an institution that already has a fully executed agreement in case the Office of Affiliations is unable to come to agreeable terms with the requested institution or it takes longer than 4-6 months to process.

All email correspondence regarding affiliation agreements should be sent to LUCOMAffiliations@liberty.edu. 

Rotation Site Assignments⁴

OMS-III core and required rotations take place in hospitals, clinics, and physicians’ offices where the preceptors are credentialed and appointed faculty of LUCOM and where the college has formal affiliation agreements.

Students are not permitted to change core and required clinical rotations, dates, preceptors, or locations without the written permission of the LUCOM Office of Clinical Education. Any student who does request such a change must do so in writing at least 30 days in advance with specific reasons before any determination will be made by LUCOM. At times, additional documentation may be necessary.

LUCOM reserves the right to change its rotation sites, required rotations, and schedules at any time.

Rotation Site Assignment Process

During the fall semester of a student’s OMS-II year, the Office of Clinical Education shall make available information concerning the core rotation sites and will educate students on the requirements, rights, and opportunities of the OMS-III clinical curriculum. During the spring semester of a student’s OMSII year, the Office of Clinical Education executes a systematic process by which students are assigned to core rotation sites. Detailed information concerning the site assignment process will be provided to students by the Office of Clinical Education. Students are expected to adhere to and meet all requirements and assigned deadlines set by the Office of Clinical Education pertaining to the site assignment process.

Students may be required to participate in on-site or virtual orientation session(s) prior to beginning clinical rotations.

Rotation Site Housing

Students are expected to provide their own housing during the OMS-III and OMS-IV years. Student housing is not the responsibility of the College or University, and the ultimate responsibility for all housing and transportation belongs to the student.

Consistent with Liberty University policy, males and females should not be housed together unless they are first-degree relatives or married. Property should be cared for as if it belonged to the student. All students in hospital or college provided housing will individually and jointly be responsible for any damages incurred. No pets are allowed in housing provided by the university. Housing is for students      only. While the students may have members of their family accompany them on their rotations, they are      not permitted to occupy LUCOM housing unless approved 30 days in advance in writing by the LUCOM Office of Clinical Education. The student must assume all responsibility and costs associated with family housing, travel, and arrangements for family housing must be made on the student’s own time. The student may elect to live with family or in privately arranged housing rather than in the provided housing. Under no circumstances must the location of the housing interfere with the student’s ability to arrive at assigned duties on time at the rotation site.

Financial Responsibilities

If a selective or elective site requires that an administrative fee be paid by LUCOM, the student will pay this additional cost to LUCOM via the online portal, who will arrange to send payment to the site. LUCOM will pay up to $100 of administrative fees or stipends to selective or elective sites outside of the core sites. Sites that charge a fee are noted on the CORE platform. LUCOM Office of Financial Aid has budgeted funds to the student’s financial aid package for the cost of audition and away elective rotations.  Please contact LUCOM Office of Financial Aid for more information on how to access these funds.

Meals

Rotation sites are not obligated nor expected to provide meals to LUCOM students. If a rotation site chooses to provide meals for the students, it is done so strictly at the discretion of the medical institution and is in no way required or expected.

COMLEX Board Exams⁵

Overview of COMLEX Examinations

The Comprehensive Osteopathic Medical License Examination of the United States (COMLEX) is a three-level, national standardized licensure examination designed for licensure for the practice of osteopathic medicine. The examinations are offered by the National Board of Osteopathic Medical Examiners (NBOME). Osteopathic students have an individual relationship to the NBOME and must understand that the practice of medicine (beginning after graduation from the COM) commencing with entry into a graduate medical education program (residency program) is tied to passage of the NBOME examinations during undergraduate medical education years.

COMLEX Levels 1 and 2-CE are generally offered during the second and third year of medical study, and success on these examinations is a requirement for LUCOM graduation. Successful completion of COMLEX Levels 1 and 2-CE and graduation from a COCA accredited College of Osteopathic Medicine are requirements needed for residency programs to obtain Trainee Licenses for first-year residents accepted for residency. COMLEX Level 3 is offered following medical school graduation, typically in the first year of residency, and success is linked to advancement during residency, as well as ultimate state licensure. Student candidates and residency candidates with the NBOME are responsible for understanding and abiding by the policies and procedures set forth by the NBOME.

LUCOM requires all students to adhere to a timeline across all four years of the curriculum that promotes timely student progression, and optimally prepares students to meet graduation requirements for the DO degree. The timeline and requirements additionally equip students to become eligible to enter GME programs via the Match.

COMLEX Eligibility

Academic and Professional Standing

LUCOM and the National Board of Osteopathic Medical Examiners (NBOME) require that students be in good academic and professional standing at LUCOM to take COMLEX Level 1 and 2-CE. To sit for COMLEX Level 1, students must be currently passing or have passed all OMS-II curriculum requirements to date. Similarly, to sit for COMLEX Level 2-CE, students must be currently passing or have passed all OMS-III curriculum requirements to date.

Predictive Modeling

In addition to meeting academic and professional eligibility requirements, LUCOM has developed predictive models that utilize student performance scores to predict COMLEX readiness for each COMLEX exam level. Prior to sitting for the exam, students must be released to sit for the COMLEX examination based upon the predictive model. Students will be notified of their eligibility and release status via email. Any students who are not released based on the predictive model will receive further instructions in the email correspondence. Students are responsible for the information and instructions contained in all email correspondence. Being released to sit for COMLEX by the predictive model and/or the Board Release Group does not guarantee the student’s success; the student is ultimately responsible for his/her preparation for and performance on the examination. Board Release Group

Board Release Group (BRG)

The Board Release Group is charged with upholding the integrity of LUCOM’s predictive model and enacting processes to evaluate student readiness, providing guidance to students to help them best prepare to take COMLEX, reviewing COMLEX delay requests, monitoring COMLEX test dates and associated policy compliance, and following up with students who fail a COMLEX examination. The BRG is comprised of LUCOM faculty and staff in various academic and administrative roles.

Deadline to Sit for COMLEX⁶

COMLEX Level 1 must be taken no later than the final day of spring semester of the OMS-II year of study and must not conflict with any clinical site orientation requirements. COMLEX Level 2-CE must be taken no later than the final day of spring semester of the OMS-III year of study. Students who sit after this deadline must receive prior approval from the Board Release Group.

Students are expected to schedule COMLEX exams and any necessary retakes following the deadlines established in this policy, deadlines established by the College administration, and the students’ own timelines for completing rotations and graduating on time. Satisfactory completion of Level 1 and 2-CE is also factored into the COCA (Commission on Osteopathic College Accreditation) requirement for all students to complete degree requirements within six years (inclusive of any leaves of absence or interruptions of curriculum progress) from the date of matriculation.

COMLEX/Rotation Delay Requests

Students must take COMLEX within the timeline that the examination is offered once LUCOM determines the student is eligible. Students may not be absent from scheduled rotations or alter the established clinical training schedule for board study during their OMS-III or OMS-IV years outside of any time designated for board review by the COM administration, policy, or procedures without documented approval by the Board Release Group.

Students requesting a board study delay beyond the posted deadline or a rotation delay beyond the standard early-July start must complete the “Boards/Rotation Delay Request” form located on the LUCOM website under Academic Documents and Forms. The completed form must be received by May 31. The Board Release Group will review requests for COMLEX-related delays and the Office of Clinical Education will review requests that impact the rotation schedule. Students seeking subsequent changes are required to submit a new request form. Submission of a request does not guarantee its approval.

COMLEX Failure

The Board Release Group, Office of Clinical Education, and the LUCOM Office of the Registrar will monitor COMLEX score reports provided by the National Board of Osteopathic Medical Examiners. Students who fail Level 1 or 2-CE of COMLEX will be contacted by the Director of Assessment and Outcomes or designee shortly after scores are released.

Students who fail Level 1 or 2-CE of COMLEX will be required to take action according to the following table. Any students who are required to, or choose to, complete an approved remedial program will be responsible for all costs associated with remedial programs. LUCOM has no obligation to consider any external individual or group or organization opinion(s) on student performance or preparation for licensing examinations. The student’s date of graduation, inclusion in class rank, and rotation schedule or site placement may be negatively impacted by any board failures.

Note: Registration and rotation schedule adjustments may occur following a COMLEX failure. Any registration changes must be communicated with the Office of Clinical Education and the LUCOM Office of the Registrar. Rotation changes may impact aspects related to financial aid, therefore students are encouraged to discuss the implications of the options and their possible outcomes with the LUCOM Office of Financial Aid.

Student Grading, OMS-III and OMS-IV

A portion of the OMS-III student’s core rotation grade is based on the preceptor’s evaluation of the student. The preceptor evaluation must be completed for each student on each rotation by the preceptor to whom the student has been assigned, or administratively by the DSME or the appropriate clinical dean.

If there is more than one supervising physician and/or paper evaluations are utilized, either the lead preceptor, the DSME, or the rotation site’s Office of Medical Education is responsible for combining evaluations and forwarding one overall evaluation of the student to the LUCOM Office of Clinical Education. In a case where an evaluation by the preceptor cannot be obtained, the grade may be administratively assigned by the DSME. In a circumstance where the DSME is unable to produce a cumulative evaluation for a student, the Office of Clinical Education, per the direction of the appropriate clinical dean, will assume the responsibility of assigning a grade for the rotation.

Preceptors’ summative comments in the designated field on student evaluations are used in the Medical Student Performance Evaluation (MSPE), or “Dean’s Letter”.

The OMS-IV student’s rotation grade is based on the preceptor’s evaluation of the student. The preceptor evaluation must be completed for each student on each rotation by the preceptor. Much like it is the responsibility of the OMS IV student to secure their rotations, it is also their responsibility to ensure that their preceptor completes and submits the evaluation to The Office of Clinical Education before leaving the rotation.

If there is more than one supervising physician and/or paper evaluations are utilized, either the lead preceptor, the DSME, or the rotation site’s Office of Medical Education is responsible for combining evaluations and forwarding one overall evaluation of the student to the LUCOM Office of Clinical Education. In a case where an evaluation by the preceptor cannot be obtained, the grade may be administratively assigned by the DSME. In a circumstance where the DSME is unable to produce a cumulative evaluation for a student, the Office of Clinical Education, per the direction of the appropriate clinical dean, will assume the responsibility of assigning a grade for the rotation.

If a student fails a rotation/course, the LUCOM Office of Clinical Education will refer the student to the Student Progress Committee. Any failed OMS-III rotation/course must be successfully repeated prior to advancing to OMS-IV. Any failed fourth year rotation/course must be successfully repeated prior to degree conferral.

Failing any single rotation/course places the student on probation and will require appearance before Student Progress Committee (SPC).  Failing two rotations/courses mandates a second referral to the SPC. The student may be subject to dismissal. Failing three rotations/courses is grounds for automatic dismissal. Failing any single repetition of a rotation/course is grounds for dismissal.

Medical Student Performance Evaluation (Dean's Letter)

The Medical Student Performance Evaluation (MSPE) is a formal letter of objective evaluation issued by the Dean and serves as an evaluation tool in the application process for post-doctorate training programs. This evaluation summarizes the levels of accomplishment a student has achieved during medical school. Specifically, the MSPE provides a succinct chronology of a student's entry and progress through medical school, which includes the preclinical and clinical rotation records, noteworthy characteristics, commentary on the student’s professional performance while in medical school, and the student’s summary of academic performance.  The MSPE is generally available for students by October of the OMS-IV year. Since the MSPE is a part of the student record, students may be permitted to review their MSPE prior to it being uploaded to ERAS. Students can only view the MSPE in the Office of the Registrar. The College of Osteopathic Medicine provides the document to ERAS and up to 10 other institutions free of charge. Thereafter it will cost $5 for each request.

Electronic Residency Application Service (ERAS)⁷

The Association of American Medical Colleges developed ERAS to transmit residency applications, letters of recommendation, the MSPE, transcripts, and other supporting credentials from applicants and medical schools to residency program directors.

The Office of Clinical Education will provide students with support and instructions for accessing ERAS.

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5.4 Patient Care Supervision, 6.9 Clinical Education, 6.10 Clinical Experience

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5.1 Professionalism

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5.4 Patient Care Supervision

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6.11 Comparability Across Clinical Education Sites

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11.4a COMLEX-USA

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6.9 Clinical Education

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9.2 Academic Standards, 9.6 Career Counseling