ExaminerNational Board of Medical Examiners3750 Market StreetPhiladelphia, PA 19104-3102

www.nbme.org

Spring/Summer 2016 Volume 63, Number 1

The Membership of the National Board ofMedical Examiners held its 102nd AnnualMeeting in Philadelphia on March 31 andApril 1, 2016. The 2016 Annual Meetingincluded three plenary sessions: an open-ing session on the morning of March 31;an afternoon session on March 31; and aclosing session on the morning of April 1.The remaining meeting time on March 31and April 1 was devoted to small groupsessions.

The meeting began with a plenary sessionthat included the roll call; welcomeremarks by the chair; ratification ofappointments of representative members;approval of the 2015 Annual Meetingminutes; announcement of online surveysfor meeting evaluation and committeeinterest to be distributed at meeting end;and presentations by the treasurer, presi-dent, and chair.

Members of the NBME and guests assem-bled in five small groups on March 31 andfive different small groups on April 1.Small group participants were visited by10 teams of individuals from the NBMEstaff and membership (“topic teams”).Each topic team facilitated discussion ofissues focusing on topics selected by theExecutive Board Planning and GovernanceCommittee prior to the Annual Meeting:diversity, inclusion, and implicit bias;strategic planning for the future; enhanc-ing Membership engagement; product dis-covery; research and development; newproduct development; USMLE and medicalschool services; other NBME products and

In This Issue:

1 2016 Annual Meeting of the NBME Membership

1 Dr. Melnick Announces His Plans toRetire

4 NBME’s Brian Clauser Appointed Editorial Board Chair for NCME Book Series

5 Eric Holmboe Receives 2016 John P. Hubbard Award

6 NBME and the National Consortium for Credentialing of Health & Wellness Coaches

7 International Foundations of Medicine Looks Forward to Its Second Decade

8 2017 Hubbard Award Call for Nominations

services; business operations; and NBMERenewal and member involvement in thenext century.

Presentation from the President

Using the poet David Whyte’s explorationof the concept of pilgrimage, Dr. Melnick’spresentation focused on passages inNBME’s history and the milestones thatsymbolize a “collective NBME journey.”His presentation outlined NBME’s evolu-tion during its first century, centennialanniversary celebration in 2015, andachievements in recent decades, many inwhich Dr. Melnick participated or which heled. At the conclusion of his presentation,Dr. Melnick spoke of a “different way–orjourney–to tread” for himself. He sharedhis decision to retire from the position ofNBME president in 2017. In recognition of

Donald E. Melnick, MD, has announced his plans to retire aspresident and CEO of the National Board of MedicalExaminers in the first half of 2017. “In more than 15 years aspresident and 33 years of service to the NBME, I have been soproud to steward our mission of patient safety,” Dr. Melnicktold the Annual Meeting of the NBME Membership in present-ing his decision to step down. “It has been a privilege and ajoy to work with hundreds of volunteers and staff to developassessments that contribute to effective, safe care forpatients.”

(continued on page 4)

(continued on page 3)

© 2016 NBME

2016 Annual Meeting of the NBME Membership

Dr. Melnick Announces His Plans to Retire

INSIDE THE NBME

2

1 Dr. Melnick addressing the Membership

2 NBME treasurer, Dr. Paul Wallach

3 NBME staff and members in

small group discussion

4 Dr. Patricia Whitley-Williams receives

the Distinguished Service Award

5 Dr. David Steward receives

the Distinguished Service Award

6 Mr. David Disbrow presenting the

Strategic Futures Committee and Open CI

7 NBME chair, Ms. Suzanne Anderson

Scenes from the 2016 Annual Meeting

1

2

3

7

4 5

6

3

Dr. Melnick’s 33 years of service to theNBME, including more than 15 years ofleadership as president, members andguests present at the meeting engaged ina standing ovation to honor Dr. Melnick.

Presentation from the Chair

Using a theme of “the next 100 years,”Ms. Anderson’s presentation coveredmajor themes that the NBME mightencounter as it embarks on its next centu-ry of service after celebrating its centenni-al anniversary in 2015. She spoke of deci-sions, opportunities, paths, and NBME’swish to lead change and drive its future.She provided updates on activities of thepast year, key collaborations and events,recognition of NBME volunteers and staff,and the importance of enhancing NBME’smission as it enters its second century ofservice to the public and the health pro-fessions. She outlined plans for theExecutive Board to begin a search for Dr.Melnick’s successor, invited input fromNBME members during the searchprocess, and described opportunities formembers to contribute, such as service onthe Search Committee and participation ina survey on assessing executive searchneeds.

Presentation from the Treasurer

NBME treasurer and Audit Committeechair, Dr. Paul Wallach, provided a presen-tation that included, among other topics,2015 Finance Committee and AuditCommittee highlights, 2015 operating per-formance (revenues and expenses) andinvestment performance, 2016 budgetdevelopment, 2015 external audits, enter-prise risk management activities, internalcontrols, and IT security and disasterrecovery.

Strategic Futures Committee andOpen CI

During the conclusion of the plenary ses-sion on March 31, Mr. David Disbrow ofthe Center for Innovation (CI) announcedthe creation of a new committee, namedthe Strategic Futures Committee, to pro-mote a rigorous process of scanning andprioritization across multiple domains,identifying trends and drivers important tothe NBME. He invited NBME members toexpress interest in serving on the commit-tee through the committee interest survey.He noted that the Strategic FuturesCommittee will rely on input from multiplestakeholders to accomplish NBME goals.He asked all NBME members to engage in

environmental scanning for the organiza-tion by responding to an email invitingindividuals to a site to set up a digital pro-file using "Open CI," a platform to contin-ue instigation and exploration for mem-bers throughout the year.

Distinguished Service Awards

Ms. Anderson presented the Edithe J. LevitDistinguished Service Award to two indi-viduals: Dr. Patricia Whitley-Williams, con-cluding her final term in the NBMEMembership, and Dr. David E. Steward, avolunteer who continues serving theNBME after more than 25 years of contri-butions. Ms. Anderson directed attentionindividually to their valuable contributionsand many years of loyal NBME service andexpressed hope for their continued con-nections with the NBME.

Presentation of the 2016 HubbardAward

During the Hubbard Award luncheon, the2016 John P. Hubbard Award was con-ferred on Dr. Eric S. Holmboe, member ofthe NBME and senior vice president, mile-stones development and evaluation,Accreditation Council for GraduateMedical Education (see page 5).

(Annual Meeting , continued from page 1)

4

In April 2016, Dr. Brian E. Clauser was appointed as chair of the editorial board for the NationalCouncil on Measurement in Education’s (NCME ) Applications of Educational Measurement andAssessment book series.

Brian is vice president of Measurement Consulting Services for the NBME and has more than twodecades of applied experience in psychometrics and with editorial experience as a former editor ofthe Journal of Educational Measurement (JEM). The Applications of Educational Measurement andAssessment series is intended to increase understanding and inform research-based applied educa-tional measurement and assessment. Intended audiences include NCME members, graduate stu-dents in measurement and assessment, and professionals in related fields engaged in measurementand assessment (e.g., psychology, educational leadership, educational and learning policy, curriculumand instruction, learning sciences, and certification and licensure).

Congratulations, Brian.

NBME’s Brian Clauser Appointed Editorial Board Chair for NCMEBook Series

Dr. Brian E. Clauser

Since joining the NBME in 1983, Dr.Melnick has served as senior medical eval-uation officer, vice president for institu-tional development and research, vicepresident for evaluation programs, andsenior vice president. In 2000, theExecutive Board named him president.Over the span of his career at NBME, hehas led development of the United StatesMedical Licensing Examination (USMLE®);implementation of computer-based test-ing; use of simulated patient encountersin computer-based assessment; and theaddition of a clinical skills component tothe USMLE. In the last decade alone, hehas championed accelerated expansion ofNBME’s international services and itsassessment for all healthcare professionswho seek the organization’s services.

“As healthcare has evolved, the NBMEhas evolved to address changing needs,”said Dr. Melnick, in reflecting on morethan three decades at NBME. “Whenphysicians became increasingly mobileacross the United States, we developedthe USMLE to help state medical boardssynchronize their requirements for licen-sure. Now we develop assessments for aglobal healthcare enterprise, as both pro-fessionals and patients cross nationalboundaries constantly. It’s an enormouslyexciting time.”

Suzanne Anderson, NBME chair, said aninternational search for a new presidentwill begin immediately. “Don has been avisionary leader,” she said. “He has con-tinuously challenged us to strengthenNBME assessments and to connect themto the values of healthcare professionalswho put patients first. We will seek candi-dates who can take advantage of changeand innovate to carry forward that legacy.”

Dr. Melnick received his BA fromColumbia Union College (now WashingtonAdventist University) and MD from LomaLinda University and is a diplomate of theNBME and the American Board of InternalMedicine. Prior to his appointments atthe NBME, Dr. Melnick was an associateprofessor in the departments of medicineand pharmacology, chief of the division ofgeneral internal medicine in the depart-ment of internal medicine, and medicaldirector of John Marshall Medical Services,the faculty group-practice at MarshallUniversity School of Medicine. He is aMaster of the American College ofPhysicians, a Fellow of the AmericanCollege of Medical Informatics, and aDistinguished Fellow of the AmericanCollege of Physician Executives. He haspublished numerous articles on theassessment of physicians’ competence.

(Dr. Melnick’s Retirement, continued from page 1)

THE NBME SALUTES…

decades of scholarship, teaching, leader-ship, and service as they relate to theassessment of clinical competence and thedevelopment and evaluation of expertisein medicine. Eric has devoted his entirecareer to the scientific advancement ofresidency education and standards foraccreditation, methods of evaluation forboard certification, and perhaps mostimportantly in the reliable assessment ofclinical competence. Eric has the rare abili-ty to convey complex information aboutthe assessment of clinical competence tothe least experienced and to the mostadvanced evaluation professionals equallywell.

“Among his many contributions, Eric hascontributed greatly in the field of work-place assessment and programmaticassessment. In pursuit of the goal of more

reliable clinical evaluation, Eric and hiscolleagues have developed an outstandingfaculty development program that focuseson the scientific application of new andimproved evaluation methods. As the leadauthor of a definitive text on assessmentin medicine, his countless scholarly contri-butions have all had a profound impact onassessment practice. His textbook, APractical Approach to the Evaluation ofClinical Competence, has sold over 4,000copies, and at the request of the publisher,he and his co-editor are working on thesecond edition. Considered one of thethree most-recognized leaders in work-place assessment in the world, Eric’slearned support has led to great strides inthe field, ultimately laying the foundationfor innovations in the field of medical edu-cation and engaging a wide variety ofstakeholders in a collaborative pursuit ofexcellence in physician training andassessment. As a colleague and peer I canpersonally attest to the importance ofEric’s significant contributions and leader-ship.

“In addition to his scholarly contributions,Dr. Holmboe is also widely known as abeing a mentor and teacher of otherassessment leaders. Providing leadershipand mentorship in the pursuit of excel-lence in physician training resonatesstrongly throughout all aspects of Eric’scareer.”

Dr. Holmboe is senior vice president, mile-stones development and evaluation,

5

PROFILE

At the 2016 Annual Meeting of theNBME, Eric Holmboe, MD, was selected asthe recipient of the 2016 John P. HubbardAward. The award is given to individualswho have made outstanding contributionsto the pursuit of excellence in the field ofevaluation in medicine. Joseph P. Grande,MD, PhD, member of the 2016 HubbardAward Committee, announced Dr.Holmboe’s selection at the AnnualMeeting of the NBME Membership onMarch 31, 2016.

In presenting the award, Dr. Grande stat-ed: “In recognition of outstanding contri-butions to evaluation in medicine, I ampleased to announce that the recipient ofthe 2016 Hubbard Award is one of ourown NBME members, Eric Holmboe. Eric isinternationally recognized for the consis-tent quality and significance of his

Eric Holmboe Receives 2016 John P. Hubbard Award

Dr. Holmboe (center) with NBME president, Donald Melnick, and chair, Suzanne Anderson

(continued on page 6)

In May, 2016, the NBME and the NationalConsortium for Credentialing of Health &Wellness Coaches (NCCHWC) signed anagreement for the launch of a national cer-tification for individual health and wellnesscoaches in the United States. Founded in2010, the NCCHWC supports the develop-ment and recognition of professionalhealth and wellness coaches, the integra-tion of basic coaching skills into the prac-tices of existing health professions, and theadvancement of a collaborative researchagenda with the compilation of evidenceon best practices across the field of healthand wellness coaching.

The agreement with NBME supports NCCHWC’s efforts to establish a nationalcertification that grounds both profes-sional practice and education standards inthe field of health and wellness coaching.The nonprofit NCCHWC assembled a vol-unteer team of experienced educators andleaders to unify interprofessional perspec-

tives and follow best practices to identifynational standards. Key milestones in thisprocess included a national stakeholdersummit, a job task analysis, and a nationalvalidation survey to clarify the tasks per-formed, as well as the minimum requisiteskills and knowledge needed for effectivepractice.

Karen Lawson, MD, a co-founder of NCCHWC, stated that this agreement is a“pivotal event in the evolution of healthand wellness coaching. We appreciate theassessment expertise, psychometric rigor,testing implementation, and professionalcredibility offered by the National Board ofMedical Examiners.”

The intent of the long-term strategic rela-tionship is to build the emerging profes-sion of health and wellness coaches and tofinance, develop, implement, and furtherpromote high standards of training, educa-tion, research, and credentialing for the

health and wellness coaching profession.Both organizations envision a professionalcommunity that is dedicated to high qual-ity and continuous improvement and thatserves as an advocate for the developmentand certification of high-quality coachingskills across healthcare, academia, and in-dustry.

NCCHWC co-founder Margaret Moore,MBA, noted, “It became clear that ourfield would make a giant leap forward bycombining NBME’s first-class expertise andinnovation in assessing the knowledge andskills of health professionals and the six-year volunteer accomplishments of NCCHWC in uniting the field around com-mon standards.” NBME president DonaldMelnick, MD, added, “NBME has long rec-ognized the need to protect the health ofthe public through state of the art assess-ment of health professionals. Moving thespectrum beyond physicians to includehealth and wellness coaches dedicated tohelping the public with lifestyle improve-ment is part of our long-term vision.”

The NBME looks forward to a long, pro-ductive relationship with NCCHWC. Formore information about NCCHWC, pleasevisit its website:

http://www.ncchwc.org/.

6

NBME and the National Consortium forCredentialing of Health & Wellness Coaches

OUT & ABOUT

Accreditation Council for GraduateMedical Education. The NBME establishedthe Hubbard Award in 1983 in specialtribute to the late John P. Hubbard, MD.Honoring Dr. Hubbard as a principal, guid-ing force of the NBME, this award

acknowledges his creative and inspiredleadership of the organization during his25-year tenure as its chief executive. Dr.Holmboe deservedly joins the ranks of thedistinguished individuals whom the NBMEhas honored over the years with this pres-tigious award. His selection as the recipi-ent followed a call for nominations pub-

lished widely in the spring of 2016. The2016 Hubbard Award Committee, chairedby Graham T. McMahon, MD, MMSc,included as members Peter G. Anderson,DVM, PhD, Kevin W. Eva, PhD, Joseph P.Grande, MD, PhD, Brian D. Hodges, MD,PhD, and Miguel A. Paniagua, MD.

(Hubbard Award , continued from page 5)

7

The International Foundations of Medi-cine® (IFOM®) exam program celebrates its10th anniversary in 2017, so it is worthtaking stock of the program as we lookback at 10 years of service to the interna-tional medical education community andahead to how we can make the programeven more useful to our global colleaguesand partners.

IFOM Then. . .

The program launched with the IFOM Clin-ical Science Exam (CSE) in 2007, with thegoal of providing a valid and reliable as-sessment of the core knowledge of medi-cine expected of students nearing thecompletion of undergraduate medicalschool anywhere in the world. The examwas modeled on the USMLE Step 2 ClinicalKnowledge (CK) exam. The exam was ini-tially used mostly by European medicalschools.

IFOM Now. . .

In the years since, the CSE has found awider and more diverse user base. It is stillused by numerous European medicalschools and by international studentspreparing to take Step 2 CK. However,there are now user schools in every regionof the world, and the test is used for manypurposes, including as a medical schoolexit exam, an end-of-course or end-of-rotation exam, and as an intern or resi-dency selection exam.

Although we still provide equivalent Step2 CK scores, the IFOM CSE scores aremostly used independently, and somecountries and user schools have workedwith NBME to set their own, locally rele-vant passing standards.

Two exams have joined the IFOM programover the years. In addition to the CSE, anIFOM Basic Science Exam (BSE) waslaunched in 2011 and is used as an end-of-course exam. An IFOM CSE Self-Assess-ment Exam was launched in 2013 and isoffered in International English and Span-ish, with a Brazilian Portuguese versioncoming in late 2016.

The IFOM CSE and BSE exams are cur-rently available in three modalities: schoolsand other institutions may administer theexam at their sites as a web-based orpaper-and-pencil test (IFOM has no plansto eliminate the paper option in the fore-seeable future). Individuals may also takeeither IFOM exam at a Prometric testingcenter in any of approximately 50 coun-tries; nearly one-fifth of IFOM examineesnow take the exam this way rather thanthrough institution-based administrations. The IFOM CSE is offered in InternationalEnglish and Spanish, as well as in Euro-pean Portuguese, and we are consideringoffering a Brazilian Portuguese version in2017.

IFOM is managed by a committee of physi-cians representing different medical spe-cialties and regions of the world. IFOM

committee members are appointed by theNBME president and serve renewable two-year terms. The committee serves an over-sight role, but members also write originalitems for the IFOM exams and review alltest forms for all three exams (CSE, BSE,and the CSE Self-Assessment). CurrentIFOM committee members are:

Maya Hammoud – Chair (USA)Joseph Adu (Ghana)Ángel Centeno (Argentina)Ricardo Correa Marquez (USA/Panama)Stephen Daniels (USA)Christopher Feddock (USA)Hamdy Hossam (Qatar)Zeina Kanafani (Lebanon)Ricardo Komatsu (Brazil)Janelle Rhyne (USA)Derek Soon (Singapore)Michael Wan (Australia)Alison Whelan (USA)

The Future of IFOM

The numbers of IFOM user schools and in-dividual examinees grow every year, andusers have told us that they value the highquality and sophistication of the examquestions, the knowledge and care appliedto creating exam forms that cover allmajor medical topics and practice areas,and the reliable, expertly produced IFOMscores.

International Foundations of Medicine LooksForward to Its Second Decade

INSIDE THE NBME

(continued on page 8)

8

The NBME invites nominations for the 2017 John P. Hubbard Award. This award recognizes individuals who have made a significant and sustainedcontribution to the assessment of professional competency and educationalprogram development at any level along the continuum of medical educa-tion and delivery of healthcare. It is expected that the successful candidatewill have demonstrated outstanding achievement in one or more of the following areas:

• A substantial record of fostering the development of evaluationmethods and/or measurement techniques; or

• Personal contributions to basic or applied research in the creation or improvement of assessment methodology; or

• Accomplishment in improving the quality of evaluation at an organizational level; or

• Contributions through the education or mentoring of students, colleagues, fellows, or graduate students, to further progress in evaluation.

Please visitwww.nbme.org

for more information

on the Hubbard Award.

The deadline forsubmissions is

September 9,2016.

Call for NominationsJOHN P. HUBBARD AWARD

However, we still have work to do. TheIFOM program is committed to keeping allnew exam questions and exam content

blueprints current with medical problemsand practice around the world. And, weare determined to widen the circle ofschools, countries, and regions that canuse IFOM by continually improving the

exams’ accessibility through fair pricingand user-friendly but secure ordering andadministration procedures.

(IFOM, continued from page 7)