Medical Student Performance Evaluation

Professionalism is a foundational expectation of the TCOM curriculum and is emphasized throughout all four years of training. Students are expected to demonstrate professional behavior, including empathy, integrity, ethical conduct, motivation, and respect, in their academic and clinical activities. Significant professionalism concerns, including violations of academic integrity, may result in disciplinary action in accordance with UNT Health and TCOM policy and are documented in the student’s academic record as appropriate.

Students complete an integrated, system-based curriculum organized in two passes: an initial focus on normal structure and function, followed by disease-focused integration. In the second phase, content is organized around patient-presentations and fully integrates the osteopathic approach to patient care. All preclinical systems courses are graded Honors/Pass/Fail. 

Osteopathic Medical Practice courses run parallel to and integrate with the system courses and support the development of clinical skills, including physical exam, osteopathic manipulative medicine, simulation, ultrasound, and communication.

Students also participate in Professional Identity & Health Systems Practice courses, which provide longitudinal exposure to health systems science and support the development of professional identity. Topics include ethics, patient safety, population/public health, innovation, emotional intelligence, interprofessional education, health and wellness, and healthcare policy.

The TCOM clinical curriculum is delivered through a network of affiliated clinical rotation sites, where students engage in supervised, hands on patient care experiences across core/required and elective clerkships. The curriculum emphasizes progressive development of clinical reasoning, procedural skills, and osteopathic core competencies, supported by simulation activities, site based didactics, and faculty mentorship. Student performance is evaluated using standardized clinical evaluation tools across clerkship sites.

All core/required clinical clerkships are graded Honors/Pass/Fail. Honors designation is determined using a standardized set of criteria that includes performance on the Comprehensive Osteopathic Medical Achievement Test (COMAT) examination, clinical evaluation ratings, and professionalism expectations.

Criteria for Honors designation includes:

• COMAT score of 91 or above for the clerkship

• No ratings of “Below Expectation” on any domain of the milestone-based clinical evaluation

• No violations of any clinical education procedure during the clerkship (e.g. unexcused absences or missed deadlines)

If all criteria are met, the Clerkship Director may award Honors for a core/required clerkship. Elective clerkships are graded Pass/Fail only.

The core and required clerkships for year 3 are:

• Family Medicine

• Internal Medicine

• Obstetrics-Gynecology

• Osteopathic Manipulative Medicine

• Pediatrics

• Psychiatry

• Surgery

During their third year, all students complete a two-week Patient Safety course. This course culminates with students sitting for the Certified Professional in Patient Safety (CPPS) credential.

• In partnership with the Institute of Healthcare Improvement, TCOM was the first U.S. medical school to integrate patient safety certification into the undergraduate medical curriculum with the goal of preparing the next generation of physicians with proficiency in the core standards of patient safety.

Students continue the Professional Identity and Health Systems Practice curriculum during the clinical years, including completion of a project addressing a healthcare system challenge, which may serve as a foundation for future residency quality improvement work.

COMAT scores are reported by the NBOME as standardized scores with a national mean of 100 and a standard deviation of 10. 

Students who achieve scores at or above the 90^th percentile nationally receive a designation of “Recognition” for that exam.

The distributions below display the percentage of students receiving Pass versus Honors in each clerkship. 

 

Licensing Exams: All students are required to pass COMLEX-USA Level 1 and Level 2-CE before graduation (Level 1 is pass/fail; Level 2-CE passing score ≥ 400). COMLEX-USA is a national standardized examination series used for licensure of osteopathic physicians and assesses medical knowledge and clinical skills required for practice. This examination serves as the primary licensure assessment pathway for osteopathic medical students. 

Core Competency Capstone (C3DO): As part of an NBOME pilot initiative, students in the Class of 2027 completed the Core Competency Capstone (C3DO), a multi-station assessment of clinical skills. Students were required to demonstrate competency in core clinical domains, including patient evaluation, clinical reasoning, osteopathic principles, and humanistic skills as part of graduation requirements.

Translating Osteopathic Understanding into Community Health (TOUCH) is a national osteopathic student service initiative. TCOM students participate in community service activities beyond the formal curriculum. Exceptional involvement may be recognized through TOUCH award designations (e.g., bronze, silver, gold levels) and may be noted in the MSPE.

TCOM offers a rural medicine track (Rural Osteopathic Medical Education, ROME) for selected students. Participants begin additional rural-focused curriculum in the first year, including additional coursework and early clinical experiences in underserved settings. 

In the third year, Rural Scholars complete all core/required clerkships in rural community sites and conduct a community health quality improvement project. Students also participate in specialized training, such as the Agromedicine Workshop focused on identifying, treating, and preventing occupational and environmental hazards in rural communities. 

Participation in the ROME program is noted in the MSPE for those students.