Board orders · Physicians and PAs
Clinical Competence Assessments for Physicians: KSTAR, CPEP and PACE Explained
If a medical board has ordered, or is likely to order, a clinical competence assessment, this page compares the programs boards actually use: what each one tests, how many days it takes, what the programs publish about cost, who receives the report, and what usually happens once the report reaches the board.
Reviewed October 2026 against the FSMB Post-Licensure Assessment System (PLAS) program list and its Directory of Physician Assessment and Remedial Education Programs (updated August 17, 2026), program pages from CPEP, UC San Diego PACE and Texas A&M KSTAR, Medical Board of California board materials, Texas Medical Board minutes and Mississippi State Board of Medical Licensure records
Short answer: A clinical competence assessment is an independent, multi-day evaluation that a state medical board orders when it has a question about whether a physician or PA can practice safely. KSTAR at Texas A&M runs a 2-day on-site assessment; CPEP in Denver does most of its assessment remotely, with structured interviews about your own charts; and UC San Diego's PACE runs a 3-5 day hybrid assessment that ends in a four-category grade. Each one combines some mix of oral clinical interviews, simulated patients, knowledge tests and cognitive screening, then sends a report that the board uses to decide what happens next. Your order decides which programs count, so confirm acceptance with the board before you pay any fee.
Key takeaways
- FSMB's Post-Licensure Assessment System (PLAS), run with the National Board of Medical Examiners, lists six collaborating assessment programs: CPEP, Drexel, LifeGuard, UC San Diego PACE, Texas A&M (KSTAR) and the University of Florida.
- FSMB lists KSTAR at 2 days and $12,600, CPEP at 1-2 days and $9,000 to $14,000, and PACE at 3-5 days and $16,000 to $19,000; PACE's own page says most assessments cost $13,000 to $18,000.
- The clock is usually short. A December 2024 Texas Medical Board final order required a KSTAR assessment within 120 days, and the text of California's model probation condition presented to its board in 2016 set enrollment within 60 calendar days of the decision's effective date.
- Of 1,509 physicians graded in PACE clinical competence assessments from January 1998 to July 2025, 45.5% ended in a clear pass and 9.9% in a fail; the rest passed with minor or major recommendations.
- The report is the start of the next phase, not the end: CPEP says most of its education plans last 9 to 18 months, and PACE will not reassess a failed physician sooner than six months after the first assessment.
What a clinical competence assessment is, and what it is not
A clinical competence assessment answers one question for a board: can this clinician practice safely in their specialty right now, and if not, what would it take? It does that by testing you directly, over one to several days, against the standard expected of a practitioner with your training and scope.
UC San Diego's PACE program, presenting to the Medical Board of California in August 2025, described its purpose as determining whether a physician is competent and safe to continue practicing or to return after a prolonged absence. Its assessments are organized around the six core competencies used by the ACGME and the American Board of Medical Specialties: medical knowledge, patient care, practice-based learning, interpersonal and communication skills, professionalism and systems-based practice.
It helps to separate three things that are often confused, because an order may name one and not the others:
Clinical competence assessment
Specialty-matched, multi-method evaluation of how you actually practice. Ends in a narrative report with findings and recommendations. This page is about these.
SPEX
FSMB's Special Purpose Examination: a single computerized test of general medical knowledge, described in FSMB's directory as one 8-hour exam taken at a test center. It checks knowledge, not your practice.
Remedial course
Education ordered after a finding, such as a prescribing, records or ethics program. A course teaches; it does not evaluate whether you are competent. Some programs, including PACE and CPEP, run both.
Some programs also offer a separate fitness-for-duty evaluation, which looks at whether a physical, neurological or mental health condition affects practice. A competence assessment can add health components if concerns appear, but if your order says "fitness for duty" or "comprehensive evaluation," read it as a different kind of evaluation and ask the board which one it means.
Why a board orders an assessment, and where it shows up in an order
Boards order assessments when the concern is about competence rather than conduct alone. PACE's 2025 presentation listed the usual reasons for referral: a high rate of poor outcomes compared with peers, chronic documentation deficiencies, complaints from patients, peers or staff, problems that normal interventions have not resolved, and re-entry to practice after more than 24 months away. A single adverse event that raises questions about judgment or skill can also lead a board to order one.
An assessment can appear at almost any stage of a board case, which is why the timing of your own matters. If you are still at the investigation stage, our guide to the stages and timing of a medical board investigation explains where an order like this usually fits. The three most common forms are:
- A term of a final or agreed order, often alongside other conditions such as a preceptorship, chart monitoring or a course.
- A condition before you can practice, sometimes called a condition precedent, where you may not see patients until you pass.
- A licensure step, where a board defers a reinstatement or reissuance decision until it has the assessment report.
KSTAR assessment within 120 days, alongside a preceptorship
At its December 13, 2024 meeting, the Texas Medical Board adopted a final order, following a proposal for decision from the State Office of Administrative Hearings, that required "completion of KSTAR assessment within 120 days." The same order also imposed a preceptorship, a PACE course, chart monitoring, a referral to the Texas Physician Health Program, a $5,000 administrative penalty and a public reprimand. The assessment was one condition among several, and it sat next to a separate course requirement.
Source: Texas Medical Board, minutes of the December 13, 2024 board meeting (physician not named here).
Reissuance deferred until a KSTAR report arrived
In October 2020, the Texas Medical Board's Licensure Committee deferred an applicant's request to have their license reissued "pending successful completion of a KSTAR evaluation," citing disciplinary history, impairment and time out of practice. The applicant had to reappear before the committee once the report was received, and the application would be treated as withdrawn if the evaluation was not completed in 120 days.
Source: Texas Medical Board, Licensure Committee minutes, October 15, 2020 (applicant identified only by number).
California shows how the condition can be written in detail. Its Manual of Model Disciplinary Orders includes an optional clinical competence assessment condition. In the modified text presented to the Medical Board of California in July 2016, during the update to the manual's 12th edition, the physician had to enroll within 60 calendar days of the decision's effective date in a program equivalent to UC San Diego's PACE program and approved in advance by the board or its designee, and to complete it within six months of enrolling unless the board agreed in writing to an extension. The physician pays all costs, and whether they passed is left solely to the program. If the physician fails to enroll, take part in or complete the program on time, the board can notify them to cease practice within three calendar days. Your own order's wording is what binds you, so check it rather than relying on the model text. If your order is from Texas, read it alongside our guide to the Texas Medical Jurisprudence Exam term in a board order, which often appears in the same orders.
The FSMB PLAS network: which programs boards rely on
There is no single national list of approved assessment programs, because approval belongs to each state board. The nearest thing to a common reference is FSMB's Post-Licensure Assessment System (PLAS), a joint program of the Federation of State Medical Boards and the National Board of Medical Examiners. PLAS supplies standardized knowledge exams and computer-based case simulations, and works formally with these programs:
- The Center for Personalized Education for Professionals (CPEP), based in Denver, with a second testing center in Raleigh, North Carolina
- Knowledge, Skills, Training, Assessment and Research (KSTAR), at Texas A&M, with assessments held in Bryan, Texas
- Physician Assessment and Clinical Education Program (PACE), UC San Diego School of Medicine
- The University of Florida program in Gainesville, listed by FSMB as the Florida Competency Advancement Program; the university calls it the Florida Comprehensive Assessment and Remedial Education Services (CARES) Program
- LifeGuard, in Harrisburg, Pennsylvania
- The Drexel Medicine Physician Refresher/Re-Entry Course, in Philadelphia, which FSMB lists as an assessment ($2,000 to $6,000) followed by an individualized university preceptorship run in 6-week blocks at $7,500 tuition per block, so it is mainly a refresher and re-entry route rather than a stand-alone assessment
FSMB also publishes a wider Directory of Physician Assessment and Remedial Education Programs, last updated August 17, 2026. It is useful but has clear limits: FSMB says it has not evaluated the programs or their faculty, a listing is not an endorsement, and details may be incomplete or out of date. Many entries are fitness-for-duty, addiction or behavioral evaluations rather than clinical competence assessments; the directory also lists Acumen's fitness-to-practice assessment as a PLAS collaborator, but that is a behavioral evaluation rather than a clinical skills assessment.
Individual boards publish their own lists. The Mississippi State Board of Medical Licensure, for example, keeps a list of approved facilities "for licensees who have been directed by the Board to complete a competency evaluation." It names PLAS, CPEP, the Florida Competency Advancement Program (UF CARES), Drexel, KSTAR, LifeGuard, PACE and the Upstate New York Comprehensive Clinical Competency Center.
Application fees are usually non-refundable: $350 at KSTAR and $500 at PACE. Get the board's or your probation monitor's written confirmation that the program you choose satisfies your order first, and keep it with your compliance records.
KSTAR, CPEP, PACE and two other programs side by side
The table brings together what FSMB and the programs themselves publish. Where FSMB's figures and a program's own page differ, both are shown, and the program's own page is the better guide. Prices and timings change, so treat these as a starting point for a phone call, not a quote.
| Program | Where and how | Length | Published cost | Core components | Report |
|---|---|---|---|---|---|
| KSTAR (Texas A&M) | On site, Texas A&M Health Science Center campus, Bryan, TX | 2 days | $12,600 (FSMB); $350 non-refundable application fee | Standardized patients, record review, NBME multiple-choice testing, cognitive screening, physician interviews | About 4 weeks (FSMB) |
| CPEP (Denver, CO) | Mostly remote by videoconference; testing centers in Denver and Raleigh for simulations | 1-2 days (FSMB); on-site time usually limited to 2 days | $9,000 to $14,000 (FSMB); CPEP says fees vary by specialty and scope | 2-4 structured clinical interviews on 24-40 of your charts, simulated patients, neurocognitive screen, procedural simulation if relevant, NBME, NBOME or NCCPA exams if appropriate | About 10-12 weeks (CPEP); about 8 weeks (FSMB) |
| PACE (UC San Diego) | Hybrid: remote elements plus at least 1 day in person in San Diego | 3-5 days | Most $13,000 to $18,000 (PACE); $16,000 to $19,000 (FSMB) | Oral clinical exam, simulated clinical skills, physical and cognitive screening; may add chart-stimulated recall, PLAS exams and a 360-degree survey | 6-8 weeks after all elements, about 10-14 weeks from application (PACE); 4 weeks after all components (FSMB) |
| Florida Competency Advancement Program (University of Florida) | Gainesville, FL | 2-3 days | Varies with assessment needs (FSMB) | PLAS exams, chart-stimulated recall, standardized patient exam and psychological evaluation, tailored to specialty (FSMB) | 8-10 weeks (FSMB) |
| LifeGuard (Pennsylvania) | Harrisburg, PA | Assessment 1-3 days; full program typically 3-6 months | $8,500 to $10,000 for the full program (FSMB) | PLAS exams, neurocognitive assessment, independent medical exam, standardized patients, simulation lab, records review, peer review and professionalism assessment; preceptorship or proctorship where required (FSMB) | About 4 weeks after all components (FSMB) |
Sources: FSMB PLAS Clinical program list and FSMB Directory (August 2026); CPEP Overview of Assessment Process 2025; UC San Diego PACE Clinical Competency Assessment page; Texas A&M KSTAR Physician Assessments page. Costs exclude travel and lodging.
The numbers matter less than three practical differences:
How much is remote
CPEP runs most assessments by videoconference and brings people to Denver or Raleigh only for hands-on simulations in some specialties. KSTAR is two days on site in Bryan. PACE mixes remote elements with at least one day in San Diego. If travel, childcare or a practice restriction makes time away hard, this may decide it, provided your order allows a choice.
How much rests on your own charts
CPEP's model leans heavily on your real patients: you submit 24 to 40 charts and specialty-matched consultants each spend about 90 minutes questioning you on 8 to 10 of them. PACE may add chart-stimulated recall. If your charts are thin or you have been out of practice, ask each program how it handles that before you enroll.
The third difference is who sees the result. When a third party such as a board refers you to PACE, the report goes to that party and PACE does not send it to you directly. CPEP describes its report as confidential and shared with you and anyone you name in a release, which in a board case will include the board. Ask your attorney how you will get a copy before the board discusses it.
For physician assistants, the same programs apply. CPEP's assessment is open to physicians, PAs, advanced practice nurses and podiatrists and can use NCCPA exams. KSTAR runs a separate 2-day PA assessment, reviewed by a panel of physicians and PAs. PACE lists a PA assessment in its menu. If you are a PA facing a complaint, our guide to PA board complaints covers the earlier stages.
From order to report: what the weeks and days involve
No program publishes an hour-by-hour schedule, and each one tailors the assessment to your specialty and the concerns in your file. What they do publish gives a clear picture of the sequence:
Your deadline usually runs from the effective date, not the day you read it. Note whether the order sets a date to enroll, a date to complete, or both.
KSTAR asks for your medical school diploma, residency certificates, CME records for the past 12 months with provider and hours, copies of all board letters and orders, any specialized testing results and a current CV. PACE takes a $500 non-refundable application fee, then an initial payment of $10,500 (which includes the $500) to complete enrollment; the balance is due before assessment activities begin.
CPEP and PACE both say scheduling takes about 4 to 6 weeks. CPEP collects your patient charts in this period; PACE may run some elements remotely by video.
Two days on site at KSTAR; interviews, simulated encounters and a neurocognitive screen at CPEP, with on-site time usually two days or less; 3 to 5 days in total at PACE, with at least one in person.
About 4 weeks at KSTAR (FSMB); about 10 to 12 weeks at CPEP, where the findings are analyzed by a team that generally includes five physicians; 6 to 8 weeks after the last element at PACE.
The board, or its compliance staff, reads the findings and decides on the next step. The program recommends; the board decides.
Because the whole process can take three months or more from application to report, a 60- or 120-day deadline is tighter than it looks. If you cannot enroll in time because of program availability, ask the board for an extension in writing before the deadline passes, not after.
What each component is testing
Oral exam and chart-stimulated recall
A same-specialty clinician walks through cases, often your own, asking why you made each decision. This tests reasoning and whether your notes reflect it.
Simulated patient encounters
Trained actors present a case. CPEP uses these to assess communication and documentation; you usually write a note afterward.
Multiple-choice exams and case simulations
NBME, NBOME or NCCPA exams, or PLAS subject exams in clinical neurology, family medicine, internal medicine, obstetrics and gynecology, pediatrics and psychiatry, plus computer-based case simulations.
Cognitive and health screening
A computerized screen of functions such as memory and reaction time. Concerns about health can lead to further evaluation, such as a separate fitness-for-duty evaluation.
Procedural simulation
For proceduralists such as surgeons and gastroenterologists. CPEP does not run these remotely, which is one reason some participants still travel.
Professionalism and root cause analysis
PACE's assessment includes a professionalism and behavioral evaluation and a written root cause analysis, so how you understand what went wrong is part of what is measured.
Preparing honestly: what helps and what does not
An assessment is designed to measure how you practice, so there is no shortcut, and trying to "cram" the narrow facts of your case usually misses the point. What does help is arriving organized, rested and clear about your own practice. If you have not yet started any remediation, our guide to starting remediation before a board conference covers timing and evidence; this section is about the assessment itself.
- Read the order with your attorney and list every deadline it sets: enrollment, completion and report submission.
- Call two or more accepted programs about availability before you apply, then get the board's confirmation of your choice in writing.
- Gather the documents the program asks for in the first week, especially your last 12 months of CME records with provider names and hours.
- Ask the program which exams it will use. If PLAS computer-based case simulations (CCS) are included, FSMB advises taking the CCS tutorial and practicing with the sample cases on the USMLE website.
- Review current guidelines for the conditions you see most often, not only the case that led to the complaint. Assessors test your general practice.
- Look at your own charts as an assessor would. Can a colleague follow your reasoning from the note alone?
- Be ready to talk calmly and specifically about the events behind the referral, including what you would now do differently. If you need help putting that into words, see our guide to showing insight and accountability to a board.
- Disclose health issues, medications or sleep problems that could affect cognitive testing when the program asks. Hiding them helps no one.
Reading the report: categories, recommendations and real outcomes
Reports are narrative: they describe strengths, list any deficiencies with the reasoning behind them, and make recommendations. PACE also gives one of four final grades, and because it presented its long-term results to the Medical Board of California in 2025, it is the clearest public picture of how these assessments turn out.
Two points follow from those numbers. First, most physicians assessed at PACE passed, and two in three passed with no more than minor recommendations. An assessment order is serious, but it is not a prediction of failure. Second, about one in three ended with significant recommendations or a fail, so it is sensible to plan for the possibility of further education before the report arrives.
The category descriptions matter as much as the label. PACE defines Category 3 as significant, often broad, deficiencies in a physician who is still capable of practicing safely, typically needing "a considerable educational investment." Category 4 can also reflect a physical or mental health problem that prevents safe practice, which is why some failures lead to a health evaluation rather than more education.
Other programs do not publish a grading scale in the same way. CPEP's report sets out areas for improvement, the rationale for each conclusion and educational recommendations. In both cases, the recommendations, not just the headline result, will shape what the board asks of you.
Documentation problems come up often, both as a reason for referral and as a finding. PACE's own examples of minor recommendations include a documentation course.
After the report: education plans, preceptors and reassessment
The program sends the report; the board decides what to do with it. What follows usually depends on how serious the findings are. FSMB's PLAS page lists the typical follow-up options: individualized education plans, CME courses, practice monitoring, proctoring, remediation, retesting or re-entry programs.
Get and read the full report
Work out with your attorney how and when you will receive a copy, especially if the program sends it only to the board. Read the recommendations line by line; they are often the template for the board's next order.
Expect the board to act on the recommendations
A clear pass may be enough to close that condition. Recommendations often turn into new terms: specific CME, a preceptor, chart review, proctoring or limits on scope or patient load. A fail can mean a stop-practice period or a requirement to complete a re-entry program before returning.
Enroll in an education plan if one is recommended
At CPEP, an educational intervention is a separate program with separate fees, built from the assessment findings. It usually combines self-directed study of the evidence, CME from accredited providers, supervised point-of-care experience and chart reviews with a same-specialty preceptor. CPEP says most interventions last 9 to 18 months (FSMB's listing gives 6 to 12 months), and FSMB notes that CPEP sends regular progress reports to the referring organization.
Work with a preceptor or monitor
A preceptor is a clinician with your training, specialty and scope who reviews your charts and discusses cases with you. Boards may also order separate chart monitoring, as the December 2024 Texas order did.
Prepare for reassessment if required
PACE does not reassess a physician sooner than six months after the first assessment, and it tells failed physicians who are candidates for remediation to plan on at least a full year of dedicated study. It does not recommend reassessment where the deficits would need residency or fellowship-level retraining, or where a health problem is affecting competence.
Keep evidence as you go
Keep a dated log of what you studied, what you changed in practice and what your preceptor said. When you next appear before the board, organized evidence of learning carries more weight than a stack of certificates. Our guide to writing a reflective statement for a licensing board explains how to present it.
If you disagree with the result
An assessment report is evidence, and you can respond to it. The usual route is through your attorney: a written response to the board, a request to correct factual errors in the report, or, in some cases, a second assessment at another accepted program. A second opinion does not cancel the first report, though, and a board can rely on both.
Two programs, the same conclusion
After a complaint that procedures had been performed without adequate skill, a physician agreed not to practice surgery and completed a PACE assessment in mid-2021, which returned a Category 4 (fail). The physician disagreed with the findings and asked for a second assessment at another board-approved program, CPEP, which in October 2021 classified the physician's management of delivery as "unsafe" and the performance as "not competent." On July 21, 2022, the Mississippi State Board of Medical Licensure suspended the license, with reinstatement conditional on completing a board-approved re-entry training program, and assessed costs not to exceed $10,000.
Source: Mississippi State Board of Medical Licensure, board actions, 2022 (physician not named here).
The lesson is not that second opinions never help. A second assessment is most useful where there is a specific, documented reason the first one was unrepresentative, such as an assessment outside your real scope of practice, and least useful where it simply repeats the same tests. Discuss it with a licensing attorney before you commit the time and money.
Choosing a program when your order gives you a choice
Many orders name a single program. Where yours allows an approved or equivalent program, these questions usually decide it:
- Acceptance: is it on your board's list, or has the board approved it in writing for you?
- Deadline: can it schedule you, finish the assessment and send a report within the deadline in your order?
- Specialty match: does it have assessors in your specialty and subspecialty, and simulations for any procedures you perform?
- Format: how much can be done remotely, and how many days away from practice will it take?
- Total cost: what does the fee include, what is non-refundable, and what will travel and lodging add?
- What comes next: if education is recommended, does the program run its own plan, and would the board accept it?
Programs that also run education plans can make the next stage smoother, but you are not usually required to use the same organization for both. Check what your board will accept before you sign up for either.
Common mistakes with board-ordered assessments
- Paying an application fee before the board approves the program. Fees of $350 to $500 are non-refundable, and the full fee can exceed $12,000.
- Counting the deadline from the wrong date. Orders usually run from the effective date of the decision. Three months from application to report can swallow a 120-day deadline.
- Treating a course as a substitute. A remedial course, ours included, is not an assessment. The Texas order above required a KSTAR assessment and a PACE course as two separate terms.
- Preparing only for the case in the complaint. Assessors test your general practice in your specialty.
- Downplaying the events behind the referral. Blaming others or minimizing the problem in interviews tends to show up in a professionalism finding.
- Losing track of the report. If the program reports only to the board, arrange through counsel to see it before the board meets.
- Stopping learning after the report. Boards read recommendations and expect to see them carried out.
For how assessments fit with the wider set of education terms in physician orders, including ethics and professionalism programs, see our hub on board-ordered courses for physicians. If you are still writing your first reply to the board, start with our guide to responding to a medical board complaint.
Maintaining Clinical Competence
A self-paced course of about three hours for US licensees on how competence is defined, checked and kept current across a career. It covers the six general competencies, self-assessment and personal clinical audit, building a personal competence plan, and a section on what happens when competence is questioned, including what a clinical competence assessment involves. It is supporting education to help you prepare and show structured learning. It is not an assessment and cannot satisfy an order to complete one.
Our courses are education.
Frequently asked questions
Can I choose which assessment program to attend?
Only if your order allows it. Some orders name one program; others allow any program on the board's list, or a program equivalent to PACE and approved in advance, as in the 2016 text of California's model condition. Mississippi, for example, publishes a list of approved facilities. Get written approval for your choice before you apply.
Is a clinical competence assessment the same as the SPEX exam?
No. SPEX is a single computerized exam of general medical knowledge. A competence assessment is a multi-day, specialty-matched evaluation that includes interviews, simulated patients and screening as well as knowledge testing. A board may order either one, or both.
Who pays for a board-ordered competence assessment?
Usually the physician. The 2016 text of California's model condition states that the respondent pays all expenses, and PACE says it does not offer payment assistance or financing. Travel and lodging are extra at every program. Ask your malpractice carrier or employer whether any coverage applies, but do not assume it does.
Can the assessment be done online?
Partly, depending on the program. CPEP does most assessments by videoconference, with travel to Denver or Raleigh only for hands-on simulations in some specialties. PACE combines remote elements with at least one in-person day in San Diego. KSTAR's physician assessment is two days on site in Bryan, Texas.
Will the assessment result be made public?
The report itself usually goes to the referring board and is not published by the program. However, board orders that require or follow an assessment are generally public, and a board can describe the findings in a public order, as Mississippi did in 2022. Discipline is also reportable to the National Practitioner Data Bank.
Can I take a competence assessment voluntarily, before a board orders one?
Yes. PLAS programs accept self-referrals as well as referrals from boards, hospitals and practices, and some physicians do this to support re-entry or to answer a concern early. A self-referred report comes to you, but whether and how to share it with a board is a decision to make with a licensing attorney.
What happens if I fail the assessment?
The board decides. Outcomes can include a remediation program, supervised practice, a stop-practice period until re-entry training is completed, or, in serious cases, suspension. PACE will not reassess sooner than six months after the first assessment and tells candidates for remediation to plan on at least a full year of dedicated study.
Official sources
- Federation of State Medical Boards: PLAS Clinical, collaborating assessment programs (length, cost, report timing)
- Federation of State Medical Boards: PLAS Assessment Resources (subject exams, case simulations, collaborating programs)
- Federation of State Medical Boards: PLAS Information
- Federation of State Medical Boards: Directory of Physician Assessment and Remedial Education Programs (last updated August 17, 2026)
- Center for Personalized Education for Professionals (CPEP): Clinical Competence Assessments
- CPEP: Overview of Assessment Process 2025
- CPEP: Educational Interventions
- UC San Diego School of Medicine, PACE: Clinical Competency Assessment
- UC San Diego School of Medicine, PACE: Assessment Outcomes (Categories 1-4)
- Texas A&M Rural and Community Health Institute: KSTAR Physician Assessments
- Texas A&M Rural and Community Health Institute: KSTAR Physician Assistant Assessment
- University of Florida College of Medicine: Florida Comprehensive Assessment and Remedial Education Services (CARES) Program
- Medical Board of California: Board meeting August 21, 2025, Agenda Item 6, UC San Diego PACE Program presentation
- Medical Board of California: Board meeting July 28, 2016, Agenda Item 23, Disciplinary Guidelines second modified text (clinical competence assessment condition)
- Texas Medical Board: Events, Agendas and Meeting Minutes (board meeting of December 13, 2024)
- Texas Medical Board: Licensure Committee meeting minutes, October 15, 2020
- Mississippi State Board of Medical Licensure: Approved competency evaluation facilities
- Mississippi State Board of Medical Licensure: Board Actions (2022)
- USMLE: Computer-based Case Simulations (CCS) format, tutorial and sample cases
Checked October 2026.