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Competency Assessment

Competency Assessment

The UC San Diego PACE Program's Competency Assessment is a state-of-the-art, rigorous evaluation of a physician's ability to safely practice medicine that is built on the vast knowledge and experience gained from evaluating more than 1600 physicians over the past 20 years.  It is a highly customized evaluation specifically tailored to each individual physician's current (or intended) area of practice and the reason for referral.

Common reasons for referral include:
  • Concerns about a physician's knowledge, skills, or abilities
  • Physician Re-entry: A physician has been out of practice and needs to demonstrate competence in order to re-enter the workforce
  • A physician is complying with a consent agreement or medical board order

Upon successful enrollment into the PACE Competency Assessment we will conduct a pre-assessment case review: a multidisciplinary case conference dedicated to formally examining all relevant background materials surrounding the physician's reason for referral as well as requested pre-assessment self-report measures with the purpose of creating an individualized assessment program.

The total cost of most assessments is between $13,000 - $18,000. Due to the complex and high-stakes nature of the program, it can take several months to complete the Competency Assessment. The in-person elements take 1-2 days for most physicians.

Although each assessment will be custom tailored to the participating physician, there are certain "core" components, which together form the foundation of most PACE competency assessments.

  • Oral Clinical Examination
  • Physician Health Screening
  • Clinical Observation with UC San Diego Faculty

Additional elements of the Competency Assessment will be selected from the list below based on the Pre-Assessment Case Review:


  • Chart Audit
  • Chart Stimulated Recall

  • Multiple Choice Question Exams
  • Computerized Case Simulations (PRIMUM) followed by a faculty led Transaction Simulated Recall (TSR) interview

  • History and Physical on a mock patient
  • Standardized Patient Evaluation
  • Anesthesiology Simulation
  • Noelle High Stakes OB Simulator
  • Laparoscopic Surgical Simulation
  • SIM Man Emergency Medicine Simulator
  • Customized Simulation Activity

A survey of physicians peers that helps give an understanding about how they are perceived professionaly by those around them.

If necessary, to help understand or explain findings during assessment.

In cases where concerns exist about a physician's physical or mental wellbeing, we may include additional health-related evaluations as part of the competency assessment. In some cases the participating physician may be asked to undergo a separate Fitness for Duty Program.

Each completed PACE assessment results in a comprehensive written report which summarizes the participating physician's performance on each aspect of the evaluation and includes a detailed summary and recommendations section which describes how the physician's overall performance relates to his/her ability to safely practice and outlines any recommendations necessary for ensuring the participant's ongoing safety to practice.  Each assessment report categorizes the physician's overall performance into on of four possible outcomes or final grades.

  • PASS

    Signifies a good to excellent performance in most or all areas measured and is consistent with safe practice and competency. No significant deficiencies are noted.


    Signifies a performance during which minor deficiencies were noted that do not affect the physician's ability to practice safely, but may have an effect on optimal performance. Physicians in this category performed competently overall, but did sub-optimally on one or more aspects of the assessment. Recommendations for how to remediate deficiencies will be outlined.

    Significant deficiencies were noted. The physician is capable of practicing safely, but may not currently be reaching his/her full potential. Physicians in this category are likely to have broad deficiencies that cover multiple domains and will require a considerable educational investment and occasionally a change in behavior. Recommendations for how to remediate deficiencies will be outlined.

  • FAIL

    Signifies a poor performance that is not compatible with overall physician competency and safe practice. Physicians in this category performed poorly on all (or nearly all) aspects of the assessment. Alternatively, the physician could have a physical or mental health problem that prevents him/her from practicing safely. These physicians are unsafe and, based on the observed performance in the PACE assessment, represent a potential danger to their patients. Some physicians in this category may be capable of remediating their clinical competency to a safe level and some may not. We will provide our recommendations regarding remedial educational activities. The faculty and staff of the UC San Diego PACE Program do not give an outcome of "Fail" lightly or casually. This assignation reflects major, significant deficiencies in clinical competence, and physicians who receive this outcome, if they are deemed to be candidates for remedial education, should think in terms of engaging in a minimum of one full year of dedicated study and other learning activities requiring on average 30 to 40 hours per week. Under no circumstances will the UC San Diego PACE Program allow a physician to participate in a re-assessment less than six months from the time of completion of the initial assessment.

Scheduling and Completion of the Assessment:

Due to the complexity and high-stakes nature of the physician competency assessments, it takes on average 3-4 months to issue a final report from the date of the initial application. While every effort is made to complete the program as quickly as possible, ensuring that the work is done thoroughly and correctly is our first priority.