Take USMLE or just COMLEX?

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I am a second year and was wondering if I should take both tests or just the COMLEX. I am in the top 35% of my class and right now I am leaning toward IM or EM. I really don't think I want to do surgery or any of the super competitive specialties right out of school, but I still may want to do a fellowship following residency in IM or something of the sort. Would it be recommended to take the USMLE if I wanted to do EM or get a fellow ship someday? Our school isn't the greatest at giving advice on this so any help would be much appreciated!

Take USMLE. Don't think about this anymore and just fork up the $550.

If you're top 35% I'd go for it.

Originally Posted by Es Pontas

Take USMLE. Don't think about this anymore and just fork up the $550.

Yes

Originally Posted by thepoopologist

If you're top 35% I'd go for it.

and yes

If you want to, then do it. Otherwise it is not necessary. People who tell you it is are just as biased against DO's as they think residencies are.

Originally Posted by ttjones

If you want to, then do it. Otherwise it is not necessary. People who tell you it is are just as biased against DO's as they think residencies are.

Don't listen to this guy, it is necessary at some programs and highly recommended at others. I think it is always a wise idea to give yourself more options, so think if you can do well, by all means take it.

Definitely take it because you're in top half of your class and will most likely do well on it. You don't really know which programs you will be applying to and what if those programs "prefer" USMLE? And what if your USMLE is really good and would definitely make you stand out?

Fork over the extra money and take it. You will be better prepared for rotations anyway because thinking process behind answering USMLE questions are vastly different than COMLEX.

Originally Posted by Rollo

Definitely take it because you're in top half of your class and will most likely do well on it. You don't really know which programs you will be applying to and what if those programs "prefer" USMLE? And what if your USMLE is really good and would definitely make you stand out?

Fork over the extra money and take it. You will be better prepared for rotations anyway because thinking process behind answering USMLE questions are vastly different than COMLEX.

you could also end up like me, where I spent all my energy on the usmle and ended up getting a very solid grade on the comlex by the nature of similar material, but got the elusive 99 in the usmle and now I don't need to be concerned about mycomlex grade at all. If you nail the usmle the comlex (which is viewed as more of a 'did you do poorly, average, well or great' test) becomes so secondary.

Originally Posted by DocEspana

you could also end up like me, where I spent all my energy on the usmle and ended up getting a very solid grade on the comlex by the nature of similar material, but got the elusive 99 in the usmle and now I don't need to be concerned about mycomlex grade at all. If you nail the usmle the comlex (which is viewed as more of a 'did you do poorly, average, well or great' test) becomes so secondary.

Exactly. I did relatively better on USMLE than COMLEX and now I'm barely considering entering the DO match.

take it.
I don't regret NOT taking it, but it limits you even if you're SURE you think your career is going in a very specific direction. I chose to focus heavily on the COMLEX because the exams are SO different in style that people can get tripped up in the semantics. My original intent was EM... lo and behold I fell hard for anesthesia. I'll take Step II USMLE, but it would have been better for me had I taken step 1.

Research areas of medicine you're interested in and fish programs for current and past DO residents. EM and GAS have alot of DO's even at top programs (Emory-EM, Yale/J. Hopkins), and may have matched with JUST COMLEX scores.

Like everyone has said, if you're in the top half of the class and you put in the leg work and have a solid plan of attack, then you will do fine. I would recommend taking it.

Take it.

It was the smartest thing I ever did.

.

I am in the process of getting interviews. I have contacted allopathic em programs and this is the response I received from some top institutions. "We recommend you to take the USMLEs, we will grant you an interview solely based on COMLEX scores, but PDs have a difficult time comparing COMLEX scores to USMLE scores, and as a result an interview does not necessarily grant you a high ranking due to the fact that they are difficult exams to compare and we are used to seeing more USMLE scores vs COMLEX." Point being, if you are considering EM and at an allopathic institution, especially top tier EM programs, you should make sure you do not give them a reason to not consider you. USMLEs in my opinion were much easier than COMLEX at least for step 2. There were no suprises. What you learn in your boards prep is what you get, whereas comlex had pleasant surprises that I feel some interns and residents may not even know. Good luck!

To play devils advocate...

I studied only for the USMLE (and studied my butt off) and did just below average on it, but did very much above average on the COMLEX. I am applying EM this year and as of yet have only gone to DO interviews. I applied to over 50 programs and was told flat out by a few of the more competitive MD programs that I would not be considered due to a low (relatively) USMLE. I don't know if any of this really matters yet as its pretty early on in the interview process and many of these places may not have taken a DO without amazing scores anyway. My gut feeling is that for me, doing a little below average on the USMLE and doing great on the COMLEX has probably hurt me more than if I had only my COMLEX scores. As the programs who understand the COMLEX still just see an OK USMLE.

Also, one thing that has really surprised me is the variation between programs and how they view board scores. One big DO program flat out told me that they don't even consider them at all, while others have claimed to be impressed by my scores. It seems that the DO world really only cares about elective rotations and letters, while the MD world cares much more about board scores. Its been my experience that in the DO match, the only EM programs that will take a student that did not rotate with them are those in less desirable locations. The whole process is frustrating and confusing.

I would tell a DO to take both only if they had enough time to study for it. Understand that if you fail the USMLE, your options will essentially be zero outside of community MD FM programs, and is seems to me that just doing average on it has not helped me at all. Med students are pretty bad at being able to size themselves up and make a realistic assessment of their abilities. They tend to always overestimate themselves. Take a few practice tests and if you are not reliably scoring 225+ I don't see a reason to risk it.

Also, a lot of this depends on the field. From what I have seen, ortho, optho, derm, prs, Irads and ent are essentially closed doors to DOs, thus I would say to hell with it and take both, as a bad score means almost nothing. You will be applying to DO anyway. FM, many IM, peds, pmr and maybe psych are pretty wide open so even a midrange score is not going to hurt you. The difference is in the mildly competitive fields where DO's have been able to match in the past, EM, gas, neuro, rads academic IM and maybe gen surg. (gen surg may be a stretch). A poor score can really hurt you, and an average student may be better off taking only the COMLEX and applying to DO friendly places.

Also I have found from a very small sample size that class rank has little to do with how well you will do on the USMLE.

Just my 2 cents.

Originally Posted by danzman

Take a few practice tests and if you are not reliably scoring 225+ I don't see a reason to risk it.

... A poor score can really hurt you, and an average student may be better off taking only the COMLEX and applying to DO friendly places.

Also I have found from a very small sample size that class rank has little to do with how well you will do on the USMLE.

Agree.

while its difficult for a PD to convert comlex to usmle, is there such a thing as a comlex score high enough that the PD would just get that its "higher than most"? As in, is 'significantly higher than average' recognizable?

Originally Posted by irJanus

while its difficult for a PD to convert comlex to usmle, is there such a thing as a comlex score high enough that the PD would just get that its "higher than most"? As in, is 'significantly higher than average' recognizable?

The equation the AOA has given ACGME programs is (for step one)
USMLE Step 1 = 67.97 + 0.24 x COMLEX-USA Level 1

The average usmle score is around 224, so to get an average USMLE score, according to that equation, you need to score ~650 on the comlex.

From my searching, most decent ACGME IM programs want to see a +600 on the comlex.

Btw, I scored in the low 600's on the comlex and in the low 250's on the USMLE.

Just take the usmle, it makes life easier.

Originally Posted by cliquesh

The equation the AOA has given ACGME programs is (for step one)
USMLE Step 1 = 67.97 + 0.24 x COMLEX-USA Level 1

The average usmle score is around 224, so to get an average USMLE score, according to that equation, you need to score ~650 on the comlex.

From my searching, most decent ACGME IM programs want to see a +600 on the comlex.

Btw, I scored in the low 600's on the comlex and in the low 250's on the USMLE.

Just take the usmle, it makes life easier.

to summarize for those who missed his point (it wasnt spelled out) the AOA scoring system is all sorts of messed up. if the average score for the USMLE equilibrates to 2 standard deviations above average on the COMLEX, something is terrible wrong.

Originally Posted by DocEspana

to summarize for those who missed his point (it wasnt spelled out) the AOA scoring system is all sorts of messed up. if the average score for the USMLE equilibrates to 2 standard deviations above average on the COMLEX, something is terrible wrong.

I was thinking the same thing. Either our curriculum is vastly different at DO schools or that conversion system is hella messed up. I'll bank on the latter.

I plan on taking both, why not?

Take both. You'll do fine.

Originally Posted by DocEspana

to summarize for those who missed his point (it wasnt spelled out) the AOA scoring system is all sorts of messed up. if the average score for the USMLE equilibrates to 2 standard deviations above average on the COMLEX, something is terrible wrong.

Correct. According to that AOA equation, I barely break a 200 on USMLE converted score while in real life, my USMLE score is 30+ points higher than that.

Originally Posted by p1acebo

I plan on taking both, why not?

I found USMLE to be a very hard test. You are taking a chance that you may not do well on it. Of course you may or may not have to report it (depending on who you ask or what you believe).

Originally Posted by costales

Take both. You'll do fine.

This is easy to say until you take the test. I studied as hard as I could and made a 200. It is not an easy test by any stretch of the means.

Originally Posted by irJanus

while its difficult for a PD to convert comlex to usmle, is there such a thing as a comlex score high enough that the PD would just get that its "higher than most"? As in, is 'significantly higher than average' recognizable?

i don't think anyone knows the answer to this question but I doubt it.

Originally Posted by Rollo

Correct. According to that AOA equation, I barely break a 200 on USMLE converted score while in real life, my USMLE score is 30+ points higher than that.

Same deal with me. The comlex converted to 25 points lower than ky actual usmle.

25 points is a huge deal on the usmle.

Originally Posted by Arch Guillotti

I found USMLE to be a very hard test. You are taking a chance that you may not do well on it. Of course you may or may not have to report it (depending on who you ask or what you believe).

I see where you are coming from and I definitely understand the risk. Personally, I feel as though you need to be confident in your abilities to do well on any exam. If I don't feel like I can do well on the USMLE, then why should my confidence be any different for the COMLEX? I understand they are different exams but I really think your faith in yourself for test taking should transcend to any exam. So ya I am going to take the USMLE no matter what and if I score poorly than so be it.

Take both.

Also, this question has been beaten to death on this forum, hasn't it?

take it, if anything at least step 2

Originally Posted by wanna_be_do

Take both.

Also, this question has been beaten to death on this forum, hasn't it?

Originally Posted by DocEspana

Where do people get all these gif and jpegs to post in forums that fit so perfectly?

Gotta know your pop culture cold. Then you can just search for the gifs you want on google. But blinding searching for something rarely yeilds results.

Originally Posted by DocEspana

Gotta know your pop culture cold. Then you can just search for the gifs you want on google. But blinding searching for something rarely yeilds results.

that's the best advice yet

From a DO Associate Program Director at an allopathic IM residency: Take It (Steps 1&2). Lots of DO schools, including mine, told us that it is "not necessary". Not true. As the amount of AMG, IMG and DO graduates has increased, and continues to increase - programs (or should I say a good number of IM programs for sure!) are requiring the USMLE for DO applicants nowadays. A lot of places won't even consider you without USMLE scores, even if you did very well on the COMLEX. Study for it, take it, and if you don't do well - then just don't release it or apply to allopathic programs that require it. Do NOT take the USMLE Step 2 CS - definitely not needed.

Take it. Study like you've never studied before though because you only get one crack at it.

Originally Posted by insidor

From a DO Associate Program Director at an allopathic IM residency: Take It (Steps 1&2). Lots of DO schools, including mine, told us that it is "not necessary". Not true. As the amount of AMG, IMG and DO graduates has increased, and continues to increase - programs (or should I say a good number of IM programs for sure!) are requiring the USMLE for DO applicants nowadays. A lot of places won't even consider you without USMLE scores, even if you did very well on the COMLEX. Study for it, take it, and if you don't do well - then just don't release it or apply to allopathic programs that require it. Do NOT take the USMLE Step 2 CS - definitely not needed.

Does anyone know if this is still possible? I heard if you take it you have to submit it these days.

For Heaven's Sake,

take it.

Please take it.

I wish I had. Now I'm more than halfway through 3rd year and just realizing that all the programs I was looking at only accept USMLE. And all I have is Comlex...

Don't be stuck where I am. Take the test.

.

From my understanding and some posts that I have read, the COMLEX and USMLE is very, very similar in content (with COMLEX containing an OMM section), but the testing structure and question type is different?

Originally Posted by YiSheng

From my understanding and some posts that I have read, the COMLEX and USMLE is very, very similar in content (with COMLEX containing an OMM section), but the testing structure and question type is different?

COMLEX doesn't have an OMM "section" per se, it just has questions that incorporate OMM principles and treatments. mostly the viscerosomatic reflexes (which spinal levels correspond to which parts of the body), which is listed conveniently on one page in the Savarese OMT Review book.

i think the biggest difference was that the USMLE's questions were very detailed, and often required second order thinking to reach the answer, whereas a COMLEX type question will just be a one-liner such as: "A child comes in with a fever and is coughing. What is the organism?"

re: "testing structure being different", COMLEX is slightly longer, 8 blocks of 50 questions. USMLE is 7 blocks of 46 questions. passing score on the COMLEX is always 400. passing score on USMLE is 189, but that changes depending on the group taking the test.

Another difference between the USMLE and Comlex, in my opinion, is that the USMLE is more predictable. On my USMLE, I recognized every disease/drug/microorganism. I might not have remembered the answer, but I saw it somewhere in a review book. On my comlex, however, there was stuff that I never heard of before. Also, I feel like the USMLE assessed your medical knowledge more than the comlex. The comlex just seems like a random factoid test. I did fine on both, though.

You should take the USMLE.

Take USMLE, it helps when you apply to allo programs.
--advice from a 4th year applying this year.

It hurt me more than it helped. I did well on COMLEX but below average on USMLE. This was the case with most of my friends who took both as well.

My suggestion would be to sign up for it and study, then take some NBME practice exams before you loose a lot of money on your deposit if you have to drop it. (Assuming you can get most of your money back, which I think you can.) If you were not getting at least a 220 on your practice exams I would not take it.

Originally Posted by VA1986

You have to report it to ERAS if you took it. But apparently, it is up to each program to specifically request a USMLE transcript from you.

If you take it you HAVE to report it to each ACGME program that you apply to period. There is no ifs and buts about it! If you don't you are in violation of ACGME rules and can be sanctioned (even after you match)!

Only take the USMLE if you know for a fact you are going to score >220. Otherwise it will hurt you more than it will help. Having said that, if you score >220, then it will definitely help you.

Originally Posted by BAM502

It hurt me more than it helped. I did well on COMLEX but below average on USMLE. This was the case with most of my friends who took both as well.

My suggestion would be to sign up for it and study, then take some NBME practice exams before you loose a lot of money on your deposit if you have to drop it. (Assuming you can get most of your money back, which I think you can.) If you were not getting at least a 220 on your practice exams I would not take it.

Most people I know are in the same boat as you are!

Very good advice!

Originally Posted by bala565

Most people I know are in the same boat as you are!

Very good advice!

Hmm. Everyone I know in my class that took it did >220. That being said, when people do less than stellar they are not necessarily going to be vocal about it. Hard to say for sure.

But yea...The NBME exams are excellent predictors of how you will score. Definitely good advice.