3rd year, 446 COMLEX, Fail USMLE 1. What can I do?

[Callihan]

Hello everyone,

I earned a 446 on the COMLEX 1 and Failed the USMLE Step 1. What are my realistic options for residency? If I take and do really well on USMLE Step 2 will any allopathic doors open up for me? Kindly, please don't say Family Practice because I know that. I would appreciate some real feedback and maybe some stores of people in similar situations.

Also, would this failure on the USMLE Step 1 affect me in the future for jobs and fellowships?

Thank you.

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[Skippygonenuts]

Well if FP is completely off your list, maybe it'll help your feedback to share what IS on your list? Everything besides FP? Is IM on your list? OB?

 

[Callihan]

OB is not on my list. I suppose everything else is. So far my favorite rotation has been surgery and least favorite has been IM.

 

[st2205]

I'm not an authority by any means, but I'd have to say your doors to allopathic surgery are closed, especially if you never took USMLE for a passing grade, irrespective of how well you do on step 2.

 

[Colbert]

I'm sorry to say, but no one here is going to be able to tell you much that you don't already know. Also, without really saying what you're considering, how can anyone tell you what's an option? You don't want FM, fine, but how about peds, psych, PM&R? You like surgery, but you're probably already aware that ENT, ortho, neurosurg are out of the picture.

If you really want general surgery, you need to bust your hump and murder step 2. Then, you should see if your school sponsors any surgery programs and talk to the directors there. You'd have to do audition rotations and show them out amazing you are and that the step 1 doesn't tell the whole story.

I can say from experience that depending on what you what to do, it may still be an option. I had a <500 COMLEX 1, busted my hump, and got a >600 COMLEX II. I did two EM audition rotations and both program directors basically offered me a spot at their programs gift-wrapped with a bow on it. Why? The scores helped, sure, but I worked my tail off, was always early, never asked if I could go, and if I wasn't at the hospital I was nose-deep in an EM book. It wasn't the scores that did it, it was the auditions.

 

[Colbert]

I would also say that if you failed USMLE Step 1 and never retook it with a passing score, you're better off skipping the allopathic match and throwing all your eggs in the osteopathic match.

 

[Taty]

For osteopathic match kill Level 2, rotate at the places where u want to go and get killer LORs...

For allopatic if you still want to be in the run retake it and kill it,take Step 2 and kill it...I dont know about allopatic general surgery though. There is some bias exists because u are a DO it will add to it if u failed Step 1, but u never know...

 

[Tinapay]

I have a buddy that was in a very similar situation. Failed USMLE I, below average COMLEX I and II, didn't take USMLE II. Matched into a Peds allopathic program. It can be done but the pickings will be slim. It will all depend on what you are going for.

 

[nlax30]

I would say allopathic gen surg is out of the question. From what I've heard from friends it was a pretty brutal year for allo surg in the match and know a few really competitive students who didn't get what they wanted.

I wouldn't say all allo programs are out of reach, but I would say big name, competitive programs are, regardless of specialty.

Regardless, take step 2 early, do well, and bust your hump on audition rotations.

 

[dominate]

i would just go for AOA residencies. it is my understanding that if you apply only to AOA you don't have to reveal your usmle score.

 

[HealingDoc]

If you go for AOA residencies, I completely second the idea of killing COMLEX 2 and audition rotations. If you are truly passionate about succeeding, use that passion to fuel your work ethic. You can schedule audition rotations at the dually accredited programs.

For ACGME-only residencies, you will want to retake Step 1 and also take Step 2. If retaking USMLE Step 1 is not an option but you still want an allopathic program, you'll run the high risk of having to scramble. Maybe someone can chime in on this- but I think that in worst case scenario, you might be able to scramble into an allopathic transitional year with an IM or surgery track?

 

[Taty]

I would say allopathic gen surg is out of the question. From what I've heard from friends it was a pretty brutal year for allo surg in the match and know a few really competitive students who didn't get what they wanted.

I wouldn't say all allo programs are out of reach, but I would say big name, competitive programs are, regardless of specialty.

Regardless, take step 2 early, do well, and bust your hump on audition rotations.

Agree, general surgery match was very brutal this year.

 

[peppy]

I agree with those who say that allo surgery is going to be hard to get, based on what I've seen. I think your best strategy would be to focus on identifying osteopathic general surgery programs you would be interested in, doing away rotations there if possible, and trying to shine. If they like what they see when you rotate with them, that can sometimes help make up for a not so great board score. But allo surgery is too much of a risk in my opinion - I'd really focus on the osteo programs.

 

[BobBarker]

Allo gen surg wont be hard to get, it is impossible. Osteopathic gen surg, you still have a chance at with an improved Comlex and great work ethic on your away rotations.

 

[Callihan]

I appreciate the great feedback! Firstly I would like to apologize to the vagueness of my question. I was just genuinely curious as to what specialties I can absolutely cross of my list and what specialties I can include. Secondly, I would like more information on if that failed USMLE would haunt me for the rest of my career or may I just hide it forever by completing an Osteopathic Residency? I know of many IMG's that have failed Steps, passed on retake, and then matched eventually, why are they treated better than Osteopathic graduates?

For Tinapay do you know which Pediatric program your friend was accepted into and if it was a quality program or not?

I have figured General Surgery-Allopathic is out of the question.

Could I please have more information on the Allopathic Scramble Option? How exactly does that work?

How much would doing very well on the USMLE Step 2 do to help me match into allopathic residency which are not general surgery?

Thank you very much!

 

[st2205]

I know of many IMG's that have failed Steps, passed on retake, and then matched eventually, why are they treated better than Osteopathic graduates?

Because of a selection bias in how you've gathered this information. You're not going to hear of all the IMGs that failed->passed->didn't match because they're not in the US to tell people these stories.

 

[Just Joshin]

Could I please have more information on the Allopathic Scramble Option? How exactly does that work?

I can't answer your other questions, but the scramble is something available to people who enter the allo match and fail to match. What happens is that these candidates (who didn't match) are told they didn't match on Monday of Match Week. They're sent a list of programs with openings left over so they and people on their behalf can start calling and faxing those programs, begging for the slot. Basically, it becomes a race to try to snag something that's still open by Thursday. It's a nightmare, from what I've heard and you're left choosing from programs that for whatever reason others didn't want or rank. I understand they're tweaking it for next year so that it's more "humane," but I don't know the specifics.

 

[Gheorgia]

i would just go for AOA residencies. it is my understanding that if you apply only to AOA you don't have to reveal your usmle score.

I may be wrong but isn't there a duty to disclose if you have taken the USMLE if you are applying for AOA residencies. Also even if you applied to AOA residencies, undoubtly your interviewer will ask if you applied to allo residencies or if you've ever taken the USMLE (I would not advise lying if they do ask about it). Unfortunately, the OP is in a rock and hard place and I can definitely see how limited he/she is in applying to only primary care residencies unless the OP retakes the USMLE and destroys it.

 

[Doctor4Life1769]

I may be wrong but isn't there a duty to disclose if you have taken the USMLE if you are applying for AOA residencies. Also even if you applied to AOA residencies, undoubtly your interviewer will ask if you applied to allo residencies or if you've ever taken the USMLE (I would not advise lying if they do ask about it). Unfortunately, the OP is in a rock and hard place and I can definitely see how limited he/she is in applying to only primary care residencies unless the OP retakes the USMLE and destroys it.

There is no "duty to disclose."

You do not have to disclose having taken the USMLE to DO residencies. Will they ask about it? Likely not. Only one program asked me, but I was applying anesthesiology, so it is very common to see applicants applying to both. It wasn't in my app because I had just taken it. I scored well, and updated accordingly, mainly for the MD programs. Even if they ask, I would still play the game and say "no." No AOA program is going to investigate whether the candidate took the USMLE, and it can only potentially hurt you. Or, it may not matter, because AOA primary care is not at all competitive.

 

[PeepsLove]

Take it from me, your scores are going to hurt you unless you get a lot better on step 2. Shoot for nothing less than 550. I know a guy who got 500 on step 1 and failed step 2 then passes with a 500 and matched ortho. Is that common? No but it can happen. Me, I scored 440 on both steps but I matched anesthesia. Was it easy, no? But I killed my rotations and interviews (offered by all the places I rotated at but 2). My recommendation is to seriously consider what you like. Set your auditions up early. Go for what you like but also have some backups. I also applied to IM but after all my interviews I only ranked Anesthesia. It's ok to apply to 2 program types. I would avoid MD stuff though. A fail for most is an automatic no way.

 

[HealingDoc]

At callbacks today they explained how the new scramble process will work- programs with empty seats will give priority to those who have interviewed at their residency that year. After that, they open the seats to anyone scrambling. This encourages you to apply for more programs, but it also encourages programs to be more selective when granting interviews. Unfortunately I didn't catch the part when they said whether this is for MD, DO, or both.

 

[Doctor4Life1769]

Take it from me, your scores are going to hurt you unless you get a lot better on step 2. Shoot for nothing less than 550. I know a guy who got 500 on step 1 and failed step 2 then passes with a 500 and matched ortho. Is that common? No but it can happen. Me, I scored 440 on both steps but I matched anesthesia. Was it easy, no? But I killed my rotations and interviews (offered by all the places I rotated at but 2). My recommendation is to seriously consider what you like. Set your auditions up early. Go for what you like but also have some backups. I also applied to IM but after all my interviews I only ranked Anesthesia. It's ok to apply to 2 program types. I would avoid MD stuff though. A fail for most is an automatic no way.

DO anesthesiology?

 

[BobBarker]

Has to be. MD programs all have respect for the match process and don't offer positions except for the rare prematch. DO programs for some reason love to offer positions then make their rank list according to who has accepted their offer.

 

[PeepsLove]

Has to be. MD programs all have respect for the match process and don't offer positions except for the rare prematch. DO programs for some reason love to offer positions then make their rank list according to who has accepted their offer.

Hey Bob, not sure who your comment was about, me or the dude talking about the scramble? If it's me, check this out. Yes it was DO but it could have been MD. I personally know a girl who had something like 10 MD interviews (including Cleveland Clinic) with scores lower than mine. No joke, 400 even on step I and ~405 on step II without a USMLE. I also know a dude with sub 500 on both steps and no USMLE that also had MD interviews. I know the guy matched DO anesthesia and I'm not sure about the girl (I don't think she even applied DO). Moral of the story, anything is possible.

 

[Doctor4Life1769]

Hey Bob, not sure who your comment was about, me or the dude talking about the scramble? If it's me, check this out. Yes it was DO but it could have been MD. I personally know a girl who had something like 10 MD interviews (including Cleveland Clinic) with scores lower than mine. No joke, 400 even on step I and ~405 on step II without a USMLE. I also know a dude with sub 500 on both steps and no USMLE that also had MD interviews. I know the guy matched DO anesthesia and I'm not sure about the girl (I don't think she even applied DO). Moral of the story, anything is possible.

I highly doubt this.

Every MD program I spoke with wanted COMLEX 600+ w/o USMLE. So, I doubt this story you are saying.

BTW, thanks Bob for all your advice. I really appreciated your patience with me. I'm definitely glad I ignored the DO match in favor of the MD match.... and I'm really happy with my program.

 

[PeepsLove]

I highly doubt this.

Every MD program I spoke with wanted COMLEX 600+ w/o USMLE. So, I doubt this story you are saying.

BTW, thanks Bob for all your advice. I really appreciated your patience with me. I'm definitely glad I ignored the DO match in favor of the MD match.... and I'm really happy with my program.

You can highly doubt it till your blue in the face if you want but it's still true, not like it matters though. I partially agree with your numbers though, most places still want to see a USMLE >220. My advice to whoever started this post is to know what you have to offer a program and find ones that want that too. Some want numbers, others want diligent workers that they can work with.

 

[Doctor4Life1769]

You can highly doubt it till your blue in the face if you want but it's still true, not like it matters though. I partially agree with your numbers though, most places still want to see a USMLE >220. My advice to whoever started this post is to know what you have to offer a program and find ones that want that too. Some want numbers, others want diligent workers that they can work with.

A lot more want numbers than they openly claim.
Aways at MD programs only help if you have what they're initially looking for.

 

[womp]

I personally know a girl who had something like 10 MD interviews (including Cleveland Clinic) with scores lower than mine. No joke, 400 even on step I and ~405 on step II without a USMLE.

You can highly doubt it till your blue in the face if you want but it's still true, not like it matters though. I partially agree with your numbers though, most places still want to see a USMLE >220.

Is it actually common to get >220 on USMLE but just 405 on COMLEX? That's like what, 2 standard deviations?

 

[Doctor4Life1769]

Is it actually common to get >220 on USMLE but just 405 on COMLEX? That's like what, 2 standard deviations?

It's possible if you suck at OPP/OMM.

However, I'm still not buying that little anecdote from the previous poster.

 

[BobBarker]

Someone with barely passing Comlex scores only, would not get 10+ interviews for allopathic anesthesia. Sure they might get some interviews, places they rotated, places their LOR writers went for residency, but they arent going to get 10+.

Thats beside the point, as you misread my post. My inference that it was a DO program had little to do with your scores. It was based on you stating you were offered spots at interviews. That just doesn't happen at allo programs as they actually respect the match process. Nearly every DO program in every field doesnt do the match legitimately. They all offer positions then rank to match those who have accepted.

 

[PeepsLove]

Is it actually common to get >220 on USMLE but just 405 on COMLEX? That's like what, 2 standard deviations?

I really doubt that happens much or at all unless you're really sick (or hungover) for the COMLEX day. Question though, why would you ask if that's common then reference me? I've never put those to items together like that.

 

[PeepsLove]

Someone with barely passing Comlex scores only, would not get 10+ interviews for allopathic anesthesia. Sure they might get some interviews, places they rotated, places their LOR writers went for residency, but they arent going to get 10+.

Yeah I never said 10+. I said like 10. Could be 8 could be 12. I just know she had several interviews with those scores. I do have a theory as to why she got so many interviews. She is FREAKING HOT AS ALL GET OUT. So maybe the program director just wanted some eye candy and never really gave her a fair shake in his head.

 

[Doctor4Life1769]

Yeah I never said 10+. I said like 10. Could be 8 could be 12. I just know she had several interviews with those scores. I do have a theory as to why she got so many interviews. She is FREAKING HOT AS ALL GET OUT. So maybe the program director just wanted some eye candy and never really gave her a fair shake in his head.

Now you're really trolling. Sounds to me the chick was likely lying. She may have rotated through CCF, that'll guarantee you an interview at CCF.

 

[PeepsLove]

Now you're really trolling. Sounds to me the chick was likely lying. She may have rotated through CCF, that'll guarantee you an interview at CCF.

She very well could be lying, that's always possible. I generally try to believe people aren't lying and are honest. It's was one of those informal residency dinners where everyone mingles and asks about where they have interview etc. So she very well could make it all up but that's far less likely than her actually telling the truth about it, especially when she was honest with her scores (I saw the transcript while in the directors office as it was left open on his desk). If you're going to lie about the interviews why not lie about the scores too?

 

[Doctor4Life1769]

Score reports are left wide open on a director's desk for the world to see when entering his office?

 

[PeepsLove]

Score reports are left wide open on a director's desk for the world to see when entering his office?

He had all the summaries of applicants that they were interviewing spread out on his desk. Wasn't too bad until he left for 5 minutes while I was in the room. Needless to say, my eyes wandered.