COMLEX residency screening *READ*

[Throwawaycall]

I don’t post on here but just am here to hopefully help a few out

as we know last years level one was a crap fest and we had lower scores than our counterparts. This made it harder to match into previously MD programs that had hard cutoffs of 500 or so for an interview. BUT to alleviate this problem we could just take USMLE right? Do well and IM programs on the MD side could care less right? Easy.

WRONG

I noticed a few of my friends not getting invites (sub 500 comlex but >230 step) at places a 230 was not even required for a DO.

So I asked a couple program directors on a few of my throwaway interviews what’s up how do you screen do students that took step and comlex.
first thing they often hit is the 500 button. Never even see your app even if you get 250 step. I doubt this is universally true but it does happen, may be a reason the season seems dry, and is completely the NBOME fault for screwing us

TLDR: if you have a strong step but the NBOME has their way with you on comlex. CALL/EMAIL PROGRAMS AND TELL THEM YOU TOOK STEP AND TO LOOK AT YOUR DAMN APP


do work folks

and effthe NBOME

peace out

don’t let the crap fest process get you down. Worst they can say is NO

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[NotAProgDirector]

If you're doing "throwaway interviews", that's taking spots from the people you're talking about.

 

[BorntobeDO?]

If you're doing "throwaway interviews", that's taking spots from the people you're talking about.

Doesn't mean the advice isn't valid tho. Sometimes people match at throwaway interviews also. I don't have an issue even tho I wish I had more interviews myself.

 

[Throwawaycall]

If you're doing "throwaway interviews", that's taking spots from the people you're talking about.

Sorry I should have said backups or safeties. Got too caught up in my screen name.
You all inv people you don’t really want sometimes also so don’t be all virtue-ish here.
we want to match and you want to fill your spots. Let’s be real here we all have the right tohold backups

 

[AlteredScale]

Sorry I should have said backups or safeties. Got too caught up in my screen name.
You all inv people you don’t really want sometimes also so don’t be all virtue-ish here.
we want to match and you want to fill your spots. Let’s be real here we all have the right tohold backups

Are your backups previously AOA programs

 

[Throwawaycall]

Are your backups previously AOA programs

Not the ones I asked at. Community ACGME or lower tier university/branch university progs in non coastal areas (I’m not applying East or west coast) just south, Midwest, and some land of cornfield places.

I know there are some branch university progs that used to be AOA but I’m not really applying former aoa much

also I only have like 5-7 back ups so it’s not likeI’m some super stellar app sucking up all the invites lol

 

[AlteredScale]

Not the ones I asked at. Community ACGME or lower tier university/branch university progs in non coastal areas (I’m not applying East or west coast) just south, Midwest, and some land of cornfield places.

I know there are some branch university progs that used to be AOA but I’m not really applying former aoa much

also I only have like 5-7 back ups so it’s not likeI’m some super stellar app sucking up all the invites lol

Makes sense.

In reading some of @aProgDirector 's post, filters can be made in so many ways (eg "filter all applications with a COMLEX at or above 550 AND/OR USMLE at or above 230") so hard to say there's a hard or fast rule but ur take home is to do well on both.

5-7 backups is really good. Good job.

 

[Throwawaycall]

Makes sense.

In reading some of @aProgDirector 's post, filters can be made in so many ways (eg "filter all applications with a COMLEX at or above 550 AND/OR USMLE at or above 230") so hard to say there's a hard or fast rule but ur take home is to do well on both.

5-7 backups is really good. Good job.

I guess backups would just be bottom 1/3 invites not like I have a million IVs haha but we could consider anything past ten a backup according to NRMP data. . I think some of the places use the comlex for DOs just assuming many don’t take STEP. Not a hard and fast rule but places get so many apps we are so likely to fall through the cracks. It’s unfortunate and a lot of students don’t know this. I had several friends match their top 1-3 last year from making calls or sending emails later in the season. And this is for invites they never would have gotten without calling

 

[AlteredScale]

I guess backups would just be bottom 1/3 invites. I think some of the places use the comlex for DOs just assuming many don’t take STEP. Not a hard and fast rule but places get so many apps we are so likely to fall through the cracks. It’s unfortunate

I understand.

Who knows. If you can filter scores in any way, shape, or form, then it's difficult to make any generalizations beyond just do as well as possible on both tests.

 

[Throwawaycall]

I suppose lesson to be had is making calls or sending emails to places you know you may have been passed over is worth it. As soon as they hit that comlex button if you fall under it that great step score might not even matter. Was more common this year due to nbome grading scale this year.
All the people going on <10 interviews are brave souls

 

[AlteredScale]

All the people going on <10 interviews are brave souls

Well, some people may not have 10 interviews yet....

NBOME grading scale most def hurt alot of applicants.

 

[Throwawaycall]

Well, some people may not have 10 interviews yet....

NBOME grading scale most def hurt alot of applicants.

You are right. Was more in a response to those frowning upon backup interviews. Or throwaways. And another reason to call dem programs

 

[NotAProgDirector]

Sorry I should have said backups or safeties. Got too caught up in my screen name.
You all inv people you don’t really want sometimes also so don’t be all virtue-ish here.
we want to match and you want to fill your spots. Let’s be real here we all have the right tohold backups

My confusion was over the concept of "throwaway" interviews, which I assumed were "Interviews where I know in advance I'm not going to be ranking them, but I want a chance to practice interviewing or ask questions that might get me unranked". There's nothing wrong with going on a reasonable number of backup interviews.

 

[Throwawaycall]

My confusion was over the concept of "throwaway" interviews, which I assumed were "Interviews where I know in advance I'm not going to be ranking them, but I want a chance to practice interviewing or ask questions that might get me unranked". There's nothing wrong with going on a reasonable number of backup interviews.

No sorry I should have worded it better. Plan on ranking all so far (maybe not one after the pre dinner). Just not top ones I’d like to be at. Not like I’ve applied anything competitive or anything above low to mid tier anyway mostly just otherwise due to location. Not program itself. I would def cancel past 15 since I don’t have the money and may cancel a couple
I did apply fairly broadly so not like I’m raking in 90% invites from a selective list of top tier programs

 

[Sardonix]

How does one get a 250 on Step1 and manage to get sub-500 on COMLEX?

 

[Cardboard101]

How does one get a 250 on Step1 and manage to get sub-500 on COMLEX?

Through the magic of OMM

 

[deleted645092]

How does one get a 250 on Step1 and manage to get sub-500 on COMLEX?

You don't.

 

[BorntobeDO?]

Through the magic of OMM

I got a laugh but this just isn't true. Still well worth the comment.

 

[Throwawaycall]

We had a few 240 sub 500s not quite twofiddys

tons of <500 >220 which sadly knocked people off the chart for some decent IMplaces

 

[Kardio]

We had a few 240 sub 500s not quite twofiddys

tons of <500 >220 which sadly knocked people off the chart for some decent IMplaces

As an incoming student, what would you say could cause a big score discrepancy to happen?

 

[Robotfishbrain]

Ill be honest I received a sub 500 but got above average on USMLE simply because the questions were much more clear to me on USMLE vs Comlex. People complain that COMLEX is a poorly written test, which may be true, but the crux of the issue is all the prep material is geared towards Step 1 question writing and not COMLEX. The information that I normally rely on to answer questions on Step 1 were simply not there in the Comlex because the idea of "difficult" questions on the comlex is writing questions as vague as possible and/or making time a much bigger factor.

So the question in this thread is how can these two scores differ so much -- I personally believe the COMLEX is much more about test taking skills than clinical knowledge. I enter the match next year and I hope I can get places to look at my Step 1 rather than my Comlex.

 

[Throwawaycall]

As an incoming student, what would you say could cause a big score discrepancy to happen?

Comlex not being a good standardized exam and nbome lowering the average. If you go on the comlex score percentile thing it’ll show how much it varies year by year. And what person above said

 

[DrStephenStrange]

I agree that having vague poorly written questions plus only 72 seconds per questions can be harder than having nicely written questions plus 90 seconds per questions. Therefore contributing to a lower score.

Sent from my SM-G973U using SDN mobile

 

[NecFasc92]

I agree that having vague poorly written questions plus only 72 seconds per questions can be harder than having nicely written questions plus 90 seconds per questions. Therefore contributing to a lower score.

Sent from my SM-G973U using SDN mobile

You haven’t taken either exam dude lol. My comlex was written much better than my usmle, for both steps. The usmle has no logical flow to the questions. Sure the comlex was much more vague but the “poorly written” viewpoint that gets thrown around really is translated to “the questions were more vague and I’m made that there wasn’t more information so I need a way to describe the vagueness.”

 

[Throwawaycall]

Not sure which I would call better written but end of the day they can’t keep comlex average stable like usmle does

 

[AlteredScale]

Not sure which I would call better written but end of the day they can’t keep comlex average stable like usmle does

Yep. My level 1 score is >90th percentile one year, then 78th percentile the next. NBOME just changed the blueprint for the NBOME level 2, and the majority of my colleagues as well as I either stayed the same or had a score lower than our level 1 ( though still within 1 SD of the mean for me at least)...I think this change was more drastic for colleagues and I because we took a year off to do an additional year of research and teaching. who knows. but they really need to find a better way of normalizing scores.

 

[deleted645092]

You haven’t taken either exam dude lol. My comlex was written much better than my usmle, for both steps. The usmle has no logical flow to the questions. Sure the comlex was much more vague but the “poorly written” viewpoint that gets thrown around really is translated to “the questions were more vague and I’m made that there wasn’t more information so I need a way to describe the vagueness.”

IMO it’s the vagueness that makes it poorly written almost by definition. I had so many contradictory findings and statements on COMLEX there were times where I just sat confused about if it was a med student that wrote the question or a specialist. The biggest areas were endocrinology and cardiology on Level 1 where the physiology questions just didn’t make sense, and on Level 2 it was a lot of the guideline stuff where they gave multiple correct answers for a given patient.

The biggest difference between the 2 is that on USMLE there was always enough information to answer the question, you just had to be able to pick out the detail that made one answer better. COMLEX was more about broad demographics and oftentimes truly didn’t have enough information to make one answer absolutely correct.

 

[Robotfishbrain]

You haven’t taken either exam dude lol. My comlex was written much better than my usmle, for both steps. The usmle has no logical flow to the questions. Sure the comlex was much more vague but the “poorly written” viewpoint that gets thrown around really is translated to “the questions were more vague and I’m made that there wasn’t more information so I need a way to describe the vagueness.”

We're each talking about an n = 1 here, but what you wrote has not been the consensus at my school. Of course there are wtf questions on both exams, but after completing UWorld, I walked into the USMLE exam knowing what to expect much more than any prep materials (COMBANK and COMQUEST) for the COMLEX. After leaving the exams, I felt any question I did not know on USMLE was because of lack of knowledge, not confusion over questions. I also vehemetly disagree that step 1 has no logical flow. Again, of course there's wtf questions on both, but the approach to these exams is not similar at all for those of us that are not great test takers.

 

[Robotfishbrain]

IMO it’s the vagueness that makes it poorly written almost by definition. I had so many contradictory findings and statements on COMLEX there were times where I just sat confused about if it was a med student that wrote the question or a specialist. The biggest areas were endocrinology and cardiology on Level 1 where the physiology questions just didn’t make sense, and on Level 2 it was a lot of the guideline stuff where they gave multiple correct answers for a given patient.

The biggest difference between the 2 is that on USMLE there was always enough information to answer the question, you just had to be able to pick out the detail that made one answer better. COMLEX was more about broad demographics and oftentimes truly didn’t have enough information to make one answer absolutely correct.

I agree 100%. The answer to those questions that have multiple right answers is always trying to get at "which one of these two correct answers is more common in this vague scenario?" It's frustrating.

 

[blah12346497]

How do we know if there are comlex cut offs if the website does not specifically say that? I'm applying EM with <500 level 1 but 230 step 1. Only 3 non-AI interviews.

 

[Ho0v-man]

IMO it’s the vagueness that makes it poorly written almost by definition. I had so many contradictory findings and statements on COMLEX there were times where I just sat confused about if it was a med student that wrote the question or a specialist. The biggest areas were endocrinology and cardiology on Level 1 where the physiology questions just didn’t make sense, and on Level 2 it was a lot of the guideline stuff where they gave multiple correct answers for a given patient.

The biggest difference between the 2 is that on USMLE there was always enough information to answer the question, you just had to be able to pick out the detail that made one answer better. COMLEX was more about broad demographics and oftentimes truly didn’t have enough information to make one answer absolutely correct.

I felt my level 1 was very reasonable, which was surprising considering what I’ve read on here. But this is exactly how I’ve been feeling on the comats.

 

[BorntobeDO?]

I felt my level 1 was very reasonable, which was surprising considering what I’ve read on here. But this is exactly how I’ve been feeling on the comats.

It also depends on the form you get. Some are much clearer than others. For instance on level 1 I got the crap form that was random low yield and very difficult. However on level 2 I had a form that I felt was much clearer. I scored about the same percentile on both 1 and 2 even with all that. I have mixed feelings, on the one hand my comlex scores actually make it look like a reasonable test, but many of my friends had weird falls from level 1 or a huge rise. Its just not very consistent.

 

[hallowmann]

How do we know if there are comlex cut offs if the website does not specifically say that? I'm applying EM with <500 level 1 but 230 step 1. Only 3 non-AI interviews.

I wouldn't worry about it at this point. You can never know if they don't tell you, but in general it's less of an issue in EM than IM.

 

[cookiegrub]

Someone needs to give us DO guinea pigs a break. I mean MD applicants are not being made to take comlex and so only their step counts. But for us everyone wants us to take step. I swear I would have done a 1000x better on comlex if I had gotten the chance only to focus on that but admin needs to know these are 2 different exams. I get it if AOA residency looking at comlex but it dont make a lot of sense for pinning DO applicants when their usmle may look better than the comlex which is arguably composed differently...that was the whole premise for us folks for taking this exam..

 

[Epilepsy365]

They need to turn the Comlex into a pass or fail exam bc nobody gives a crap about the three digit score or its percentile.

 

[Throwawaycall]

Talked to another one this week that said they don’t even know what comlex means besides
<500 suck
>500 ok
>600 good
>700 probably really good
It’s sad. Not on PD part but for having to take the exam

 

[Epilepsy365]

Talked to another one this week that said they don’t even know what comlex means besides
<500 suck
>500 ok
>600 good
>700 probably really good
It’s sad. Not on PD part but for having to take the exam

>700 : are you just a bone psycho who’s a danger to patient care?
>600 : are you weird?
>500 : hm... so you know some OMM. Maybe you have a chance to be normal
>400 : high chance of being a normal slacker

Dead serious about this mindset.

 

[Mass Effect]

How does one get a 250 on Step1 and manage to get sub-500 on COMLEX?

This actually wasn't too difficult to do back when I was a student about 5 years ago. I didn't take the USMLE, but I had classmates who did and a couple were USMLE stars and got lousy COMLEX scores (one was 240 and 470). There's a certain nuance to how COMLEX questions are written, which is why people are told to do the COMLEX-specific q-banks, even if they nail UWorld, just to get used to the style of question. There was a huge difference (back then) between UW questions and ComBank questions. UW questions were harder, more complex, but there was absolutely no mistaking what they were getting at/asking. ComBank questions were worded so poorly that half the time I was wondering what the question was or why this was a question. I had no idea what they were going for, which was also reflective on the COMLEX. I ended up doing well on COMLEX only because I did all the COMLEX banks I could.

Things may have changed, but that's my experience.

 

[sharpstickie]

>700 : are you just a bone psycho who’s a danger to patient care?
>600 : are you weird?
>500 : hm... so you know some OMM. Maybe you have a chance to be normal
>400 : high chance of being a normal slacker

Dead serious about this mindset.

I’m in this post and I don’t like it.

 

[Epilepsy365]

This actually wasn't too difficult to do back when I was a student about 5 years ago. I didn't take the USMLE, but I had classmates who did and a couple were USMLE stars and got lousy COMLEX scores (one was 240 and 470). There's a certain nuance to how COMLEX questions are written, which is why people are told to do the COMLEX-specific q-banks, even if they nail UWorld, just to get used to the style of question. There was a huge difference (back then) between UW questions and ComBank questions. UW questions were harder, more complex, but there was absolutely no mistaking what they were getting at/asking. ComBank questions were worded so poorly that half the time I was wondering what the question was or why this was a question. I had no idea what they were going for, which was also reflective on the COMLEX. I ended up doing well on COMLEX only because I did all the COMLEX banks I could.

Things may have changed, but that's my experience.

Nope, it’s still the same.

That’s why I am a huge advocate of DO schools using NBME for their third year shelves instead of the COMAT. Just familiarity with the style of quests and mindsets can boost a person original raw % by 8-12%, which is a 100-150 COMLEX boost and a 15-20 USMLE boost.

 

[Throwawaycall]

comlex just low effort cash cow for nbome. 660+ a pop goes up 30 a year and cost more than step.

bastards

Even though if you read their website they make it sound like a great test. Only people I know that liked comlex were the ones who did well on comlex and not well on step. No bias there.
Nontheless the worst part is the failure to properly standardize the scores and lack of having a plan in place if scores end up being higher than prior years. Shame on you nbome

 

[Throwawaycall]

Nope, it’s still the same.

That’s why I am a huge advocate of DO schools using NBME for their third year shelves instead of the COMAT. Just familiarity with the style of quests and mindsets can boost a person original raw % by 8-12%, which is a 100-150 COMLEX boost and a 15-20 USMLE boost.

I woulda been happy just not taking fm comat. You can tell these questions were written by fm docs who refer everything put sinusitis out to specialists

 

[ritts]

You haven’t taken either exam dude lol. My comlex was written much better than my usmle, for both steps. The usmle has no logical flow to the questions. Sure the comlex was much more vague but the “poorly written” viewpoint that gets thrown around really is translated to “the questions were more vague and I’m made that there wasn’t more information so I need a way to describe the vagueness.”

Completely disagree. Vagueness in itself makes the Comlex a poorly written exam. USMLE gives you everything you need to answer their questions and you know exactly what they're asking. I've never heard of anyone getting >250 and <500 though

 

[Throwawaycall]

Completely disagree. Vagueness in itself makes the Comlex a poorly written exam. USMLE gives you everything you need to answer their questions and you know exactly what they're asking. I've never heard of anyone getting >250 and <500 though

I could think of several questions on L1 I couldn’t have answered with google. Had a few of those on step 2 also. None of L2 or S1 though. Almost swear my L2 and S2 were swapped. But I agree L1 takes the cake in poor questions. Excluding comats who win by a mile

 

[Giovanotto]

I liked the comlex more because it was an easier test. It was more of a formality sort of exam, which IMO is what a licensing exam should be. The USMLE is overly complicated and difficult. I've already purged more than half of what I learned on STEP 1&2. For once, I prefer the DO approach to licensing exams.

The USMLE would make much more sense in a free market where you can forgo medical school and just take boards for licensing purposes. Don't make me pay 500k and waste 4 years of my youth and on top of that have me prove myself. It's the school's responsibility to vouch for me, and if it isn't, then what am I going to school for? Make up your mind people.

 

[Throwawaycall]

I liked the comlex more because it was an easier test. It was more of a formality sort of exam, which IMO is what a licensing exam should be. The USMLE is overly complicated and difficult. I've already purged more than half of what I learned on STEP 1&2. For once, I prefer the DO approach to licensing exams.

The USMLE would make much more sense in a free market where you can forgo medical school and just take boards for licensing purposes. Don't make me pay 500k and waste 4 years of my youth and on top of that have me prove myself. It's the school's responsibility to vouch for me, and if it isn't, then what am I going to school for? Make up your mind people.

Idk the exams have to be more diff than real life because you don’t have MCQ when trying to diagnose and have to be able to reproduce the info raw. Plus my comlex was mostly omm and msk. Usmle was more pertinent to what clinicals wanted. Being easier isn’t a better exam. The exam being used as a pass fail is entire nother topic I won’t delve into.


we could go back and forth all day but even if comlex was better written. It’s purpose is destroyed by failure to standardize

I liked step one the best out of the three. I thought step two level two and level one where not written as well after thinking about it

but nontheless an exam with 300-400q is bound have to a few wtf but step actually maintaining a similar year to year score is the breaker. Not to mention it is what programs want. We all knowcomlex should not exsist

 

[Giovanotto]

Idk the exams have to be more diff than real life because you don’t have MCQ when trying to diagnose and have to be able to reproduce the info raw. Plus my comlex was mostly omm and msk. Usmle was more pertinent to what clinicals wanted. Being easier isn’t a better exam. The exam being used as a pass fail is entire nother topic I won’t delve into.


we could go back and forth all day but even if comlex was better written. It’s purpose is destroyed by failure to standardize

But that's essentially what it comes down to. Either make it a simple P/F exam, or go balls to the walls and make everyone pass, but whoever does better gets to have more access to specialties. The current USMLE system of P/F + a score is absolutely ridiculous and I think students should be more upset about it. At least the comlex is incredibly easy to pass.

 

[Throwawaycall]

But that's essentially what it comes down to. Either make it a simple P/F exam, or go balls to the walls and make everyone pass, but whoever does better gets to have more access to specialties. The current USMLE system of P/F + a score is absolutely ridiculous and I think students should be more upset about it.

We have to have some way to stratify and I don’t think as a DO we would want pass fail. I’ve been to a few programs I know would not have taken me as an IV have I not done better than step average. But I agree the entire system is meh we should be able to presign contracts with places we auditioned at and mutually liked. You know, like a free market capitalistic system

I think there was another thread on this though and the premise was if we made steps PF then mcat would be the determinant. Which would be insane

 

[Giovanotto]

We have to have some way to stratify and I don’t think as a DO we would want pass fail. I’ve been to a few programs I know would not have taken me as an IV have I not done better than step average

That's where we disagree. I think pedigree and where you went to school should matter, and I say that as a DO. And since it matters, school A with high prestige and pedigree shouldn't cost the same as school B with DO students, no research opportunities, and lousy clinicals. Giving people hope that somehow smashing steps means they went to the same school as someone at Harvard is incredibly deceiving and I'm glad PDs realize that. It also puts the onus on the student to achieve what they can, which sure, sounds fair, except you're paying through the roof.

I say this to my own dismay, but the current system makes very little sense to me.

 

[Throwawaycall]

That's where we disagree. I think pedigree and where you went to school should matter, and I say that as a DO. And since it matters, school A with high prestige and pedigree shouldn't cost the same as school B with DO students, no research opportunities, and lousy clinicals. Giving people hope that somehow smashing steps means they went to the same school as someone at Harvard is incredibly deceiving and I'm glad PDs realize that. I say this to my own dismay, but the current system makes very little sense to me.

Do we really want mcat to determine our future? I don’t think I have heard of anyone from a DO school wanting pedegree to matter. We would all be doomed to less residency choice