Should I take Step 1?

[TisNowd]

Before everyone says "of course you should" I think my background is kind of important. I'm a 2nd year student that's in the bottom quarter of my class. I did pretty well first year (around average) but had some family issues happen during second year, which eventually caused me to fail a class. Other than that, my second year grades were less than spectacular, but I actually feel like I know the material pretty well. I'm pretty positive I want to go into family med, but have ruled out pretty much every "competitive" field for residency and want to do residency in 1 of 2 metro areas that are very DO friendly.

It was also recommended that I not take the USMLE by my dean and advisor (one of them is an MD), because they feel like I'm at risk of failing or barely passing, which they say would look worse than just having a decent COMLEX. I feel pretty confident that I'll be okay for the COMLEX though, and scored around average for our class on a diagnostic test that is supposed to help us figure out what subjects are our weak points, and I haven't started studying a ton yet since classes just recently got out. Our class average is normally above the national average for level 1, which makes me feel even better. I've also done around 1,000 questions on one of the major Qbanks and am getting 55-60% of the questions right pretty consistently.

I'm not sure whether I should take Step 1 since I did pretty poorly during second year and I'm not trying to get into any fields or geographical areas that are tough for DOs. Right now I'm signed up to take Level 1 at the beginning of August, and might take Step 1 at the end of July. Will not taking Step 1 really hurt my app that bad? Would it be worse to fail or get a low Step 1 score than not take it at all?

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[FrkyBgStok]

only you know the real answer to that, but in my opinion, there is no reason at all to not take the USMLE unless you think you will definitely fail it. I personally think it is very hard to say which specialty you are going into unless you have done 3rd year. One example is that for me, I started med school wanting peds, then at the end of first year i got involved with the free clinics and wanted family med or em all the way until my second family med rotation third year when i realized that there was no way i could do family med. so i applied peds which is still fairly DO friendly, but there are exponentially more MD peds programs than DO programs in my area so I was very grateful i took the usmle.

I am sure there are times when people fail, but i have never heard someone say "i wish i didn't take step 1," but i have heard tons of people say that they wish they had taken it.

 

[Petypet]

If 100% on family med, you do not need it. If you have an inkling of uncertainty (which I would recommend you have at this point) then take it. You have over 2 months to study, you will do fine if you put in the leg work.

 

[GUH]

What are your NBME scores? That will help inform this decision.

But if you are really in the middle of your class (and not at a new school) then you should consider taking it for now.

 

[GUH]

I am sure there are times when people fail, but i have never heard someone say "i wish i didn't take step 1," but i have heard tons of people say that they wish they had taken it.

It's easy to say coulda woulda shoulda and talk big to people but it's a lot harder to tell someone that you actually took a test and failed it.

 

[EmergDoc2B]

The fact you struggled in your didactics tells me you would be at risk for scoring poorly on the USMLE. There are a few studies out there that point to class rank as well as a metric to use when thinking about taking both exams. Also, the fact that youre asking the question is also telling. If youre having doubts then just focus on the one exam and knock it out.
I wish you the very best.

 

[Goro]

I can't recommend it.

Before everyone says "of course you should" I think my background is kind of important. I'm a 2nd year student that's in the bottom quarter of my class. I did pretty well first year (around average) but had some family issues happen during second year, which eventually caused me to fail a class. Other than that, my second year grades were less than spectacular, but I actually feel like I know the material pretty well. I'm pretty positive I want to go into family med, but have ruled out pretty much every "competitive" field for residency and want to do residency in 1 of 2 metro areas that are very DO friendly.

It was also recommended that I not take the USMLE by my dean and advisor (one of them is an MD), because they feel like I'm at risk of failing or barely passing, which they say would look worse than just having a decent COMLEX. I feel pretty confident that I'll be okay for the COMLEX though, and scored around average for our class on a diagnostic test that is supposed to help us figure out what subjects are our weak points, and I haven't started studying a ton yet since classes just recently got out. Our class average is normally above the national average for level 1, which makes me feel even better. I've also done around 1,000 questions on one of the major Qbanks and am getting 55-60% of the questions right pretty consistently.

I'm not sure whether I should take Step 1 since I did pretty poorly during second year and I'm not trying to get into any fields or geographical areas that are tough for DOs. Right now I'm signed up to take Level 1 at the beginning of August, and might take Step 1 at the end of July. Will not taking Step 1 really hurt my app that bad? Would it be worse to fail or get a low Step 1 score than not take it at all?

 

[kenjixshadow]

Every post in this thread is right on its own way. Here is mine. My friend was in the bottom tier, got sub 500 on COMLEX 1, but she somehow managed to pull 224 on Step 1. Her NBME ranges were around 220-230 and she got a similar score in the real deal. I don't want to tell you not to take the USMLE. Take one or two NBME and then make your decision from there.

 

[bowjangles]

If you are fam med, you have no reason to take USMLE. You can match either with just COMLEX. Concentrate on destroying COMLEX 1.

 

[DO2015CA]

And @Goro also can't recommend Other things/schools. If you trust him on those things and think his judgments are right then I'd listen again

...and if you think he's a crackpot then do as you will

 

[ninjaman22]

Why don't you take a NBME and see where you stand? If you get a 210-220 on your first NBME, then I think you have something to work with. But if you take the NBME and get below 200, I would stay away.

 

[Azete]

Forgive my ignorance, but what's the logic behind not taking USMLE? Outside of money and another brutal testing day, is there a reason to not take it?

I haven't taken either, but everything I've heard says COMLEX is every bit as difficult if not more so. The material is pretty consistent, save for OMM, so additional study time would be minimal. It would seem the same percentile you score on COMLEX would be roughly the same percentile you score on USMLE, and you save yourself some discrimination during match from those PDs that think COMLEX is a clown school exam. I'm just trying to understand the logic, so I don't make a mistake myself.

 

[ninjaman22]

Forgive my ignorance, but what's the logic behind not taking USMLE? Outside of money and another brutal testing day, is there a reason to not take it?

I haven't taken either, but everything I've heard says COMLEX is every bit as difficult if not more so. The material is pretty consistent, save for OMM, so additional study time would be minimal. It would seem the same percentile you score on COMLEX would be roughly the same percentile you score on USMLE, and you save yourself some discrimination during match from those PDs that think COMLEX is a clown school exam. I'm just trying to understand the logic, so I don't make a mistake myself.

I haven't taken either of them yet but from what I have been hearing, COMLEX is definitely not harder than the USMLE. COMLEX is way too unpredictable. I think the USMLE is more of a logical and thinking exam, whereas COMLEX is not. A lot of people would find it difficult and that's why usually people score lower on their USMLE than the COMLEX.

 

[hallowmann]

Forgive my ignorance, but what's the logic behind not taking USMLE? Outside of money and another brutal testing day, is there a reason to not take it?

I haven't taken either, but everything I've heard says COMLEX is every bit as difficult if not more so. The material is pretty consistent, save for OMM, so additional study time would be minimal. It would seem the same percentile you score on COMLEX would be roughly the same percentile you score on USMLE, and you save yourself some discrimination during match from those PDs that think COMLEX is a clown school exam. I'm just trying to understand the logic, so I don't make a mistake myself.

COMLEX is more unpredictable, but certainly not harder. Also in general what I've seen is that it doesn't seem worth it to take the USMLE if you'll get below 215-220. It's even worse if you fail.

OP, if you'll do at least that well, it's probably worth taking it. Not that I want to deter people from FM, but you might change your mind in clinicals and that Step 1 might make it easier to.

 

[SurgeDO]

wait, you are telling me that the dean of your osteopathic medical school is telling you not to take the USMLE? shocking!

take the USMLE.

 

[racerwad]

Forgive my ignorance, but what's the logic behind not taking USMLE? Outside of money and another brutal testing day, is there a reason to not take it?

I haven't taken either, but everything I've heard says COMLEX is every bit as difficult if not more so. The material is pretty consistent, save for OMM, so additional study time would be minimal. It would seem the same percentile you score on COMLEX would be roughly the same percentile you score on USMLE, and you save yourself some discrimination during match from those PDs that think COMLEX is a clown school exam. I'm just trying to understand the logic, so I don't make a mistake myself.

As others have posted, the only reason to not take the USMLE is if you are certain you will be scoring below the average for your specialty. I found COMLEX much more difficult: poorly worded questions, actual typos, my own personal disinterest in aspect of OMM (the ironically are frequently tested). I found the USMLE to have much longer stems but I still knew exactly what they were asking me. Oftentimes, on the COMLEX, the stem would something absurd like "child comes in w/ a strawberry tongue" and then each of the answers correlate to some aspect of the treatment of Kawasaki's, but I have no idea what aspect they're asking me about. I made my goals to just pass COMLEX and focus on USMLE.

I scored in the low-teens (percentile) on Level 1 and the average on Step 1. Of course I wished I had done better on Step 1, but it didn't really impact me in the Match.

Unless you are basically not passing either board exam and really need to focus on a single test, just take the USMLE.

 

[Drrrrrr. Celty]

wait, you are telling me that the dean of your osteopathic medical school is telling you not to take the USMLE? shocking!

take the USMLE.

If he's at risk of failing it, do you still recommend it? I mean what's the relationship between doing well and doing well on the usmle?

 

[Azete]

As others have posted, the only reason to not take the USMLE is if you are certain you will be scoring below the average for your specialty. I found COMLEX much more difficult: poorly worded questions, actual typos, my own personal disinterest in aspect of OMM (the ironically are frequently tested). I found the USMLE to have much longer stems but I still knew exactly what they were asking me. Oftentimes, on the COMLEX, the stem would something absurd like "child comes in w/ a strawberry tongue" and then each of the answers correlate to some aspect of the treatment of Kawasaki's, but I have no idea what aspect they're asking me about. I made my goals to just pass COMLEX and focus on USMLE.

I scored in the low-teens (percentile) on Level 1 and the average on Step 1. Of course I wished I had done better on Step 1, but it didn't really impact me in the Match.

Unless you are basically not passing either board exam and really need to focus on a single test, just take the USMLE.

That's a pretty big disparity between your COMLEX/USMLE scores; I was always under the impression that studying for one was roughly equal to studying for the other. I'll probably need to revise my strategy a bit.

 

[JustPlainBill]

So -- remember that this advice and $1.00 will get you a coke out of the vending machine ----

I make no bones about the fact that I struggled in med school -- older non-trad with poor prep and 1.5 hour 1 way drive during first year the first time through --- repeated first year after moving closer to school and grades improved by 20% -- was a high C/low B student in 2nd year with no failures ---

When getting ready to start studying for boards, I was actually called in by the powers that be and advised NOT to take the USMLE as I was at risk for failure, blah, blah, blah --- Turns out, it makes the school look bad also --- and you do have to report the USMLE scores, including failures ---

So I use Kaplan questions and study for the COMLEX which was the WRONG thing to do --- COMLEX is a poorly written exam and bears no resemblance to the real world --- and I did a sub 500 on it (479 I think) --- so afterwards in 3rd year, I'm looking at what I want to do -- and the same people that advised me NOT to take the USMLE are asking me why I didn't take the USMLE and that now, 3 months into 3rd year, it's too late to study for it, etc.

Always watch how much skin someone has in the game when they're handing out advice -- the school hierarchy wants to make their numbers look good and failures of board exams are a big no-no -- it directly impacts their attendance, standing and most important -- raises and tenure. They could give a rats behind less about you, especially if you're in the bottom quarter -- the only reason they care is if you flunk out, it looks bad. Those are the facts of life.

if you're hammering 55-60% so far, good on you, you'll probably pass the USMLE especially if it's UWorld or Kaplan (UWorld is better, IMHO) -- Get Comquest for COMLEX and you'll smoke it ---

Do you take the USMLE -- well, only you can answer that -- how are you going to approach it -- with trepidation and a "Everyone said I was going to fail and they obviously know what they're talking about, woe is me" mentality or a "Screw what everyone else thinks, I hope whoever wrote this beast prepared, because I d**n sure know I have" mentality and own that pig before you even step in the door?

Take some time, listen to Marcus Luttrell's motivational speech to the football team on youtube ---- get the mentality down and let it become a part of you -- it's more than beer soaked testosterone, but a way of life ---

this is your life, you figure out what you want to do and go do it --- or you can be a sniveling whiner who listens to what everyone else thinks and blow an opportunity and live in the shadows forever ---

Get some.

 

[racerwad]

That's a pretty big disparity between your COMLEX/USMLE scores; I was always under the impression that studying for one was roughly equal to studying for the other. I'll probably need to revise my strategy a bit.

I don't think that my experience is totally generalizable to the rest of the population. Seeing questions about viscerosomatics/cranial make me crazy and I am basically willing to throw those questions away. I was also totally positive I would not be applying for any AOA residencies so it didn't make a difference to me whether I barely passed or killed the COMLEX.

My point was just that even average students can do well on USMLE and that the only folks who should categorically not take it are: 1) OMM true believers who will be doing an OMM/NMM residency, 2) students who are at risk of failing any given class, so that the extra stress of an additional exam could put their ability to pass either exam in jeopardy. Otherwise, the limitations you are putting on yourself both geographically and specialty-wise are not worth a single day's worth of testing.

My last piece of advice is to take COMLEX first and use it as one last practice test for the USMLE. I know I got a lot of points on my USMLE due to reviewing materials I realized I didn't know as well as I should on COMLEX. This seems to run counter to everyone else's advice of USMLE, then OMM review, then COMLEX. I just was not willing to give up points on the USMLE for any reason.