USMLE & couple's match

[schwasted589]

Hi,

I know it's kinda early for me to be worrying about this since I have a year left before the test but I was hoping someone wiser could give me advice since I can't figure out what to do.

My fiance and I are rising 2nd years in med school. He's interested in Anesthesia/Ortho/Gen Surg and I'm not sure about anything yet but interested in (OB, peds, EM, IM, psych).

He isn't planning on taking the USMLE because he's gunning for AOA Ortho/Gen Surg and feels like he doesn't need to take it. I was planning on taking it because I was under the impression that most good programs want USMLE scores and I'm not sure if I want to do a fellowship yet.

However, we just learned about the couple's match a few days ago. We were really excited but then...we found out that it doesn't even apply since I want to do ACGME and he wants to stick with AOA. He suggested that maybe I don't take the USMLE and focus on the COMLEX so that we can go into the couple's match together. His reasoning is that the chances of me getting a ACGME residency and him getting an AOA residency in the same area is going to be difficult and very risky.

I'm not sure what to do.

There's pro-cons to either but the biggest thing is: if I just take the COMLEX and decide to go the AOA residency route, am I screwing myself over (in the event I stick with the 4 specialties I mentioned above) careerwise? Am I going to be out of the running for a fellowship in peds/IM? Am I not going to be able to get proper training? I know that these are all really dramatic but I really only have the sdn forums to go to for advice and well, they're all kinda doom and gloom about AOA residencies....so I'm sorry if I'm offending anyone--that's not my intention; I'm just not well-informed.
The biggest positive would be that I could focus on just taking 1 test, and 1 test well vs trying to study for the USMLE too.

On the other hand, if I take the USMLE, I guess I can decide later down the line what route we want to take. But, that's going to take away from COMLEX studying...and my school only gives 2 weeks off to study for it anyways. Plus, I feel like I'm going to kick myself if I do do well on the USMLE and still have to go into the AOA couple's match.

Obviously staying close to each other for residency is extremely important for the two of us, and we're both willing to make sacrifices in terms of residency placement/spots if that means being together. And I'm not 100% sure of my specialty whereas he is pretty set on Ortho / Gen Surg at this point.

I'd appreciate any help/advice you can offer. And kicking the SO to the curb isn't an option, so...

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[hallowmann]

If I were in your situation, I'd take both exams, if you feel you'll do well on the USMLE. There is no point limiting your options now. Your fiance could change his mind and it might be better for him to go ACGME, he might bomb the COMLEX and ortho would be out, etc. On an even more morbid note, you guys could break up or he could die (I know it sounds terrible but stuff happens). You don't want to limit your future just based on what he thinks/wants right now.

In the end, if you take both, you can always do the AOA couples match. Don't view it as being pointless though, because ultimately you're doing it to keep your options open, so whether you use it or not, it's still worth it.

Really, what if he steps into surgery 3rd/4th yr and hates it? I know a guy who was gunning for ortho from day 1 of med school. He had the grades, but the second he did his surgery rotations, he was really turned off by it. He did a Path elective, loved it, and is making $300k doing that right now. He didn't take the USMLE, but had to apply ACGME (there are no AOA path programs). It could happen. Its best for both of you to keep your options open.

 

[NurWollen]

I agree with Hallowman. I also think fiance should consider taking the USMLE. Even with scenarios much happier that what Hallowman mentioned. What if he does very well on both exams? ACGME Ortho is a tough spot to land but you never know, and that's just one of the specialties he's considering. It's not that unusual for a DO to match ACGME General Surgery and I dare say anesthesiology is one of the most DO-friendly specialties there is. If he decides on Anesthesiology he should be aiming for ACGME and the couplds match would be very realistic for you.

 

[schwasted589]

hmm thanks for the advice guys.

That's what I'm trying to tell him so hopefully he'll listen.

What I'm more worried about is...say we decide to go the AOA couple's match route down the line--is that something I need to avoid for something like peds/obgyn? Most of the matches at my school for those have been ACGME so I wasn't sure if the AOA programs just aren't up to par or what. We want to stay around Chicago area and surrounding states (Michigan, Ohio, etc) and I know there's a lot of AOA options for some specialties there. I just don't know if those AOA residencies horrible vs the ACGME counterparts. Like ER for example.

 

[schwasted589]

The other problem is that because of religious obligations/family stuff/rotations/scheduling, our wedding is going to be immediately after boards. I feel like I'm going to be pushed for time to try to get both tests taken (I'm planning on taking the COMLEX 5 days before the deadline)...so that's another concern. I don't want to take it and bomb it because I had less time than everyone else.

is studying during rotations not doable at all? or maybe I should just take the USMLE step 2 instead?

This is a whole new language/world to me and it's frustrating because I'm so confused. :S

 

[hallowmann]

Most people I know that take both, take the USMLE first, then spend a week studying saverese, then take the COMLEX. From what I hear its not really like taking 2 separate exams, but you need a little time getting used to the format (and obviously to study OMM).

And, I didn't mean to be depressing, there certainly are positive things that could happen, where going ACGME might be better for both of you, as NurWollen said.

As far as worrying about how AOA compares to ACGME, I'd cross that bridge when you get there.

As far as the two exams go, its not like studying for one, is really going to take away from studying for another, its the same knowledge being tested. In fact, a lot of people I know use UWORLD instead of COMQUEST, whether they're taking the USMLE or not. If I were you, I'd plan for taking both, study hard in general, and then when you're a week or so away, take a practice test and see how you do. If you do anywhere close to average on the test (mid-220s) or above, I say take it, if you barely pass, I say drop it, and plan to take Step 2.

Obviously, you should discuss your plan with your fiance, and ultimately the decision is up to you, but that's honestly what I would do in your situation.

 

[koan]

Planning to take both exams, and only bailing on USMLE if your practice test scores are low as hallowmann mentioned, will keep the most doors open for both you and your fiancé. Nearly everyone changes their mind about specialty, often during 3rd year after you've already taken Step/Level 1. Many people who skip USMLE step 1 then regret it. But taking USMLE step 2 alone, without Step 1, is less beneficial for an ACGME match than vice versa (for whatever reason... Step 2 seems like it should be more relevant to residency... and some ACGME programs do now emphasize Step 2 to the extent that they require a score before they will extend an interview... but Step 1 is still the gold standard).

Also, you really don't need much time between the two exams. I took USMLE, two days off to study Savarese, then COMLEX. A third day in between would have been nice but isn't essential. I believe many people make the mistake of taking too much time in between, and in a week of studying only OMM forget some of those little factoids held in your short-term memory.

Lastly, don't let your wedding interfere with this stuff. Board scores will have implications that reach beyond simply matching a residency program, to how much control you have over where you end up and whether the couples match will be feasible. You should both be shooting for high scores, so work hard this year! Good luck!

 

[cliquesh]

Like everyone else in this thread, I would encourage BOTH of you to take the USMLE (at least step 1).

I couples matched, by the way. We didn't have any trouble matching. Feel free to PM me if you have any specific questions when the time comes.

 

[schwasted589]

Planning to take both exams, and only bailing on USMLE if your practice test scores are low as hallowmann mentioned, will keep the most doors open for both you and your fiancé. Nearly everyone changes their mind about specialty, often during 3rd year after you've already taken Step/Level 1. Many people who skip USMLE step 1 then regret it. But taking USMLE step 2 alone, without Step 1, is less beneficial for an ACGME match than vice versa (for whatever reason... Step 2 seems like it should be more relevant to residency... and some ACGME programs do now emphasize Step 2 to the extent that they require a score before they will extend an interview... but Step 1 is still the gold standard).

Also, you really don't need much time between the two exams. I took USMLE, two days off to study Savarese, then COMLEX. A third day in between would have been nice but isn't essential. I believe many people make the mistake of taking too much time in between, and in a week of studying only OMM forget some of those little factoids held in your short-term memory.

Lastly, don't let your wedding interfere with this stuff. Board scores will have implications that reach beyond simply matching a residency program, to how much control you have over where you end up and whether the couples match will be feasible. You should both be shooting for high scores, so work hard this year! Good luck!

Yeah that's what I had originally planned on doing (taking both tests) but now that we have to do couple's match FOR SURE, I've been a little confused. I'm going talk to my fiance about him taking the USMLE but for whatever reason, I don't think he's going to do it (he's a nontrad applicant with previous experience in clinical settings so I think he's REALLY serious about ortho).

I wish we could couple match between ACGME and AOA combined. It'd be so much easier.

 

[hallowmann]

Yeah that's what I had originally planned on doing (taking both tests) but now that we have to do couple's match FOR SURE, I've been a little confused. I'm going talk to my fiance about him taking the USMLE but for whatever reason, I don't think he's going to do it (he's a nontrad applicant with previous experience in clinical settings so I think he's REALLY serious about ortho).

I wish we could couple match between ACGME and AOA combined. It'd be so much easier.

Who knows, maybe by 2016 enough of the AOA ortho programs will be ACGME accredited, that it'd make sense to do an ACGME couples match. Complete speculation, but who knows how quickly places will make the transition, its all still up in the air.