Who fails COMLEX?

[GUH]

There are definitely not 1/3 of the dots below the 400 line on any of those. Also remember that a first-time pass rate is likely to be slightly higher than an overall pass rate because someone who fails once is probably more likely to fail again than someone taking e exam for the first time.

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[Drrrrrr. Celty]

http://www.nbome.org/standardsetting_faq.asp

Unlike the USMLE, where they increase the cut score (188 to 192, for instance), on the COMLEX, they rescale the pass bar to match the percent correct (so a 400 would have been 67% before, but now it's a 70%, for instance), thus making the scale reset every few years and become more difficult.

Yah people were talking about it this year. It makes no sense and it seems to just exist to confuse residency programs.

 

[IslandStyle808]

Unlike the USMLE, they re-scale the COMLEX every 4-5 years so that a 500 is the new average. So if you keep getting smarter students, the COMLEX keeps getting harder, unlike the USMLE, where scores keep slowly ticking up and the bar to fail moves with it.

The problem with this is that many residencies set their COMLEX score at the 50th-75th percentile, while their USMLE scores are at the 15th percentile- I was looking at one program that had a minimum 200 for the USMLE and a 540 for the COMLEX, for instance. Depending on how they set their cutoffs, that means we have to hit both, which really hurts us given the recent recalibration- a 200 on the USMLE is easy AF to get, but a 540 COMLEX means I'm going to have to spend way more time with Savarese than I'd like, which detracts from my USMLE.

Are there any residences that take it as a hit either the USMLE or COMLEX minimum rather than both?

On a side, note we need more comments like this because I get sick of the whole USMLE studying = COMLEX studying, which is not totally true. I have seen several posts from students who had passed the USMLE, but not the COMLEX (mainly because they were too focused on the USMLE materials).

 

[Mad Jack]

Are there any residences that take it as a hit either the USMLE or COMLEX minimum rather than both?

On a side, note we need more comments like this because I get sick of the whole USMLE studying = COMLEX studying, which is not totally true. I have seen several posts from students who had passed the USMLE, but not the COMLEX (mainly because they were too focused on the USMLE materials).

We had a kid last year that got a 250 on the USMLE and failed the COMLEX. It happens, because they are very different exams that focus on very different things. As to programs and their views of whether a pass on one or both is required, I couldn't say. I do know that at several the fourth years applied to, the USMLE was a limiting factor despite high COMLEX scores (600+ on one with a <220 on the other). Don't know how the other way around would work (240+ with a 500-). I'd imagine that the USMLE probably takes priority since it is an apples-to-apples comparison, but who knows.

 

[skeletor06]

Unlike the USMLE, they re-scale the COMLEX every 4-5 years so that a 500 is the new average. So if you keep getting smarter students, the COMLEX keeps getting harder, unlike the USMLE, where scores keep slowly ticking up and the bar to fail moves with it.

The problem with this is that many residencies set their COMLEX score at the 50th-75th percentile, while their USMLE scores are at the 15th percentile- I was looking at one program that had a minimum 200 for the USMLE and a 540 for the COMLEX, for instance. Depending on how they set their cutoffs, that means we have to hit both, which really hurts us given the recent recalibration- a 200 on the USMLE is easy AF to get, but a 540 COMLEX means I'm going to have to spend way more time with Savarese than I'd like, which detracts from my USMLE.

I've looked at FREIDA, and I noticed the same thing. If that's the case, then why do so many COMs tell their students not to take the USMLE, even if they're "poorer" students? I get that the consensus is that the USMLE is a more difficult exam, but is it so much more difficult that it wouldn't be worth getting even a 200-210, say, on the USMLE if it gives you a shot at a residency? It would be harder to get 50-75th percentile on COMLEX than it would 15th percentile on USMLE. @Goro, do you have any thoughts?

 

[GUH]

I've looked at FREIDA, and I noticed the same thing. If that's the case, then why do so many COMs tell their students not to take the USMLE, even if they're "poorer" students? I get that the consensus is that the USMLE is a more difficult exam, but is it so much more difficult that it wouldn't be worth getting even a 200-210, say, on the USMLE if it gives you a shot at a residency? It would be harder to get 50-75th percentile on COMLEX than it would 15th percentile on USMLE. @Goro, do you have any thoughts?

Someone who is expected to score around 200 is at some risk of failing, which would be unquestionably detrimental.

 

[67552931811]

I've looked at FREIDA, and I noticed the same thing. If that's the case, then why do so many COMs tell their students not to take the USMLE, even if they're "poorer" students? I get that the consensus is that the USMLE is a more difficult exam, but is it so much more difficult that it wouldn't be worth getting even a 200-210, say, on the USMLE if it gives you a shot at a residency? It would be harder to get 50-75th percentile on COMLEX than it would 15th percentile on USMLE. @Goro, do you have any thoughts?

It's all about saving face, dude.

 

[Goro]

I can only tell you what we advise at our school, which is that weaker students do NOT take USMLE. As we teach to COMLEX, the weaker student have their best chances with this exam. Our best students could do well on USMLE even if it were written in Korean (and no, they're not all Korean!).

I've looked at FREIDA, and I noticed the same thing. If that's the case, then why do so many COMs tell their students not to take the USMLE, even if they're "poorer" students? I get that the consensus is that the USMLE is a more difficult exam, but is it so much more difficult that it wouldn't be worth getting even a 200-210, say, on the USMLE if it gives you a shot at a residency? It would be harder to get 50-75th percentile on COMLEX than it would 15th percentile on USMLE. @Goro, do you have any thoughts?

 

[hallowmann]

Are there any residences that take it as a hit either the USMLE or COMLEX minimum rather than both?

On a side, note we need more comments like this because I get sick of the whole USMLE studying = COMLEX studying, which is not totally true. I have seen several posts from students who had passed the USMLE, but not the COMLEX (mainly because they were too focused on the USMLE materials).

Its unlikely that you would do great on the USMLE and fail the COMLEX. You might do mediocre or below average on USMLE and fail COMLEX, but well and fail seems unlikely, because seriously the info you need for both is mostly the same.

With regards to the programs, what I've heard is that its program-specific. Most ACGME programs would pay more attention to the USMLE and ignore the COMLEX if the USMLE was above cutoffs and good. That said, some programs might filter for each one. It really varies. Generally, you expand options by taking and doing OK or better on the USMLE (people put the cutoff for it being worth it in the 215-220 range).

 

[Drrrrrr. Celty]

I can only tell you what we advise at our school, which is that weaker students do NOT take USMLE. As we teach to COMLEX, the weaker student have their best chances with this exam. Our best students could do well on USMLE even if it were written in Korean (and no, they're not all Korean!).

What is a weaker student though?

What would you imagine a student who's middle of the class to score conservatively on both exams?

 

[Goro]

A weaker student is one who consistently sits around 70-75%. Our students who are above 80% do fine on COMLEX. I don't have the numbers handy. I can't speak as to USMLE because we never see the numbers.

"Weak students" are not merely the sum of their grades. As mentioned previously, these students have deficits in work ethic, coping skills, motivation and their self-interest. If they have mental health issues, depression is usually at the heart of their performance issues.

Those of you who are med students may have had review sessions in your coursework. Every notice who shows up? Generally, it's NOT the students who need help!

What is a weaker student though?

What would you imagine a student who's middle of the class to score conservatively on both exams?

 

[IslandStyle808]

Its unlikely that you would do great on the USMLE and fail the COMLEX. You might do mediocre or below average on USMLE and fail COMLEX, but well and fail seems unlikely, because seriously the info you need for both is mostly the same.

With regards to the programs, what I've heard is that its program-specific. Most ACGME programs would pay more attention to the USMLE and ignore the COMLEX if the USMLE was above cutoffs and good. That said, some programs might filter for each one. It really varies. Generally, you expand options by taking and doing OK or better on the USMLE (people put the cutoff for it being worth it in the 215-220 range).

In most cases, people who do well on one do well on the other. The ones that also don't do well on the COMLEX are also low scoring on the USMLE. I totally agree with you on both points. However, the trend of those that fail the COMLEX, but still pass the USMLE, tend to also not study enough of the COMLEX resources. The information is the same, but the presentation of the information is different, hence using both materials is important. I feel this is something that is not emphasized enough on here.

For the cut off on the COMLEX and USMLE, taking both is in your best interest (probably true for those who are a the low end of the class ranks). Meeting the cut off for both board exams is probably another under emphasized reason for DO students not getting interviews at a small percentage of programs. It kind of sucks, but it is what it is.

Thanks for the response.

 

[user3]

We had a kid last year that got a 250 on the USMLE and failed the COMLEX. It happens, because they are very different exams that focus on very different things. As to programs and their views of whether a pass on one or both is required, I couldn't say. I do know that at several the fourth years applied to, the USMLE was a limiting factor despite high COMLEX scores (600+ on one with a <220 on the other). Don't know how the other way around would work (240+ with a 500-). I'd imagine that the USMLE probably takes priority since it is an apples-to-apples comparison, but who knows.

I don't see how someone could drop from ~90th percentile USMLE to ~5th percentile COMLEX. maybe an average or marginal COMLEX, but not failing. There has to be more to the story. I realize that many questions are poorly written, but it is still graded on a curve and has enough similar content to USMLE...

 

[Mad Jack]

I don't see how someone could drop from ~90th percentile USMLE to ~5th percentile COMLEX. maybe an average or marginal COMLEX, but not failing. There has to be more to the story. I realize that many questions are poorly written, but it is still graded on a curve and has enough similar content to USMLE...

Maybe they didn't study OMM at all- that's 30% of the exam alone. Couple that with a bad day and maybe not studying between the two exams and I guess it could be possible. And the exam is not curved, it is normalized and standardized, just like the USMLE and MCAT. Also, the exam style of COMLEX is very different- I've found that when I jump from UWorld to COMBank, my performance suffers because I overthink questions substantially.

Personally I just want a decent 50th percentile showing on both, hoping UWorld, FA, Savarese, etc can get me there.

 

[Drrrrrr. Celty]

Maybe they didn't study OMM at all- that's 30% of the exam alone. Couple that with a bad day and maybe not studying between the two exams and I guess it could be possible. And the exam is not curved, it is normalized and standardized, just like the USMLE and MCAT. Also, the exam style of COMLEX is very different- I've found that when I jump from UWorld to COMBank, my performance suffers because I overthink questions substantially.

Personally I just want a decent 50th percentile showing on both, hoping UWorld, FA, Savarese, etc can get me there.

Is it really 30%? I mean for crying out loud this is supposed to be a medical boarding test....
I mean how much of it is knowing crap like what side of the table you're on or minuta of how techniques are done?

 

[Mad Jack]

Is it really 30%? I mean for crying out loud this is supposed to be a medical boarding test....
I mean how much of it is knowing crap like what side of the table you're on or minuta of how techniques are done?

It's mostly big picture. And it isn't that 30% of the exam is pure OMM, it's that 30% of the questions involve OMM- like, they'll have a Chapman's point that gives away the diagnosis but the other information is lacking, for instance, so without knowing your OMM choosing the right medication or test becomes very difficult.

 

[hallowmann]

Is it really 30%? I mean for crying out loud this is supposed to be a medical boarding test....
I mean how much of it is knowing crap like what side of the table you're on or minuta of how techniques are done?

20-30%, mostly viscerosomatics and Ribs on mine from what I remember, but also a lot of straight ortho/MSK stuff (special tests, specific muscle questions, etc.). On my USMLE there was actually a good amount of MSK stuff and I had to take a moment to make sure I wasn't taking the COMLEX.

 

[Drrrrrr. Celty]

It's mostly big picture. And it isn't that 30% of the exam is pure OMM, it's that 30% of the questions involve OMM- like, they'll have a Chapman's point that gives away the diagnosis but the other information is lacking, for instance, so without knowing your OMM choosing the right medication or test becomes very difficult.

Ok, that's reasonable. As of late our OMT department has been trying to convince us the OMM on the COMLEX involves memorizing every detail of how to do the technique and being able to know the answer without even reading the answers or else you'll run out of time.

 

[Drrrrrr. Celty]

20-30%, mostly viscerosomatics and Ribs on mine from what I remember, but also a lot of straight ortho/MSK stuff (special tests, specific muscle questions, etc.). On my USMLE there was actually a good amount of MSK stuff and I had to take a moment to make sure I wasn't taking the COMLEX.

Really? I thought MSK was very limited on the usmle.

 

[hallowmann]

Really? I thought MSK was very limited on the usmle.

Yeah so did I, then I took it and had a block with like 5-10 MSK questions. Grand scheme, it wasn't huge, but OPP actually did help me at getting all of those fast and easily.

The USMLE really covers a lot of broad topics. Some will always predominate, but you'll see a lot of variety on the USMLE. The COMLEX felt like it tested 3 main topics, and they varied depending on which test you took, so if got tested on your weaker topics, you had a bad day.

 

[sylvanthus]

Ok, that's reasonable. As of late our OMT department has been trying to convince us the OMM on the COMLEX involves memorizing every detail of how to do the technique and being able to know the answer without even reading the answers or else you'll run out of time.

Oftentimes COMLEX will toss in random OMT findings that you don't even need in order to answer the question. Pure OMT questions were relatively rare, at least on my 3 steps, and bloody easy. Just read the green book the day or two before and it is enough.

 

[Goro]

I concur. there's something about the story that automatically doesn't pass the sniff test. Even if one blew off all the OMM/OPP component of COMLEX, one still should be able to pass, if one can pass USMLE.

I don't see how someone could drop from ~90th percentile USMLE to ~5th percentile COMLEX. maybe an average or marginal COMLEX, but not failing. There has to be more to the story. I realize that many questions are poorly written, but it is still graded on a curve and has enough similar content to USMLE...

Of the COMLEX exams that I have sat for (yes, faculty can do that), I'd say at most, pure OMT/OPP counts for 10% of the exam. COMLEX still seems to be Pathophysiology> Med Micro > Pharm>> OMM/OPP = Clinical Anatomy = Clinical Neuro > everything else.

 

[doczebra]

I've looked at FREIDA, and I noticed the same thing. If that's the case, then why do so many COMs tell their students not to take the USMLE, even if they're "poorer" students? I get that the consensus is that the USMLE is a more difficult exam, but is it so much more difficult that it wouldn't be worth getting even a 200-210, say, on the USMLE if it gives you a shot at a residency? It would be harder to get 50-75th percentile on COMLEX than it would 15th percentile on USMLE. @Goro, do you have any thoughts?

Lol.

 

[Postictal Raiden]

Took COMSAE E early this week and every third q was either MSK or OMM. If this test is a good reflection of what COMLEX will be, then I think my USMLE score will be significantly higher than my COMLEX score.

 

[Drrrrrr. Celty]

Took COMSAE E early this week and every third q was either MSK or OMM. If this test is a good reflection of what COMLEX will be, then I think my USMLE score will be significantly higher than my COMLEX score.

That's pretty crazy.

 

[hallowmann]

Took COMSAE E early this week and every third q was either MSK or OMM. If this test is a good reflection of what COMLEX will be, then I think my USMLE score will be significantly higher than my COMLEX score.

That sounds about right. 25-30%. It's easy points guys. Study savarese for 2-3 days and watch those Chapmans/Viscerosomatics YouTube videos.

 

[TheaterOfTheme]

Of the COMLEX exams that I have sat for (yes, faculty can do that), I'd say at most, pure OMT/OPP counts for 10% of the exam. COMLEX still seems to be Pathophysiology> Med Micro > Pharm>> OMM/OPP = Clinical Anatomy = Clinical Neuro > everything else.

How are your scores coming along, @Goro ?

 

[Goro]

My items tend to be right where NBOME want them, if anything, on the easier side.

How are your scores coming along, @Goro ?