Prediction of USMLE Scores from COMLEX.

Well, my inital reaction is that the mean and SD are wrong on that study. The mean is 500 and the SD is 79. I don't feel like playing with the numbers to see what that would change, though.

Lexmark said:

If DO's wish to practice medicine they should be held to the same standard as all other practicing physicians and pass the USMLE. If the AOA requires them to take COMLEX as well that's between them and the AOA.

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So if I said that if MD's wanted to practice medicine they should take the COMLEX, how would that make you feel? How about this: we will let the states decide (as they have) which licensing exams qualify for medical licensure and abide by those rules. Thanks for your input though, I only have my own statistics to go on.

Lexmark said:

http://www.kcom.edu/academia/ResScholAct/Res-Presentations/ResPresentations2003.htm

See entry for Slocum PC, Johnson J. I have this paper.

Results: (from their survey group) The mean score on Step I of COMLEX was 549(SD 73), Step I of USMLE was 201(SD 22). The Pearson correlation coefficient of the scores from the Step I exams was 0.83 (p<0.0001). The Step I USMLE score is predicted by the corresponding COMLEX score using the equation yI=67.97+0.24*xI (R2(Prediction)=0.68).

Conclusion: There is a correlation between the scores of COMLEX and the corresponding USMLE exam. USMLE scores can be predicted from COMLEX-USA scores moderately well, indicated by R2(Prediction) values.

The message is quite clear. A passing USMLE score of 182 corresponds to a COMLEX score of 479, which is about the 38th percentile. This means 38% of DO students have not "passed" the USMLE. The USMLE is a minimum competency exam.

If DO's wish to practice medicine they should be held to the same standard as all other practicing physicians and pass the USMLE. If the AOA requires them to take COMLEX as well that's between them and the AOA.

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I have so many problems with this, mainly because it is not representative of the test taking population as a whole, and because the extra information tested on the COMLEX, and the sheer amount of material is mind-boggling. Taking multiple exams also has an effect, as I am sure you would realize if MD's were taking the COMLEX (I believe this would affect their USMLE scores negatively). Dont even make me talk about selection bias, either...

DrMom said:

Well, my inital reaction is that the mean and SD are wrong on that study. The mean is 500 and the SD is 79. I don't feel like playing with the numbers to see what that would change, though.

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You are correct concerning the mean and SD used by NBOME in constructing COMLEX scores.

The mean and SD that the instigator, I mean OP, was referring to pertains only to those who filled out that particular survey.

Lexmark said:

http://www.kcom.edu/academia/ResScholAct/Res-Presentations/ResPresentations2003.htm


The message is quite clear. A passing USMLE score of 182 corresponds to a COMLEX score of 479, which is about the 38th percentile. This means 38% of DO students have not "passed" the USMLE. The USMLE is a minimum competency exam.

If DO's wish to practice medicine they should be held to the same standard as all other practicing physicians and pass the USMLE. If the AOA requires them to take COMLEX as well that's between them and the AOA.

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The actual stastics for DOs who have taken the USMLE in the oft-cited link
http://www.usmle.org/scores/2003perf.htm

are these: in 2002, 30% of DOs who took USMLE 1 for the first-time failed, compared to 8% for first-time US MDs and 36% for IMGs

in 2003 those stats were 27%, 10%, 35%

I have mixed feelings about the whole issue. As Idiopathic points out, the fact that DO students have another test to prepare for creates somewhat of a burden.

However, the majority of time that DO students spend prepping for COMLEX is done with USMLE-specific review sources. Also, we like to make the claim that we learn everything that MDs do plus OMM, and that studying OMM does not take time away from studying other medical subjects. To make the assertion that we as a group do not-so-great on the USMLE because we have to spend time prepping for COMLEX undermines this argument. I agree that US MD students would have trouble with the COMLEX on the account of the OMM, but allopaths generally make no claims to be able to OMM.

The unpleasant truth is that on the whole the admissions standards for DO schools are less than those of US MD schools, and that on the whole this correlates to poorer performance on the USMLE.

The solution? For one thing, the current DO schools need to weigh the advantages of increasing class size (such WVSOM is in the process of doing) versus the obvious disadvantage that doing so necessitates lowering admission standards.

I don't think that DOs should be required to take the USMLE to practice medicine, but the fact that DOs underperform US MDs on the USMLE should not be entirely ignored or dismissed by our profession.

Lexmark said:

>>"I don't think that DOs should be required to take the USMLE to practice >>medicine".

Why? All other physicians have to take it. I could understand if DO's practiced medicine in a different way. But, as most of us know, there's no difference in the way MD's and DO's practice. I feel that all ACGME programs should require applicants to provide USMLE scores. How could such a requirement be unreasonable or unfair?

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The ACGME programs requiring USMLE scores for residency admission is a different matter than State Medical Boards requiring DOs to take the USMLE for licensure. If I'm not mistaken, individual ACGME programs have the discretion not to accept COMLEX scores, and some exercise that right.

On a purely ethical or philosophical sense, DOs probably should be required to take the USMLE. From a practical standpoint, it is not worthwhile to pursue that measure, because it would be a step backward for DOs overall. Currently, the COMLEX is sufficient to gain full medical licensure, and that represents a positive state of legal recognition of DO education.

I'm curious as to exactly what your proposal is for requiring the USMLE of osteopathic students. Should it be required by the schools for graduation? The osteopathic boards for licensure? All of the above? What then should be the fate of the COMLEX? If we keep it as an additional test - that would not be well-received. Dropping it entirely, which I sense you would favor, raises a whole other host of questions.

Venomous thread.. Yuck!

EctopicFetus said:

Venomous thread.. Yuck!

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In many ways, your condemnatory interjection is venomous in its own regard.

In beginning this thread, Lexmark addressed an "elephant in the living room" of Osteopathy with no easy answers, that is bound to stir certain emotions in its responses. It makes for an interesting discussion, and I certainly haven't intended to be "venomous" in my posts, simply stating honest (and at times mixed) opinions and feelings and raising questions about what, if anything, is the significance of DOs relative underperformance on the USMLE compared to US MDs.

Induction, I wasnt aiming at you. I was simply stating what the overall tone of this particular thread was. I think from now on I will bow out of MD vs DO threads.

john kerry for president? are you kidding me? what are you smoking?

zorro21 said:

john kerry for president

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I'm glad you agree.

i dont agree. john kerry and his sidekick are a bunch of jack asses.

zorro21 said:

i dont agree. john kerry and his sidekick are a bunch of jack asses.

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Technically, I dont think two people is 'a bunch' of anything. Go troll elsewhere.

Maybe when they are jackasses to the extreme that Kerry/Edwards are, two is a sufficient number for a bunch......

Unless Zorro was referring to Kerry/Heinz-Kerry, in which case, two is DEFINITELY a sufficient number for a bunch.

Back to life now.....