USMLE vs. COMLEX: advice from a 4th year

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CityDweller

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Hi everyone,

I realize that my advice is unsolicited, but I wanted to share my interview experience with you all and tell you my thoughts. I am a 4th year D.O. student applying ONLY to allopathic Internal Medicine residencies. When I was a second year, I decided to take both the COMLEX and USMLE because I had no idea what I wanted to do in life. I studied pretty hard, and did well, 95 USMLE, 90 on COMLEX. My third year I figured out I wanted to go into internal medicine. Since IM is not that competitive, normally I could probably get in anywhere. But last year we found out my husband was moving to Louisiana, and so that's where I am currently trying to match. It is a DO sparse area with ZERO IM programs in the state. You never know what will happen or where you will want to match.

To get to the point... I went on my first interview today at an allopathic program. Each and every interviewer commented on my board scores and said they were impressive. I was surprised that apparently board scores STILL carry a lot of weight. They still mean something and are to be taken seriously. I had a great feeling from the interviews and now I believe my chances of matching are high. I strongly suggest taking both the USMLE and COMLEX for almost any situation you are in, unless
(1) you are 100% certain that you are going into a DO residency
(2) you are 100% certain you are going for something competitive like radiology, ortho, optho, ent, where your chances would be slim in the MD match. Go for DO in this case.
Even specialties like pediatrics or emergency med, if you want to stay in a big city or certain geographical area, are going to have limited programs.
My advice is to take both exams. Things will change your 3rd year and taking both exams is the safest route to keeping all your options open. I know it is an extra burden, but you will be glad and proud that you took both exams. In my personal experience, it was beneficial for me to take both, since my current circumstances have taken me out of DO-friendly areas. PM me with any questions and good luck!
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CityDweller said:
To get to the point... I went on my first interview today at an allopathic program. Each and every interviewer commented on my board scores and said they were impressive. I was surprised that apparently board scores STILL carry a lot of weight. They still mean something and are to be taken seriously....
Click to expand...

Well... my comments here weren't solicited either... but I've been on quite a few interviews this year, both oste and allo, and while your board scores might have gotten you the interview, they won't get you a spot in the program. I've asked every PD and DME that I interviewed with what their criteria will be for selecting candidates and they all said it's more important to find people who fit in with us rather than going on board scores. Board scores don't mean crap when you are working side-by-side with the team for three years. They want people they like. This is an actual job where you will be expected to pull your own weight and get along with everyone else.

So, it's good that you have high board scores. They will probably get you some good interviews. Congrats to you. But don't dwell on it because you might just be surprised in the end.
 
scpod said:
Well... my comments here weren't solicited either... but I've been on quite a few interviews this year, both oste and allo, and while your board scores might have gotten you the interview, they won't get you a spot in the program. I've asked every PD and DME that I interviewed with what their criteria will be for selecting candidates and they all said it's more important to find people who fit in with us rather than going on board scores. Board scores don't mean crap when you are working side-by-side with the team for three years. They want people they like. This is an actual job where you will be expected to pull your own weight and get along with everyone else.

So, it's good that you have high board scores. They will probably get you some good interviews. Congrats to you. But don't dwell on it because you might just be surprised in the end.
Click to expand...

That's a pretty crappy thing to say. Board scores are sometime the first thing programs filter for. And if your reply to this is "screw those programs that screen that way", well, there are quite a few that do - especially the more competitive specialties.

Of course PDs are going to tell you at every place that you've *interviewed* at that it's important to find people that will get along with everyone else - you've already cleared the scores/grades/LOR filter. There's a guy out there with an equally great personality and skills, but didn't make it past that filter, that is not being told these things, because he wasn't interviewed.

That's the point. Geeze.
 
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tkim said:
That's a pretty crappy thing to say. Board scores are sometime the first thing programs filter for. And if your reply to this is "screw those programs that screen that way", well, there are quite a few that do - especially the more competitive specialties....
Click to expand...

I understand that, and I know all about the filters. I mentioned high scores will get you an interview. This thread is specifically about IM programs too, nothing else. My point is that great board scores are not going to guarantee you a spot and you need to perform in other ways in order to make sure you don't find yourself in the scramble.
 
I think the point of OP's advice was to take both the USMLE and COMLEX. I think trying to do well on the exams is a given. ;)
 
So the interviewers commented on your board scores.....did they only comment on your USMLE board scores?

I don't see how you come to the conclusion that the USMLE portion of your scores made all the difference.

I'm not saying it isn't a good idea to take the USMLE, but I don't think many programs will nix you merely for not having it. If the program takes DO's, they are probably familiar with the comlex. An intern at my institution is a DO that matched radiology at an allopathic program and he mentioned that he did strictly comlex...no USMLE.

Again, I'm not trying to prove you wrong, but I don't see how anything you have posted proves that the USMLE opens so many doors. Please explain
 
Most allopathic programs do not give a crap about the Comlex, if they have USMLE scores to look at. If you want to go to an allopathic program you owe it to yourself to take atleast USMLE Step 1. Fields like anesthesiology (which is really becoming tougher to match over the last few years) and radiology, you need to take both Step 1 and 2. PERIOD.
 
TexasPhysician,
I wrote that I was merely speaking from personal experience and that from the reactions of the allopaths that interviewed me, I believe it is wise to take both exams. Just like my experience was anecdotal, so is your friend who matched into radiology with only a COMLEX. The case you speak of is extremely rare.

To the others that spoke of boards scores getting you in the door/the interview... of COURSE! You need to have a likeable personality to back it up. The score is not everything... but it is important. And it is important to take the test. Even the old-timer physician, practicing for 30+ years, made a comment about the score. Do you think he even knows what a good COMLEX score is? Heck, I don't even know!
 
CityDweller said:
Hi everyone,

I realize that my advice is unsolicited, but I wanted to share my interview experience with you all and tell you my thoughts. I am a 4th year D.O. student applying ONLY to allopathic Internal Medicine residencies. When I was a second year, I decided to take both the COMLEX and USMLE because I had no idea what I wanted to do in life. I studied pretty hard, and did well, 95 USMLE, 90 on COMLEX. My third year I figured out I wanted to go into internal medicine. Since IM is not that competitive, normally I could probably get in anywhere. But last year we found out my husband was moving to Louisiana, and so that's where I am currently trying to match. It is a DO sparse area with ZERO IM programs in the state. You never know what will happen or where you will want to match.

To get to the point... I went on my first interview today at an allopathic program. Each and every interviewer commented on my board scores and said they were impressive. I was surprised that apparently board scores STILL carry a lot of weight. They still mean something and are to be taken seriously. I had a great feeling from the interviews and now I believe my chances of matching are high. I strongly suggest taking both the USMLE and COMLEX for almost any situation you are in, unless
(1) you are 100% certain that you are going into a DO residency
(2) you are 100% certain you are going for something competitive like radiology, ortho, optho, ent, where your chances would be slim in the MD match. Go for DO in this case.
Even specialties like pediatrics or emergency med, if you want to stay in a big city or certain geographical area, are going to have limited programs.
My advice is to take both exams. Things will change your 3rd year and taking both exams is the safest route to keeping all your options open. I know it is an extra burden, but you will be glad and proud that you took both exams. In my personal experience, it was beneficial for me to take both, since my current circumstances have taken me out of DO-friendly areas. PM me with any questions and good luck!
Click to expand...

Great post. Too bad there are some in this forum who don't want to hear it.
 
CityDweller said:
TexasPhysician,
I wrote that I was merely speaking from personal experience and that from the reactions of the allopaths that interviewed me, I believe it is wise to take both exams. Just like my experience was anecdotal, so is your friend who matched into radiology with only a COMLEX. The case you speak of is extremely rare.

To the others that spoke of boards scores getting you in the door/the interview... of COURSE! You need to have a likeable personality to back it up. The score is not everything... but it is important. And it is important to take the test. Even the old-timer physician, practicing for 30+ years, made a comment about the score. Do you think he even knows what a good COMLEX score is? Heck, I don't even know!
Click to expand...

You mentioned that you "strongly suggest" taking the USMLE. I don't see how you can strongly suggest anything based on an n=1 where none of your interviewers even singled out the USMLE as being important (you only mentioned that interviewers commented on your "scores"). I know that my example was anecdotal as well....that was the point.

I'm not saying that you are wrong either. I was just wondering if anyone has a good source on this or if a PD on here would chime in.

Spending an extra few thousand dollars to take USMLE's seems crazy to me unless there is strong truth that it will benefit people.

Disclaimer: I am an MD student about to graduate, but IF I were a program director, I wouldn't fault DO students for not taking the USMLE. Granted I am NOT the general population, but a good COMLEX scores is a good COMLEX score to me.

I can't think of a good reason why USMLE scores make a difference besides interviewers being too lazy to understand COMLEX scores.
 
first, scpod, your comment is extremely rude in that you are basically insinuating the OP has no social skill.

Second, If I ever become a PD, I would never accept an applicant whose only board exam taken is one that features cranial osteopathy.
 
MSSM2013 said:
first, scpod, your comment is extremely rude in that you are basically insinuating the OP has no social skill.

Second, If I ever become a PD, I would never accept an applicant whose only board exam taken is one that features cranial osteopathy.
Click to expand...

Tit for tat. Awesome.
 
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question-- how do students prepare for both exams. i'd imagine there would be a lot of cross coverage of material on both exams. how much more time does it take to prepare for the usmle after studying for comlex and vice versa.
 
You need to go through USMLE World and take at least one NBME exam to adequately prepare for USMLE.
 
TexasPhysician said:
I can't think of a good reason why USMLE scores make a difference besides interviewers being too lazy to understand COMLEX scores.
Click to expand...

This sounds like a pretty good reason to me. I think very few MDs know anything about the comlex scoring system or how to assess a good score, and interviewers don't have a ton of time to look that stuff up.

And as mentioned above, getting your foot in the door isn't something to dismiss. If you don't get an interview, you can't show off those super groovy social skills. :rolleyes:
 
Doctor Bagel said:
This sounds like a pretty good reason to me. I think very few MDs know anything about the comlex scoring system or how to assess a good score, and interviewers don't have a ton of time to look that stuff up.

And as mentioned above, getting your foot in the door isn't something to dismiss. If you don't get an interview, you can't show off those super groovy social skills. :rolleyes:
Click to expand...

As a program director, I think it is vital to understand the simple grading ranges of 2 exams (how hard could it be?). ERAS even helps filter applications based on certain scores that PD's can input. It would take 5 minutes for a PD to come up with the COMLEX equivalent to a cut-off USMLE score.

After the PD or whomever chooses the select few to interview, I don't see why any other interviewer needs to understand the COMLEX or USMLE scores. If the PD invited them for an interview based on meeting necessary criteria, the interview should be based on things other than test scores.

I do understand that my scenario involves the PD using 5 minutes productively.....which may not always be the case.
 
TexasPhysician said:
As a program director, I think it is vital to understand the simple grading ranges of 2 exams (how hard could it be?). ERAS even helps filter applications based on certain scores that PD's can input. It would take 5 minutes for a PD to come up with the COMLEX equivalent to a cut-off USMLE score.

After the PD or whomever chooses the select few to interview, I don't see why any other interviewer needs to understand the COMLEX or USMLE scores. If the PD invited them for an interview based on meeting necessary criteria, the interview should be based on things other than test scores.

I do understand that my scenario involves the PD using 5 minutes productively.....which may not always be the case.
Click to expand...


some allo PD may choose to not accept an osteo exam, even if they have all the time in the world.
 
My COMLEX is suiting me quite well as I interview at some very good programs. With that being said, if you are good at taking tests than take the USMLE.
 
TexasPhysician said:
As a program director, I think it is vital to understand the simple grading ranges of 2 exams (how hard could it be?). ERAS even helps filter applications based on certain scores that PD's can input. It would take 5 minutes for a PD to come up with the COMLEX equivalent to a cut-off USMLE score.

After the PD or whomever chooses the select few to interview, I don't see why any other interviewer needs to understand the COMLEX or USMLE scores. If the PD invited them for an interview based on meeting necessary criteria, the interview should be based on things other than test scores.

I do understand that my scenario involves the PD using 5 minutes productively.....which may not always be the case.
Click to expand...

True, but I doubt this happens as much as it should. If programs are motivated to have DO applicants, which they are in most fields in my neck of the woods, I think they really do take the time to figure out what comlex scores mean and lots state on their website that they accept the comlex. If a program isn't used to taking DOs because they're in a region that doesn't have many, figuring out comlex scores might not be something a PD even thinks about doing.

Personally I don't think there's equivalent harm in taking the USMLE versus not taking it. Sure it costs $500 bucks and sucks to study for, but you really do close some doors if you opt not to take it. I've met 4th years who were considering taking USMLE Step 1 because the field/area/program they found out they were interested in required it. That seriously sucks. Why not keep your options open?
 
MSSM2013 said:
Second, If I ever become a PD, I would never accept an applicant whose only board exam taken is one that features cranial osteopathy.
Click to expand...

That's a shame, because many NY IM allopathic residency programs do accept DO applicants with only the COMLEX.

I'm sure we all look forward to you becoming a PD :laugh:
 
Doctor Bagel said:
but you really do close some doors if you opt not to take it.
Click to expand...

You close even more doors if you do poorly on it. Some might say you don't belong in med school to begin with if you can't do well enough on it, but that's a different topic for a different day. Making a blanket statement that every DO applicant should take the USMLE is *****ic (not directed at you DB).
 
J1515 said:
That's a shame, because many NY IM allopathic residency programs do accept DO applicants with only the COMLEX.

I'm sure we all look forward to you becoming a PD :laugh:
Click to expand...

it shouldn't matter anyway because we are looking at different tier of programs.
 
CityDweller said:
Hi everyone,

I realize that my advice is unsolicited, but I wanted to share my interview experience with you all and tell you my thoughts.
Click to expand...

I'm a little late to the party, but wanted to say thanks for posting this. It's good to hear different viewpoints from people who have been through the process.
 
wanna_be_do said:
Anecdotal statement, or real data supporting this?
Click to expand...

Doesn't need any real data... if there's a filter that is based on USMLE scores-- and many of those are in place-- your application will never even be seen. Not even if you made >700 on COMLEX.

The only real "data" available shows that the average DO student does poorly on USMLE. So.... you really could hury yourself with a crappy USMLE score.
 
For those of you early in your education, you should seriously consider taking the USMLE, regardless of specialty, because it is headed towards "survival of the fittest" for osteopathic medical students. AOA/COCA is not your friend. Allopathic class sizes are expanding; VSAS is becoming more popular, thus limiting osteopathic medical students chances of networking at sites they're interested in; AOA/COCA is giving accreditation to foreign osteopathic medical schools, without requiring their respective countries to have enough postgraduate training slots for each grad for 7 years after acreditation; and of course the unchecked growth of osteopathic medical schools in the US without enough residencies for all of their graduates.
FYI (mentioned in another thread, but will repeat again): I'm in a very "DO-friendly" primary care residency, and this year, very few DO's (count on less than 1 hand) were invited to interview, no DO visiting students have rotated so far, and inteview season is almost over.
 
TexasPhysician said:
I'm no expert on NYC, but I've met numerous DO's at quality institutions on my interview trail that have never taken a USMLE.
Click to expand...

Hmm, maybe that's where my perspective is different. I know we're both applying in psych and at good programs, but I've seen very few DO applicants or residents on the interview trail. I've been interviewing mainly on the west coast with some east coast thrown in, and yeah, DOs aren't that well represented where I've been. Since I've met so few DOs I haven't been able to ask them about comlex vs. usmle, but I can't see how PDs or interviewers would be that familiar with comlex since they probably see it so little.

And maybe this is old info, but I thought you had the option of not releasing your USMLE score if you didn't want to if you're an osteopathic applicant.
 
I agree with the advice of the original poster. I have had allopathic interviewers comment favorably on my USMLE score in particular. Some of them did not know what the COMLEX is exactly or what material it covers.
They are busy people who don't necessarily have the time or interest to investigate what COMLEX scores mean. The easier that you make it for them to see how awesome you are, the better.
Sure, you could hurt yourself if you do poorly on the USMLE, but there is no reason why a DO can't do as well as an MD if you study as hard as the MD students do for it.
 
Doctor Bagel said:
Hmm, maybe that's where my perspective is different. I know we're both applying in psych and at good programs, but I've seen very few DO applicants or residents on the interview trail. I've been interviewing mainly on the west coast with some east coast thrown in, and yeah, DOs aren't that well represented where I've been. Since I've met so few DOs I haven't been able to ask them about comlex vs. usmle, but I can't see how PDs or interviewers would be that familiar with comlex since they probably see it so little.

And maybe this is old info, but I thought you had the option of not releasing your USMLE score if you didn't want to if you're an osteopathic applicant.
Click to expand...

Our geography is a little different. I'm strictly SE. TX to NC below the Mason Dixon line. I could definitely see the west coast being less DO friendly - it is quite competitive for US MD applicants as well.
 
Personally, I think it sucks that we are even forced to make this decision.

LCME acccreditation + USMLE Steps--> will give DO schools more respect
 
wanna_be_do said:
Anecdotal statement, or real data supporting this?
Click to expand...

Seriously? It's common sense. If you take the USMLE and do poorly, you have no excuse and have just sealed your fate. If you don't take it at all, you can at least claim that you saw no need to take it because you've performed well on your own licensing exam and have the grades to back it up.

Like I tell everyone, you should do two practice NBME tests before taking the real thing. If you perform at an acceptable level, then go ahead and take it. If you fail the NBME tests or barely pass, then do not go ahead with it.

It all comes down to predicting how you will do.
 
J1515 said:
Like I tell everyone, you should do two practice NBME tests before taking the real thing. If you perform at an acceptable level, then go ahead and take it. If you fail the NBME tests or barely pass, then do not go ahead with it.
Click to expand...

This is good advice. I'm also with peppy in his statement that there's no reason one can't do as well because they are DO students. Some of the high scorers who stick around and give advice on the Step 1 forum are DOs/DO students, and heck, OSU has Goljan teaching them for a freaking year.
 
It seems most of this USMLE vs COMLEX business is regional, I plan on staying in the upper midwest (MI, IL, OH) to do my residency and I was told that COMLEX should be sufficient at most but of course not all residencies. If someone does decide that they want to take the USMLE, cant we take it during 3rd year?
 
desijigga said:
If someone does decide that they want to take the USMLE, cant we take it during 3rd year?
Click to expand...

You can, but I would not recommend it. You would probably do worse on it since 3rd year rotations will leave you with very little time to study intensely like you would (or should) do if you took it at the same time as COMLEX Level 1 before 3rd year. Even the easy rotations are still usually 9-5 or so, so it is not like you can devote hours a day to studying like you can the summer before 3rd year.
Even if you did have ample time for taking the USMLE later, studying intensely for the boards is a painful experience and most people would find it hard to find the motivation to study that hard a second time.
 
The best time to take the USMLE Step 1, if you decide to would be right after the COMLEX Step 1. It's all down hill after taking the first exam. Once you hit rotations you begin learning more practical and useful clinical information and forgetting all the minor details you obsessed about for the Step 1 exams. I took both 2 days apart and did pretty well on both.
As for different strategies for studying, I was set on going to an allopathic IM program so I mainly focused on the USMLE Step 1. Studying for that prepared me for the COMLEX as well, and I just spent a few days reviewing the OMM material. With respect to percentiles, I ended up doing better on the USMLE.
 
TexasPhysician said:
I can't think of a good reason why USMLE scores make a difference besides interviewers being too lazy to understand COMLEX scores.
Click to expand...


I'm a 4th year DO student and I can't even tell you what a good COMLEX score is. I've heard above 600 is good, but other than that I don't think you can really compare one test to the other because they are very different in their focus and I've taken COMLEX 1 & 2 and USMLE 1 & 2. I can certainly tell you what I think a good, great, and excellent USMLE score is, although my opinion may vary with others. I don't think its a matter of PDs being lazy. I think that the information just isn't out there. There are some conversion tables, but since the 2 tests are so different, I don't see how they help. On all of the interviews I have gone on, only my USMLE score has been commented on. I even had a PD ask me what a good COMLEX score is and how to interpret COMLEX scores. I would second the recommendation to take the USMLE step 1 at the very least. I think it opens more doors, especially if you are looking at competitive programs in any specialty.
 
scpod said:
Summer before third year? Are there schools that give you a summer off before third year?
Click to expand...
He may be talking about the month or two off between end of class and start of 3rd year that will be completely consumed by board study. At least for me it will be.
 
Yeah, I thought that all the schools gave students at least a few weeks off before rotations for board prep.
 
scpod said:
Summer before third year? Are there schools that give you a summer off before third year?
Click to expand...

Surely most schools offer some sort of break between 2nd and 3rd year to take board exams. If they're not, they really need to reevaluate their schedules because that's a huge disservice to students. We got about six weeks between the end of 2nd year and start of clinicals to take Step 1 and have a quick break.
 
Doctor Bagel said:
Surely most schools offer some sort of break between 2nd and 3rd year to take board exams. If they're not, they really need to reevaluate their schedules because that's a huge disservice to students. We got about six weeks between the end of 2nd year and start of clinicals to take Step 1 and have a quick break.
Click to expand...


During our year, PCOM did not given us much time. Instead they decided to make us take courses in geriatrics, surgery, peds, and emergency medicine. Maybe thats why PCOM's board scores are not good??
 
Definitely varies by region. If you want to match at an allopathic school in the SOUTH, you should take the USMLE. There are some reputable schools down here which take a DO every now and then . . . even in ROAD specialties - but i would say most of them want USMLE scores. And med students can get on sdn to pontificate all day about how PDs should understand COMLEX scoring and conversions-- except that they are the PD. Which, last I checked, makes them the one in charge. So really, I guess they can choose any test they like.

And can we give these folks a bit of credit? They are not *****s. They have the same brains you do, and the same natural curiosity. Dont you think they would investigate this whole 'comlex' thing after a few applications? Wouldnt they check to see what is covered and what the questions look like? Surely you dont think that all of these PDs blindly accept that there is some other nebulous test out there and it performs the same function as the USMLE.

While yes, my experience is anecdotal and I have no evidence-based studies to give you a p-value regarding my observations (some of you guys are tools by the way) I know of a program director or two who have actually looked into the comlex -- and they dont like it. They realize that the tests are, in fact, rather dissimilar and test two completely different ways of thinking (eg. deductive reasoning vs. memorization and clue-hunting).

Perhaps they ask for a certain test because they really do have an understanding of the differences between the two . . . and maybe they have an informed preference.
 
JLM said:
Definitely varies by region. If you want to match at an allopathic school in the SOUTH, you should take the USMLE. There are some reputable schools down here which take a DO every now and then . . . even in ROAD specialties - but i would say most of them want USMLE scores. And med students can get on sdn to pontificate all day about how PDs should understand COMLEX scoring and conversions-- except that they are the PD. Which, last I checked, makes them the one in charge. So really, I guess they can choose any test they like.

And can we give these folks a bit of credit? They are not *****s. They have the same brains you do, and the same natural curiosity. Dont you think they would investigate this whole 'comlex' thing after a few applications? Wouldnt they check to see what is covered and what the questions look like? Surely you dont think that all of these PDs blindly accept that there is some other nebulous test out there and it performs the same function as the USMLE.

While yes, my experience is anecdotal and I have no evidence-based studies to give you a p-value regarding my observations (some of you guys are tools by the way) I know of a program director or two who have actually looked into the comlex -- and they dont like it. They realize that the tests are, in fact, rather dissimilar and test two completely different ways of thinking (eg. deductive reasoning vs. memorization and clue-hunting).

Perhaps they ask for a certain test because they really do have an understanding of the differences between the two . . . and maybe they have an informed preference.
Click to expand...

:laugh:

I agree that it is better to take the USMLE.

Disclaimer: I did not for some very good reasons that I rather not divulge because it may give away who I am.
 
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