448 COMLEX... what are my options? *UPDATE*

[boyington!]

Just got my Level 1 score back today, very disappointed in myself. I've always been a good test-taker and got good grades in med school, but I walked out of that exam feeling like it simply did not test me over the things that I studied.

I'm doing well on third-year rotations so far, my favorite two specialties are ER and IM. I just love being in a hospital. Am I doomed to primary care? Should I try to take Step 1 (I've already started studying) in the winter or spring? Any advice on how to proceed generally?

For added context, I have already secured a couple of LoRs from docs in the specialties I like, I have 4 publications in the realm of biomedical research, and an MS in biomedical science.

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[Angus Avagadro]

448 is like 17%tile. Good news most programs dont consider it. Step 1 is usually the standard, so a solid score would do wonders to boost your app. Bad news, its 17 %tile. Take Step 1 only after you are cometely prepared. Good luck and best wishes

 

[ToKingdomCome]

Unfortunately, these things happen. I think you have a good shot at IM. EM is also possible if you crush step 2 since they tend to favor that. TBH, I would not worry about Step 1 at this late in the game. Focus on former DO IM programs

 

[Ho0v-man]

If you think you can get an average-ish score, or at least pass comfortably, then I’d go or step 1. Need to go all in on it between now and January which will suck while in rotations. If you can’t hit a comfortable pass by January, then you need to give up and focus on level 2. Even if you take step 1, you’ll have to gear up for step 2 pretty quickly after you take it.

 

[hungrydoc710]

A pass on Step 1 (and solid Step 2) would open lots of IM doors. Maybe even low tier-academic if 210/230+ on Steps.

As it stands right now, I'd say FM and comm IM are on the cards for you.

 

[MLNS]

IM is primary care dawg...

 

[boyington!]

Thanks everyone for the replies.

If you think you can get an average-ish score, or at least pass comfortably, then I’d go or step 1. Need to go all in on it between now and January which will suck while in rotations. If you can’t hit a comfortable pass by January, then you need to give up and focus on level 2. Even if you take step 1, you’ll have to gear up for step 2 pretty quickly after you take it.

448 is like 17%tile. Good news most programs dont consider it. Step 1 is usually the standard, so a solid score would do wonders to boost your app. Bad news, its 17 %tile. Take Step 1 only after you are cometely prepared. Good luck and best wishes

I have decided to take Step 1 in January. I think my biggest mistakes for COMLEX were not using Uworld (did all of Combank and Comquest) and not taking enough practice tests. I really believe I can do well, though I acknowledge it's gonna take some serious discipline on my part.

IM is primary care dawg...

Lol sorry I should have been more clear. In my own context, I equate internal medicine specifically with being a hospitalist (because that's what I would want to be), but I recognize internal medicine generally is considered primary care and IM docs often serve as PCPs and whatnot.

 

[Doctor_anonymous]

Bro, go out and buy UWorld and study your ass off every day. Download or buy a sub to Boards and Beyond and do them in concert. Consider Amboss if you have already used UWorld and then take step 1. You can't expect they'll take you seriously with that score so just go do more better good on Step 1.

 

[Dreamstoo]

Know a few who had sub 450s (or within 420-460 range) on COMLEX Level 1.
1. Didn't fair much better on Level 2 - matched into a well respected community FM. Had stellar letters (very likable social person) and unique research experience. I think was stuck between FM and IM in the end but fell in love with FM during his rotation in 3rd year. Highly sought after program by DO students in the area.
2. Similar story without much extracurricular activities (but better class grades) - university FM program that's not-so competitive in a cheap rural area, their benefits/salary is much more than what they'd get in their hometown. Known to be a chill residency and sought after by local DO students.
3. Did much better on Level 2 and got a ~230 on Step 2 (didn't take Step 1) - ended up matching into an IM program that matches very well into their subspecialty of choice. Did far better during the last 2 years of medical school than the first 2. No red flags but not much research/ECs. Some unique hobbies/side hustles.
4. Not really similar to the first 3 but I know someone who narrowly failed COMLEX and broke a sub 500 on the retake. Ended up at a university PM&R programs with classmates who I know had 220/230 Step scores.

Scores are only part of it and I'm almost 100% sure none of these were done through "connections" ^

 

[boyington!]

Studied (relatively) hard during rotations and took Step 1 three weeks ago and got a 235. Applying IM btw.

Will my 448 be held against me in some way when applying for residency? I'm mostly wondering about traditionally osteopathic programs. Should I be prepared to explain the disparity and/or address it in personal statements?

Thanks yall!

 

[Ho0v-man]

Studied (relatively) hard during rotations and took Step 1 three weeks ago and got a 235. Applying IM btw.

Will my 448 be held against me in some way when applying for residency? I'm mostly wondering about traditionally osteopathic programs. Should I be prepared to explain the disparity and/or address it in personal statements?

Thanks yall!

Who cares if former DO programs hold that against you? You’ll likely match a very good community program or an academic program as long as you do well on step 2 also and aren’t super picky with geography. Congrats on turning it around like that. It’s a big accomplishment.

 

[Tragal Pointer]

Studied (relatively) hard during rotations and took Step 1 three weeks ago and got a 235. Applying IM btw.

Will my 448 be held against me in some way when applying for residency? I'm mostly wondering about traditionally osteopathic programs. Should I be prepared to explain the disparity and/or address it in personal statements?

Thanks yall!

The important question is why limit yourself to traditionally ostepathic programs with a 235 step? Why would you want to go anywhere that gave more value to a COMLEX score? Legitimate question.

 

[DOVinciRobot]

Studied (relatively) hard during rotations and took Step 1 three weeks ago and got a 235. Applying IM btw.

Will my 448 be held against me in some way when applying for residency? I'm mostly wondering about traditionally osteopathic programs. Should I be prepared to explain the disparity and/or address it in personal statements?

Thanks yall!

Go to a solid MD program and don't look back. That's a big turn around. Honestly who gives a crap what the traditionally osteopathic programs will do.

 

[boyington!]

Who cares if former DO programs hold that against you? You’ll likely match a very good community program or an academic program as long as you do well on step 2 also and aren’t super picky with geography. Congrats on turning it around like that. It’s a big accomplishment.

The important question is why limit yourself to traditionally ostepathic programs with a 235 step? Why would you want to go anywhere that gave more value to a COMLEX score? Legitimate question.

Go to a solid MD program and don't look back. That's a big turn around. Honestly who gives a crap what the traditionally osteopathic programs will do.

I was mainly asking as a practical matter because there is one DO program in my state with a good reputation/in a great area that I plan on applying to and I was just wondering if it was something I should address in the app. But I totally understand where you guys are coming from, it's probably not worth worrying about. Thank you all for the encouraging words!

 

[Spectreman]

Just wanna say congrats

 

[Tragal Pointer]

I was mainly asking as a practical matter because there is one DO program in my state with a good reputation/in a great area that I plan on applying to and I was just wondering if it was something I should address in the app. But I totally understand where you guys are coming from, it's probably not worth worrying about. Thank you all for the encouraging words!

I get it. But also congrats on a solid step score. COMLEX is garbage and everyone knows it, including the NBOME.

 

[DOVinciRobot]

I was mainly asking as a practical matter because there is one DO program in my state with a good reputation/in a great area that I plan on applying to and I was just wondering if it was something I should address in the app. But I totally understand where you guys are coming from, it's probably not worth worrying about. Thank you all for the encouraging words!

If everything else is in order you’ll probably be competitive for that program honestly. Your Step score will open some doors that were previously closed. That’s a great accomplishment and you’ll keep a competitive IM applicant

 

[sunshinefl]

I was mainly asking as a practical matter because there is one DO program in my state with a good reputation/in a great area that I plan on applying to and I was just wondering if it was something I should address in the app. But I totally understand where you guys are coming from, it's probably not worth worrying about. Thank you all for the encouraging words!

Apply anyway, don’t address it, try to increase your level 2 and maintain your step 2. My level 1 was <500 but I got invites to residencies who wanted higher scores based on either my step 1, level 2, or both making up for it. I’m sure I missed out on some places who just straight up filtered <500, but without knowing who those are just roll with what you have. You did excellent on step 1! Congratulations!

 

[HoneyBadger3]

Congrats! 235 is more than enough to get into a solid academic IM program. Step 1 will always be held in higher regard than COMLEX. Any program that is still living in the COMLEX=USMLE fantasy is probably not a place you want to be at anyway. Unfortunately some DO advisors will still tell students that program directors treat them as equals. Couldn't be more wrong...

 

[Oligodinero]

Congrats! 235 is more than enough to get into a solid academic IM program. Step 1 will always be held in higher regard than COMLEX. Any program that is still living in the COMLEX=USMLE fantasy is probably not a place you want to be at anyway. Unfortunately some DO advisors will still tell students that program directors treat them as equals. Couldn't be more wrong...

agreed. USMLE trumps COMLEX every. single. time. The only exception, as mentioned before, will be those programs who have a filter set for COMLEX. There are plenty of places that'll ignore a low COMLEX and see a solid USMLE and extend an interview.

 

[hungrydoc710]

Step 2 is where the money's at now

 

[deleted1100659]

I was involved with the selection process for my program. My program has been taking DOs for years and to this day they still have no idea about comlex scores. They google the percentile thing on nbome (one attending at least) and the others just kind of make vague guesses. USMLE is a lot more understood

 

[cadingcading]

Congrats! You just opened the door to more competitive programs and other specialties if you are interested...good job.