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Long story short I did not pass the USMLE and scored 453 on COMLEX. I have no intentions of retaking USMLE so this may be a silly question but is there any reason to even apply ACGME? Is it a requirement to pass the USMLE in order to do an ACGME residency? If not, will any programs consider someone with a USMLE failure if they have passed COMLEX? I will be taking Level 2, obviously hoping for improvement, but not Step 2. Appreciate the time, it is all very confusing to me.