Are D.O. students disadvantaged on USMLE?

[theSupremeHobgoblin]

Hi guys. I'm sorry because I can't find information that addresses this exact question.

1. Do you guys feel that if a DO student decides to study for both the USMLE as well as COMLEX that they are at some kind of disadvantage over someone who only had to study for the USMLE or only for the COMLEX?

I think it's logical to assume that if a person puts 100% of the effort into only one or the other exclusively, their score is generally likely to be better, than had they been studying for both...but perhaps this difference wouldn't be significant.

2. On a separate note, I was wondering if people feel that osteopathic schools would teach the non-OMM material differently from how allopathic programs would. i.e., do osteopathic schools prep students as well as allopathic schools for the USMLE, or are DO students at a disadvantage for USMLE?

If there are already threads that address this I'm happy to look at those, but I couldn't find them. Please share your thoughts.

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[TheOther]

Based on my personal experience:

1. Studying hard for and doing well on USMLE usually means you'll also do well on COMLEX. It's rare for one to do well on USMLE and bomb COMLEX.

2. The beauty of med ed today is the abundance of board-focused resources outside of school curriculums. Pathoma, Sketchy, Boards and Beyond, First Aid, UWorld are more than enough to do well on boards. I think that school curriculums that afford more time outside of mandatory class time are valuable.

 

[Mad Jack]

My study plan for the COMLEX was basically just USMLE+2 days of OMM questions. It doesn't slow you down at all.

 

[Postictal Raiden]

I don't think there's a disadvantage for step1, but I think if your clinical rotations lack didactics and structured education, then you can be at some disadvantage for step2.

 

[Who Knows!]

Maybe I was the odd man, but after taking my USMLE I struggled to read omm. Was so burnt out, and was not used to the format of the test. Felt rushed and the questions were worded so poorly. If I did COMBANK I felt I would have been more prepared just because of the question style. DO I regret it? absolutely not. Focus on step, thats all PD care about.

STEP 1: 244
COMLEX: 528

 

[SpartanWolverine]

Maybe I was the odd man, but after taking my USMLE I struggled to read omm. Was so burnt out, and was not used to the format of the test. Felt rushed and the questions were worded so poorly. If I did COMBANK I felt I would have been more prepared just because of the question style. DO I regret it? absolutely not. Focus on step, thats all PD care about.

STEP 1: 244
COMLEX: 528

Completely agree. Did relatively much better on USMLE.

I wish the OMM portion of the COMLEX exams was perhaps a distinct subscore as it can really be a drag for those of us who focus heavily on USMLE. Of course I blame no one but myself for barely flipping through OMM material and basically ignoring COMLEX-format questions!

 

[electrolight]

I don't think there's a disadvantage for step1, but I think if your clinical rotations lack didactics and structured education, then you can be at some disadvantage for step2.

But why? Step 2 knowledge is everything we already know just in algorithm form. Read the books and do the questions. Uworld barely reflects my clinical experience, but I can still do above average on the questions.

 

[megsannon22]

1. Do you guys feel that if a DO student decides to study for both the USMLE as well as COMLEX that they are at some kind of disadvantage over someone who only had to study for the USMLE or only for the COMLEX?
I think this is true, because you have to study for more content of course for OMM. The other medical content is similar but covering all the osteopathic stuff takes extra time.

 

[SpartanWolverine]

1. Do you guys feel that if a DO student decides to study for both the USMLE as well as COMLEX that they are at some kind of disadvantage over someone who only had to study for the USMLE or only for the COMLEX?
I think this is true, because you have to study for more content of course for OMM. The other medical content is similar but covering all the osteopathic stuff takes extra time.

Naw. I would focus 95% on studying USMLE material... The depth and complexity of USMLE questions will easily prepare you for the COMLEX. I basically only studied USMLE-type questions and still did very well on the COMLEX. Granted that OMM was my lowest score by a long shot, but I really just can't stand the stuff and thus put off looking through the green book for way too long.

 

[atomheart]

#2: Much of my education was self-discovery. The true disadvantage is your school's relative focus on OMM in my opinion. It is less about content, and more about time. I did feel at a slight disadvantage as DO when studying for my boards because I was forced by my school to put in an extra ~8hrs every week to study something completely unrelated to modern medicine. Week by week, this amounted to over 100 extra hours lost during my dedicated period. Objectively, the amount of prep time you get and extra M2 requirements vary by school (allopathic schools may have research requirements).

I felt at a HUGE disadvantage having to set aside time into studying for COMLEX. I do not feel that a very poor score (<500) or fail on COMLEX will be overshadowed by a great USMLE score, but I'm also not so sure that a great score on COMLEX would help overcome a poor USMLE score. It's like you're constantly at a double standard as a DO. Like most people who take both, I feel that the existence of COMLEX mostly serves to hurt DO students attempting to match ACGME in the next several years. I am of the opinion that NO USMLE will be as much a red flag for ACGME match in the future as a fail on COMLEX is today. We'll see. Many of my classmates opted for this option because they felt it would eliminate the double standard.

I feel that several schools (even allopathic) are hard pressed to admit that their curriculum doesn't matter compared to the weight of board scores, and continue to push their filler curriculum. Like everyone else has said, put 99% of your effort into USMLE, and make COMLEX a 1% afterthought. Do the bare minimum to get through your school's filler, up to and including skipping class altogether to focus on boards.

TL;DR: Time and motivation are the major limiting factors on your board scores. you should work to minimize real or perceived disadvantage by doing the absolute minimum during M2 to pass classes while learning the USMLE material.

 

[510586]

Based on my personal experience:

1. Studying hard for and doing well on USMLE usually means you'll also do well on COMLEX. It's rare for one to do well on USMLE and bomb COMLEX.

2. The beauty of med ed today is the abundance of board-focused resources outside of school curriculums. Pathoma, Sketchy, Boards and Beyond, First Aid, UWorld are more than enough to do well on boards. I think that school curriculums that afford more time outside of mandatory class time are valuable.

So hypothetically if a person was decently capable and their school barely touched USMLE subjects, how far could they get with just those sources? I have only like 4-6 hours per week max I can spend on part I and 2 summers (approximately 6 weeks each) to prepare for it.

 

[TheOther]

So hypothetically if a person was decently capable and their school barely touched USMLE subjects, how far could they get with just those sources? I have only like 4-6 hours per week max I can spend on part I and 2 summers (approximately 6 weeks each) to prepare for it.

Hard to say, too may variables. The hours spent study and understanding the basic curriculum material contributes to how much time you need to spend on board prep. My school had minimal mandatory classroom time so I studied for exams alongside board prep material throughout my preclinical years.

 

[Cath Up]

Accepted DO student here. Is it conventional wisdom to take USMLE prior to COMLEX? Can you take USMLE second (and why would anyone do that?).

 

[TheOther]

Accepted DO student here. Is it conventional wisdom to take USMLE prior to COMLEX? Can you take USMLE second (and why would anyone do that?).

I personally recommend USMLE first.

As you progress through dedicated study, you should hit a certain pace where you’ll reach a “peak” — the point where your knowledge and critical thinking ability isn’t overwhelmed by fatigue. Beyond this point, you risk a decline in performance. The USMLE requires more critical thinking and drawing of a broader/deeper level of understanding of the material, so you ideally want to be hitting this “peak” right around your Step 1 date. The remaining energy can be spent on studying up on OPP for COMLEX.

I don’t advise taking COMLEX prior because of the time invested reviewing OPP is better spent on the material for USMLE. Plus you risk getting fatigued quicker if you take in within the week prior to the USMLE...8 blocks of 50qs left me dead at the end of COMLEX.

 

[Cath Up]

I personally recommend USMLE first.

As you progress through dedicated study, you should hit a certain pace where you’ll reach a “peak” — the point where your knowledge and critical thinking ability isn’t overwhelmed by fatigue. Beyond this point, you risk a decline in performance. The USMLE requires more critical thinking and drawing of a broader/deeper level of understanding of the material, so you ideally want to be hitting this “peak” right around your Step 1 date. The remaining energy can be spent on studying up on OPP for COMLEX.

I don’t advise taking COMLEX prior because of the time invested reviewing OPP is better spent on the material for USMLE. Plus you risk getting fatigued quicker if you take in within the week prior to the USMLE...8 blocks of 50qs left me dead at the end of COMLEX.

This makes sense. Thank you for the advice!

I am trying to gain a better understanding of how successful DO students prepare for the USMLE. I saw that you studied throughout preclinical years, but can I get a sense of how thorough this was and when you started to pick things up (and how long was your dedicated)? I have seen people advocate to willingly decrease school performance/rank in lieu of increasing step 1 study time during OMSII. Did you do this?

Also curious what you scored and if you were happy with it- don't see it on this thread and cannot see post history. Feel free to PM, or not share if not comfortable doing so! Thank you very very much for any info you can provide.

 

[moyamoya6]

Accepted DO student here. Is it conventional wisdom to take USMLE prior to COMLEX? Can you take USMLE second (and why would anyone do that?).

My initial plan was take the USMLE first and then cram in OMM within a week to take COMLEX. Our school had a deadline to take the COMLEX, and I didn't feel ready to take the USMLE after taking a few NBMEs. So I took COMLEX first, then rescheduled my USMLE a few weeks later at the earliest open spot that was available. I did feel like I hit a plateau by the time USMLE rolled around, but glad to score above the average on each.

Hoping to take my step 2 a week before my COMLEX 2 this time.

 

[MrWonderful]

No, I do not think there is any disadvantage. What stinks is having to physically sit for 2 eight-hour exams. That is a bit draining. But as far as raw preparation goes, the content is the same. I often hear students complain about different appearances or question stems or something... but does heart failure really change that much when its Times New Roman vs. Calibri?

It's not as bad as everybody makes it sound, in fact you are lucky you are able to take COMLEX because you can do average on the "medicine" but if you perform extremely well on OMM (which constitutes up to a third of your exam) your score is a lot higher. Yes, program directors care a lot about your COMLEX score. I scored below average on USMLE but scored 620+ on COMLEX because I was in the top percentile for OMM. It feels really good that this inflation can happen to an otherwise vanilla score.

I spent 2 months with the standard UFAP prepping for USMLE and used the last 1.5 weeks to do OMG OMT to sure up my OMM. Does it stink? Yeah. But welcome to life. We know what we signed up for when we went to a DO school.

 

[SpartanWolverine]

No, I do not think there is any disadvantage. What stinks is having to physically sit for 2 eight-hour exams. That is a bit draining. But as far as raw preparation goes, the content is the same. I often hear students complain about different appearances or question stems or something... but does heart failure really change that much when its Times New Roman vs. Calibri?

It's not as bad as everybody makes it sound, in fact you are lucky you are able to take COMLEX because you can do average on the "medicine" but if you perform extremely well on OMM (which constitutes up to a third of your exam) your score is a lot higher. Yes, program directors care a lot about your COMLEX score. I scored below average on USMLE but scored 620+ on COMLEX because I was in the top percentile for OMM. It feels really good that this inflation can happen to an otherwise vanilla score.

I spent 2 months with the standard UFAP prepping for USMLE and used the last 1.5 weeks to do OMG OMT to sure up my OMM. Does it stink? Yeah. But welcome to life. We know what we signed up for when we went to a DO school.

Unfortunately that works both ways. I focused entirely on USMLE resources and don't give two... shakes of a dog's tail... for OMM. I bombed OMM on both COMLEX I/II which significantly dragged me down. Did fine on USMLE though.

 

[MrWonderful]

Unfortunately that works both ways. I focused entirely on USMLE resources and don't give two... shakes of a dog's tail... for OMM. I bombed OMM on both COMLEX I/II which significantly dragged me down. Did fine on USMLE though.

True, but I think you are probably more the exception than the rule. And depending on what specialty the OP wants to go into, having a good+ COMLEX will probably be necessary.

 

[MrTaco92]

So just to get an idea of what most people here recommend for comlex prep, is it something along the lines of...
Pure usmle studying (0 omm/combank q's) -> take usmle -> combank q's + green book for 2-3 days -> take comlex?
Or is this just pushing it a bit too far?

 

[TheOther]

So just to get an idea of what most people here recommend for comlex prep, is it something along the lines of...
Pure usmle studying (0 omm/combank q's) -> take usmle -> combank q's + green book for 2-3 days -> take comlex?
Or is this just pushing it a bit too far?

This is what I did and most of my closest friends. We all did relatively well on both (230+/600+). You might even want to take a day off after Step 1 to recover then study 2-4 days. Eg. take Step 1 on a Monday then Level 1 that Friday or following Monday.

Edit: timeline

 

[MrWonderful]

So just to get an idea of what most people here recommend for comlex prep, is it something along the lines of...
Pure usmle studying (0 omm/combank q's) -> take usmle -> combank q's + green book for 2-3 days -> take comlex?
Or is this just pushing it a bit too far?

I would recommend a week between the exams. The mental/physical toll it takes to sit in a testing center for 8 hours is rough. Doing this (quickly) back-to-back can be miserable.

Also, I don't recommend the green book unless you're already extremely strong on OMM to begin with. Otherwise, use OMG OMT for better explanations and a more purposeful focus on high yield topics. This is what I used and felt it was largely superior to the green book. In a few years from now I think they will be the mainstream resource but for now they are relatively new/unknown. But either way, couple your OMM review with COMQUEST Q-bank and do all the OMM questions and you'll be fine.