COMLEX level 1 score, no USMLE, what residencies are open?

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Cyp4503A4

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I received my level 1 score about a week ago and scored somewhere between 500-505. I didn't take the USMLE. I don't really have much extracurriculars apart from a few community service activities through clubs and church. I haven't done research apart from undergrad, although I suppose if it'll help, I can look for a few opportunities during this academic year. I'm planning on taking step 2, hopefully that would help me out a little. But at this point, what specialties are still possible? I'm very open to primary care. Is IM still possible?

Thanks!

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Pathology, FM, Anesthesiology, community IM... and maybe psych.

Gas really like students having step scores, so I wouldn't go for that without it. Path, FM, Peds, community IM, and psych are doable. I wouldn't risk any surgical specialties.
 
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I'm so sorry, but what does gas stand for? Is it GI? I thought that was a fellowship, isn't it?

Gas really like students having step scores, so I wouldn't go for that without it. Path, FM, Peds, community IM, and psych are doable. I wouldn't risk any surgical specialties.
 
Gas really like students having step scores

I agree. Almost all of the 35 anesthesia programs I reached out to wants a step 1 AND 2 from DO students. There are some missouri programs that will tell you that comlex is fine, but you'll learn later on that they will favor a DO with step scores over almost any comlex score. They said "If you have a good score like a 650 you're probably in good shape but we still want to see USMLE transcripts".
 
I received my level 1 score about a week ago and scored somewhere between 500-505. I didn't take the USMLE. I don't really have much extracurriculars apart from a few community service activities through clubs and church. I haven't done research apart from undergrad, although I suppose if it'll help, I can look for a few opportunities during this academic year. I'm planning on taking step 2, hopefully that would help me out a little. But at this point, what specialties are still possible? I'm very open to primary care. Is IM still possible?

Thanks!
Take a look at this:
 

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I agree. Almost all of the 35 anesthesia programs I reached out to wants a step 1 AND 2 from DO students. There are some missouri programs that will tell you that comlex is fine, but you'll learn later on that they will favor a DO with step scores over almost any comlex score. They said "If you have a good score like a 650 you're probably in good shape but we still want to see USMLE transcripts".
I wonder why is that! If someone can score 500+ in COMLEX, I assume that student can at least get 210+ in step1, which is not a terrible score for gas these days... I don't get why PDs are so obsessed about step1...
 
I wonder why is that! If someone can score 500+ in COMLEX, I assume that student can at least get 210+ in step1, which is not a terrible score for gas these days... I don't get why PDs are so obsessed about step1...

Because they're ACGME programs. We should be held to the same standards that MD students are. I completely agree with them. I would venture a guess and say that basically zero ACGME program directors have ever taken comlex and are at best familiar with it. They're accommodating enough letting us apply to their programs when we don't let them apply to ours. It is the gold standard licensing exam.
 
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I wonder why is that! If someone can score 500+ in COMLEX, I assume that student can at least get 210+ in step1, which is not a terrible score for gas these days... I don't get why PDs are so obsessed about step1...

Also, a 500 COMLEX Score (about 20-25 points below average) would probably equate to a < 210 USMLE score. From the score reporting on SDN of those who took both over the past year, I've seen a trend of:
200 usmle --> mid-high 400 COMLEX
210 usmle --> 500-510 COMLEX
220 usmle --> 580 COMLEX
230 usmle --> 640+ COMLEX
240+ usmle --> 700+ COMLEX

Of course, there is plenty of variation with what I listed above, each student is different. If one student is amazing at OMM, they might have a disproportionately high COMLEX but a lower USMLE. For the most part though, ACGME residency programs prefer USMLE since they can directly compare you against other MD applicants. A 220+ USMLE is much more assuring than the student who scores around 550 on COMLEX. For example, one residency program I saw listed their screening cutoff as either a 600+ COMLEX or a 220+ USMLE. Just to show you how one program compares one exam against the other.

COMLEX also scales crazy high when you get into the upper percentiles. The student who scores a 240 on USMLE (less than 1 s.d.) will usually score 1-2 standard deviations above the national average for COMLEX.

And tbh, if I was a US MD program director, I would be worried in using COMLEX when nearly 25% of the exam is testing on OMM, a completely unrelated subject to MD residency. It allows for great variation where someone could have a 600+ COMLEX by just being really strong in OMM and very average at everything else.
 
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Also, a 500 COMLEX Score (about 20-25 points below average) would probably equate to a < 210 USMLE score. From the score reporting on SDN of those who took both over the past year, I've seen a trend of:
200 usmle --> mid-high 400 COMLEX
210 usmle --> 500-510 COMLEX
220 usmle --> 580 COMLEX
230 usmle --> 640+ COMLEX
240+ usmle --> 700+ COMLEX

Of course, there is plenty of variation with what I listed above, each student is different. If one student is amazing at OMM, they might have a disproportionately high COMLEX but a lower USMLE. For the most part though, ACGME residency programs prefer USMLE since they can directly compare you against other MD applicants. A 220+ USMLE is much more assuring than the student who scores around 550 on COMLEX. For example, one residency program I saw listed their screening cutoff as either a 600+ COMLEX or a 220+ USMLE. Just to show you how one program compares one exam against the other.

COMLEX also scales crazy high when you get into the upper percentiles. The student who scores a 240 on USMLE (less than 1 s.d.) will usually score 1-2 standard deviations above the national average for COMLEX.

And tbh, if I was a US MD program director, I would be worried in using COMLEX when nearly 25% of the exam is testing on OMM, a completely unrelated subject to MD residency. It allows for great variation where someone could have a 600+ COMLEX by just being really strong in OMM and very average at everything else.

I wouldn't base your data off of SDN.
Plenty of 550-580s with 230s at my school.

And OMM can hurt just as much as it can help. Personally, it was the hardest part of my exam by far. Also I know someone at my school that got a 257 on step, but a 580 on comlex and their OMM was below borderline performance on the breakdown.
 
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I wouldn't base your data off of SDN.
Plenty of 550-580s with 230s at my school.

There's plenty of variation with the data I listed. I'd draw attention to the ACGME program I mentioned that aligned a 600 COMLEX with a 220 USMLE. Unfair as that might be, that's the point I'm trying to make:

a 220+ USMLE, even though below average, will open a lot more doors than a 550 COMLEX. So, as previous posters mentioned, if you can score > 210 on an NBME, you should take the USMLE.
 
I would probably try to take in October during my elective month. Otherwise, if my NBME just scores just aren't working out, if I were to go for family medicine with just a COMLEX, would I have a decent shot at a west coast program? Hopefully somewhere in California/Nevada area?
 
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I would probably try to take in October during my elective month. Otherwise, if my NBME just scores just aren't working out, if I were to go for family medicine with just a COMLEX, would I have a decent shot at a west coast program? Hopefully somewhere in California/Nevada area?

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf

The ACGME 2016 osteopathic match results. You can look at the average COMLEX score per specialty, those who matched in which score range, etc. One thing to consider though, is that this match report does not account for whether or not each student had a USMLE score in addition to their COMLEX score.
 
I really dislike it that us as DO's had to take both USMLE/COMLEX for both levels. I have done it. What I think gets underemphasized is that the tests, while testing the same content, are drastically different. When our allopathic counterparts tell us "its basically the same thing"... I find that hard to believe. I know people are going to find this strange... but the COMLEX level II is really more patient care based than the USMLE. Most of the presentations at the hospital where I am auditioning are going to be vague presentations where you will have to take the best guess of pt. presentation. I think the USMLE, especially on my test (unfortunately) has caught on to the vague presentations, which is why I didn't do as well despite preparing insanely hard for it. It was hard for me to prepare for both because you need a different mentality for both. I think they have to eliminate the COMLEX... only giving a seperate OMM section after the USMLE for DO students.
 
I wonder why is that! If someone can score 500+ in COMLEX, I assume that student can at least get 210+ in step1, which is not a terrible score for gas these days... I don't get why PDs are so obsessed about step1...

The average step 1 score for anaesthesia is 230. Getting a 210 isn't "not a terrible score" its barely passing, and while you probably will match as an MD I can hardly say the same for a DO with a 210.

I really dislike it that us as DO's had to take both USMLE/COMLEX for both levels. I have done it. What I think gets underemphasized is that the tests, while testing the same content, are drastically different. When our allopathic counterparts tell us "its basically the same thing"... I find that hard to believe. I know people are going to find this strange... but the COMLEX level II is really more patient care based than the USMLE. Most of the presentations at the hospital where I am auditioning are going to be vague presentations where you will have to take the best guess of pt. presentation. I think the USMLE, especially on my test (unfortunately) has caught on to the vague presentations, which is why I didn't do as well despite preparing insanely hard for it. It was hard for me to prepare for both because you need a different mentality for both. I think they have to eliminate the COMLEX... only giving a seperate OMM section after the USMLE for DO students.

If you don't like it then either a) petition the accrediting body for DOs to adopt the USMLE with OMM questions thrown in b) don't apply ACGME or c) don't go to a DO school in the first place.


The USMLE allows you to be compared directly with allopathic medical students. If you want to go to an allopathic residency then it's not unreasonable to expect to have to take the same exams that allopathic students take and perform comparably.
 
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The average step 1 score for anaesthesia is 230. Getting a 210 isn't "not a terrible score" its barely passing, and while you probably will match as an MD I can hardly say the same for a DO with a 210.

You pretty much need a pulse to match as an MD student, just passing gives you a shot at anesthesia. As for a DO, can't really say.
 
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You pretty much need a pulse to match as an MD student, just passing gives you a shot at anesthesia. As for a DO, can't really say.
It's amazing that people still think gas and radiology are still competitive when these specialties have virtually 100% match rate for MD...
 
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It's amazing that people still think gas and radiology are still competitive when these specialties have virtually 100% match rate for MD...
Most specialties have match rates >90% for MDs, it's really only Derm and surgical subspecialties that have high rates of not matching.

The average USMD can match most fields with little issue, but also remember the average MD is scoring in the 230s on Step 1 and 240s on Step 2, which is well above most program's cutoffs in most fields.
 
Most specialties have match rates >90% for MDs, it's really only Derm and surgical subspecialties that have high rates of not matching.

The average USMD can match most fields with little issue, but also remember the average MD is scoring in the 230s on Step 1 and 240s on Step 2, which is well above most program's cutoffs in most fields.

Right, but the point we are getting at is that people are so fixated on step score averages they don't focus on match rates. The higher the match rate, the greater the range of board scores in matching. If anesthesia had a 100% match rate, then it wouldn't matter if you had a 192 or a 260 you would still match. It is only the caliber of the programs that would differ (referring to only MD on this topic).
 
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The average step 1 score for anaesthesia is 230. Getting a 210 isn't "not a terrible score" its barely passing, and while you probably will match as an MD I can hardly say the same for a DO with a 210.

According to the 2016 NMRP match data I posted above, osteopathic applicants with a COMLEX I score in the 501-550 range had 37/38 people match ACGME Anesthesiology. I'd imagine that a D.O. with a 210 step 1 would score at least in the 501-550 range. Even out of the 17 osteopathic applicants who scored 450-499 on COMLEX had 10/17 match anesthesiology. Point is, anesthesiology isn't that competitive anymore.
 
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Next person who posts the osteopathic charting outcomes should be shot. That data is worthless. The comlex scores of all the DOs who matched ACGME is meaningless considering 90% of them took USMLE but that's not included in the report. That report is barely more than fire pit kindling.
 
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Next person who posts the osteopathic charting outcomes should be shot. That data is worthless. The comlex scores of all the DOs who matched ACGME is meaningless considering 90% of them took USMLE but that's not included in the report. That report is barely more than fire pit kindling.

Nope. Probably over 30% of people who matched ACGME did so with just COMLEX. And even then pretending that someone's going to get a 230 or 240 with a 520 on their comlex is pretty hilarious. So essentially if people are matching with 520s, they're doing it with 210-220s on step 1 too.
 
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Nope. Probably over 30% of people who matched ACGME did so with just COMLEX. And even then pretending that someone's going to get a 230 or 240 with a 520 on their comlex is pretty hilarious. So essentially if people are matching with 520s, they're doing it with 210-220s on step 1 too.
Disagree with your method of extrapolation. Also what percent of that 30% is family med?
 
Disagree with your method of extrapolation. Also what percent of that 30% is family med?

I imagine half with IM, Peds, and other low competitive fields getting there.

Idk, but my school's comlex average is nearly a 580 and our usmle average is still just below the us average. I don't believe anyone's doing well on USMLE and then not doing well on COMLEX unless their USMLE was a fluke.
 
I imagine half with IM, Peds, and other low competitive fields getting there.

Idk, but my school's comlex average is nearly a 580 and our usmle average is still just below the us average. I don't believe anyone's doing well on USMLE and then not doing well on COMLEX unless their USMLE was a fluke.
Your reasoning is sound. I just think the lack of data is enough to seriously compromise the usefulness of the report.
 
Next person who posts the osteopathic charting outcomes should be shot. That data is worthless. The comlex scores of all the DOs who matched ACGME is meaningless considering 90% of them took USMLE but that's not included in the report. That report is barely more than fire pit kindling.

Yes, there is no report of who also took USMLE and if so what their score was. However, to say that it's worthless is absurd. You really think the 37/38 applicants who matched ACGME anesthesiology with a 501-550 COMLEX all took USMLE and had a solid 230+ USMLE score? Yeah right. Even if 50% of those students took USMLE, their step average was likely in the 210s-220s. Sure, there will be exceptions with those who had a 230+ USMLE but for some reason only got a 501-550 on COMLEX. But for the most part, the students with a below average COMLEX did not end up with a 220+ USMLE or didn't take the USMLE to begin with.
 
Next person who posts the osteopathic charting outcomes should be shot. That data is worthless. The comlex scores of all the DOs who matched ACGME is meaningless considering 90% of them took USMLE but that's not included in the report. That report is barely more than fire pit kindling.

Or you could have a person like meatornado come down here and tell you your matching potential is equivalent to a caribbean graduate. That report proved him dead wrong...
 
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I would probably try to take in October during my elective month. Otherwise, if my NBME just scores just aren't working out, if I were to go for family medicine with just a COMLEX, would I have a decent shot at a west coast program? Hopefully somewhere in California/Nevada area?

You'll be fine with FM, even out west, but you'll have to apply to most of the programs. There's like 40-some in CA from what I remember, but a lot of the UC programs want to see USMLE scores. You should still have a shot at the affiliates though, and there are a lot of less competitive programs out there too. Make sure you apply to some of the smaller less competitive programs (Eisenhower, Marian, Northridge, PIH, etc.) as well as some of those less competitive programs in neighboring states like Oregon, Washington, and Nevada.

The average step 1 score for anaesthesia is 230. Getting a 210 isn't "not a terrible score" its barely passing, and while you probably will match as an MD I can hardly say the same for a DO with a 210...

A 210 is actually practically a standard deviation above passing (192).

Its not a great score, but I think we can tone down the hyperbole a bit by being more accurate and putting things into perspective.

Or you could have a person like meatornado come down here and tell you your matching potential is equivalent to a caribbean graduate. That report proved him dead wrong...

What are you talking about man? That NRMP official report is just the DO schools skewing data to make it seem like they're matching better than the Caribbean. As a DO you'd be lucky to match FM in "rural ND".
 
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Yes, there is no report of who also took USMLE and if so what their score was. However, to say that it's worthless is absurd. You really think the 37/38 applicants who matched ACGME anesthesiology with a 501-550 COMLEX all took USMLE and had a solid 230+ USMLE score? Yeah right. Even if 50% of those students took USMLE, their step average was likely in the 210s-220s. Sure, there will be exceptions with those who had a 230+ USMLE but for some reason only got a 501-550 on COMLEX. But for the most part, the students with a below average COMLEX did not end up with a 220+ USMLE or didn't take the USMLE to begin with.
Maybe not useless just not helpful. I could be just bitter that they went through all the trouble and easily could have just included USMLE.
 
A 210 is actually practically a standard deviation above passing (192).

Its not a great score, but I think we can tone down the hyperbole a bit by being more accurate and putting things into perspective.
6 of one and half-dozen of the other dude.
 
So, what is it with Meatornado anyway? Was he not hugged enough as a kid? He's one of the very few MDs I know of that honestly believes they're superior to DOs. I'm a first year student at the "dreaded, for-profit RVUCOM" and every single MD at the job I just left was stoked for me. Shoot, even my MD family doctor seriously considered quitting his job and trying to get a job as a professor here when I told him about the new campus opening up (I think it helps that his son is a DO).
 
So, what is it with Meatornado anyway? Was he not hugged enough as a kid? He's one of the very few MDs I know of that honestly believes they're superior to DOs. I'm a first year student at the "dreaded, for-profit RVUCOM" and every single MD at the job I just left was stoked for me. Shoot, even my MD family doctor seriously considered quitting his job and trying to get a job as a professor here when I told him about the new campus opening up (I think it helps that his son is a DO).

I'll admit he does give realistic advice most of the time. However, he does go off serious tangents which is why I take what he says with a large grain of salt.
 
So, what is it with Meatornado anyway? Was he not hugged enough as a kid? He's one of the very few MDs I know of that honestly believes they're superior to DOs. I'm a first year student at the "dreaded, for-profit RVUCOM" and every single MD at the job I just left was stoked for me. Shoot, even my MD family doctor seriously considered quitting his job and trying to get a job as a professor here when I told him about the new campus opening up (I think it helps that his son is a DO).

He does and he doesn't. He believes that people who have the same level of residency training or higher are his equal. Though he prides himself on reminding people on here that only a hand full of DOs will get there.
 
He does and he doesn't. He believes that people who have the same level of residency training or higher are his equal. Though he prides himself on reminding people on here that only a hand full of DOs will get there.
So this must mean the gal from LECOM this year who matched 3rd best plastics residency in the nation is his superior..? Unless of course his residency was the 3rd best or better in the nation.
 
3rd best plastics residency in the nation is his superior..?

Seeing as you know so much about the rankings of plastics programs.... any plastics match is a fantastic match but let's not go pretending they matched plastics at MGH.
 
Seeing as you know so much about the rankings of plastics programs.... any plastics match is a fantastic match but let's not go pretending they matched plastics at MGH.
So sorry bro, I forgot you were the expert.
 
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Wow, this has gone way down the DO hole, I look forward to proving you all right/wrong when I match my top 3 ranked Mass General (main campus) Ortho with my 550 Comlex only app! They will take one look at my leadership in the Surgery, Rads, and SGA; mission trip to Honduras, and know that I am the one.
 
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Is OP not competitive for neuro and PMR?

If you're asking whether they're above the average matched individual for those specialties or even the 50th percentile of applicant, then the answer is no. Could they match into those fields? Neuro, probably without any issue, PMR, probably with a very broad application.
 
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Seeing as you know so much about the rankings of plastics programs.... any plastics match is a fantastic match but let's not go pretending they matched plastics at MGH.
I was providing an example of the exception to the rule, I understand that. The point of what I said was to inquire as to whether or not he'd truly feel a DO who matched really well to be his equal or if he'd still hold onto his bias. As a DO student, I'm not anticipating that MGH or other insanely competitive programs will be a part of my future. I should add that I'm still grateful to be in medical school, regardless.
 
MeatTornado actually wasn't as bad as people make him out to be, at least towards the end. Often he just spoke truths that no one wanted to hear.
 
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its interesting that people consider a 210 usmle bad when >50% of DOs who take usmle score less than a 230.
 
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its interesting that people consider a 210 usmle bad when >50% of DOs who take usmle score less than a 230.

Warped perspectives. Impressionable first years who are above average their whole life and believe as such that they'll hit 240s with ease, etc.


Sent from my iPad using SDN mobile
 
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its interesting that people consider a 210 usmle bad when >50% of DOs who take usmle score less than a 230.

Because it's nearly 1SD below mean, you're talking >20th percentile of test takers here.
 
The mean is lower for do students compared to md students.

But most of the people who take Step 1 are doing so to get ACGME residencies. Sure, the mean is lower for DOs but DOs aren't being compared solely to other DOs in the application process so it's irrelevant.
 
But most of the people who take Step 1 are doing so to get ACGME residencies. Sure, the mean is lower for DOs but DOs aren't being compared solely to other DOs in the application process so it's irrelevant.

Y
But most of the people who take Step 1 are doing so to get ACGME residencies. Sure, the mean is lower for DOs but DOs aren't being compared solely to other DOs in the application process so it's irrelevant.
the point is most do students who take it will score less than 230 and it's likely a lot of dos score around 210 to 220. With a 210 even you still have options
 
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