COMLEX Score between 500-510. What's available to me?

[drturk1]

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Hey guys, so I got my COMLEX score back last month, but with the start of rotations and everything, haven't been able to process what specialties my future entails. My school's advising department isn't the best either, so I thought I'd turn to SDN for some guidance. I was wondering what specialties are still available?

 

[Robotfishbrain]

http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf

Edit: You can also look at what Program directors say in each speciality, but with an overall response rate of 35%, the data is not statistically valid. YMMV

http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

 

[BurntFlower]

Hey guys, so I got my COMLEX score back last month, but with the start of rotations and everything, haven't been able to process what specialties my future entails. My school's advising department isn't the best either, so I thought I'd turn to SDN for some guidance. I was wondering what specialties are still available?

Did you take the USMLE?

 

[drturk1]

Did you take the USMLE?

I didn’t; had it scheduled but my practice scores were too low to comfortably take it

 

[UnoMas]

Without a Step 1 score, COMLEX in that range is good for FM, IM, Peds, PMR, maybe EM at former DO programs

 

[AlbinoHawk DO]

Without a Step 1 score, COMLEX in that range is good for FM, IM, Peds, PMR, maybe EM at former DO programs

I would say you still have a shot at child neuro, neuro (undesirable programs), pathology and of course dermatology (just kidding).

 

[Black Coffee 24/7]

I didn’t; had it scheduled but my practice scores were too low to comfortably take it

What specialties are you interested in? Your score isn't that bad for the majority of former AOA programs in a good portion of specialties.

 

[DocWinter]

Outside of some top enders like ortho, derm, uro, don’t think in terms of field as the barrier, consider the level within those fields.

You can match ER or surgery in AOA programs easier than you can IM or peds in university setting for example.

 

[Rekt]

Am I living on a different planet? Some of these suggestions for OP are ridiculous. I'd say you can match FM, community IM, and Peds if you have the personality. That's about it.

 

[DocWinter]

Am I living on a different planet? Some of these suggestions for OP are ridiculous. I'd say you can match FM, community IM, and Peds if you have the personality. That's about it.

Why would you say? What about an average step one score screams to you cannot do any better than low end internal medicine at the best? Who exactly do you think are these thousands of rock stars that are matching in to IM, ER, OB, anesthesia, etc? You do know that half of all doctors graduate at the lower half of the class right?

 

[Rekt]

Why would you say? What about an average step one score screams to you cannot do any better than low end internal medicine at the best? Who exactly do you think are these thousands of rock stars that are matching in to IM, ER, OB, anesthesia, etc? You do know that half of all doctors graduate at the lower half of the class right?

500 in no way equates to a 230 and it's not even close. Simple as that. And 500 isn't even close to the average anymore, it's more like 560. It's essentially equatable to getting in 400s a couple years ago. Plus the merger and more and more DO students taking Step? Someone WITHOUT Step and a score of around 500, I'd put them in the bottom 15-20% of DO applicants.

 

[DocWinter]

And 500 isn't even close to the average anymore, it's more like 560. It's essentially equatable to getting in 400s a couple years ago.

Someone WITHOUT Step and a score of around 500, I'd put them in the bottom 15-20% of DO applicants.

I think the average the past couple years has been closer to a 520 to 530. All I can say is that if you think someone with a 500 score is in the bottom 20% of the class on average I just don’t really think you’re in tune to the reality.

 

[drturk1]

500 in no way equates to a 230 and it's not even close. Simple as that. And 500 isn't even close to the average anymore, it's more like 560. It's essentially equatable to getting in 400s a couple years ago. Plus the merger and more and more DO students taking Step? Someone WITHOUT Step and a score of around 500, I'd put them in the bottom 15-20% of DO applicants.

Not going to lie, was definitely surprised at some of the suggestions as well.

However, I don’t know if everyone received the email, But they readjusted the curve on the COMLEX again. Apparently, they do it every few years - no idea why- but it took me longer than the average 4 weeks to get my score back. Still, I do know that not taking Step 1 already puts me at a huge disadvantage which is why I wanted to ask

 

[Rekt]

I think the average the past couple years has been closer to a 520 to 530. All I can say is that if you think someone with a 500 score is in the bottom 20% of the class on average I just don’t really think you’re in tune to the reality.

Pair all that with no Step and I'm not far off. I'm not trying to be mean, but it's important to keep applicants realistic. You're the type of person that makes it dangerous for borderline students.

 

[UnoMas]

I know of FIVE people, personally, who matched EM (2), academic Anesthesia (2), and Neuro this past year who all had sub 500 comlex scores for both level 1 (no usmle).

The usmle, in the grand scheme of things, isn't as dire as your view thinks.

I am going out on a limb here and say these people MUST have had something really exceptional to their apps: multiple pubs, OUTSTANDING audition rotations, connections etc. They are the exceptions not the rule. I know for sure I would be scared ****less applying to Anesthesia or EM with sub 500s score on both Levels and without a Step score. That's a recipe for a really stressful 4th year and potentially a disastrous Match week. Doesn't take much to get a decent score on the Step and it saves you so much troubles and headaches

 

[DocWinter]

Count me as an average score, no USMLE no research, average B student who matched a surgical specialty. No red flags average joe kind of deal. Also know a few with close to 600s who didn’t match going for things well within their range

I just don’t buy it

 

[UnoMas]

Nope. Just normal, hard-working, non-weirdos. I also have a personal friend who matched EM at his #1 2 years ago with a pre-clinical fail and 405 level 1 and 470 level 2. I can think of 15-20 people that I know, personally, over the last 2-3 years who match the non-usmle, didn't crush boards profile.

I also have a relative who is involved in residency rankings (won't say the field but you can PM me if you want to know more) at a pretty solidly ranked MD school (also non primary care) and they don't really care about the usmle from DO students. They care considerably more about rotating with them (as a DO).

Yeah I guess we just have to agree to disagree. I talked to quite a few academic program directors as well and they all said "highly recommended" that I have a Step 1 for their specialties. When I talk to 2nd and 3rd years I always recommend them taking the Steps as you want to set yourself up for a good, non-stressful 4th year. You don't want to stress yourself out doing 3-4 audition rotations trying to match into something that's only moderately competitive and still risk not matching. Having a step 1 score also gives you more geographical freedom, instead of matching into some place that nobody wants to live.

I am risk-adverse that way. But then again, you play the cards that you are dealt with (pre-clinical fails, board failures, etc.)

I don't doubt your personal anecdotes but I still think those are exceptions rather than the rule. For the Class of 2020, I would want to be as comparable to their MD counterparts as I could.

 

[Staphylococcus Aureus]

The interactive charting outcomes mute a lot of these arguments. You can see what % students matched by specialty with comlex only in the MD match the last three years (and no, it’s not only rural FM, and I doubt all these people had something godly about their application). That’s your best bet on gauging which specialty you’re competitive for with a 500 comlex.

 

[Rekt]

Now now, clearly the 34/44 who matched EM with a 500/550 and no usmle step 1 are living on a diff planet than rekty

So you're fine with a 1 and 4 chance in not matching? Go for it. Maybe you both should go into Derm together and start a Mohs practice.

 

[tunicaexterna]

Not going to lie, was definitely surprised at some of the suggestions as well.

However, I don’t know if everyone received the email, But they readjusted the curve on the COMLEX again. Apparently, they do it every few years - no idea why- but it took me longer than the average 4 weeks to get my score back. Still, I do know that not taking Step 1 already puts me at a huge disadvantage which is why I wanted to ask

I didn’t get this email - did they give a ballpark for the new average?

Our school’s average actually went up for level 1 (from last year) which would be weird if they readjusted the average back down.


Sent from my iPhone using SDN mobile app

 

[Stagg737]

Hey guys, so I got my COMLEX score back last month, but with the start of rotations and everything, haven't been able to process what specialties my future entails. My school's advising department isn't the best either, so I thought I'd turn to SDN for some guidance. I was wondering what specialties are still available?

You're also fine for psych if your LORs and MSPE evals are solid. Had scores will below yours and had no problems getting plenty of interviews and matching.

I am going out on a limb here and say these people MUST have had something really exceptional to their apps: multiple pubs, OUTSTANDING audition rotations, connections etc. They are the exceptions not the rule. I know for sure I would be scared ****less applying to Anesthesia or EM with sub 500s score on both Levels and without a Step score. That's a recipe for a really stressful 4th year and potentially a disastrous Match week. Doesn't take much to get a decent score on the Step and it saves you so much troubles and headaches

I think you're over-estimating how competitive those fields are. Yes, no Step score will make things harder and definitely limit options, but if OP applies broadly and is willing to go anywhere in the US then neither of those fields are off-limits at all. I know quite a few people with sub-500 COMLEX scores and no Step 1 who matched to ACGME EM with little stress. Gas is also one of the most DO friendly fields there is now. So again, not really as much of a problem as one would think so long as you've got a COMLEX>500 (only 9 people with level 1 >500 didn't match while 213 matched).

At the same time, you really only needed a 200 on Step 1 to have a very strong chance of matching gas as a DO. So unless a person shooting for gas is legit worried they'll fail then they should take Step 1. Especially since the merger will be ending soon and more PDs may shift to a USMLE-only policy.

 

[CoomassieBlue57]

So you're fine with a 1 and 4 chance in not matching? Go for it. Maybe you both should go into Derm together and start a Mohs practice.

FYI the charting outcomes are for first ranked speciality, so it’s a 1/4 chance of not matching EM, but those students may have matched FM if they ranked it below EM for example.

 

[UnoMas]

You're also fine for psych if your LORs and MSPE evals are solid. Had scores will below yours and had no problems getting plenty of interviews and matching.



I think you're over-estimating how competitive those fields are. Yes, no Step score will make things harder and definitely limit options, but if OP applies broadly and is willing to go anywhere in the US then neither of those fields are off-limits at all. I know quite a few people with sub-500 COMLEX scores and no Step 1 who matched to ACGME EM with little stress. Gas is also one of the most DO friendly fields there is now. So again, not really as much of a problem as one would think so long as you've got a COMLEX>500 (only 9 people with level 1 >500 didn't match while 213 matched).

At the same time, you really only needed a 200 on Step 1 to have a very strong chance of matching gas as a DO. So unless a person shooting for gas is legit worried they'll fail then they should take Step 1. Especially since the merger will be ending soon and more PDs may shift to a USMLE-only policy.

I would love to hear the stories of these 500 COMLEX only people who matched Anesthesiology. I know none. I must have talked to at least 30-40 attendings/residents in the past 3 years, all the DOs took Step 1 and strongly recommend that I take it, well at least at the programs that I think provide good training.

25/35 without a Step 1 score matched Anesthesiology last year, that's 71% match rate, pretty ***** if you ask me- that's Derm, Ortho, Plastics level match rate. No way to know the COMLEX scores of these guys and gals, could be 500 or 700, who knows. No way to know the quality of the kind of programs that they matched into. No way to know how many audition rotations they did as a 4th year- audition rotations are neither required nor recommended for Anesthesiology. I love Anesthesiology but I would go nuts if you asked me to do 3-4 audition rotations just to have a chance to match- it's frustrating standing there taking space not getting to be in with the action.

Looking at the NRMP statistics alone doesn't really tell you the whole story. Your quoted statistics doesn't tell you who took Step 1 and who didn't. Advising naive osteopathic medical students on how to match into a specialty that is not yours just using the match statistics is not prudent. No offense, I know you meant well. Any scenario or situation that would leave you with a sub 90% match rate is not really available to you

It's true that having a passing Step 1 score certainly helps a lot.

 

[Stagg737]

I would love to hear the stories of these 500 COMLEX only people who matched Anesthesiology. I know none. I must have talked to at least 30-40 attendings/residents in the past 3 years, all the DOs took Step 1 and strongly recommend that I take it, well at least at the programs that I think provide good training.

25/35 without a Step 1 score matched Anesthesiology last year, that's 71% match rate, pretty ***** if you ask me- that's Derm, Ortho, Plastics level match rate. No way to know the COMLEX scores of these guys and gals, could be 500 or 700, who knows. No way to know the quality of the kind of programs that they matched into. No way to know how many audition rotations they did as a 4th year- audition rotations are neither required nor recommended for Anesthesiology. I love Anesthesiology but I would go nuts if you asked me to do 3-4 audition rotations just to have a chance to match- it's frustrating standing there taking space not getting to be in with the action.

Looking at the NRMP statistics alone doesn't really tell you the whole story. Your quoted statistics doesn't tell you who took Step 1 and who didn't. Advising naive osteopathic medical students on how to match into a specialty that is not yours just using the match statistics is not prudent. No offense, I know you meant well. Any scenario or situation that would leave you with a sub 90% match rate is not really available to you

It's true that having a passing Step 1 score certainly helps a lot.

Just to be clear, I would never advise someone with a sub-500 Level 1 and no Step 1 to only apply to a field like gas as that ~70% match rate is not good. I would advise them to also apply to fields like FM or IM (mid-low tier) as back-ups as well. I'm just pointing out that if someone does have those test scores and wants gas, that they still have a fair chance at getting in, just not to hang their hat on it. I'd also add that if someone is applying to EM or gas with a 205 Step 1, they're not going to be standing a chance at any of the strong programs anyway, so having a mediocre COMLEX like 470 that PDs may not know what it means may actually be better than having a Step 1 of 200 that they know is terrible.

I'll also say that I don't advise any DO students to only take COMLEX unless they legitimately believe they will fail Step 1. Not having a Step 1 is still okay for many fields, but it seems that we're moving in the direction of "a poor Step 1 is better than no Step 1" pretty quickly, and I think that will only get worse after the merger is complete. I say this as someone who only took COMLEX (was averaging ~210 on practice USMLEs and didn't want an obviously poor score) and had no problems getting interviews or matching to my #1 in my field.

 

[drturk1]

Just to be clear, I would never advise someone with a sub-500 Level 1 and no Step 1 to only apply to a field like gas as that ~70% match rate is not good. I would advise them to also apply to fields like FM or IM (mid-low tier) as back-ups as well. I'm just pointing out that if someone does have those test scores and wants gas, that they still have a fair chance at getting in, just not to hang their hat on it. I'd also add that if someone is applying to EM or gas with a 205 Step 1, they're not going to be standing a chance at any of the strong programs anyway, so having a mediocre COMLEX like 470 that PDs may not know what it means may actually be better than having a Step 1 of 200 that they know is terrible.

I'll also say that I don't advise any DO students to only take COMLEX unless they legitimately believe they will fail Step 1. Not having a Step 1 is still okay for many fields, but it seems that we're moving in the direction of "a poor Step 1 is better than no Step 1" pretty quickly, and I think that will only get worse after the merger is complete. I say this as someone who only took COMLEX (was averaging ~210 on practice USMLEs and didn't want an obviously poor score) and had no problems getting interviews or matching to my #1 in my field.

Hey Stagg, do you mind me asking what field you went into?

I guess my overall goal of this post was to ask wha specialties are reasonable for me to apply to; seeing Gas on there, I was definitely suspicious and agree with what UnoMas was saying about most programs wanting Step 1. At this point, I'm just trying to see which I could match into - I already know I wasn't competitive for surgical subspecialties obviously with Step, derm, gen surg, rads, and gas. And I understand that I will need to apply to mainly past AOA programs, but I was just curious regarding specialties like Psych, PMR, and EM.

For the most part, I've always thought about IM, specifically becoming a hospitalist. I'm just curious, however, how many options I do have. Thank you

 

[Black Coffee 24/7]

Hey Stagg, do you mind me asking what field you went into?

I guess my overall goal of this post was to ask wha specialties are reasonable for me to apply to; seeing Gas on there, I was definitely suspicious and agree with what UnoMas was saying about most programs wanting Step 1. At this point, I'm just trying to see which I could match into - I already know I wasn't competitive for surgical subspecialties obviously with Step, derm, gen surg, rads, and gas. And I understand that I will need to apply to mainly past AOA programs, but I was just curious regarding specialties like Psych, PMR, and EM.

For the most part, I've always thought about IM, specifically becoming a hospitalist. I'm just curious, however, how many options I do have. Thank you

Stagg went to Psych

But regarding PMR, EM, and Psy, here are your chances based on my research:

Psych: not very good in the current environment
PMR: solid chances assuming with great MSPE and LORs; 2-3 away rotations here
EM: solid chances assuming with great MSPE, LORs, and SLOE; need to get at least average to above average Comlex 2 here

 

[AlbinoHawk DO]

Am I living on a different planet? Some of these suggestions for OP are ridiculous. I'd say you can match FM, community IM, and Peds if you have the personality. That's about it.

Apparently you are living in a different planet. Programs in Pathology, Child Neuro, Adult Neuro and I'd even go as far as saying low-tier Anesthesia are not very competitive as a whole. This is not to say you'll be matching at a high ranked program like Mayo, but there are plenty of residencies in undesirable locations. I'd say PMR and EM would require a lot of work, but I wouldn't discount them entirely. With auditions, I don't think OP will be restricted to only FM, community IM or Peds.

 

[Rekt]

Apparently you are living in a different planet. Programs in Pathology, Child Neuro, Adult Neuro and I'd even go as far as saying low-tier Anesthesia are not very competitive as a whole. This is not to say you'll be matching at a high ranked program like Mayo, but there are plenty of residencies in undesirable locations. I'd say PMR and EM would require a lot of work, but I wouldn't discount them entirely. With auditions, I don't think OP will be restricted to only FM, community IM or Peds.

To each is their own I suppose. Everyone has their own level of risk they'll take.

Speaking from an EM standpoint. Comlex alone at that level would be a significant barrier to landing aways and thus, any meaningful SLOEs, making it very difficult to match. And since we're all dumping anecdotes, a lot of my friends are doing gas and nearly all of the programs they have talked to and rotated at said they very strongly prefer DO applicants to have both Step 1 and 2.

 

[Stagg737]

Hey Stagg, do you m

ind me asking what field you went into?

I guess my overall goal of this post was to ask wha specialties are reasonable for me to apply to; seeing Gas on there, I was definitely suspicious and agree with what UnoMas was saying about most programs wanting Step 1. At this point, I'm just trying to see which I could match into - I already know I wasn't competitive for surgical subspecialties obviously with Step, derm, gen surg, rads, and gas. And I understand that I will need to apply to mainly past AOA programs, but I was just curious regarding specialties like Psych, PMR, and EM.

For the most part, I've always thought about IM, specifically becoming a hospitalist. I'm just curious, however, how many options I do have. Thank you

Stagg went to Psych

But regarding PMR, EM, and Psy, here are your chances based on my research:

Psych: not very good in the current environment
PMR: solid chances assuming with great MSPE and LORs; 2-3 away rotations here
EM: solid chances assuming with great MSPE, LORs, and SLOE; need to get at least average to above average Comlex 2 here

I'm psych.

I think you've got a shot at all of those field and slightly disagree with black coffee.

Psych your odds are still pretty good. In my class 25 people applied for psych and 22 matched psych, 1 matched IM, 1 scrambled into a TRI and 1 went unmatched (for reasons other than not having Step). I'd say about half of those people (including myself), did not take Step. More and more programs are looking for USMLE scores now, and a few more are requiring it as an easier way to cut down the massive and growing applicant pool, but it's still a very valid option and likely will be for the next 2-3 years.

PMR may be a little harder. It's not the easy field that you could just walk into 5 years ago and my PMR attendings said they don't recommend people with scores below 220 apply without also applying to back-up fields. I'm honestly not sure what their views on no USMLE are, but it's now a more competitive field than people realize.

Agree on EM. Definitely obtainable for DOs without Step scores if they're solid applicants. EM and gas are actually 2 of the most DO friendly specialties on the ACGME side and for EM as long as you have solid SLOEs it seems like not having a Step score is overlooked at many programs according to my EM attendings and friends who matched in EM.

If you don't have a Step score, you're almost certain not going to be considered at elite or top tier programs in any field, but it is still very reasonable to expect to match in many if you apply broadly and to the right programs.

Edit: The key is applying smart and really doing your research on where you actually stand a chance. Look at regional programs, programs that commonly take DOs, and especially programs that have matched people from your school before. Knowing how your limited and applying to as many places where those limits don't exist or are forgiven is essential to a successful match cycle imo. Also knowing what's important to PDs in those fields and making sure those are a strength will benefit you massively (for example psych values LORs and MSPE attending evals above all during pre-interview season).

 

[073116]

Hey guys, so I got my COMLEX score back last month, but with the start of rotations and everything, haven't been able to process what specialties my future entails. My school's advising department isn't the best either, so I thought I'd turn to SDN for some guidance. I was wondering what specialties are still available?

Pretty much everything. Don't listen to stock sdn agenda - remember that 99% of people here are acne ridden idiots (same pre-med mentality profanes living on a ramen who still live with parents to save money lol and who get angry for $50 worth of nbme while paying $300k for education lmao) - specifically for mods I'm stating that this is not a bad word or offense but rather a Latin proverb (from Latin: idiota - meaning without a clue) and a scientific opinion or description of a disease if you like.
PM me if you want real world examples of DO graduates matching to derm etc. or DO graduates who failed comlex several times and still matched to pmnr (their first choice place/residency btw). I have plenty of them. Mostly East Coast, but I guess it's still same thing across US.