COMLEX/USMLE

[Arch Guillotti]

I am a second year DO student trying to prepare for Step I of the boards (aka "hell"). I am interested in pursuing an allopathic ER residency or anesthesiology - east coast preferably southeast, though at this point it is all subject to change. As such, since these are both moderately "competitive" fields, I am planning on taking the USMLE in addition to the COMLEX, though I just cannot bring myself to sign up for the USMLE just quite yet. Does anyone else have this problem. Unsure of whether or not to take the USMLE? I figure that it is better to take it and get it out of the way than find out I should have taken it, somewhere on down the line. Unfortunately I feel like I am rolling the dice and I could end up screwing myself over. yes I know that both tests are supposedly equally hard - but there is the burnout factor of taking the USMLE 1 after 1 day of rest following the COMLEX. Also I just have a nagging fear that I will bomb it. I have the same fear, but not as strong for the COMLEX. I didn't do that great on the MCAT (26) but I am doing fine in medical school, in the top 40% of my class.

My main question is what the deal is with Steps 2 and 3, assuming that I take USMLE Step I and enter an allopathic residency. Do you automatically take Step II in medical school? Is Step 3 up to the residency program? Is it necessary to take it since you already have to take the COMLEX (I assume).

Now I am damn near certain that I am not gonna flunk either exam, but what if you bomb the USMLE as a DO student. Is there any recourse? Seems like you could apply for a DO residency and it would never come up. Are your scores automatically released to the programs or do you do it yourself? For instance, what if someone did well on the COMLEX but bombed the USMLE? What to do then? I realize that all of this is a little shady and that the bottom line is that everybody is gonna see all your scores no matter what.

Finally, I know the two tests are written differently - the USMLE is very detailed but vignette oriented (at least from the sample questions) and the COMLEX is supposedly more starightforward minutiae. I don't really believe that allopathic/osteopathic students are taught specifically to take their respective boards (hence, as some would say, lies the discrepancy in DO scores who take the USMLE). I have heard that you should prepare for the two tests differently since they are written differently. But how? Basic medical science is basic medical science, right? And the only content difference is the OMT stuff and question style, correct? So maybe doing practice questions for each one is the best way to tease out the diffrences. FWIW, I am not planning on taking a review course since I am a self directed studier. I plan on using First Aid, BRS path/phys, ridiculous micro, savarese, and high yield neuro, step up and lippincotts if time permits. Also I paln on doing as much of qbank as I can.

TIA

Arch Guillotti

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[Freeeedom!]

I took both the USMLE and the COMLEX steps 1 and 2. Here is my input regarding your ordeal.

Take USMLE step 1 and do WELL. Especially for EM, you should aim for at least 205-215 range. Then for your COMLEX aim for the mid to high 80's.
Don't take the step 2 of the USMLE because you simply will not need to! But of course you must take all 3 of the COMLEX steps. The USMLE gets you in the door and the COMLEX reassures them that you are a quality candidate!

The USMLE is different, but the only difference in studying that you will have to do is to study for OMT for the COMLEX...there isn't a good way to seperate the tests. Really, just do a thousand practice questions and study like a hound!

 

[doughboy]

I had that very same dilemma about taking both exams. I signed up for the USMLE but I ended up not taking it because I ended having surgery and IM my first blocks of rotations and I didn't want to do bad on the USMLE. If you do decide to take the USMLE then you have to do well on it. If you are interested in allopathic programs than that is a necessity. Do better on the USMLE than the COMLEX. Some people in my school told me I didn't need the USMLE and that programs would look at my COMLEX but that is not the case. I wasn't really sure what residency I was going to pursue either so that was another reason I decided to postpone the USMLE. Plus I got my COMLEX scores back and I kicked ass on it. So then time goes by and fourth year rolls around and I've decided to go allopathic OBGYN and now I find out that most programs want to see you take the USMLE so they can compare you. So I signed up again to take the USMLE and I'll tell you its a difficult task to restudy all that crap again. Plus, you're tired too. So I did decent on USMLE but not nearly as well as I would have done had I taken it with my COMLEX. No matter what I think you should take the two exams at the most one month apart. The material is basically the same. Plus, the OMM on the COMLEX is really basic and they test on principles and not techniques. Nothing to worry about unless you're a OMM *****. They only thing is that I don't know what its like for allopathic ER. Most of my friends went into the DO ER programs with ease. Your best bet is to find a DO that went into the allopathic programs or you can call the program directors of the programs you are interested in and ask them what they prefer. Most will give you an honest answer. At a couple of my interviews the doctors asked me what COMLEX is so don't think that everyone knows it or even cares about it. I think most programs use a cut off system when inviting you for interviews and so that board score is important. A big thing is that you can have the USMLE scores not be reported to your school and so they won't have record of it if you decide that you really bombed it. You have to write a letter regarding this before you take the exam so be prepared. Plus, both exams are graded on a curve so even though you don't think you did well you could end up with a good score. There were several people in my class who took USMLE step 1 during our fourth year because we realized how important and advantageous it was when we applied to allopathic programs. Plus, we found out a lot of DO programs suck and there were too few spots in the ones we wanted so of course we looked toward the MD programs. But then again, ER is a whole different field than what I am going into.

 

[Freeeedom!]

Doughboy and I agree, and since I am matching EM in an allopathic residency...listen carefully to what I say. Take both exams very close to each other ( I took them 2 days apart and did NOT STUDY OMT until 2 days before the exam).
Remember, the USMLE helps get you into the door and that is all. (and by that, I mean interviews).
I should also stress the point that doughboy made, if you choose to NOT report your USMLE scores, then that is also an option...but only an option of last resort. The USMLE step 2, unless you scored 210 or so, should not be taken, most allopathic students wait till march or so before they take it anyway (after interviews).

By the way, do an Allopathic EM residency. Yes, it is terribly competative and you will find yourself interviewing with people from Vandy to Brown (as I have). But DO residencies in EM are not at good EM hospitals and simply of lower quality...for many reasons.

 

[gasrx]

I agree with most of Freeedom's post except that if you do well on Step 1, definately take Step 2. Take Step 2 in October/Nov., if you do well it will help when it comes to ranking you for a program. I definately worked that way for me. Hopkins even asked me if I plan on taking step 2. I would also try to for a score >225 ( or >90), because the mean is 210. You want to beat the mean. For anesthesia this year some programs cut off for interviews were 230. I don't plan on taking step 3 because that is only to get your medical license. Good luck

 

[drusso]

I took both USMLE step I and II and did well on both. It's not that big of deal. Studying for the COMLEX will prepare you for studying for the USMLE because the material overlaps tremendously. Yes, it's kind of a pain in the butt to study for two sets of boards, but there are residency directors out there who prefer DO students to have both the USMLE and COMLEX. This might change in the future as residency directors become more familiar with the COMLEX, but for now you're best served taking both. It's really not that big of a deal. Just do it.

P.S.: I will likely NOT take step USMLE Step III because it's taken after the first year of residency and by that time residency programs could care less which exam you take as it is only licensing issue and not a academic selection process any more.

 

[Freeeedom!]

Let me clarify some of my statements, and then give justifications.
USMLE step 2...IS NOT NECESSARY for interviews. Sure I took it, but ALL of my MD counterparts were taking it AFTER the match, therefore it makes NO sense to take it. Sure, if you take it and do great, then it is a big plus for you, but if you don't take it...then you are no different than 80% of other interviewees. It certainly is not necessary for licensure.
Scores ranging from 205-215 can get you into the door WITH an accompanying 85% on the COMLEX. That is solid. You can always aim high, but I wanted to give you an easy minimum.
Once you are in the door, you must nail your interview...it is all personality at that point, and they don't want to work with a jerk. Buy Isserson's guide, and get ready to write thank you cards!!

Anyway, good luck with school, and good luck to everyone in their residency.
Merry Christmas
Capt. Freedom

 

[Arch Guillotti]

Thank you all for your very helpful and constructive replies. I am going to take the USMLE and give it my best shot. I don't know why Step I of the boards freaks me out so much because I am a pretty good student, and although I am not the most effective studier I am confident that I can stick to the study schedule I have laid out.

Part of my hesitation to take the USMLE comes from the old DO party line - that if a residency doesn't like the COMLEX (COMLEX discrimination) then I should be slighted in some why and shouldn't want to match there. There is also a DO "urban legend" I have heard circulating - that a DO applicant was asked by several allopathic programs to take the USMLE and he refused - but got in all the programs anyway. I refuse to toe these lines.

I know that I want a residency at an academic medical center or large teaching hospital in the Southeast - DO residencies obviously do not fulfill the geographic requirement nor do they offer equivalent educational/instructional/clinical opportunities - no matter what propaganda DO schools and the AOA spew forth.

 

[pags]

Take the USMLE. Don't be one of those DO's that wished that they took the USMLE. You will never, ever be more prepared than right now regarding these exams. Don't miss this opportunity. Yea, it's another test day and $$$, but it can open more doors for you come interview time. If you are a good test taker, don't worry, you will not bomb it. I'm sure you study well and work hard, because that's all it really takes to post a good score. Most people who perform well on the COMLEX also do well on the USLME. By the way, I do think the different style of questioning in each exam transends into osteopathic vs. allopathic school exam styles.

 

[doc2003]

I'm a DO student who took the COMLEX I already. I am taking the USMLE early in 2002. I will only take step I of the USMLE. In anesthesiology (which is becoming more competitive) and in ER (which is already very competitive) it is nearly a must so that program directors can compare all of the applicants who did NOT have a chance to rotate through the department.

 

[ATS]

It is imperative to take the USMLE to obtain any competitive allopathic residency position. Even if you want something like IM, you'll need high USMLE scores to get into your top programs. Take USMLE steps 1 and 2 to keep all your options open. USMLE and COMLEX are very similar tests. If you study for one, you'll be prepared for both. Your scores will be similar for the two exams. However, program directors will know how to interpret the USMLE scores (unlike, the COMLEX- most allopathic program directors have no clue what it is) and will be able to compare you to other applicants. You'll be on a more level playing field with your allopathic colleagues. By not taking USMLE 1 and 2, you simply give allopathic program directors another reason not to take you into their program.

 

[Freeeedom!]

People aren't reading previous posts...especially about interviews and USMLE step 2.