D.O. student interest in psychiatry

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Hello all; Rising 3rd year osteopathic student with a lot of interest in the field of psychiatry, particularly maybe a fellowship in Child and Adolescent. Currently wondering is COMLEX really sufficient, or are programs generally requiring USMLE as well (I do recognize on program websites, it is stated as USMLE or COMLEX; but does that reflect the reality)? Geographically, i am hoping somewhere in the southeast, southwest maybe midwest.
 
I'm a DO student and I took Step 1 and I'm also taking Step 2. PDs appreciate those who do so. You want to make the PDs happy.
 
USMLE helps. Even programs that say one or the other, like to see USMLE. With all of the hyper applying, even small differences are used to decide who gets invited to interview. You probably will get in without USMLE if you are very much against taking it, but spending a day and the money is still small compared to the 4 years of education you are paying for. Don't be penny wise and pound foolish.
 
If you think you will fail, strongly consider changing careers. It only becomes more challenging and passing step II isn't a very high bar. It has a 98% pass rate. Not taking it says you identify yourself as being in the bottom 2%. As much as everyone is equal, when it comes to hard numbers, some are more equal than others. What ever anyone says, this is a competition. How programs value schools, scores, and heart varies, but all three are always in play.
 
MacDonaldTriad said:
If you think you will fail, strongly consider changing careers. It only becomes more challenging and passing step II isn't a very high bar. It has a 98% pass rate. Not taking it says you identify yourself as being in the bottom 2%. As much as everyone is equal, when it comes to hard numbers, some are more equal than others. What ever anyone says, this is a competition. How programs value schools, scores, and heart varies, but all three are always in play.
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Not to be nitpicking because your point still stands, but as an interesting side note: 92% and 90% for step 2 CK and CS respectively for first time takers getting a D.O. According to the USMLE data set for 2014-15.
 
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MacDonaldTriad said:
prospective DO applicants should take note of the above. Objective data is objective.
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I agree with everything you have said. I am taking both. However, if we take both and perform as well or better than our counterparts, then we should be viewed as equals (or superior in the latter case) in terms of medical knowledge. It pisses me off when people say well you're a DO so your 240 is now a 230. No. My 240 is a 240.
 
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postbacpremed87 said:
I agree with everything you have said. I am taking both. However, if we take both and perform as well or better than our counterparts, then we should be viewed as equals (or superior in the latter case) in terms of medical knowledge. It pisses me off when people say well you're a DO so your 240 is now a 230. No. My 240 is a 240.
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I would agree with everything you have said. Objectively, a 230 is a 230 and a 240 is a 240, and sometimes 260s can be miserably bad doctors.
 
Do program directors even care about step 2 scores? I mean unless you fail or totally blow it out of the water.
 
ChiTownBHawks said:
46 DO students took the CS last year.. 46... Don't you think the CS plug is *slightly* misleading?

O, it's 94% for CK, not 92. FYI.

United States Medical Licensing Examination | Performance Data
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I had the numbers correct but realized I was looking at the 2014-15 data, sorry.

I agree about the n=46 point. However, I was not interpreting the data so much as just straightening out that DO students had passed at 92 and 90% for CK and CS respectively. The correct numbers for 2016 included 94% and 91% for 2015-16. Sorry all, that's what I get for trying to be resourceful and do some data digging 🙂
 
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MacDonaldTriad said:
If you think you will fail, strongly consider changing careers. It only becomes more challenging and passing step II isn't a very high bar. It has a 98% pass rate. Not taking it says you identify yourself as being in the bottom 2%. As much as everyone is equal, when it comes to hard numbers, some are more equal than others. What ever anyone says, this is a competition. How programs value schools, scores, and heart varies, but all three are always in play.
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I didn't take it. Probably would have passed, but my NBME scores were close enough to the cutoff to give me pause. Focused on COMLEX, got a decent score and a reasonable number of ACGME interviews. Although I ended up matching to an AOA program, several friends who didn't take the USMLE did end up matching to ACGME psychiatry. If you're not shooting for a competitive program, USMLE is still not necessary for DOs to match into psychiatry. Maybe that will change in the future, but it wasn't true for 2017.
Telling people to consider dropping out of medical school because they decided not to take a test that isn't actually required is bad advice.
 
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Taking step 2 or not wasn't my point. If I new I was in the bottom 2% of medical students, I would question my ability to practice medicine safely. There are a few hard stops in the educational process, licensing exams are one of them, but there aren't very many such stops. Once accepted, most everyone gets through.
 
MacDonaldTriad said:
Taking step 2 or not wasn't my point. If I new I was in the bottom 2% of medical students, I would question my ability to practice medicine safely. There are a few hard stops in the educational process, licensing exams are one of them, but there aren't very many such stops. Once accepted, most everyone gets through.
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Where do you get the idea that the bottom 2% of medical students (as determined by an optional multiple-choice exam) are unable to practice medicine safely? Why not the bottom 1% or the bottom 20%?
 
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I think more significant is the suggestion that if you think you'd fail [which OP didn't mention], then consider another career. I'd be curious what the actual correlation is between thinking you're going to fail and failing. I suppose I could give it a shot on my high functioning anxious patients by helping facilitate their catastrophizing. One thing is certain: if someone is willing to take their track record of success (getting in to medical school and passing the first two years) and toss that aside for another career because that's what's recommended if you think you might fail, then that person absolutely lacks enough sound judgment to practice medicine.
 
Another reason to take Step 2 is that your interview season will be less stressful. I'm willing to trade 8 hours of clicking answers for having more options this fall. I'm just a silly non-traditional 4th year DO student but I guarantee you taking Step 2 will make this fall less stressful.
 
If a program is truly DO friendly, then COMLEX is sufficient. Although a good USMLE score will help your application.
 
st2205 said:
I think more significant is the suggestion that if you think you'd fail [which OP didn't mention], then consider another career. I'd be curious what the actual correlation is between thinking you're going to fail and failing. I suppose I could give it a shot on my high functioning anxious patients by helping facilitate their catastrophizing. One thing is certain: if someone is willing to take their track record of success (getting in to medical school and passing the first two years) and toss that aside for another career because that's what's recommended if you think you might fail, then that person absolutely lacks enough sound judgment to practice medicine.
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The other dimension of course is that DOs need to take an entire different series of exams with their own quirks and issues. If it were as simple as saying that DOs are avoiding USMLE because it is perceived to be harder or they're afraid they'll fail it'd be completely different. They need to pass a different exam series and thus need to worry about passing or failing both.
 
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postbacpremed87 said:
Another reason to take Step 2 is that your interview season will be less stressful. I'm willing to trade 8 hours of clicking answers for having more options this fall. I'm just a silly non-traditional 4th year DO student but I guarantee you taking Step 2 will make this fall less stressful.
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You are correct.
 
Partial highjacking-

So I took both tests and did great on USMLE step 1 (33%tile) and excellent on COMLEX level 1 (5%tile). I'm applying to Fm-Psych and Im-Psych programs most of which have had a D.O or two over the years (UPMC, UCSD, Iowa, Cinci, Emory, MUSC, to name a few) . I am absolutely thrilled with both of my scores but fear that the average PD will not be as familiar with COMLEX and will overlook the score and just use the USMLE given it is the great equalizer. When all is said and done I feel like I am at least in the running with my USMLE score but would love to have the COMLEX push me over the edge if it can. Thoughts?
 
Personally, I don't have the first clue as to the differences in USMLE vs COMLEX or how the contents vary and by how much. I'm afraid the majority of our applicants have USMLE, generally we look at USMLE to compare you to other applicants. I suppose if the particular person you are up against has both and you rock COMLEX with similar USMLEs, it could be different. Not to conflate the earlier topic too much, but not having step II could be more of a deal killer than not having USMLE, particularly if there are any other concerns about academic performance.
 
MacDonaldTriad said:
Personally, I don't have the first clue as to the differences in USMLE vs COMLEX or how the contents vary and by how much. I'm afraid the majority of our applicants have USMLE, generally we look at USMLE to compare you to other applicants. I suppose if the particular person you are up against has both and you rock COMLEX with similar USMLEs, it could be different. Not to conflate the earlier topic too much, but not having step II could be more of a deal killer than not having USMLE, particularly if there are any other concerns about academic performance.
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Not to hijack, but how do you process a student with a disparity between comlex and usmle? Say a 450 in comlex and a 225+ in usmle? Do you just choose to ignore the comlex entirely the moment you see a usmle score?
 
Drrrrrr. Celty said:
Not to hijack, but how do you process a student with a disparity between comlex and usmle? Say a 450 in comlex and a 225+ in usmle? Do you just choose to ignore the comlex entirely the moment you see a usmle score?
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NO worries I would not say that was a hijack at all you essentially asked the same question and I did... "if you have both scores does COMLEX even matter." According to MacDonaldTriad its probably somewhere more on the side of USMLE is really what they will be looking at. MacDonald is that a safe roundup of what you said?
 
medhead1990 said:
NO worries I would not say that was a hijack at all you essentially asked the same question and I did... "if you have both scores does COMLEX even matter." According to MacDonaldTriad its probably somewhere more on the side of USMLE is really what they will be looking at. MacDonald is that a safe roundup of what you said?
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lol, I'm so brain dead from boards I didn't even notice that they were similar haha
 
This is a good question because a disparity between USMLE and COMLEX could speak to just a lot of variability in either performance, or computer tests validity in general. Frequently there are people who fail a step and then pass with a comment like "I was in a bad relationship, or a relative died, or I should have studied more for this but my MBA course was rough". We are asked to accept this explanation, so if these are valid explanations, we should ignore a discrepancy. I don't speak for all directors or at least shouldn't so much, but either through laziness or just the reasoning that no one accidentally kills a step, if you have done well at least once on a step, you probably successfully learned the material.
You could extrapolate this into failing a rotation and then remediating it, but this is a bigger deal. Particularly if the concerns were professionalism or communication. These aren't covered well on tests, although if someone has something it would be worth money.
 
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MacDonaldTriad said:
This is a good question because a disparity between USMLE and COMLEX could speak to just a lot of variability in either performance, or computer tests validity in general. Frequently there are people who fail a step and then pass with a comment like "I was in a bad relationship, or a relative died, or I should have studied more for this but my MBA course was rough". We are asked to accept this explanation, so if these are valid explanations, we should ignore a discrepancy. I don't speak for all directors or at least shouldn't so much, but either through laziness or just the reasoning that no one accidentally kills a step, if you have done well at least once on a step, you probably successfully learned the material.
You could extrapolate this into failing a rotation and then remediating it, but this is a bigger deal. Particularly if the concerns were professionalism or communication. These aren't covered well on tests, although if someone has something it would be worth money.
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As usual great advice. Thanks for the input Mickie-D's-3's!
 
postbacpremed87 said:
However, if we take both and perform as well or better than our counterparts, then we should be viewed as equals (or superior in the latter case) in terms of medical knowledge. It pisses me off when people say well you're a DO so your 240 is now a 230. No. My 240 is a 240.
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People have that opinion because very few people choose DO schools. A few years ago I saw they surveyed DO students and over 90% said they would have chosen MD if they had been accepted. Also DO schools do themselves no favors by having such large class sizes. It gives the appearance of being a doctor mill.
None of that is to say that individuals shouldn't be judged individually.
 
Someone should study the 10% who choose to be discriminated against in the post graduate education process.
 
MacDonaldTriad said:
Someone should study the 10% who choose to be discriminated against in the post graduate education process.
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That would be an interesting study. I would consider myself part of that demographic, I was what I considered a mid-tier/upper mid-tier MD applicant and ended up going to a DO school because it was the cheapest option for me and I knew I wanted to do a primary care specialty (fm or psych). I did not apply to any school that would have tuition over 30k a year or a high cost of living. It significantly limited our options but I really could care less about prestige.
 
I have no information about the relative cost of DO vs MD. As long as you get to where you want to be, power to you.
 
As a DO who scored 239 on Step 1 and took Step 2 CK, what score are you looking for on CK? Would a candidate who took Step 2 and maintained at 239 be ranked higher to get an interview than a candidate who didn't take Step 2 at all?
 
postbacpremed87 said:
As a DO who scored 239 on Step 1 and took Step 2 CK, what score are you looking for on CK? Would a candidate who took Step 2 and maintained at 239 be ranked higher to get an interview than a candidate who didn't take Step 2 at all?
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A score that is 20 points lower than the one you'll get is good enough 😉
 
postbacpremed87 said:
As a DO who scored 239 on Step 1 and took Step 2 CK, what score are you looking for on CK? Would a candidate who took Step 2 and maintained at 239 be ranked higher to get an interview than a candidate who didn't take Step 2 at all?
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Yes, maybe I'm not understanding the question, but Of Course is all I can say. How would anyone even begin to argue the other side? Maybe I'm missing something?
 
MacDonaldTriad said:
Yes, maybe I'm not understanding the question, but Of Course is all I can say. How would anyone even begin to argue the other side? Maybe I'm missing something?
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239 on step2 is a lower percentile than 239 on step1. Therefore, getting the same score on CK would reflect a drop in performance from step1. The above poster was wondering if he endures such a drop in performance, would that have more negative effect on his application than not having a step2 score at all?
 
OK, a 239 on step 2 is a little less impressive than a 239 on step 1, but it means you will graduate and you will be able to start work if we put you on our rank list. Anything passing is better than not having step 2 in my opinion.
 
MacDonaldTriad said:
OK, a 239 on step 2 is a little less impressive than a 239 on step 1, but it means you will graduate and you will be able to start work if we put you on our rank list. Anything passing is better than not having step 2 in my opinion.
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How many times do we get to repeat this sage advice between now and February 16th?
 
I'm sure this discussion would take everyone aback if it were on derm or ortho. Most applicants have step 2, if you don't, it says you didn't get your act together like most everyone else did. OPD and I have had medical students argue with us about this, but post graduates agree with us. Even if OPD and I are wrong about this, our beliefs makes us right by definition and we are in good company if you ask PDs.
 
MacDonaldTriad said:
OK, a 239 on step 2 is a little less impressive than a 239 on step 1, but it means you will graduate and you will be able to start work if we put you on our rank list. Anything passing is better than not having step 2 in my opinion.
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OldPsychDoc said:
How many times do we get to repeat this sage advice between now and February 16th?
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So just to be clear, even a sub-200 Step 2 would be considered better than not taking it (and only taking COMLEX)? I'm just curious because more than a few attendings including 2 PDs (ACGME) told me that unless I felt confident I could hit at least 210 I shouldn't take it. I'm just confused because I've gotten very different advice from different attendings and PDs in the field, and with the things I've heard about the last match's standards for psych I've been getting nervous about fourth year and the match.
 
Stagg737 said:
So just to be clear, even a sub-200 Step 2 would be considered better than not taking it (and only taking COMLEX)? I'm just curious because more than a few attendings including 2 PDs (ACGME) told me that unless I felt confident I could hit at least 210 I shouldn't take it. I'm just confused because I've gotten very different advice from different attendings and PDs in the field, and with the things I've heard about the last match's standards for psych I've been getting nervous about fourth year and the match.
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I think something to be cleared here. DO's don't need USMLE for graduation. DO's are required to take COMLEX. Not until recently, DO students didn't bother taking the USMLE unless they were applying for competitive specialties.
 
Ibn Alnafis MD said:
I think something to be cleared here. DO's don't need USMLE for graduation. DO's are required to take COMLEX. Not until recently, DO students didn't bother taking the USMLE unless they were applying for competitive specialties.
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I realize this. The attendings/PDs I talked to were within the past year.


splik said:
If you got less than 209 you would fail...
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Didn't realize passing for CK was 210. I assumed passing for Step 1 and CK were the same (192), I guess that clears that up...
 
Honestly if a program is DO unfriendly it won't matter what your USMLE score is. The majority of the southeast and Midwest psychiatry programs are quite DO friendly, COMLEX alone is quite sufficient. You're probably going to run into the most trouble with the southwest (really just California)
 
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