DO, apply to ophthalmology?

[12glaucoma34]

Been reading SDN for a while and usually can find answer with search, but nothing close to my circumstances.

About six weeks ago, I completed a four week ophthalmology rotation and it was awesome. I wasn't sure if I wanted to do it, but definitely liked it a lot. The more I think about it, the more I like it. Anyways, here is my question? Is it too late to apply or should I bother based on the information to follow:

DO student with COMLEX Level 1 and Level 2 both between 750 and 800. Similarly, my class rank and GPA match the quality of my COMLEX. Honors in every third year rotation. USMLE Step 1, didn't take. Given the lateness of my decision to possibly pursue this as a career option, I don't have time to set up additional rotations before the SF match in January so all I could do I apply with what I have done to this point.

Here are some other details, I really like another specialty (no reason to name specifically) and I'm undecided about which I like better. I'm just running out of time....I wish there was more time between required 3rd year rotations and decision time if y'll know what I mean. I feel like I'd be equally happy in either at this point. The unique thing about ophthalmology is the SF match being in January is I could go unmatched and still do the match in March for the other specialty I like. It doesn't seem that expensive to apply to the SF match and see what happens, but if I have no shot I don't want to do it. I was thinking maybe apply to 10-20 ophthalmology programs and hope for the best ($200-300).

Any insight from those with actual perspective into this field is greatly appreciated. No input needed from premeds. And yes, I know, if I wanted to do ophthalmology I should have taken USMLE. The USMLE ship has sailed, but you can still mention it if it makes you sleep better tonight. Also, any specific programs who might consider my application would be helpful.

Gracious

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[DrfluffyMD]

Not sure if there is any optho program take COMLEX but then again I am not an optho guy. Are there DO optho programs?

 

[Jjanbieh]

Not sure if there is any optho program take COMLEX but then again I am not an optho guy. Are there DO optho programs?

In 2012 there were 11 ophtho spots available in the AOA match, not sure how many increased over the years but can't imagine many. It's a guarantee everyone had top scores so I'm guessing audition rotations and letters and research put you over the top.

 

[12glaucoma34]

Not sure if there is any optho program take COMLEX but then again I am not an optho guy. Are there DO optho programs?

PCOM has an ophthalmology program. Their website says to send them the application directly to them. I'm not sure if osteopathic programs participate in the SF match.

 

[12glaucoma34]

In 2012 there were 11 ophtho spots available in the AOA match, not sure how many increased over the years but can't imagine many. It's a guarantee everyone had top scores so I'm guessing audition rotations and letters and research put you over the top.

In the DO world, audition rotations are a big deal (MD doesn't really have audition rotations from my understanding). Since I won't have done any, I don't think applying to DO programs will give me an advantage.

 

[DrfluffyMD]

In the DO world, audition rotations are a big deal (MD doesn't really have audition rotations from my understanding). Since I won't have done any, I don't think applying to DO programs will give me an advantage.

Like I said, not sure if there are any ACGME optho programs take COMLEX or whether your score is interpretable for them.

My community ACGME radiology program director told me that he doesn't care about a 800 comlex if there isn't a USMLE, and that's in something a lot less competitive than optho. It's about the inability to compare candidates.

 

[12glaucoma34]

I think the biggest overlying question is in regards to USMLE. Does my lack of USMLE effectively shut the door to ophthalmology or is there still a chance? I can live with either because I really like another specialty too.

Additionally, I can't find an answer to program websites or anywhere else online.

 

[Lexdiamondz]

I think the biggest overlying question is in regards to USMLE. Does my lack of USMLE effectively shut the door to ophthalmology or is there still a chance? I can live with either because I really like another specialty too.

Additionally, I can't find an answer to program websites or anywhere else online.

Realistically, ACGME optho is very competitive, with the Step 1 average being around 245, and without a Step 1 score at all your chances of matching are effectively zero. People in the ACGME world generally give less weight to COMLEX scores and competitive specialties in particular generally don't give a **** about them at all, so your only shot for Optho is to try and match at an AOA residency. Sorry dude.

 

[12glaucoma34]

Like I said, not sure if there are any ACGME optho programs take COMLEX or whether your score is interpretable for them.

My community ACGME radiology program director told me that he doesn't care about a 800 comlex if there isn't a USMLE, and that's in something a lot less competitive than optho. It's about the inability to compare candidates.

Point understood and don't disagree. I have also talked to a program director for surgery who stated he can overlook no USMLE with a "stellar" COMLEX only. Not sure how many program directors would think this way, I'm sure they are in the minority.

Obviously from my COMLEX, my USMLE would have been stellar too. It is just a matter of a program director being willing to accept that scoring two standard deviations above the mean on COMLEX is going to translate to at least a 85-90th percentile on USMLE too.

 

[12glaucoma34]

Realistically, ACGME optho is very competitive, with the Step 1 average being around 245, and without a Step 1 score at all your chances of matching are effectively zero. People in the ACGME world generally give less weight to COMLEX scores and competitive specialties in particular generally don't give a **** about them at all, so your only shot for Optho is to try and match at an AOA residency. Sorry dude.

Does AOA ophthalmology participate in the SF match? If not, it gives me more time to find an audition rotation and get a LOR from an ophthalmologist.

 

[DrfluffyMD]

Obviously from my COMLEX, my USMLE would have been stellar too. It is just a matter of a program director being willing to accept that scoring two standard deviations above the mean on COMLEX is going to translate to at least a 85-90th percentile on USMLE too.

Not so. They are two different exams testing two entirely different populations. Just because you were two standard deviations above the mean on COMLEX absolutely does not mean you'll achieve the same on USMLE.

Don't trust me? The prevailing conversion formula that many PDs use put a 750 comlex 1 at 247, roughly 2 points above the optho average.

Source: How to Predict USMLE Scores From COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs | The Journal of the American Osteopathic Association

 

[ERDOC555]

My thoughts:

1. AOA Residencies are going extinct. Not sure how many optho ones are left right now, but by 2020 there should be 0, as they will have all merged with ACGME. It may be worth your time to look at the few remaining ones and see if any will be available to you.
2. A perfect D.O. applicant with crazy step and research, MIGHT be able to match an ACGME ophto spot. Very challenging and unlikely but theoretically possible.
3. I could be mistaken, but I thought you needed a step 1 score to match into ACGME residency. I also thought all MDs have to complete Steps 1, 2, and 3. Even if this isn't required for some reason, I couldn't imagine many PDs interviewing someone without a step 1.

As you said though, with SF match their isn't much risk in dual applying. Worst and most likely scenario you waste time and money. Best case scenario you match optho.

 

[DrfluffyMD]

My thoughts:

1. AOA Residencies are going extinct. Not sure how many optho ones are left right now, but by 2020 there should be 0, as they will have all merged with ACGME. It may be worth your time to look at the few remaining ones and see if any will be available to you.
2. A perfect D.O. applicant with crazy step and research, MIGHT be able to match an ACGME ophto spot. Very challenging and unlikely but theoretically possible.
3. I could be mistaken, but I thought you needed a step 1 score to match into ACGME residency. I also thought all MDs have to complete Steps 1, 2, and 3. Even if this isn't required for some reason, I couldn't imagine many PDs interviewing someone without a step 1.

As you said though, with SF match their isn't much risk in dual applying. Worst and most likely scenario you waste time and money. Best case scenario you match optho.

Not all acgme residencies require step 1, but almost all competitive ones do.

 

[12glaucoma34]

Not so. They are two different exams testing two entirely different populations. Just because you were two standard deviations above the mean on COMLEX absolutely does not mean you'll achieve the same on USMLE.

Don't trust me? The prevailing conversion formula that many PDs use put a 750 comlex 1 at 247, roughly 2 points above the optho average.

Source: How to Predict USMLE Scores From COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs | The Journal of the American Osteopathic Association

Fair enough, my guess is that a 247 is likely on the lower end of possible ranges for my theoretical USMLE score.

 

[DrfluffyMD]

Fair enough, my guess is that a 247 is likely on the lower end of possible ranges for my theoretical USMLE score.

I think you should definitely try to apply into DO derm or ortho programs. You can try to apply to SF match but honestly, my thought as someone who may become an IR APD in one or two years is that no amount of COMLEX score can be used for ranking of my candidates. It's like if you tell me that you had a perfect LSAT score. Impressive, but cannot be used to gauge the ability of my candidates.

I will also ask this question to a current radiology PD doing AMA in the rad forum.

 

[Lexdiamondz]

Does AOA ophthalmology participate in the SF match? If not, it gives me more time to find an audition rotation and get a LOR from an ophthalmologist.

I don't believe so, but I can't say that for sure.

Fair enough, my guess is that a 247 is likely on the lower end of possible ranges for my theoretical USMLE score.

Its hard to extrapolate what you would have gotten on the USMLE based on your COMLEX score. The two exams test similar material, but from what DOs who have taken both have said, for the most part they have very different question styles.

More importantly, your COMLEX score is curved relative to other DOs who took the exam, which is why for an ACGME program director whose applicant pool is made up up >95% USMDs a COMLEX score is totally useless and not even worth looking at. Just because you scored exceptionally well among an applicant pool which is, on average, weaker than the average USMD doesn't mean you would have scored equally as phenomenally on the USMLE. You probably would have done well, but "predicting" a theoretical score of >245 on an exam you've never taken sounds silly and kind of arrogant tbh.

 

[AnatomyGrey12]

2. A perfect D.O. applicant with crazy step and research, MIGHT be able to match an ACGME ophto spot. Very challenging and unlikely but theoretically possible

Honestly I used to think that too but after doing some digging into some of the competitive DO ACGME surgical sub (and derm) matches over the last year or two I've been very surprised at the Step scores of some of these people. They aren't the "crazy" scores I was expecting, still good, but not killer (think below 250). The thing they all have in common are: 1. Pubs. Quality research with more than two actual publications. 2. Almost all rotated at the programs that eventually took them and built solid connections, got great LORs, etc. 3. Put together very intelligent match strategies with a back up in place (important). It was interesting and it changed my opinion. Now I hold the opinion that for a DO to match these super competitive fields it's the research and networking that lands them spots, once their board scores are adequate enough, oh and the balls to skip the AOA match (there is definitely something to be said about this, although it will be moot in the coming years).

3. I could be mistaken, but I thought you needed a step 1 score to match into ACGME residency. I also thought all MDs have to complete Steps 1, 2, and 3. Even if this isn't required for some reason, I couldn't imagine many PDs interviewing someone without a step 1.

Nah DOs don't need the Step to match in ACGME, but it definitely helps and is an unwritten rule for the more competitive stuff. Even the people who do match competitive ACGME fields usually only take Step 1, and 2 CK though.

 

[Anti-PD1]

5 DOs matched into ACGME ophtho last year. 20 applied.

 

[IslandStyle808]

Honestly I used to think that too but after doing some digging into some of the competitive DO ACGME surgical sub (and derm) matches over the last year or two I've been very surprised at the Step scores of some of these people. They aren't the "crazy" scores I was expecting, still good, but not killer (think below 250). The thing they all have in common are: 1. Pubs. Quality research with more than two actual publications. 2. Almost all rotated at the programs that eventually took them and built solid connections, got great LORs, etc. 3. Put together very intelligent match strategies with a back up in place (important). It was interesting and it changed my opinion. Now I hold the opinion that for a DO to match these super competitive fields it's the research and networking that lands them spots, once their board scores are adequate enough, oh and the balls to skip the AOA match (there is definitely something to be said about this, although it will be moot in the coming years).

You by far are one of the most solid posters on SDN. I totally agree with this post. I've looked at the ophthalmology forums through the years and have seen student who weren't even that stellar match into ophthalmology (talking about USMLE scores of 230). And the two things I've noticed from the ones that do match are 1) usually plan for the field from MS1 and 2) very strategic about their application. People forget that DOs in general do poorer in the USMLE overall, have extreme difficulty finding even any research, and pretty much plan terribly when applying.

For example look at the link below and see how many application DOs sent out for a variety of ACGME fields. In every hyper competitive field, DO send out less applications than their MD counterpart (like 1/2 to 1/3). I understand they may have back ups, but if they want a good shot then they should be at least sending at least the same amount of applications as US MD students (in addition to applications to back up specialities).

ERAS Statistics - ERAS - Services - AAMC

So this gives the DO bias and even worse effect than it already has.

 

[Lexdiamondz]

Does AOA ophthalmology participate in the SF match? If not, it gives me more time to find an audition rotation and get a LOR from an ophthalmologist.

You by far are one of the most solid posters on SDN. I totally agree with this post. I've looked at the ophthalmology forums through the years and have seen student who weren't even that stellar match into ophthalmology (talking about USMLE scores of 230). And the two things I've noticed from the ones that do match are 1) usually plan for the field from MS1 and 2) very strategic about their application. People forget that DOs in general do poorer in the USMLE overall, have extreme difficulty finding even any research, and pretty much plan terribly when applying.

For example look at the link below and see how many application DOs sent out for a variety of ACGME fields. In every hyper competitive field, DO send out less applications than their MD counterpart (like 1/2 to 1/3). I understand they may have back ups, but if they want a good shot then they should be at least sending at least the same amount of applications as US MD students (in addition to applications to back up specialities).

ERAS Statistics - ERAS - Services - AAMC

So this gives the DO bias and even worse effect than it already has.

I believe those numbers are for applicants to AOA residencies, not specifically DO applicants to ACGME

 

[Anti-PD1]

https://www.sfmatch.org/PDFFilesDisplay/Ophthalmology_Residency_Stats_2017.pdf

 

[IslandStyle808]

I believe those numbers are for applicants to AOA residencies, not specifically DO applicants to ACGME

There is an ACGME residency section where you can select the specialty and it will show the application numbers from student in osteopathic schools. Its correct.

 

[DrfluffyMD]

I think a lot of this have to do with poor advising from DO school. I don't know if the OP has research or not, but to think that a good comlex score will get his/her foot into something like optho is a bit out there. I wonder who gave them that advice.

Comlex means nothing in the competitive ACGME world even if you have two super high scores in a row. For all I care you could have scored super well in the osteopathic therapy section which is not used in my practice.

 

[12glaucoma34]

I don't believe so, but I can't say that for sure.



Its hard to extrapolate what you would have gotten on the USMLE based on your COMLEX score. The two exams test similar material, but from what DOs who have taken both have said, for the most part they have very different question styles.

More importantly, your COMLEX score is curved relative to other DOs who took the exam, which is why for an ACGME program director whose applicant pool is made up up >95% USMDs a COMLEX score is totally useless and not even worth looking at. Just because you scored exceptionally well among an applicant pool which is, on average, weaker than the average USMD doesn't mean you would have scored equally as phenomenally on the USMLE. You probably would have done well, but "predicting" a theoretical score of >245 on an exam you've never taken sounds silly and kind of arrogant tbh.

I sense a bit of hostility towards the COMLEX that seems unwarranted, "totally useless" is certainly inaccurate. It certainly is not totally useless and if an applicant would have a score of 400 (lowest passing score) it would be an effective tool to weed out applicants. There is nothing "arrogant" about my posts. Perhaps you don't have a very good understanding of interpreting these scores. Allow me to illustrate, COMLEX Level 1 score of 750, the mean is 520 and the standard deviation is 85 (NBOME | COMLEX-USA Score Interpretation). Assuming a normal distribution yields a z score of greater than 2.7 which corresponds to 0.9965. Simply put, my score places me 9,965/10,000 of other first time COMLEX Level 1 test takers. In other words, only 35 DO students from a pool of 10,000 will do better than me. My Level 1 score is above 750. The difference among MD and DO isn't as great as you are suggesting. It is not like the very top COMLEX scores are only capable of scoring average on USMLE. I have classmates that Level 1 scores 640s and 670s with USMLE step 1 scores of 252 and 249, respectively. Also, the OMM component of my exam was the weakest part for Level 1 and Level 2. There is nothing special about the USMLE that magically makes you smarter or superior to those who haven't taken it. A step 1 score of 245 is 76/100 and scoring this good or better certainly doesn't seem silly or arrogant coming from the someone with my scores.

However, I appreciate all the advice received. My belief is the biggest thing holding back my application besides USMLE is the lack of connections to the field and research.

 

[12glaucoma34]

You by far are one of the most solid posters on SDN. I totally agree with this post. I've looked at the ophthalmology forums through the years and have seen student who weren't even that stellar match into ophthalmology (talking about USMLE scores of 230). And the two things I've noticed from the ones that do match are 1) usually plan for the field from MS1 and 2) very strategic about their application. People forget that DOs in general do poorer in the USMLE overall, have extreme difficulty finding even any research, and pretty much plan terribly when applying.

For example look at the link below and see how many application DOs sent out for a variety of ACGME fields. In every hyper competitive field, DO send out less applications than their MD counterpart (like 1/2 to 1/3). I understand they may have back ups, but if they want a good shot then they should be at least sending at least the same amount of applications as US MD students (in addition to applications to back up specialities).

ERAS Statistics - ERAS - Services - AAMC

So this gives the DO bias and even worse effect than it already has.

Totally agree with research and publications at DO schools, very difficult to obtain. As far as plan terribly when applying, that is me. Especially for some of the fields that are super competitive and then by chance you discover you like the field during 3rd or 4th year electives. By this point, you are basically so far behind you have effectively eliminated yourself. I never would have dreamed I would like ophthalmology, it seemed like pure boredom until I did the rotation and truly understood what it was about.

 

[12glaucoma34]

I think a lot of this have to do with poor advising from DO school. I don't know if the OP has research or not, but to think that a good comlex score will get his/her foot into something like optho is a bit out there. I wonder who gave them that advice.

Comlex means nothing in the competitive ACGME world even if you have two super high scores in a row. For all I care you could have scored super well in the osteopathic therapy section which is not used in my practice.

Did you write "poor advising?" You are giving my school too much credit. At my school, we get NO ADVISING, none, zero, figure it all out on your own. Good luck, hope it works out for you, tuition please.

No one gave me any advice and yes, my COMLEX scores are a bit "out there" lolz. The osteopathic manipulation questions along with the majority of USMLE step 1 will no be used in ophthalmology so that point is largely irrelevant. Also, 80% of COMLEX is non-OMM related.

 

[12glaucoma34]

I think you should definitely try to apply into DO derm or ortho programs. You can try to apply to SF match but honestly, my thought as someone who may become an IR APD in one or two years is that no amount of COMLEX score can be used for ranking of my candidates. It's like if you tell me that you had a perfect LSAT score. Impressive, but cannot be used to gauge the ability of my candidates.

I will also ask this question to a current radiology PD doing AMA in the rad forum.

Thanks for the suggestion. It is not really like LSAT because COMLEX is a medical licensing examination, despite the poorly written test questions. I'm not sure what "ability" you are referring to, but scoring in the top 10th percentile on either exam series certainly demonstrates ability. Combine that with excellent grades and clinical evaluations and you have an applicant who has truly demonstrated a high likelihood of doing well during residency, regardless of COMLEX or USMLE.

 

[Sam212]

Thanks for the suggestion. It is not really like LSAT because COMLEX is a medical licensing examination, despite the poorly written test questions. I'm not sure what "ability" you are referring to, but scoring in the top 10th percentile on either exam series certainly demonstrates ability. Combine that with excellent grades and clinical evaluations and you have an applicant who has truly demonstrated a high likelihood of doing well during residency, regardless of COMLEX or USMLE.

You've certainly done well and your accomplishments definitely demonstrate that you're in the upper echelon of medical students. Given your success in the COMLEX, you will likely do well in the USMLE as well. However, Ophtho is a very competitve specialty and the gold standard is the USMLE. Therefore, despite your accomplishments, you will likely be blackballed by most programs and will struggle just to get any interviews. I would highly recommend contacting osteopathic programs at this very moment and try to setup some kind of face time. With your stats, and hopefully a decent personality, you'll likely get a spot. Once you're done with residency/fellowship, no one will care as long as you're board certified.

 

[AnatomyGrey12]

I sense a bit of hostility towards the COMLEX that seems unwarranted, "totally useless" is certainly inaccurate. It certainly is not totally useless and if an applicant would have a score of 400 (lowest passing score) it would be an effective tool to weed out applicants. There is nothing "arrogant" about my posts. Perhaps you don't have a very good understanding of interpreting these scores. Allow me to illustrate, COMLEX Level 1 score of 750, the mean is 520 and the standard deviation is 85 (NBOME | COMLEX-USA Score Interpretation). Assuming a normal distribution yields a z score of greater than 2.7 which corresponds to 0.9965. Simply put, my score places me 9,965/10,000 of other first time COMLEX Level 1 test takers. In other words, only 35 DO students from a pool of 10,000 will do better than me. My Level 1 score is above 750. The difference among MD and DO isn't as great as you are suggesting. It is not like the very top COMLEX scores are only capable of scoring average on USMLE. I have classmates that Level 1 scores 640s and 670s with USMLE step 1 scores of 252 and 249, respectively. Also, the OMM component of my exam was the weakest part for Level 1 and Level 2. There is nothing special about the USMLE that magically makes you smarter or superior to those who haven't taken it. A step 1 score of 245 is 76/100 and scoring this good or better certainly doesn't seem silly or arrogant coming from the someone with my scores.

However, I appreciate all the advice received. My belief is the biggest thing holding back my application besides USMLE is the lack of connections to the field and research.

Combine that with excellent grades and clinical evaluations and you have an applicant who has truly demonstrated a high likelihood of doing well during residency, regardless of COMLEX or USMLE.

Yes but the problem is that ACGME PDs (especially in the competitive specialties) don't give two craps, heck I doubt they even give one crap. Throw on top of that the fact that matching these fields is a lot more than board scores and you are in a bind. The above poster has some great advice IMO. Remember though, that your score is fantastic enough for anything in the AOA match, start making connections, sending emails, making phone calls ASAP if you really absolutely want to do Optho. You honestly could just throw some apps out there like you mention for the SF match as it happens before the AOA and NRMP, just don't expect much.

 

[LittleFoot]

You seem to be really holding on to the idea that you would have done super well on the USMLE and yet you don't want us to talk about the fact you didn't take it. So I'll go ahead and say it - If you are so confident you would have done well on the USMLE, why didn't you take it? Not that it really matters at this point, but you're really fighting tooth and nail to convince us that you would have done well on it. So it seems to matter to you.

That said, I think with a score of 750-800 on level 1 you would have most likely scored >245 on USMLE. I personally scored 715 on my COMLEX and 242 on USMLE. And no, I didn't score well on OMM - in fact, it was my lowest area by far. They really are just different exams. There is a correlation between the two but there are no guarantees.

By the way, I think many of the AOA Ophthalmology programs have closed leaving only 5 or so left and I personally don't think you will match MD Ophtho with only COMLEX. So Ophtho looks like a tough match for you. What other specialty are you considering? If you like it just as much I would just apply to that one.

 

[Sam212]

I think a lot of this have to do with poor advising from DO school. I don't know if the OP has research or not, but to think that a good comlex score will get his/her foot into something like optho is a bit out there. I wonder who gave them that advice.

Comlex means nothing in the competitive ACGME world even if you have two super high scores in a row. For all I care you could have scored super well in the osteopathic therapy section which is not used in my practice.

I think that's a little outlandish, a good COMLEX score shows that you have a good grasp on basic science material and are at least a good test taker. Quite a few Anesthesia, EM, and now even Radiology programs will interview candidates with just the COMLEX. With things like surgical subspecialties and derm, it's just too many great applicants and High USMLE cut offs are a way to limit the number of applicants, nothing more. You and I both know that if applicant A scored a 240 and applicant B scored a 260, both are just as likely to be good residents. If you have demonstrated that you can score consistently above average, you will not be an academic liability. Of course, being a good resident, and ultimately a good physician is not just about how well you score on standardized tests. Just my opinion.

 

[Stagg737]

Point understood and don't disagree. I have also talked to a program director for surgery who stated he can overlook no USMLE with a "stellar" COMLEX only. Not sure how many program directors would think this way, I'm sure they are in the minority.

Obviously from my COMLEX, my USMLE would have been stellar too. It is just a matter of a program director being willing to accept that scoring two standard deviations above the mean on COMLEX is going to translate to at least a 85-90th percentile on USMLE too.

You've consistently stated you would have done well on USMLE, and given your stats I'm sure you would have. The question that every ACGME program (and maybe some DO programs) will ask is why would you not take Step 1? Some will likely take it as a lack of commitment to the field and make them think you're not 100% committed, which by your own admission you're not.

Since the SF match is first, I'd say just go for it anyway if you really think you want to do ophtho. Like you said, if it doesn't work out you can just enter the regular match for the other field you're interested in.

Not so. They are two different exams testing two entirely different populations. Just because you were two standard deviations above the mean on COMLEX absolutely does not mean you'll achieve the same on USMLE.

Don't trust me? The prevailing conversion formula that many PDs use put a 750 comlex 1 at 247, roughly 2 points above the optho average.

Source: How to Predict USMLE Scores From COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs | The Journal of the American Osteopathic Association

They are different exams, that being said there is no real way to make a conversion. I know several people at my school who scored far below 700 on Level 1 and scored well above 250 on Step 1. I also know people who did very well on Level 1 and ended up below average on Step 1.

That article is also completely idiotic and unreliable imo. It's based on the results from a single class from a single school that puts no emphasis at all on Step 1 and emphasizes OMM more heavily than any other DO school in the country. If anything, their conversion would likely be on the low end (as in high Level 1 scores there will convert to lower Step 1 scores) compared to DO students across the country, especially the DO schools that put little emphasis on OMM. Any PD who is actually using that conversion might as well throw darts at a dartboard to convert test scores, and frankly I'd question their overall methods of selecting candidates if this were part of their decision. I also think it was completely irresponsible for JAOA to publish an article suggesting that this can be used as a potential conversion tool, but that's just one more problem to add to the long list of ways the overseeing DO organizations are screwing modern DO students over.

 

[Sam212]

Not so. They are two different exams testing two entirely different populations. Just because you were two standard deviations above the mean on COMLEX absolutely does not mean you'll achieve the same on USMLE.

Don't trust me? The prevailing conversion formula that many PDs use put a 750 comlex 1 at 247, roughly 2 points above the optho average.

Source: How to Predict USMLE Scores From COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs | The Journal of the American Osteopathic Association

One of our interns scored a 826 on Comlex and a 272 on USMLE. If you're scoring over 800+ on comlex, it's not a fluke. The OP will likely get a 250+ if they took the USMLE, as they apparently scored 800+ on Comlex.

 

[Lexdiamondz]

I sense a bit of hostility towards the COMLEX that seems unwarranted, "totally useless" is certainly inaccurate. It certainly is not totally useless and if an applicant would have a score of 400 (lowest passing score) it would be an effective tool to weed out applicants. There is nothing "arrogant" about my posts. Perhaps you don't have a very good understanding of interpreting these scores. Allow me to illustrate, COMLEX Level 1 score of 750, the mean is 520 and the standard deviation is 85 (NBOME | COMLEX-USA Score Interpretation). Assuming a normal distribution yields a z score of greater than 2.7 which corresponds to 0.9965. Simply put, my score places me 9,965/10,000 of other first time COMLEX Level 1 test takers. In other words, only 35 DO students from a pool of 10,000 will do better than me. My Level 1 score is above 750. The difference among MD and DO isn't as great as you are suggesting. It is not like the very top COMLEX scores are only capable of scoring average on USMLE. I have classmates that Level 1 scores 640s and 670s with USMLE step 1 scores of 252 and 249, respectively. Also, the OMM component of my exam was the weakest part for Level 1 and Level 2. There is nothing special about the USMLE that magically makes you smarter or superior to those who haven't taken it. A step 1 score of 245 is 76/100 and scoring this good or better certainly doesn't seem silly or arrogant coming from the someone with my scores.

However, I appreciate all the advice received. My belief is the biggest thing holding back my application besides USMLE is the lack of connections to the field and research.

Again, you're missing a key point here.

One of the purposes of a scored standardised exam is to have a metric that you can compare a group of people by. Regardless of how similar the USMLE and COMLEX are content-wise, the reality is that the USMLE is a different exam, with a different style of questioning and a different style of scoring, taken by different group of people. Standardised tests aren't about being smarter - they're about being better prepared and you didn't prepare for this exam so you cannot say that you would have crushed it. Furthermore, the pool of students who take the COMLEX includes a large number of students who were actively discouraged from taking the USMLE because of a poor academic performance in years 1 & 2, so on an exam where you're scored relative to your peers, you do have a considerable advantage in being in a weaker pool.

If the vast majority of your applicant pool are MDs who take the USMLE, what value does a program director get from using a metric that doesn't apply to any of them, and instead compares to a weaker applicant pool?

So yes, in a field where only 1.08% of the matched applicants in 2017 were DOs, the COMLEX is a totally useless metric.

I think that's a little outlandish, a good COMLEX score shows that you have a good grasp on basic science material and are at least a good test taker. Quite a few Anesthesia, EM, and now even Radiology programs will interview candidates with just the COMLEX. With things like surgical subspecialties and derm, it's just too many great applicants and High USMLE cut offs are a way to limit the number of applicants, nothing more. You and I both know that if applicant A scored a 240 and applicant B scored a 260, both are just as likely to be good residents. If you have demonstrated that you can score consistently above average, you will not be an academic liability. Of course, being a good resident, and ultimately a good physician is not just about how well you score on standardized tests. Just my opinion.

I agree with your post overall, but the bolded isn't quite true.

 

[Lexdiamondz]

deleted

 

[W19]

Is it too late for OP to take step2? Will that help somehow?

 

[DrfluffyMD]

Is it too late for OP to take step2? Will that help somehow?

Step 2 would help. So would having some humility by not assuming that he would automatically do well on a totally different exam.

 

[AnatomyGrey12]

Again, you're missing a key point here.

One of the purposes of a scored standardised exam is to have a metric that you can compare a group of people by. Regardless of how similar the USMLE and COMLEX are content-wise, the reality is that the USMLE is a different exam, with a different style of questioning and a different style of scoring, taken by different group of people. Standardised tests aren't about being smarter - they're about being better prepared and you didn't prepare for this exam so you cannot say that you would have crushed it. Furthermore, the pool of students who take the COMLEX includes a large number of students who were actively discouraged from taking the USMLE because of a poor academic performance in years 1 & 2, so on an exam where you're scored relative to your peers, you do have a considerable advantage in being in a weaker pool.

If the vast majority of your applicant pool are MDs who take the USMLE, what value does a program director get from using a metric that doesn't apply to any of them, and instead compares to a weaker applicant pool?

So yes, in a field where only 1.08% of the matched applicants in 2017 were DOs, the COMLEX is a totally useless metric.



I agree with your post overall, but the bolded isn't quite true.

Eh yeah it actually is more accurate than SDN dogma dictates. I've been surprised at the applications of some of the people that have matched those fields and how many don't take USMLE.

 

[DrfluffyMD]

Eh yeah it actually is more accurate than SDN dogma dictates. I've been surprised at the applications of some of the people that have matched those fields and how many don't take USMLE.

Personally, on principle, OMM has nothing to do with my field and why should I accept an exam that test its practioner on something they will never use in my field?

 

[W19]

Did you write "poor advising?" You are giving my school too much credit. At my school, we get NO ADVISING, none, zero, figure it all out on your own. Good luck, hope it works out for you, tuition please.

No one gave me any advice and yes, my COMLEX scores are a bit "out there" lolz. The osteopathic manipulation questions along with the majority of USMLE step 1 will no be used in ophthalmology so that point is largely irrelevant. Also, 80% of COMLEX is non-OMM related.

Are you saying 20% is OMM related? If so, that's high...

 

[Lexdiamondz]

Eh yeah it actually is more accurate than SDN dogma dictates. I've been surprised at the applications of some of the people that have matched those fields and how many don't take USMLE.

I think there's a difference between "quite a few" and "some". There are some EM programs that take COMLEX, most of those tend to be former AOA programs or midwestern programs where DOs make up a large %-age of the med school graduates locally so they're familiar w COMLEX. But for the majority of ACGME EM residencies on the coasts (and PDs on sites like ALiEM have actually verbalised this in interviews) you won't get ranked highly with just a COMLEX, and posters in the EM forums who applied in the last 2-3 years with only COMLEX have stated as much. You can match, but it's much harder. It's even more true for DR

 

[Anti-PD1]

OP, I'm a 4th year student, cataracts don't do it for me, but I have some familiarity with your predicament.

If I were a DO student interested in ophthalmology I would 1) Want to train in a historically ACGME residency for many reasons (fellowship potential, research) 2) Commit like a motherf*

So here's how I see it. You can either jam in a rotation at one of the last few AOA-accredited programs left. You can apply to these programs (there are like 5, educate yourself: (http://opportunities.osteopathic.or...ec7be1f7b-9B29CD92-0875-9330-5CD90BE4022D5A5C). However, statistically, 40-50 apply for each spot. You can be the most osteopathic medical student ever, but them's hard odds.

The other option is, take a year off. Ophthalmology is a sweet gig. I wish I were interested, it's brains for me. The patients, disease diversity, and the lack of wear on yourself in the long run make it a great career choice. So pay your dues. Take a year off, study your nads off and TAKE STEP 1, get some research, a good letter, and apply next year. Even then, odds are rough. 19 applied, 5 got in, though admittedly, we have no idea what those 19 were like, they could include people like you who might have thought their excellent COMLEX score would be greeted with approval. When in doubt, assume a prestige-based system is in place.

OR, you can forget ophtho, do something else.

Let this be a lesson to all you OMSI-IIIs, Take Step 1! You have an opportunity to take the same test MD students do and show you actually are equivalent, which I know you all are. Don't pass it up. For super competitive specialties, make those two letters behind your name the ONLY difference between you and their best MD candidates. Go big or go home.

 

[AnatomyGrey12]

Personally, on principle, OMM has nothing to do with my field and why should I accept an exam that test its practioner on something they will never use in my field?

So you're saying that everything on USMLE is used in DR or IR? Excuse me if I am skeptical....

 

[DrfluffyMD]

So you're saying that everything on USMLE is used in DR or IR? Excuse me if I am skeptical....

USMLE exam covers the foundation of allopathic medicine and is used to assess competency of allopathic medical students.

DR is essentially a complete allopathic discipline because by definition we use ionization and nonionization radiation to treat disease that have nothing to do with osteopathic principles or therapies.

IR is also essentially a complete allopathic discipline.

If I become an ACGME PD, I am requiring the USMLE as the only permissible board examination for my allopathic training program.

 

[AnatomyGrey12]

USMLE exam covers the foundation of allopathic medicine and is used to assess competency of allopathic medical students.

DR is essentially a complete allopathic discipline because by definition we use ionization and nonionization radiation to treat disease that have nothing to do with osteopathic principles or therapies.

IR is also essentially a complete allopathic discipline.

If I become an ACGME PD, I am requiring the USMLE as the only permissible board examination for my allopathic training program.

Dude what are you talking about? What on earth is a "complete allopathic discipline"? OMM makes up literally only a fraction of COMLEX, and the rest is the same material as USMLE... You are the only person I have ever heard use the term "allopathic medicine" and I know you are about to start fellowship but what you are saying makes you sound like you have your head in the sand. I understand the idea of only using USMLE to distinguish candidates, but your reasoning here is a little clownish.

 

[DrfluffyMD]

Dude what are you talking about? What on earth is a "complete allopathic discipline"? OMM makes up literally only a fraction of COMLEX, and the rest is the same material as USMLE... You are the only person I have ever heard use the term "allopathic medicine" and I know you are about to start fellowship but what you are saying makes you sound like you have your head in the sand. I understand the idea of only using USMLE to distinguish candidates, but your reasoning here is a little clownish.

I am sorry. What I meant is that the majority of radiologists do not use osteopathic manipulation in their day to day clinical practice.

I said this before and I'll say this again, but I have a lot of respect for my DO colleagues, who often have to work harder to get to where I am. I am more than happy to have a DO cofellow. The thing is though, they all took the USMLE.

It's simply the benchmark for competitive med students and is irreplacible.

 

[AnatomyGrey12]

I am sorry. What I meant is that the majority of radiologists do not use osteopathic manipulation in their day to day clinical practice.

I said this before and I'll say this again, but I have a lot of respect for my DO colleagues, who often have to work harder to get to where I am. I am more than happy to have a DO cofellow. The thing is though, they all took the USMLE.

It's simply the benchmark for competitive med students and is irreplacible.

Now this I totally understand. I highly doubt any radiologists use OMM honestly, whether or not they only took COMLEX.

 

[12glaucoma34]

USMLE exam covers the foundation of allopathic medicine and is used to assess competency of allopathic medical students.

DR is essentially a complete allopathic discipline because by definition we use ionization and nonionization radiation to treat disease that have nothing to do with osteopathic principles or therapies.

IR is also essentially a complete allopathic discipline.

If I become an ACGME PD, I am requiring the USMLE as the only permissible board examination for my allopathic training program.

I completely understand and don't necessarily disagree with your argument for needing USMLE to directly compare applicants. It seems though you have an ax to grind in regards to the COMLEX. COMLEX test the same basic topics as USMLE plus OMM. I don't think you understand very much about OMM and osteopathic medicine. It is essentially identical to MD with the addition of OMM, it should be noted that greater than 95% of DOs never use OMM after they are no longer required to academically. DR is not just an allopathic discipline and your reasoning is completely flawed in the radiation example. The great vast vast vast vast majority of medicine has nothing to do with osteopathic principles or therapies. Honestly, OMM has a very limited role in nearly all fields of medicine. In my opinion, physicians are too highly trained to be doing OMM. If patients need manipulation or muscle energy techniques or massages, this should be done by the appropriate practitioners, being either PTs, mid-levels, or chiropractors. I didn't go to medical school to give out massages or work as a PT.

Not directly related, but interesting. Most (not exaggerating) of the DOs I have worked with won't allow medical students to do OMM because of the additional liabilities it carries. I know two physicians who have been sued (unsuccessfully) because of pain after manipulation.

 

[DrfluffyMD]

I completely understand and don't necessarily disagree with your argument for needing USMLE to directly compare applicants. It seems though you have an ax to grind in regards to the COMLEX. COMLEX test the same basic topics as USMLE plus OMM. I don't think you understand very much about OMM and osteopathic medicine. It is essentially identical to MD with the addition of OMM, it should be noted that greater than 95% of DOs never use OMM after they are no longer required to academically. DR is not just an allopathic discipline and your reasoning is completely flawed in the radiation example. The great vast vast vast vast majority of medicine has nothing to do with osteopathic principles or therapies. Honestly, OMM has a very limited role in nearly all fields of medicine. In my opinion, physicians are too highly trained to be doing OMM. If patients need manipulation or muscle energy techniques or massages, this should be done by the appropriate practitioners, being either PTs, mid-levels, or chiropractors. I didn't go to medical school to give out massages or work as a PT.

Not directly related, but interesting. Most (not exaggerating) of the DOs I have worked with won't allow medical students to do OMM because of the additional liabilities it carries. I know two physicians who have been sued (unsuccessfully) because of pain after manipulation.

I have no ax to grind with DO candidates. I just don't particularly like an examination that include OMM and certainly would not use it to rank candidates.

Btw, radiologyPD has chimed in over in the radiology forum. He/she does not use the COMLEX score in anyway during their selection process. Step 1 is their first filter.

At the end of the day, ACGME produces trainees that will not be boarded through the AOA. Unless a specialty has to go out of their way to cater to DO candidates, I am not sure why they are obliged to accept an examination that has nothing to do with their training pathway.

For example, is it really fair if a hypothetical student at a state MD school gets sorted below you because conversion formula placed your 800 comlex to a 250 step 1 and the MD kid got a 245? I don't think that's fair because perhaps that student would have also acored a 850 on COMLEX given different level of competition. as a result I don't personally think DO and MD candidates can be sorted by thejr board scores alone without having step 1 for both.

 

[AnatomyGrey12]

I am not sure why they are obliged to accept an examination that has nothing to do with their training pathway.

Again I want to reiterate that I understand your argument. But your reasoning as shown above is ridiculous. Step 1 has a lot of material that doesn't apply to certain fields either, and has nothing to do with the "training pathway"