Do COMLEX scores matter to an allopathic residency?

[Waysensei]

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Hey folks,

I'm a 2nd year D.O. student who is taking both COMLEX and USMLE step 1 this June. I know that I want to enter an allopathic residency, like Neurology. Most of the residencies I have looked at only accept USMLE. Therefore, obviously, I am putting most of my energy into studying for the USMLE at the expense of the COMLEX. My question is whether these allopathic residencies may consider a D.O. student's COMLEX score as well when reviewing the application and whether it is worth it for me to put time into studying for the OMM portion of the test.

Thanks!

 

[SukaNeNauka]

Having just gone through the interview process this year, I would say that everything matters on your application. If you are a DO applying to allopathic residencies, you should not have any red flags on your application, or at least make effort to have as few as possible. Keep in mind that residency programs interview many more applicants than the spots they have available. This season I have visited programs that interviewed as many as 30 people per spot. This means that they are looking for ways to narrow down their list. In my opinion, programs would be more attracted to applicants who have shown a consistently high performance across the board. My guess is neurology is not a super competitive field (I did not apply to neurology, so do not know), but top programs in any specialty will look for stellar candidates. A program basically wants to know if you are going to stick around for a required number of years, will pass your exams and boards, and will contribute to the program in a meaningful way. Any sign of pathology on your part will put your candidacy in question.

 

[FutureDocDO]

Neurology isn't competitive at all. You don't need to take the USMLE. I know people who interviewed at great places (e.g., Cleveland Clinic Foundation) without them. Anything above mid 500s will serve you well.

 

[w a n g]

Take the steps.

You dont need to submit your COMLEX scores on ERAS. I got all (>10) of my interviews in IM without submitting COMLEX scores and only USMLE scores. Imagine neurology would be similar.

One program asked for it, did not send cuz it was a crappy prog and woulda cost 65 bucks.

 

[peppy]

Study for the OMM stuff.
#1: You would feel horrible if you failed COMLEX by a margin that the OMM stuff would have prevented. It's really not that hard to study for and can provide a good safety cushion.
#2: Some MD progs do see enough DO applicants to be savvy about what COMLEX scores mean and will know enough to wonder why you aren't submitting the COMLEX when they know all DO students have to take it. No reason to risk spoiling your chances when all it takes is a day or two of OMM cramming to do better.
I suspect that this may become even more true as the number of DO grads increases over the next few years and we are more commonly seen as applicants across the board.

 

[ShyRem]

I wouldn't blow off the COMLEX too much. You have to pass it to graduate. Every year there are students who study only for USMLE and totally blow off OMM for COMLEX and end up failing the COMLEX. This may have ramifications such as delaying your third year rotations to a point where you can't graduate on time (if your school requires passing level 1 to advance to third year rotations, which some do).

 

[docmd2010]

focus ure efforts on the usmle. i applied to allo radiology, and i think one PD asked me abt my comlex score. with that said, i have a friend who failed the usmle and got below avg on the comlex. she didn't report her usmle score and got 14 neurology interviews at great programs and will most likely match to one of these great places. if u score 220+ on usmle, u can match to a top notch place like hopkins-they take DO's into their neurology program.

 

[ShyRem]

I hope she only applied to AOA programs. Because if she applied to ACGME programs and did not reveal her USMLE score, that's a violation of the ERAS rules and policies and her match could be rescinded.

 

[DrWBD]

I hope she only applied to AOA programs. Because if she applied to ACGME programs and did not reveal her USMLE score, that's a violation of the ERAS rules and policies and her match could be rescinded.

And as I've stated in the past, that rule is absolutely meaningless and ERAS has no authority enforcing it. They do not have the right to your USMLE scores without your consent. Thankfully some people understand this.

 

[ShyRem]

Interesting. How would you go about fighting that? There are a good number of folks who would love to know how to get around it without putting their match in jeopardy.

 

[redwings54]

Interesting. How would you go about fighting that? There are a good number of folks who would love to know how to get around it without putting their match in jeopardy.

Definitely interested!!

 

[DrWBD]

Interesting. How would you go about fighting that? There are a good number of folks who would love to know how to get around it without putting their match in jeopardy.

Definitely interested!!

You don't fight it. If you're in that situation you take your chances with an admittedly risky strategy and try to fly under the radar. But I do not know of anyone who took this route and was caught, for what that is worth.

 

[Boxer1]

Neurology isn't competitive at all. You don't need to take the USMLE. I know people who interviewed at great places (e.g., Cleveland Clinic Foundation) without them. Anything above mid 500s will serve you well.

Some Neurology programs do require the USMLE from DO applicants and many are fine with the COMLEX. Contacting individual programs where you are interested is the way to find out how important the USMLE will be for you.

If you are going to take both boards, and you want to have many options open to you at application time, you should plan on doing well on both exams.

 

[ShyRem]

So you're advocating lying on your application? Just don't follow the rules and hope you don't get caught? I wouldn't advise that route. The consequences if you're caught are huge.

I think I've lost some respect for you. I'm disappointed.

 

[DrWBD]

So you're advocating lying on your application? Just don't follow the rules and hope you don't get caught? I wouldn't advise that route. The consequences if you're caught are huge.

First, it isn't a lie. You're just selectively not providing information.

Secondly, it isn't necessarily wrong to ignore an unjust rule, at least from a moral standpoint. As I stated, as far as I know, ERAS has no legal right to your USMLE scores without your permission, which is why applicants need to "release" the scores to them.

As I've acknowledged, it could be risky and I wouldn't do it casually without fully understanding the possible consequences. On the other hand, the Match exists for the benefit of applicants and residency programs, not vice versa. If the programs are happy with COMLEX scores what motivation does the NRMP have to get involved? Logically it doesn't make sense to me.

I think I've lost some respect for you. I'm disappointed.

If you only think you've lost respect for me I'm obviously not trying hard enough. .

 

[NotAProgDirector]

Secondly, it isn't necessarily wrong to ignore an unjust rule, at least from a moral standpoint. As I stated, as far as I know, ERAS has no legal right to your USMLE scores without your permission, which is why applicants need to "release" the scores to them.

I think you've got the wrong argument.

Of course ERAS has no "legal right" to your USMLE scores. And, in fact, DO students who apply via ERAS need to actually release their USMLE scores to programs. ERAS doesn't just release them without your permission -- unless when DO students apply the software forces this (i.e. doesn't let you proceed to apply anywhere unless you've selected to release USMLE scores.

The problem is this: It would be perfectly legal for ERAS to state that "all students must release their USMLE scores". That's perfectly reasonable -- if ERAS and the programs it serves decide that USMLE scores are vital to the application process, they can make it manditory. You would then have the right to not apply if you didn't want to include your USMLE score.

What's potentially legally problematic is making only DO students "forced" to release USMLE scores. I'm not a lawyer, but in general treating one group of applicants different from another like this is often considered discriminatory.

Of course, although allopathic students are not technically "required" to release their scores, in reality they are -- no program is going to consider an application complete without them. Still, a legal argument might be able to be made.

That won't help someone who is terminated for application fraud, though. By the time the lawyers are done arguing it, your career is dead.

 

[DrWBD]

I think you've got the wrong argument.

Of course ERAS has no "legal right" to your USMLE scores. And, in fact, DO students who apply via ERAS need to actually release their USMLE scores to programs. ERAS doesn't just release them without your permission -- unless when DO students apply the software forces this (i.e. doesn't let you proceed to apply anywhere unless you've selected to release USMLE scores.

The problem is this: It would be perfectly legal for ERAS to state that "all students must release their USMLE scores". That's perfectly reasonable -- if ERAS and the programs it serves decide that USMLE scores are vital to the application process, they can make it manditory. You would then have the right to not apply if you didn't want to include your USMLE score.

What's potentially legally problematic is making only DO students "forced" to release USMLE scores. I'm not a lawyer, but in general treating one group of applicants different from another like this is often considered discriminatory.

Of course, although allopathic students are not technically "required" to release their scores, in reality they are -- no program is going to consider an application complete without them. Still, a legal argument might be able to be made.

That won't help someone who is terminated for application fraud, though. By the time the lawyers are done arguing it, your career is dead.

I realize that I've been using incorrect terminology, which is probably causing confusion. When I was referring to "releasing" the scores I meant allowing ERAS access to your USMLE transcript by providing them with your USMLE ID#. My understanding is that the process goes like this:
(from page 17 of http://www.aamc.org/students/eras/resources/downloads/2010myerasresidency.pdf )

1. Enter your USMLE ID in your Profile.
2. Authorize the release of your transcript under the Documents tab.
3. Decide if you want automatic transmission of your updated transcript when
USMLE results become available under the USMLE Transcript tab.
4. Assign your transcript to designated programs under the Programs tab.​

So my point is, what happens if you simply don't provide the USMLE ID#? Since DOs can apply to ACGME programs with only COMLEX scores, the CAF should be able to be completed and released to residency programs without a problem. That is the crux of this discussion, aProg - if a DO passes all the COMLEXes but fails one or more USMLE Step exams, but never actually provides his or her USMLE ID# to ERAS, how would ERAS or the programs know that the USMLE was taken? Until I hear a rational explanation I'm sticking to my guns on this one.

 

[NotAProgDirector]

So my point is, what happens if you simply don't provide the USMLE ID#? Since DOs can apply to ACGME programs with only COMLEX scores, the CAF should be able to be completed and released to residency programs without a problem. That is the crux of this discussion, aProg - if a DO passes all the COMLEXes but fails one or more USMLE Step exams, but never actually provides his or her USMLE ID# to ERAS, how would ERAS or the programs know that the USMLE was taken? Until I hear a rational explanation I'm sticking to my guns on this one.

The bolded statement is where I think we disagree. Yes, it is true that some allopathic programs will evaluate osteoopathic candidates who have only COMLEX scores. Hence, USMLE scores are not absolutely "required". However, I expect that all residency PD's would want to see USMLE scores if available. I don't see a conflict in the position that COMLEX exams alone are acceptable, but that if USMLE exam scores exist then they are required.

You are free to not list your USMLE ID on your CAF. No one is ever likely to notice. However, it is application fraud and if discovered (which is very unlikely) could create a big problem. Asking for a USMLE ID is clearly legal, as they require it of everyone (USMG's, DO's, and IMG's). You can decide that you don't want to tell them, but they have every right to ask for it -- as long as they ask everyone for the same thing. Yes, perhaps the USMLE doesn't "matter" for DO's since they can be licensed via the COMLEX pathway. However, that doesn't matter at all here -- if ERAS requires that you list your USMLE ID, and as long as they are not requiring you to list something that is protected by law (such as your race, or religion), and as long as they are requiring it of everybody, then they can do so.

I re-read the rules/instructions, and ERAS is completely in the legal safe zone. They only require that you report whether you took the USMLE or not. You do not need to release your scores -- that is your choice. Not reporting a poor score at all might be "better" for an applicant, but that's too bad. It is perfectly reasonable for ERAS to require all applicants to disclose all medical licensing exams they have attempted.

 

[ShyRem]

From the ERAS User Guide, page 14 top of page:

Tip: Osteopathic applicants only: Before you certify your ERAS application, consider whether you will apply to ACGME and/or AOA-accredited programs. If you apply to ACGME-accredited programs and you have taken the USMLE, you must report that on your CAF. If you only apply to AOA-accredited programs, you do not have to report the USMLE on your CAF.

So if you read it exactly, APD is correct. As a DO applying to ACGME programs you only have to report you took the USMLE. But I can't see any program directors not wanting your USMLE transcript. Saying "yeah, I took it" and at the same time not releasing basically screams "I failed it".

 

[w a n g]

Sorry to hijack just a little bit but does it make a difference whether DOs are licensed through the COMLEX or USMLE pathway? Obviously it does in the 4 or 5 DO board states (Penn, Michigan, etc). Im wondering if there is any benefit to getting licensed through the USMLE these days when DOs have to take their own version of CS (and taking the USMLE CS would be a pain).

Does it have any ACGME fellowship implications being licensed through COMLEX but going into an allopathic IM residency?

 

[NotAProgDirector]

Sorry to hijack just a little bit but does it make a difference whether DOs are licensed through the COMLEX or USMLE pathway? Obviously it does in the 4 or 5 DO board states (Penn, Michigan, etc). Im wondering if there is any benefit to getting licensed through the USMLE these days when DOs have to take their own version of CS (and taking the USMLE CS would be a pain).

Does it have any ACGME fellowship implications being licensed through COMLEX but going into an allopathic IM residency?

No. Separate from the application issues discussed in this thread, no one is going to care if your license is based upon COMLEX or USMLE. Allopathic fellowship PD's might be more interested in USMLE scores (another reason for DO students to consider taking the USMLE) but no one is going to care (nor is there anyway to know) how you are actually licensed. Hence, I've never seen a DO student in my program take USMLE CS -- they all take the COMLEX equiv since it's required by their medical school for graduation.