DO student debating taking step 1 during rotations with low comlex

[scutmaster3000]

First time on this site. I'm a third year in my clinical rotations. From a school in the northeast interested in residency programs anywhere but west coast. I didn't do great on COMLEX 1 with 485. I'm sad about this score since my practice tests were in the 500-600 range. I don't know what happened test day, but that is what I have. I didn't take the USMLE step 1 after I received my COMLEX score to be safe. I studied just as long and hard as my friends so I was very surprised. I'm thinking about studying and taking USMLE Step 1 during easy rotation months (~3 months). This would leave me 4 good months to study for my COMLEX 2. If it helps all my COMATS have been 100+ so far. I did well in my classes and I'm in the top 25%, solid EC, and SSP. At this point I found out I am mostly interested in ACGME programs. Not sure what specialty for sure but I would think IM, EM, OB, PMR. Has anyone done this and succeeded? Should I just focus on COMLEX 2 because of the merger? I heard USMLE Step 2 is ok to take without Step 1 is that a better option? I'm really lost because I'm hearing I should take step 1 from my professors and friends to be competitive. Thanks for the advice

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[QualityProcess]

Before you make career decisions, you need to establish career goals. Pick a specialty. How can anyone tell you about whether or not you're competitive if you haven't even picked a career?

Then go to the residency forums and read about your specialty of choice. Figure out what score you will need for THAT chosen specialty. I can tell you about IM. There are plenty of spots available for DOs in IM. Many programs are not achievable for DOs with your score, but some are achievable. Take a look at formerly AOA programs that are now ACGME accredited.

Spend half a saturday doing an NBME practice exam and see how you score. If you do well, id say maybe your comlex score is a outlier and take a shot. if you don't do well, DO NOT TAKE step 1, because some program that previously might be willing to take a shot on a student with good grades and maybe had a bad day will see that poor step 1 score instead of just a slightly-below-avg level 1.

 

[Dr.Jekyll75]

If you are really upset and think the usmle will bail you out do it . But first ask yourself , do you have time to take the step? Rotation are hard to get any free time to study . Second, take nmbe before you even attempt to start studying. I tell you this because you need a base line. If you aren't scoring at Least 200 you run a high risk of failing


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[Drrrrrr. Celty]

If you are really upset and think the usmle will bail you out do it . But first ask yourself , do you have time to take the step? Rotation are hard to get any free time to study . Second, take nmbe before you even attempt to start studying. I tell you this because you need a base line. If you aren't scoring at Least 200 you run a high risk of failing


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I'm not sure a 200 is worth taking the usmle for. Generally ppl on this board recommend at least a 210-215 because under that it may really not be all that helpful or the risk of scoring under may produce worse outcomes.

 

[Dr.Jekyll75]

I'm not sure a 200 is worth taking the usmle for. Generally ppl on this board recommend at least a 210-215 because under that it may really not be all that helpful or the risk of scoring under may produce worse outcomes.

as a baseline for his first seems reasonable

 

[hallowmann]

Take an NBME. I agree that after COMLEX studying as a baseline OP should be getting 200 or more before Step studying to really consider taking it. Even then OP should take NBMEs leading up to it and not take it if the NBMEs aren't 215+. Alternatively, if OP wants to study regardless they can study for a couple months and then take an NBME.

The NBMEs are very representative (+/-5 usually) of the true score on test day for Step 1, unlike the COMSAEs and COMLEXs which can be 100+ off.

 

[jw3600]

I love the DO delusion that SSP means anything more than "I breath oxygen" or "I have a belly button."

 

[67552931811]

I love the DO delusion that SSP means anything more than "I breath oxygen" or "I have a belly button."

 

[WillieTrill]

I love the DO delusion that SSP means anything more than "I breath oxygen" or "I have a belly button."

I don't even know what SSP stands for

 

[Goro]

I cannot recommend this course of action. First, your preceptors /attendings will want you doing clinical stuff, and NOT studying for Step I.

Second, you did poorly on COMLEX . Why do you magically think you'll do better on Step I???

Stick with AOA programs, or those ACGME that will be OK with your COMLEX score....especially is you were in the bottom third of your Class for your pre.Clinical training.

First time on this site. I'm a third year in my clinical rotations. From a school in the northeast interested in residency programs anywhere but west coast. I didn't do great on COMLEX 1 with 485. I'm sad about this score since my practice tests were in the 500-600 range. I don't know what happened test day, but that is what I have. I didn't take the USMLE step 1 after I received my COMLEX score to be safe. I studied just as long and hard as my friends so I was very surprised. I'm thinking about studying and taking USMLE Step 1 during easy rotation months (~3 months). This would leave me 4 good months to study for my COMLEX 2. If it helps all my COMATS have been 100+ so far. I did well in my classes and I'm in the top 25%, solid EC, and SSP. At this point I found out I am mostly interested in ACGME programs. Not sure what specialty for sure but I would think IM, EM, OB, PMR. Has anyone done this and succeeded? Should I just focus on COMLEX 2 because of the merger? I heard USMLE Step 2 is ok to take without Step 1 is that a better option? I'm really lost because I'm hearing I should take step 1 from my professors and friends to be competitive. Thanks for the advice

 

[scutmaster3000]

Thanks for the advice so far everyone. I plan on taking an NBME next week to see where my baseline is.

jw3600 - DO schools don't have AOA and SSP is the closest thing we have (I know it's nowhere near equivalent, but I'm happy I earned it) so I thought to include it to show I wasn't struggling in my preclinical training. I didn't know it didn't matter.

Goro - Thanks for your advice, it looks like youre faculty somewhere so I appreciate your input. To answer your question I don't expect to magically do better on USMLE Step 1. I plan to create a study plan for when I get home from the hospital, and see where I am at with NMBE practice tests as I progress with the plan before I take the actual test (or not if I'm not doing good I could always decide to back out last minute). Just like QualityProcess said I don't want to make it worse by showing I failed USMLE Step 1 on top of a slightly below average COMLEX 1. Also I just want to clarify I am in the top third not the bottom third of the class, I received A/Honors on all rotations so far, and done with most of my 3rd year core clerkships. I said ACGME because most programs are in bigger cities and maybe have higher chance of fellowship down the road. If I was a student at your school in the same situation would you advise to just focus on blowing COMLEX 2 out of the water and hope for the best? Do you think taking USMLE Step 2 without USMLE Step 1 is a good idea?

I really hate that I had a bad test day, and being limited on my options with a below average score so I just want to try to improve my chances with the match.

 

[Rekt]

Thanks for the advice so far everyone. I plan on taking an NBME next week to see where my baseline is.

jw3600 - DO schools don't have AOA and SSP is the closest thing we have (I know it's nowhere near equivalent, but I'm happy I earned it) so I thought to include it to show I wasn't struggling in my preclinical training. I didn't know it didn't matter.

Goro - Thanks for your advice, it looks like youre faculty somewhere so I appreciate your input. To answer your question I don't expect to magically do better on USMLE Step 1. I plan to create a study plan for when I get home from the hospital, and see where I am at with NMBE practice tests as I progress with the plan before I take the actual test (or not if I'm not doing good I could always decide to back out last minute). Just like QualityProcess said I don't want to make it worse by showing I failed USMLE Step 1 on top of a slightly below average COMLEX 1. Also I just want to clarify I am in the top third not the bottom third of the class, I received A/Honors on all rotations so far, and done with most of my 3rd year core clerkships. I said ACGME because most programs are in bigger cities and maybe have higher chance of fellowship down the road. If I was a student at your school in the same situation would you advise to just focus on blowing COMLEX 2 out of the water and hope for the best? Do you think taking USMLE Step 2 without USMLE Step 1 is a good idea?

I really hate that I had a bad test day, and being limited on my options with a below average score so I just want to try to improve my chances with the match.

I don't think it's worth it. You'll most likely fail it to be honest. Almost every student I have talked to that delayed their Step 1 to the clinical years significantly regrets that decision, i.e. even though they had good COMLEX scores they had a major drop for step one. It's unlikely you'll be prepared enough to score decently, or even average, for the Step 1.

 

[Goro]

Why do you think you did so poorly? Your class rank should have had you in a very good position for COMLEX.

I think that doing well on Step II will serve you better than taking your chances with Step I.

Goro - Thanks for your advice, it looks like youre faculty somewhere so I appreciate your input. To answer your question I don't expect to magically do better on USMLE Step 1. I plan to create a study plan for when I get home from the hospital, and see where I am at with NMBE practice tests as I progress with the plan before I take the actual test (or not if I'm not doing good I could always decide to back out last minute). Just like QualityProcess said I don't want to make it worse by showing I failed USMLE Step 1 on top of a slightly below average COMLEX 1. Also I just want to clarify I am in the top third not the bottom third of the class, I received A/Honors on all rotations so far, and done with most of my 3rd year core clerkships. I said ACGME because most programs are in bigger cities and maybe have higher chance of fellowship down the road. If I was a student at your school in the same situation would you advise to just focus on blowing COMLEX 2 out of the water and hope for the best? Do you think taking USMLE Step 2 without USMLE Step 1 is a good idea?

I really hate that I had a bad test day, and being limited on my options with a below average score so I just want to try to improve my chances with the match.

 

[Dr.Jekyll75]

Class ranks is baloney, you said you did 500 to 600 on the comsae? How many of them did you take? Also did you pace yourself for the exam? From what I'm told mid exam fatigue is what kills people the most.


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[scutmaster3000]

Goro- I'm not sure. A lot of my friends told me I should have used USMLE World to prep instead of just COMBANK but I don't think it's resources I just had a bad test day since as you said with my class rank I expected to do a lot better.

DrJekyll- I did all of them. My first COMSAE was 511 and the rest of them were anywhere between 540 and 610. I'd like to think I paced myself but I'm sure everyone was exhausted after their test too

 

[Dr.Jekyll75]

Goro- I'm not sure. A lot of my friends told me I should have used USMLE World to prep instead of just COMBANK but I don't think it's resources I just had a bad test day since as you said with my class rank I expected to do a lot better.

DrJekyll- I did all of them. My first COMSAE was 511 and the rest of them were anywhere between 540 and 610. I'd like to think I paced myself but I'm sure everyone was exhausted after their test too

Ya def should have done uworld for the context and just learning. The only thing that sucks about comlex is that it's poorly written exam. Stick to the nmbe first try to see where you are . Possibly ask your dean or counseling office on what to do as well. What are you aiming for ?



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[scutmaster3000]

I'm shooting for mean score at least which is around 230 I heard, but like many said I think I should start with the NBME. I'm just afraid if I don't take USMLE Step 1 I would be automatically be cutoff since I don't have a score. If get >220 at least there's a greater chance someone will take a look at my application. Does anyone know if USMLE Step 2 only score is just as good as USMLE Step 1 only score?

 

[Dr.Jekyll75]

I'm shooting for mean score at least which is around 230 I heard, but like many said I think I should start with the NBME. I'm just afraid if I don't take USMLE Step 1 I would be automatically be cutoff since I don't have a score. If get >220 at least there's a greater chance someone will take a look at my application. Does anyone know if USMLE Step 2 only score is just as good as USMLE Step 1 only score?

- i dont have number to back this but no , step 1 trumps step 2 all day every day. I was shown by my school a survey of pds, and all of them considered it more important than step 2. by goals, i mean what specialty ? Because if its peds,gyn,family or PMR you should be okay in the AOA match as long as you kill step 2 and have good LORs

 

[scutmaster3000]

My top 3 right now are PMR, EM, IM in that order.

 

[Dr.Jekyll75]

hmm aoa should be safe for all but EM especially in the mid weest

 

[scutmaster3000]

OK thanks. I really don't like being stuck with just the AOA programs. I'm sure they're good, but right now not in the locations I would want so I'll see what the NBME practice test says. Because it sounds like if I took only USMLE Step 2 instead of USMLE Step 1 then I'll still be SOL for ACGME?

 

[Dr.Jekyll75]

OK thanks. I really don't like being stuck with just the AOA programs. I'm sure they're good, but right now not in the locations I would want so I'll see what the NBME practice test says. Because it sounds like if I took only USMLE Step 2 instead of USMLE Step 1 then I'll still be SOL for ACGME?

Idk lets ask @Goro , i would say yes unless it was a former AOA

 

[Goro]

Many ACGME PDs accepting COMLEX are in Family Med, Psych, PM&R, IM, Gas, Rad, Neuro and EM. The more competitive the specialty, the less likely they'll take COMLEX I (but oddly, they're OK with COMLEX II).

Idk lets ask @Goro , i would say yes unless it was a former AOA

 

[racerwad]

I took COMLEX as a "practice test" of sorts before USMLE. After Level 1, it was clear that I still had some gaps in my knowledge, so I delayed USMLE a few months and took it later. I did better on USMLE (both 1 and 2) than COMLEX, mainly because I prepped for the USMLE. It was somewhat of a hassle studying while on wards, but really not that bad.

The importance of Step 2 varies between fields, but EM is definitely one of those specialties that likes a strong Step 2 score. The same holds for USMLE vs COMLEX for ACGME EM programs: USMLE is universally preferred. This may change somewhat as former-AOA programs become ACGME, but this won't really help you if you want to avoid AOA (current or former) programs due to locale. As a DO in a western US ACGME EM program, I would recommend having Step 1 and 2 complete when you submit ERAS.

As an aside, I think that the utility of COMLEX for successful matching will decrease as the merger progresses. The overwhelming majority of medical students take USMLE. A small fraction of residency programs (AOA) used to accept students that only took the COMLEX. Now, those programs will be accepting students that have taken USMLE, COMLEX, or both (small fraction, obvi). The proportion of applications w/ USMLE or USMLE + COMLEX vs COMLEX alone will increase for any given program, so PDs will prefer applicants that allow for an apples-to-apples comparison. This is on top of the fact that most folks know the COMLEX is a terrible test with less validity than the USMLE (again, just a numbers thing). I should clarify that the former AOA programs will probably increase the acceptance of the COMLEX overall, but I think that USMLE will still be the preferred test when it comes time to rank. This is all speculation and might turn out to be wrong. I still think all DO students interested in any ACGME program should prep for and take the USMLE.

 

[W19]

Class ranks is baloney, you said you did 500 to 600 on the comsae? How many of them did you take? Also did you pace yourself for the exam? From what I'm told mid exam fatigue is what kills people the most.


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It's a good prediction on how people will do on the step 1/2 according to advisors at my school (MD). Why it is different for DO?

 

[Dr.Jekyll75]

Because most schools don't do nbme exams their exams are professor written. And professors love throwing in a random caveat that you have to memorize that are not really bored relevant. So you're not really learning anything and those are the people that usually get the highest in the class and all they did was memorize and didn't learn the main concept


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[W19]

Because most schools don't do nbme exams their exams are professor written. And professors love throwing in a random caveat that you have to memorize that are not really bored relevant. So you're not really learning anything and those are the people that usually get the highest in the class and all they did was memorize and didn't learn the main concept


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I don't know about COMLEX, but you have to know a good amount of minutiae for step 1 and knowing them can increase one's score dramatically.

 

[Dr.Jekyll75]

Personally I think it varies from person to person we had a lot of first order questions on my exams they weren't second order to Often . And from what I've seen so far on the question banks there is no such thing as first order


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