NewNick said:
This has been discussed before. Taking both exams is doable. Many people have already done that.
Step 1 of the USMLE is fairly different than the COMLEX. Step 2 of the USMLE and COMLEX are said to be much similar, as they are both assessing the same clinical decision making that is universal amongst all physicians.
I took Step 1 of the COMLEX and USMLE in June 2004. This is back when COMLEX was still 800 questions and on paper. The USMLE is still the same format, 350 computerized questions, with 7 sections of 50 questions each. The COMLEX was four sections of 200 questions given over 2 days. Now that COMLEX is computerized, it is pretty much the same format except COMLEX has 400 questions, or 8 sections of 50 questions.
Regarding Step 1, the COMLEX was a rather straightforward test. The NBOME actually does a pretty good job mixing in OMM questions with the other questions. A lot of questions seemed like it would be an internal medicine like question, and then it is a Chapman's point or addressing an area of viscerosomatic facilitation.
The USMLE, on the other hand, can vary. I say it is like the MCAT, as there are several versions of the exam that students will be taking. Some people had an exam that they did not think was too tough, and others, myself included, walked out of the exam not really knowing how well we fared. I distinctly remember a USMLE question where there was an image of a bacteria, so you had to identify it, then you had to know what antibiotic to use, but then you had to know that this antibiotic was contraindicated from the patient's history, so then you had to know the backup antibiotic, then you had to know the mechanism of action of this backup antibiotic, but the actual answer to the question was the method of this bacteria building resistance to this antibiotic's mechanism of action. So what was that, like a 5th order question! You don't see these questions on the COMLEX. Don't let this freak you out though, the USMLE definitely had its fair share of easy questions, but the hard ones were HARD!
So why take the USMLE? I took it because I thought, but was not sure, that I would be doing family medicine. If I KNEW I was doing family medicine, then I would have saved my $400 and mental exhaustion of this exam. When entering rotations you never know if what you thought you would like you will hate, and something you did not think of before you will love. I took the USMLE so I wouldn't be closing any doors on my residency options. Now I am going family, and only AOA, so my USMLE does not mean as much to my residency application.
Some residency programs don't have a clue of how to interpret our COMLEX scores. The NBOME just revised the format of score reports over the last year making it even more difficult. By taking the USMLE allopathic programs can see how well you perform compared to an allopathic student taking the same exam. Some allopathic programs will accept a COMLEX without USMLE, and some will not even look at you without taking the USMLE. Even some osteopathic residencies like to see that you were making yourself more competitive by taking the USMLE in addition to the COMLEX.
So now the question, do you have to take USMLE Step 1, 2, or both? If you will be seeking certification through the ACGME (allopathic route), then you have to take all 3 steps of the USMLE. If you are going to be certified through the AOA, then it doesn't matter if you take USMLE Step 1 or 2 (and taking Step 3 would make no sense at all), or neither. ALL osteopathic students must complete COMLEX Steps 1 and 2, in that order, to graduate.
If you take the USMLE, you can take Steps 1 and 2 in any order, and you can take one or the other if you wish. So if you feel like your basic sciences could be stronger, but you really know what is going on in your clinical rotations, then taking Step 2 USMLE may be the right choice for you. Once again, USMLE Step 2 is much more similar to COMLEX 2 in its questioning. The only downside of taking USMLE Step 2 rather than Step 1 is if you take it too late your scores may not make it to the residency programs before they review your application and offer interviews. So if you take USMLE Step 2, take it early.
Ultimately, I studied my butt off for both exams, did really well on both, but better on the COMLEX. I will not be taking USMLE Step 2 because I am only seeking AOA certification.
Ok, I have written way too damn much now, so I am ending it here. Hope this helps.
Dan
