How do programs compare COMLEX scores to USMLE?

[genessis42]

I go to a school that is heavy on primary-care focus. We have heard that COMLEX is equal to USMLE after the merger. I get the idea of encouraging folks to choose primary fields, but it still sounds a little misleading.

I thought COMLEX is mainly acceptable to former AOA programs in terms of scaling the scores and comparing.

Is it better to still write the Step 1 if I'm unsure what type of programs I want to apply to?
On the flip side, if a DO student does Step 1 and fails it, wouldn't that look even worst than not taking it?

---

Members don't see this ad.

 

[Spectreman]

I go to a school that is heavy on primary-care focus. We have heard that COMLEX is equal to USMLE after the merger. I get the idea of encouraging folks to choose primary fields, but it still sounds a little misleading.

I thought COMLEX is mainly acceptable to former AOA programs in terms of scaling the scores and comparing.

Is it better to still write the Step 1 if I'm unsure what type of programs I want to apply to?
On the flip side, if a DO student does Step 1 and fails it, wouldn't that look even worst than not taking it?

Programs either don’t know how to interpret it or don’t care as long as you also took step. If you want something besides FM/Peds you really need to take step, there are a million old threads that cover this. If you ended up failing Step 1 you don’t have to report it, you just don’t send the score. You’ll pass though and even just a passing score opens many doors.

 

[Chibucks15]

I go to a school that is heavy on primary-care focus. We have heard that COMLEX is equal to USMLE after the merger. I get the idea of encouraging folks to choose primary fields, but it still sounds a little misleading.

I thought COMLEX is mainly acceptable to former AOA programs in terms of scaling the scores and comparing.

Is it better to still write the Step 1 if I'm unsure what type of programs I want to apply to?
On the flip side, if a DO student does Step 1 and fails it, wouldn't that look even worst than not taking it?

Do a search on here this comes up constantly.

In short, they aren't equal. Failing step looks worse than not taking it. If you are unsure what you wanna do and where you wanna do it, then plan to take it (honestly just plan to take it anyway and abort if need be)

 

[AlteredScale]

Is it better to still write the Step 1 if I'm unsure what type of programs I want to apply to?

The opposite is a bit truer with this. If you KNOW going in you wanted to do primary care specialty (community, non-academic) then sure, skip on step. But the issue is do you really know as a second year and even rising third year?

The only other reason not to take it would be if you were really at the bottom of your class and struggling to pass classes.

Take USMLE, you'll be using essentially the same resources to prep for level. Take it and keep all your doors open.

 

[Sardonix]

"We don't even know how to interpret COMLEX really. We just make sure you didn't fail it or score far lower than everyone else and then look at your Step scores." -- Multiple EM docs to my friend who applied and matched EM this year. This came from both DO and MD docs.

 

[Dr. Death]

Do a search on here this comes up constantly.

In short, they aren't equal. Failing step looks worse than not taking it. If you are unsure what you wanna do and where you wanna do it, then plan to take it (honestly just plan to take it anyway and abort if need be)

As a DO you don't have to report it. So you have nothing to lose. Even if you get a 205, you don't have to report it.

 

[Chibucks15]

As a DO you don't have to report it. So you have nothing to lose. Even if you get a 205, you don't have to report it.

I always thought it was best to report it so it would eliminate any sort of "dishonesty" vibe if you were asked. Several people have mentioned being asked why they didn't take step. Probably not ideal to lie on interview day about something like that either just in case it gets out somehow

 

[DameJulie]

Based on the programs I have researched so far, the programs who accept both exams will have a higher preferred score for COMLEX than USMLE. The most extreme example I saw is that one program prefers >600 COMLEX and >200 USMLE.

If that kind of unequal preference stays it would encourage people to take USMLE.

 

[Dr. Rafiki]

I always found the common reflex reaction of "program directors and MDs simply do not know how to interpret the COMLEX, so you'd better take USMLE" to be very odd. If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask. It's probably the easiest part of your entire evaluation of a candidate, actually. I have A LOT more respect for our MD colleagues and expect them all to be able to figure out what a good level 1 score is the same way I would expect a DO PD to figure out what a good step 1 score is.

That's not to say that one should only take COMLEX. OP, you should definitely take both, as stated on this thread. This is just some food for thought.

 

[ERK123]

I think the most legitimate reason to not take USMLE is if you are concerned that the pressure of studying for an additional exam would put you at risk for either failing COMLEX or significantly delaying sitting for COMLEX. This might be due to prior academic performance or crippling anxiety that interferes with studying. If it is the latter, then you should address this issue with professional help regardless of whether or not you plan to sit for USMLE. There are numerous students at my school who repeatedly get exceptions to delay COMLEX leading to a whole cascade of problems. A lot of them started out with a plan to take both exams when this probably was not the wisest plan, and end up feeling too stuck to give up on taking USMLE for far too long. I feel terrible for them as it is super difficult to get on top of the problem once that path begins, and really burns them out. I decided not to take USMLE relatively early in second year as I felt that I was at risk to becoming one of those students. I do not regret my decision, though I obviously would have preferred to have not felt the need to make it.

 

[DameJulie]

I think the most legitimate reason to not take USMLE is if you are concerned that the pressure of studying for an additional exam would put you at risk for either failing COMLEX or significantly delaying sitting for COMLEX. This might be due to prior academic performance or crippling anxiety that interferes with studying. If it is the latter, then you should address this issue with professional help regardless of whether or not you plan to sit for USMLE. There are numerous students at my school who repeatedly get exceptions to delay COMLEX leading to a whole cascade of problems. A lot of them started out with a plan to take both exams when this probably was not the wisest plan, and end up feeling too stuck to give up on taking USMLE for far too long. I feel terrible for them as it is super difficult to get on top of the problem once that path begins, and really burns them out. I decided not to take USMLE relatively early in second year as I felt that I was at risk to becoming one of those students. I do not regret my decision, though I obviously would have preferred to have not felt the need to make it.

If you took COMLEX and USMLE not back to back schedule, can you share how you prepared for USMLE during rotation? and how you retained those step 1 knowledge?

 

[slowthai]

I always found the common reflex reaction of "program directors and MDs simply do not know how to interpret the COMLEX, so you'd better take USMLE" to be very odd. If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask. It's probably the easiest part of your entire evaluation of a candidate, actually. I have A LOT more respect for our MD colleagues and expect them all to be able to figure out what a good level 1 score is the same way I would expect a DO PD to figure out what a good step 1 score is.

That's not to say that one should only take COMLEX. OP, you should definitely take both, as stated on this thread. This is just some food for thought.

Honestly, these PDs have like a thousand apps to go through, so they don't really care. They're just trying to spend the least amount of time possible on this stuff.

 

[ERK123]

If you took COMLEX and USMLE not back to back schedule, can you share how you prepared for USMLE during rotation? and how you retained those step 1 knowledge?

I never took USMLE

 

[Dr.Bruh]

"We don't even know how to interpret COMLEX really. We just make sure you didn't fail it or score far lower than everyone else and then look at your Step scores." -- Multiple EM docs to my friend who applied and matched EM this year. This came from both DO and MD docs.

No doubt that EM is a step heavy specialty, but I would arguable that for a sizeable minority of programs (probably 30% if you include all former DO programs that are now ACGME) having a good COMLEX will def boost your app. Just to offer a counter anectdote, my number choice for EM Residency is a large academic EM program in a popular start (MD program) and was told by the current DO residents to not skimp on COMLEX bc they do factor both scores in ranking decision for DO applicants. THey all said they were suprised but this DO has a 228 step and a 680 comlex and 700+ level 2 and said she def thinks her COMLEX helped her match that program (which i believe has close to a 240 step average).

 

[AnatomyGrey12]

If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask.

Imagine you're a PD. You have to fill 6 spots and have 1000 candidates, 750 of which are USMD with USMLE scores, 200 are IMG's with USMLE scores, 30 DOs with both COMLEX and USMLE, and 20 DO's with nothing but COMLEX. Why on earth would you spend time to google the meaning of this random test that is the only score on 2% of the applications you receive? It's also a worthless endeavor to compare percentiles between the two tests. The testing pools are drastically different. A 600 COMLEX score, a pretty solid score in the DO world, only tells that PD how you as a candidate rank compared to other DO student.... well their applicant pool isn't made up of only DO students, in fact, only 5% of the applications they've received came from DO's, so why would that PD care about your 600 when it can look at the 230/600 that other DO student has and compare him directly to the rest of the applicant pool.

 

[Sardonix]

Based on the programs I have researched so far, the programs who accept both exams will have a higher preferred score for COMLEX than USMLE. The most extreme example I saw is that one program prefers >600 COMLEX and >200 USMLE.

If that kind of unequal preference stays it would encourage people to take USMLE.

Where are you getting those numbers from, FREIDA?

If you aren't ignore this, if you are--food for thought: Even in FM the testing "cut off" values on FREIDA didn't really correlate with the interviews I got. I had a sub-210 Step 1 score yet I got interviewed at 36/39 programs I applied to, most of which had step "cutoffs" of 210 or 220. When you see a wide discrepancy between Level 1 and Step 1 cutoff scores (much like the one you listed) it may be because they're simply using an arbitrary number as a placeholder.

 

[DameJulie]

Where are you getting those numbers from, FREIDA?

If you aren't ignore this, if you are--food for thought: Even in FM the testing "cut off" values on FREIDA didn't really correlate with the interviews I got. I had a sub-210 Step 1 score yet I got interviewed at 36/39 programs I applied to, most of which had step "cutoffs" of 210 or 220. When you see a wide discrepancy between Level 1 and Step 1 cutoff scores (much like the one you listed) it may be because they're simply using an arbitrary number as a placeholder.

I don’t remember if it’s Freida or their website. It’s just that Comlex always has a higher “cutoff” if a program lists their Comlex and USMLE threshold.

your experience is delighted to hear. I definitely those “cutoff” are arbitrary

 

[sunshinefl]

Where are you getting those numbers from, FREIDA?

If you aren't ignore this, if you are--food for thought: Even in FM the testing "cut off" values on FREIDA didn't really correlate with the interviews I got. I had a sub-210 Step 1 score yet I got interviewed at 36/39 programs I applied to, most of which had step "cutoffs" of 210 or 220. When you see a wide discrepancy between Level 1 and Step 1 cutoff scores (much like the one you listed) it may be because they're simply using an arbitrary number as a placeholder.

This is a major problem I’m running into making my residency program list. Some programs have no published minimum score, some programs have 137739 different minimum scores across different sources, some show that their current resident 25-75%ile are X even though their published minimum is X+20, and some of them seem absurdly high.

 

[libertyyne]

I always found the common reflex reaction of "program directors and MDs simply do not know how to interpret the COMLEX, so you'd better take USMLE" to be very odd. If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask. It's probably the easiest part of your entire evaluation of a candidate, actually. I have A LOT more respect for our MD colleagues and expect them all to be able to figure out what a good level 1 score is the same way I would expect a DO PD to figure out what a good step 1 score is.

That's not to say that one should only take COMLEX. OP, you should definitely take both, as stated on this thread. This is just some food for thought.

The pool of test takers taking comlex is different compared to step 1. Looking at a 75th percentile comlex doesn’t really tell me how to compare to USMLE , since I am not going to making a comparison at that point it doesn’t really matter to me.
if I was comparing two comlex scores it might be meaningful. But if there are USMLE scores involved I’m just going to default to those.

 

[Sardonix]

I don’t remember if it’s Freida or their website. It’s just that Comlex always has a higher “cutoff” if a program lists their Comlex and USMLE threshold.

your experience is delighted to hear. I definitely those “cutoff” are arbitrary

I would tend to believe this relates to my previous post farther above--some programs simply don't know what an average COMLEX score is. I wouldn't be surprised if half the programs thought "Oh dang, merger is coming up and we have to list a minimum COMLEX score to qualify... Hey Bobby, you're our only DO currently in the program... what was your Level 1 score? 600? Cool, Bobby's smart. Let's put 600 or whatever."

 

[AlteredScale]

This is a major problem I’m running into making my residency program list. Some programs have no published minimum score, some programs have 137739 different minimum scores across different sources, some show that their current resident 25-75%ile are X even though their published minimum is X+20, and some of them seem absurdly high.

This is tough. I remember having to do something like this with having only Comlex scores and it took a good few months of research and contacting PC's about clarification regarding their score expectations.

I think I used FRIEDA first and then verified residency explorer.

 

[fldoctorgirl]

Where are you getting those numbers from, FREIDA?

If you aren't ignore this, if you are--food for thought: Even in FM the testing "cut off" values on FREIDA didn't really correlate with the interviews I got. I had a sub-210 Step 1 score yet I got interviewed at 36/39 programs I applied to, most of which had step "cutoffs" of 210 or 220. When you see a wide discrepancy between Level 1 and Step 1 cutoff scores (much like the one you listed) it may be because they're simply using an arbitrary number as a placeholder.

I have seen this kind of huge discrepancy directly on a program's website. Copied and pasted directly:

"USMLE Step 1 minimum scores? 200. IMGs 230."
"COMLEX Step 1 minimum score requirement? 725"

 

[Ho0v-man]

I have seen this kind of huge discrepancy directly on a program's website. Copied and pasted directly:

"USMLE Step 1 minimum scores? 200. IMGs 230."
"COMLEX Step 1 minimum score requirement? 725"

Translation:

USMD: Fog up a mirror without assistance

IMG: Be pretty smart

DO: Die for all of our sins

 

[Oh_Gee]

This is a major problem I’m running into making my residency program list. Some programs have no published minimum score, some programs have 137739 different minimum scores across different sources, some show that their current resident 25-75%ile are X even though their published minimum is X+20, and some of them seem absurdly high.

gold standard should be going to the program's website to find a cutoff score but if not listed, you might have to email the coordinator.

I also read a post on reddit or SDN by a PD who said their cutoff scores change every year due to the different number of applications they receive each year. who knows, maybe other PD's do this too

 

[libertyyne]

Translation:

USMD: Fog up a mirror without assistance

IMG: Be pretty smart

DO: Die for all of our sins

I think its more take step 1 if you dont want us to screen you.

 

[DameJulie]

This is tough. I remember having to do something like this with having only Comlex scores and it took a good few months of research and contacting PC's about clarification regarding their score expectations.

I think I used FRIEDA first and then verified residency explorer.

Do you have any good suggestions on what tools to use to explore residency programs (kind of like the MSAR for med school) since summer is here now?

The ones I've heard So far are residency explorer and Doximity. Do you have to pay for them?

 

[Lexdiamondz]

I always found the common reflex reaction of "program directors and MDs simply do not know how to interpret the COMLEX, so you'd better take USMLE" to be very odd. If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask. It's probably the easiest part of your entire evaluation of a candidate, actually. I have A LOT more respect for our MD colleagues and expect them all to be able to figure out what a good level 1 score is the same way I would expect a DO PD to figure out what a good step 1 score is.

That's not to say that one should only take COMLEX. OP, you should definitely take both, as stated on this thread. This is just some food for thought.

That's silly.

Step and COMLEX have two somewhat overlapping, but ultimately different populations, and a 75%-ile COMEX doesn't translate into a 75%-ile Step score. A PD from an allopathic program has zero incentive to try and figure out what a good Level 1 score is when literally everyone else in the US + all the IMGs wanting to match here are taking Step.

 

[genessis42]

I'mm starting to feel like they only have the COMLEX after the merger because the NBOME likes $$$. Because they could have everyone do Step 1 with an additional OMM test for DOs.

but on the flip side, the COMLEX might be of benefit because it is numerical and the Step 1 is going P/F

 

[AlteredScale]

I'mm starting to feel like they only have the COMLEX after the merger because the NBOME likes $$$. Because they could have everyone do Step 1 with an additional OMM test for DOs.

but on the flip side, the COMLEX might be of benefit because it is numerical and the Step 1 is going P/F

NBOME is in discussion of making Level 1 p/f in the near future as well. Not that it would matter much.

 

[AlteredScale]

Do you have any good suggestions on what tools to use to explore residency programs (kind of like the MSAR for med school) since summer is here now?

The ones I've heard So far are residency explorer and Doximity. Do you have to pay for them?

FRIEDA and ERAS/AAMC Residency Explorer were free and very helpful. Beyond that I went to the residency program website for additional info. Sometimes the GME handbook would also have little nuggets of info regarding scores and selection criteria.

These were free.


Sent from my iPhone using Tapatalk

 

[Deecee2DO]

I'mm starting to feel like they only have the COMLEX after the merger because the NBOME likes $$$. Because they could have everyone do Step 1 with an additional OMM test for DOs.

but on the flip side, the COMLEX might be of benefit because it is numerical and the Step 1 is going P/F

That and dont forget about a quarter of most DO classes wouldnt pass USMLE so the only way that cohort can become a doctor is if they have COMLEX. So, it does have some utility in allowing some people to be able to be doctors that otherwise wouldnt have been able to. USMLE is more challenging than COMLEX

 

[Chibucks15]

That and dont forget about a quarter of most DO classes wouldnt pass USMLE so the only way that cohort can become a doctor is if they have COMLEX. So, it does have some utility in allowing some people to be able to be doctors that otherwise wouldnt have been able to. USMLE is more challenging than COMLEX

There is no backing to that claim at all. Sure they wouldn’t score well, but I’m betting no more than 10% wouldn’t pass

 

[Deecee2DO]

There is no backing to that claim at all. Sure they wouldn’t score well, but I’m betting no more than 10% wouldn’t pass

Its my opinion. Not a fact

 

[asdf123g]

I always found the common reflex reaction of "program directors and MDs simply do not know how to interpret the COMLEX, so you'd better take USMLE" to be very odd. If you can't google the percentile-to-score converter and then match that up to USMLE scores and percentiles, then you shouldn't be treating patients and prescribing medication IMO. It's not a huge ask. It's probably the easiest part of your entire evaluation of a candidate, actually. I have A LOT more respect for our MD colleagues and expect them all to be able to figure out what a good level 1 score is the same way I would expect a DO PD to figure out what a good step 1 score is.

That's not to say that one should only take COMLEX. OP, you should definitely take both, as stated on this thread. This is just some food for thought.

No idea why theres such almost opposition and rationalizations for PD discrimination and laziness. This comment is very reasonable.

 

[asdf123g]

That and dont forget about a quarter of most DO classes wouldnt pass USMLE so the only way that cohort can become a doctor is if they have COMLEX. So, it does have some utility in allowing some people to be able to be doctors that otherwise wouldnt have been able to. USMLE is more challenging than COMLEX

Curricula are different between MD/DO schools with focuses on different subjects and different study sources often mandated by programs to do well on the COMLEX, not the USMLE. Not to mention the several extra hundreds of hours dedicated to learning OMM (often scientific woo woo that has a steep learning curve) that could be spent relaxing or board studying (lab, lecture, testing).

So I do not agree with you since this isn't a fair 1:1 comparison. I think DO's would do just as well if they didn't have so much BS to learn. MD's on a DO curricula wouldn't fair well on the USMLE either. They'd perform about the same as a DO on the COMLEX.

 

[Sardonix]

No idea why theres such almost opposition and rationalizations for PD discrimination and laziness. This comment is very reasonable.

The SDN DO section may have a tendency for self-loathing built out of the extra obstacles DO students face compared to MDs, but the responses thus far aren't justifying or defending PDs' actions. They're acknowledging the reality of the uphill battle DO applicants face.

No one here enjoys paying for x2 boards or dealing with anti-DO bias come application season. But given the choices are rail against the PDs or rail against the arbitrary, poorly managed, overly-expensive, and questionably necessary existence of COMLEX and/or the NBOME... the choice is pretty obvious. Put another way, if I have to choose between a sandwich that will provide me with sustenance but also diarrhea vs. a sandwich that will only give me diarrhea, I'll choose the first option.

 

[Deecee2DO]

Curricula are different between MD/DO schools with focuses on different subjects and different study sources often mandated by programs to do well on the COMLEX, not the USMLE. Not to mention the several extra hundreds of hours dedicated to learning OMM (often scientific woo woo that has a steep learning curve) that could be spent relaxing or board studying (lab, lecture, testing).

So I do not agree with you since this isn't a fair 1:1 comparison. I think DO's would do just as well if they didn't have so much BS to learn. MD's on a DO curricula wouldn't fair well on the USMLE either. They'd perform about the same as a DO on the COMLEX.

I actually partly agree with you on this as it does sense. But my own personal opinion is that if there were no comlex I still think there would be a higher attrition rate at some DO programs because a portion of the class would not be able to pass the USMLE (more so the students at new DO schools than established ones with higher GPAs and MCATs). Completely anecdotal I know but that is just my own theory

 

[Deecee2DO]

The SDN DO section may have a tendency for self-loathing built out of the extra obstacles DO students face compared to MDs, but the responses thus far aren't justifying or defending PDs' actions. They're acknowledging the reality of the uphill battle DO applicants face.

No one here enjoys paying for x2 boards or dealing with anti-DO bias come application season. But given the choices are rail against the PDs or rail against the arbitrary, poorly managed, overly-expensive, and questionably necessary existence of COMLEX and/or the NBOME... the choice is pretty obvious. Put another way, if I have to choose between a sandwich that will provide me with sustenance but also diarrhea vs. a sandwich that will only give me diarrhea, I'll choose the first option.

Amazing post

 

[Frank.MD]

I am 2020 class from DO school. MOST of my classmates with ONLY COMLEX scores matched into top programs includung Orthopedic surgery, dermatoloy, etc, Though I matched into TY only, not because I went to DO school. I wanted an advanced program, got a sizable interviews, but my COMLEX 2 score was not amazing, coupled with the fact that I didn't take COMLEX PE(CE) before my interviews. From my experience, taking only COMLEX alone DOES NOT stop you from matching into your favorite program of choice, ONLY your scores matter. However, having USMLE step score would open more interview opportunities, but having a low step score will DEFINATELY hunt you.
If you ask my oppinion, I would say, concentrate your efforts either in COMLEX and ace your scores, that's all you need. NOTHING more!
(now I have all my COMLEX scores, and will be starting my TY residency by this July, I will apply again in 2021 match to my program of choice, hopefully I will match).

 

[Dr. Rafiki]

The SDN DO section may have a tendency for self-loathing built out of the extra obstacles DO students face compared to MDs, but the responses thus far aren't justifying or defending PDs' actions. They're acknowledging the reality of the uphill battle DO applicants face.

No one here enjoys paying for x2 boards or dealing with anti-DO bias come application season. But given the choices are rail against the PDs or rail against the arbitrary, poorly managed, overly-expensive, and questionably necessary existence of COMLEX and/or the NBOME... the choice is pretty obvious. Put another way, if I have to choose between a sandwich that will provide me with sustenance but also diarrhea vs. a sandwich that will only give me diarrhea, I'll choose the first option.

All I'm saying is when your knee-jerk reaction is "program directors don't know how to interpret scores", then my reaction is "are you f****** kidding me?"

Once I'm an attending, if I happen to be around academia / residencies, then I plan on telling every single PD that they're a f****** idiot straight to their face if they drop that line. At least be honest about the discrimination.

 

[AnatomyGrey12]

I am 2020 class from DO school. MOST of my classmates with ONLY COMLEX scores matched into top programs includung Orthopedic surgery, dermatoloy, etc, Though I matched into TY only, not because I went to DO school. I wanted an advanced program, got a sizable interviews, but my COMLEX 2 score was not amazing, coupled with the fact that I didn't take COMLEX PE(CE) before my interviews. From my experience, taking only COMLEX alone DOES NOT stop you from matching into your favorite program of choice, ONLY your scores matter. However, having USMLE step score would open more interview opportunities, but having a low step score will DEFINATELY hunt you.
If you ask my oppinion, I would say, concentrate your efforts either in COMLEX and ace your scores, that's all you need. NOTHING more!
(now I have all my COMLEX scores, and will be starting my TY residency by this July, I will apply again in 2021 match to my program of choice, hopefully I will match).

Ok Gimpel.

 

[Alkaidius]

I actually partly agree with you on this as it does sense. But my own personal opinion is that if there were no comlex I still think there would be a higher attrition rate at some DO programs because a portion of the class would not be able to pass the USMLE (more so the students at new DO schools than established ones with higher GPAs and MCATs). Completely anecdotal I know but that is just my own theory

I do completely agree that the attrition would be higher, particularly dragged down by this incessant need to open new inexperienced schools, but if we were forced to take the USMLE eventually, I think after the initial shock period we would fair about as well as the low tier MD schools. We just got too much going against us right now...

1) Most schools don’t stress the USMLE so while all MDs go into school with their sights set on it, DOs are more ambivalent, and less determined to tackle it on average cause we don’t need to. This means we get exposed to great resources like UWorld later, especially the students with families that keep their heads down most of the time and only really stick it out for advice come board time. Essentially administration can be garbage and hold you back.

2) Two exams means double the psychological stress. When you’re taking the first one your stressing about the second one you got coming up, when you’re taking the second you’re still freaking out about how you did the first one. The average med student isn’t exactly a ball of positivity. It’s never “this just means I have two opportunities to show them how smart I am” it’s always “I have two chances to score below my standard mean and if even one is low I’m doomed...”

3) So much damned wasted time in mandatory lectures is, I think, universally accepted as a handicap. Not to mention that MDs are specifically trained to tackle USMLE style questions for two years while the average DO has just their dedicated period for experience. Are there students that start earlier or are able to make up that difference in such a short time? Of course! But not everyone, which would be needed for an accurate comparison.

To use an analogy, if taking the USMLE was like running a marathon. Then while the MD student is at the starting line waiting for the gunshot, the DO is still a couple hundred meters back just trying to get his butt over there because their idiot trainer gave them the wrong start time. Also they’ve got those 1lb weights around the wrists and ankles lol. I’m sure the difference this makes is small, but even a handful of questions makes a tremendous difference in your score on the lower end of the USMLE/COMLEX grading spectrum. Enough, I think, to change the pass %, at least.

 

[Neopolymath]

All I'm saying is when your knee-jerk reaction is "program directors don't know how to interpret scores", then my reaction is "are you f****** kidding me?"

Once I'm an attending, if I happen to be around academia / residencies, then I plan on telling every single PD that they're a f****** idiot straight to their face if they drop that line. At least be honest about the discrimination.

Sure DO discrimination is real but it has nothing to do with the reasons for prioritizing students with a USMLE score versus Comlex only. Also, I don't totally agree that PDs are just lazy (the ones I know sure are though.) The Comlex is constantly changing the average and only compares DOs to other DO students so as a generality it absolutely means they can't understand what the score means because it doesn't mean anything in the first place.

 

[Neopolymath]

I am 2020 class from DO school. MOST of my classmates with ONLY COMLEX scores matched into top programs includung Orthopedic surgery, dermatoloy, etc, Though I matched into TY only, not because I went to DO school. I wanted an advanced program, got a sizable interviews, but my COMLEX 2 score was not amazing, coupled with the fact that I didn't take COMLEX PE(CE) before my interviews. From my experience, taking only COMLEX alone DOES NOT stop you from matching into your favorite program of choice, ONLY your scores matter. However, having USMLE step score would open more interview opportunities, but having a low step score will DEFINATELY hunt you.
If you ask my oppinion, I would say, concentrate your efforts either in COMLEX and ace your scores, that's all you need. NOTHING more!
(now I have all my COMLEX scores, and will be starting my TY residency by this July, I will apply again in 2021 match to my program of choice, hopefully I will match).

 

[libertyyne]

USMLE is the gold standard.
A majority of applicants will take the test including FMGs and a large chunk of DO students.
If I am a PD why would have to bend over backwards to evaluate a non-gold standard test, especially when a majority of my applicants have step scores. If I have to , i will pick the highest number.

Not sure why this is soo confusing.

 

[Dr. Rafiki]

USMLE is the gold standard.
A majority of applicants will take the test including FMGs and a large chunk of DO students.
If I am a PD why would have to bend over backwards to evaluate a non-gold standard test, especially when a majority of my applicants have step scores. If I have to , i will pick the highest number.

Not sure why this is soo confusing.

A quick google search is bending over backwards? If you're a PD and this is your mentality then I maintain my assumption that you're a lazy and/or dumb POS.

 

[Neopolymath]

A quick google search is bending over backwards? If you're a PD and this is your mentality then I maintain my assumption that you're a lazy and/or dumb POS.

Are you just not going to acknowledge that PDs are comparing MDs, DOs, FMGs and therefore should first use the test that the largest number have in common? Help us understand what your actual point is. Is it that PDs should take more time to look at Comlex only applicants? Telling us that a 550 is average doesn't help me compare that DO to the predominantly MD and FMG candidates. How does this help?

 

[libertyyne]

A quick google search is bending over backwards? If you're a PD and this is your mentality then I maintain my assumption that you're a lazy and/or dumb POS.

No, you expect special treatment compared to every other applicant. Everyone else takes the Step 1. you want consideration the same as everyone else. Take the test and compete on equal standing.

Edit: And I already told you. If i had to pick a score on Comlex i would pick the applicant with the highest score. Solved.

 

[AnatomyGrey12]

A quick google search is bending over backwards? If you're a PD and this is your mentality then I maintain my assumption that you're a lazy and/or dumb POS.

It’s arrogant to think PDs are lazy or POS’s for not doing a search into how to interpret scores that only 2% of their application pile have.

I’m a DO, and if I’m ever a PD I won’t look at COMLEX scores at all. If you don’t have Step I’m not looking at your app.

 

[Neopolymath]

It’s arrogant to think PDs are lazy or POS’s for not doing a search I to how to interpret scores that only 2% of their application pile have.

I’m a DO, and if I’m ever a PD I won’t look at COMLEX scores at all. If you don’t have Step I’m not looking at your app.

The idea that taking step is a huge hinderance is silly. I saw that line a lot as a premed and now I really don't understand where it even originated. It's 1 day for a test you should be preparing for anyways and it costs $600 which is a drop in the bucket. There is literally zero excuse to not take the exam and it should reflect poorly.

We are operating in an MDs world so to scream this isn't fair is something that should be directed at the NBOME if anyone at all.