Is it better to have a high COMLEX and no USMLE than a high COMLEX and below average USMLE?

WhiteCoatSyndrome

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How much would having a below average USMLE score hurt you if you COMLEX is high? I am not quite sure what I want to do yet, I only have interests that I'm exploring, but I would like to be competitive at ACGME programs. I haven't taken the USMLE yet, but after receiving my COMLEX scores I have been encouraged to do so because I scored well. However, my practice nbme exams have been considerably below average. I'm going to study for a test date at the end of August and see where I stand then, but I don't want to take the USMLE and have it ultimately decrease any chances that I would have at a ACGME program.
 

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Seeing as some cut offs for DO students are loopsided, ex. COMLEX cutoff = 600; USMLE = 210 or lower, I think having even an average USMLE is helpful probably.
 

AlteredScale

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How much would having a below average USMLE score hurt you if you COMLEX is high? I am not quite sure what I want to do yet, I only have interests that I'm exploring, but I would like to be competitive at ACGME programs. I haven't taken the USMLE yet, but after receiving my COMLEX scores I have been encouraged to do so because I scored well. However, my practice nbme exams have been considerably below average. I'm going to study for a test date at the end of August and see where I stand then, but I don't want to take the USMLE and have it ultimately decrease any chances that I would have at a ACGME program.
I just read in the Research forum that applications with only a COMLEX are hard to decipher for PD's of ACGME programs and in many cases, are frowned upon since they will wonder why you didn't take the USMLE even though you scored high on the COMLEX. PD's at dually acre ACGME/AOA programs might have a different opinion but all in all I think the majority opinion is to always take the USMLE if you want to help your chances a ACGME programs.
 

Drrrrrr. Celty

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I just read in the Research forum that applications with only a COMLEX are hard to decipher for PD's of ACGME programs and in many cases, are frowned upon since they will wonder why you didn't take the USMLE even though you scored high on the COMLEX. PD's at dually acre ACGME/AOA programs might have a different opinion but all in all I think the majority opinion is to always take the USMLE if you want to help your chances a ACGME programs.
It doesn't have to do with being hard to decipher. Most programs who take DOs have likely taken them before or for many years. The issue is why take a COMLEX only score when you have applicants with USMLEs or both or MDs.
 

AlteredScale

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It doesn't have to do with being hard to decipher. Most programs who take DOs have likely taken them before or for many years. The issue is why take a COMLEX only score when you have applicants with USMLEs or both or MDs.
Well yeah that's what I mean. Any PD that's accepted DO's should be fine with a OCMLEX only applicant. I guess I should have better phrased it to what you were saying because that was exactly my point!
 

Goro

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It really depends upon what you're aiming for

How much would having a below average USMLE score hurt you if you COMLEX is high? I am not quite sure what I want to do yet, I only have interests that I'm exploring, but I would like to be competitive at ACGME programs. I haven't taken the USMLE yet, but after receiving my COMLEX scores I have been encouraged to do so because I scored well. However, my practice nbme exams have been considerably below average. I'm going to study for a test date at the end of August and see where I stand then, but I don't want to take the USMLE and have it ultimately decrease any chances that I would have at a ACGME program.
 

Drrrrrr. Celty

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Well yeah that's what I mean. Any PD that's accepted DO's should be fine with a OCMLEX only applicant. I guess I should have better phrased it to what you were saying because that was exactly my point!

I wouldn't go that far. I think that in general programs that are lower tier or next to established DO programs probably will be fine with COMLEX. Just because an IM program has taken DOs all that time, doesn't mean it's not taking competitive candidates with USMLES.


Frankly the whole issue is that as time progresses it becomes more and more ambiguous who needs to, who is recommended, and who shouldn't take the usmle. Then again with the general statistics and research on the issue being borderline non-existent since we're put into the other candidate it comes down to borderline anecdote searching.
 

AlteredScale

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I think that in general programs that are lower tier or next to established DO programs probably will be fine with COMLEX. Just because an IM program has taken DOs all that time, doesn't mean it's not taking competitive candidates with USMLES.
I agree (and hopefully you know I wasn't trying to make that huge of an assumption either). None of my statements are blanket statements. All I'm stating is that for the most part (an for the sake of the merger), taking the USMLE will be beneficial for OP especially if they are considering a competitive ACGME or even an ACGME program that here and there takes a DO (see George Washington University IM program for example).
 

Drrrrrr. Celty

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I agree (and hopefully you know I wasn't trying to make that huge of an assumption either). None of my statements are blanket statements. All I'm stating is that for the most part (an for the sake of the merger), taking the USMLE will be beneficial for OP especially if they are considering a competitive ACGME or even an ACGME program that here and there takes a DO (see George Washington University IM program for example).

Clearly, I'm typing things out to distract me from the reality that on Monday life will suck again.
 
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WhiteCoatSyndrome

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It really depends upon what you're aiming for
What I'm most interested in now is psych, rads and anesthesia in no particular order, so I'm all over the place. From what I can tell it seems a good COMLEX will take you pretty far for psych. I emailed Yale's psych program out of curiousity to see where they stood on DOs and the COMLEX and even they said they would take the COMLEX in lieu of the USMLE. Whether they prefer the USMLE, I don't know, but if they did it would be very easy for them to just not accept the COMLEX at all. I understand that ACGME rads requires USMLE for the most part. Not sure where anesthesia stands.
 
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WhiteCoatSyndrome

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A 600 COMLEX with a 220 USMLE is going to benefit you more often than not compared to a 600 COMLEX and no USMLE. A 600 and a 200? You might be hurting yourself. It's quite situational, really.
But wouldn't a 600 or above equate to higher than a 220? Therefore, wouldn't an ACGME program see you had a good score for COMLEX, but a below average usmle, possibly making you less competitive than if you had only one good score? I'm speaking obviously for programs that don't prefer the usmle. In those that do you would have to take it anyway to be considered. But say for like a competitive psych program, wouldn't having a below average usmle water down a good COMLEX that may have been better off by itself?
 

Goro

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For ACGME programs that accept COMLEX, a high COMLEX will > a low USMLE.

IF you are in the bottom 1/3rd of your Class in med school, do not bother with USMLE.
 

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the problem is that programs can be choosey and they take advantage of that. i was interested in anesthesia for a brief spell, but in my experience all across the board MD put very one sided requirements or don't take COMLEX. I saw a gas program with a a 600 requirement on COMLEX or a 205 on USMLE. Not equal scores. And even in the less competitive specialities there were many programs that flat out didn't take the COMLEX. if you are ok with matching somewhere, you should probably be fine. but if you are geographically tied, or you have a certain thing in mind, you need to approach the USMLE differently.
 
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WhiteCoatSyndrome

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the problem is that programs can be choosey and they take advantage of that. i was interested in anesthesia for a brief spell, but in my experience all across the board MD put very one sided requirements or don't take COMLEX. I saw a gas program with a a 600 requirement on COMLEX or a 205 on USMLE. Not equal scores. And even in the less competitive specialities there were many programs that flat out didn't take the COMLEX. if you are ok with matching somewhere, you should probably be fine. but if you are geographically tied, or you have a certain thing in mind, you need to approach the USMLE differently.
I agree. I had planned on studying as hard as possible for usmle this month and seeing where I stand with a test date for late August. I think the reason I did poorly on my practice tests was that I only studied for the COMLEX. Did no Uworld or anything usmle specific while doing a fast pass through FA. If I can focus on something I usually excel at it, so that's what I plan on doing his month, focusing on usmle where I didn't before.
 

dozitgetchahi

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the problem is that programs can be choosey and they take advantage of that. i was interested in anesthesia for a brief spell, but in my experience all across the board MD put very one sided requirements or don't take COMLEX. I saw a gas program with a a 600 requirement on COMLEX or a 205 on USMLE. Not equal scores. And even in the less competitive specialities there were many programs that flat out didn't take the COMLEX. if you are ok with matching somewhere, you should probably be fine. but if you are geographically tied, or you have a certain thing in mind, you need to approach the USMLE differently.
Entirely correct.

And there are many university ACGME programs out there (my IM program, for one) that take DOs but only want to see a USMLE score. My program, for instance, (which was Indiana University) has become more comfortable with DOs in general (taking iirc 7 out of 37 incoming last year) but as far as I know all of these people had good USMLE scores backing them up.
 

Drrrrrr. Celty

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For ACGME programs that accept COMLEX, a high COMLEX will > a low USMLE.

IF you are in the bottom 1/3rd of your Class in med school, do not bother with USMLE.

Do you think that bottom 1/3rd of your class is blanket for all schools tho or yours specifically? I'm not going to try to sound too nuts, but I imagine that a bottom 1/3rd of a student at a high tier program probably would be at least middle of class at lower tier schools.
 
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WhiteCoatSyndrome

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Entirely correct.

And there are many university ACGME programs out there (my IM program, for one) that take DOs but only want to see a USMLE score. My program, for instance, (which was Indiana University) has become more comfortable with DOs in general (taking iirc 7 out of 37 incoming last year) but as far as I know all of these people had good USMLE scores backing them up.
This is true, IU is pretty heavy on the USMLE. I know residents there and a past PD from IU and they all say that IU prefers USMLE for the most part. I'm not sure if that's true for psych, FM and other uncompetitive specialties though. Regardless, this just gives me more reason to study up this month and take it. I'm confident in my abilities if I focus.
 

Goro

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It's the advice I give to my students, and we have a pretty high performing group.


Do you think that bottom 1/3rd of your class is blanket for all schools tho or yours specifically? I'm not going to try to sound too nuts, but I imagine that a bottom 1/3rd of a student at a high tier program probably would be at least middle of class at lower tier schools.
 

jw3600

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Do you think that bottom 1/3rd of your class is blanket for all schools tho or yours specifically? I'm not going to try to sound too nuts, but I imagine that a bottom 1/3rd of a student at a high tier program probably would be at least middle of class at lower tier schools.
Are you calling any DO schools high tier in relativity to the population taking USMLE...?
 

Drrrrrr. Celty

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Are you calling any DO schools high tier in relativity to the population taking USMLE...?
No, in respect to the DO population taking the USMLE. Likewise it is worth mentioning that the pass rate difference between a school with an average close to 27 shouldn't be too significantly different than that of a school above a 27 ( Though the average score likely scale with increased score), but the difference between a 27 and a school with a 25 average is much larger and will on average have a weaker pass rate and scores for example. But whether my application and expansion of that to class ranks is useful who knows.
 

hallowmann

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But wouldn't a 600 or above equate to higher than a 220? Therefore, wouldn't an ACGME program see you had a good score for COMLEX, but a below average usmle, possibly making you less competitive than if you had only one good score? I'm speaking obviously for programs that don't prefer the usmle. In those that do you would have to take it anyway to be considered. But say for like a competitive psych program, wouldn't having a below average usmle water down a good COMLEX that may have been better off by itself?
Yeah that's true (a 600 is better than a 220), but there's 2 things you need to keep in mind. First the people taking both exams are different populations, so its difficult to compare them based on percentile.

Second, they are different exams, and while they cover very similar material, many PDs aren't confident in nor do they really understand the COMLEX. The USMLE is a standard, and they're using it for everyone else. They know how to evaluate it. They know how it correlates to board pass rates, etc. That's why it makes sense to take both if you're aiming for moderately competitive ACGME programs.

That said, we're talking 220+. When you hit the 210-220 range, then it gets fuzzy and really depends on what specialty you want. Below 210, I'd consider it not worth it for almost any DO.
 

Leggomyeggo128

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what about this scenario....

If you have any USMLE score and apply to acgme residencies does your comlex become obsolete?

For example:

245 USMLE and 400 comlex > 205 USMLE and 800 Comlex....at university level acgme programs.
 

Drrrrrr. Celty

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what about this scenario....

If you have any USMLE score and apply to acgme residencies does your comlex become obsolete?

For example:

245 USMLE and 400 comlex > 205 USMLE and 800 Comlex....at university level acgme programs.


I question the world where this happens. Either you decided not to study OMM and as such risk not being able to practice or the COMLEX fairy decided you were next.
 

Mad Jack

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I question the world where this happens. Either you decided not to study OMM and as such risk not being able to practice or the COMLEX fairy decided you were next.
We had it happen at my school last year- 255ish on the USMLE, fail on the COMLEX. Even he didn't know how it happened, yet there it was.
 
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Leggomyeggo128

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I question the world where this happens. Either you decided not to study OMM and as such risk not being able to practice or the COMLEX fairy decided you were next.
But does it matter?

Skimming by comlex still means you passed and can get a lisence. Everyone says PDs don't know how to interpret comlex, so I can't see how this would negatively affect anyone now that all residencies will take MD/DO. This essentially makes comlex a pass/fail exam....which I would imagine a greater majority of the DO student community would prefer anyway. This also sounds like a bonus for PDs as they no longer have to compare apples (USMLE) and oranges (comlex).

In a sense comlex is phasing its self out. And will only remain as a cash grab for the nbome and to punish us for our lower than average Mcats.
 

Drrrrrr. Celty

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But does it matter?

Skimming by comlex still means you passed and can get a lisence. Everyone says PDs don't know how to interpret comlex, so I can't see how this would negatively affect anyone now that all residencies will take MD/DO. This essentially makes comlex a pass/fail exam....which I would imagine a greater majority of the DO student community would prefer anyway. This also sounds like a bonus for PDs as they no longer have to compare apples (USMLE) and oranges (comlex).

In a sense comlex is phasing its self out. And will only remain as a cash grab for the nbome and to punish us for our lower than average Mcats.
Idk, there's no statistics on it. And PDs who have taken DOs and as such will be where 90% of DOs end up know how to interpret COMLEX. They either just don't give a crap or prefer USMLE.
 

jw3600

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what about this scenario....

If you have any USMLE score and apply to acgme residencies does your comlex become obsolete?

For example:

245 USMLE and 400 comlex > 205 USMLE and 800 Comlex....at university level acgme programs.
Before I'd say most likely. With merger I'd say 100%.
 

realdocs

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what about this scenario....

If you have any USMLE score and apply to acgme residencies does your comlex become obsolete?

For example:

245 USMLE and 400 comlex > 205 USMLE and 800 Comlex....at university level acgme programs.
Or what about this scenario...
USMLE of 215-220 and Comlex > 600
Vs.
USMLE of 230 and Comlex of 575-599
Will programs (ACGME specifically) that "say" they require atleast 600 on Comlex from a DO student automatically eliminate the second student from consideration even though the second student performed slightly better on USMLE?
 

jw3600

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This entire thread is over analysis. Everyone who is remotely capable should take the USMLE and put all they have into it. It will become necessary and the gold standard.
 

IslandStyle808

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Or what about this scenario...
USMLE of 215-220 and Comlex > 600
Vs.
USMLE of 230 and Comlex of 575-599
Will programs (ACGME specifically) that "say" they require atleast 600 on Comlex from a DO student automatically eliminate the second student from consideration even though the second student performed slightly better on USMLE?
I have read a thread which gave me insight to this question. For certain programs that have bare minimums, the first applicant mention could be screen out (USMLE 215 COMLEX >600) just like the second one can be screened out (USMLE 230 COMEX <599). What I mean to say programs don't complete disregard the COMLEX if you have a high USMLE. You can get screen out if your COMLEX is too low, even when the USMLE is far above the screen out score. I can't say this logic is uniform for all programs though.
 
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Leggomyeggo128

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I'm not so sure. USMLE is the gold standard exam. This is not argued. If a program sees a USMLE score from a DO student, why would he/she try to hash out what his/her comlex meant? Why would they even care?

if you have an average USMLE and a super high comlex..you don't get any boost. There is no reward for taking two exams. An MD applicant is not going to suffer for having not taken comlex, so it becomes a non factor when comparing candidates heads up.

Every medical student DO/MD should take the USMLE. We have the same scope and same responsibilities. It would go a long way with the public perception of DOs if everyone knew we took the same licensing exams. Acgme Program directors would know without a doubt we are just as qualified, and it would go a long way to extinguishing the last remaining bias. This just makes sense to me. (Stepping off the soap box)

I think it is quite irresponsible for DO schools to tell students to not take the USMLE, as it is basically trying to hide/protect their students/curriculum/school from being seen as inferior to the MD schools. Which...in many ways....it already is (e.g. Cranial wack jobs, chapman points, rotations, etc etc).


I have read a thread which gave me insight to this question. For certain programs that have bare minimums, the first applicant mention could be screen out (USMLE 215 COMLEX >600) just like the second one can be screened out (USMLE 230 COMEX <599). What I mean to say programs don't complete disregard the COMLEX if you have a high USMLE. You can get screen out if your COMLEX is too low, even when the USMLE is far above the screen out score. I can't say this logic is uniform for all programs though.
 

Drrrrrr. Celty

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I'm not so sure. USMLE is the gold standard exam. This is not argued. If a program sees a USMLE score from a DO student, why would he/she try to hash out what his/her comlex meant? Why would they even care?

if you have an average USMLE and a super high comlex..you don't get any boost. There is no reward for taking two exams. An MD applicant is not going to suffer for having not taken comlex, so it becomes a non factor when comparing candidates heads up.

Every medical student DO/MD should take the USMLE. We have the same scope and same responsibilities. It would go a long way with the public perception of DOs if everyone knew we took the same licensing exams. Acgme Program directors would know without a doubt we are just as qualified, and it would go a long way to extinguishing the last remaining bias. This just makes sense to me. (Stepping off the soap box)

I think it is quite irresponsible for DO schools to tell students to not take the USMLE, as it is basically trying to hide/protect their students/curriculum/school from being seen as inferior to the MD schools. Which...in many ways....it already is (e.g. Cranial wack jobs, chapman points, rotations, etc etc).
I think it's worth agreeing that still fundamentally the USMLE is an accessory for DO graduates to have. You must pass COMLEX to proceed. Hence why people at the bottom of your class are recommended to focus on COMLEX. It's better for them to focus on actually graduating than on doing an extra exam which even if they pass won't advance their goals much. Likewise having two exams likely hurts DO students as well tbh. The formats are different.

Hell even as I proceed into second year I'm scared ****less of having to take two exams.
 
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Leggomyeggo128

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I think it's worth agreeing that still fundamentally the USMLE is an accessory for DO graduates to have. You must pass COMLEX to proceed. Hence why people at the bottom of your class are recommended to focus on COMLEX. It's better for them to focus on actually graduating than on doing an extra exam which even if they pass won't advance their goals much. Likewise having two exams likely hurts DO students as well tbh. The formats are different.

Hell even as I proceed into second year I'm scared ****less of having to take two exams.
Nah...you'll do great. Focus hard on USMLE and then take a few days to cram your head with witchcraft and wizardry and take comlex.

That's what I did, and I'm sure a great majority of fellow DOs did too.

Comlex is indeed required, but it is NOT equivalent to the USMLE. The NBOME might tell you different, but they can't see us for anything other than 600 dollar paychecks. DOs should be honored we are allowed to sit for the USMLE and truly prove ourselves and validate our education in the eyes of the greater medical community. Granted we shouldn't have to do this, but once you meet the wack jobs that preach the good book of cranial, you'll be glad you have an out if you decide you need one. Take it. And don't look back.
 
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IslandStyle808

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I'm not so sure. USMLE is the gold standard exam. This is not argued. If a program sees a USMLE score from a DO student, why would he/she try to hash out what his/her comlex meant? Why would they even care?

if you have an average USMLE and a super high comlex..you don't get any boost. There is no reward for taking two exams. An MD applicant is not going to suffer for having not taken comlex, so it becomes a non factor when comparing candidates heads up.

Every medical student DO/MD should take the USMLE. We have the same scope and same responsibilities. It would go a long way with the public perception of DOs if everyone knew we took the same licensing exams. Acgme Program directors would know without a doubt we are just as qualified, and it would go a long way to extinguishing the last remaining bias. This just makes sense to me. (Stepping off the soap box)

I think it is quite irresponsible for DO schools to tell students to not take the USMLE, as it is basically trying to hide/protect their students/curriculum/school from being seen as inferior to the MD schools. Which...in many ways....it already is (e.g. Cranial wack jobs, chapman points, rotations, etc etc).
I agree with your overall message. It was a question I posed a while ago about screening applicants. It wasn't answered in same thread, but a different one. Programs have screens for applicants, this can be USMLE 210 and COMLEX of 600 for instance. A person could score a 230 and 580, and this would screen out an applicant for that certain program. This means the COMLEX becomes a weeder tool for DO applicants. My statement wasn't about the dilemma of taking the USMLE. It was the dilemma of how PDs don't use the COMLEX as a comparison tool, but still use it to weed out DOs.
 

Leggomyeggo128

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I agree with your overall message. It was a question I posed a while ago about screening applicants. It wasn't answered in same thread, but a different one. Programs have screens for applicants, this can be USMLE 210 and COMLEX of 600 for instance. A person could score a 230 and 580, and this would screen out an applicant for that certain program. This means the COMLEX becomes a weeder tool for DO applicants. My statement wasn't about the dilemma of taking the USMLE. It was the dilemma of how PDs don't use the COMLEX as a comparison tool, but still use it to weed out DOs.
I could be wrong, but i believe that is an either or situation. If your USMLE score is above cutoff you are fine.

These cut offs were most likely a way to screen the giant pool of DO candidates that would apply with just comlex. 600 is > 85%tile (?), so PDs probably set these arbritary high numbers to discourage a giant mass of "unqualified" DOs because they were too lazy and probably a tad biased. But once you take the USMLE all bets are off. You can now be straight up compared to an MD, which makes the program directors life easier and gives you a fighting chance.

Besides. 205 is very reasonable. I would hope every DO school prepares students well enough to get that score. And if not...we have to seriously evaluate and drastically change our curriculum.
 
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