MSUCOM has a discussion on USMLE.
Rather than making a decision based on national trends, each student must weigh a variety of individual factors,
such as: class rank, MCAT score/standardized testing ability, test anxiety, and specialty choice/preference. Other
variables, which may be more difficult to gauge at the end of the second year are whether or not (1) you intend to
stay in Michigan, and (2) your preferred program has a pronounced osteopathic presence (i.e., is D.O. friendly,
related to the number of DO students typically accepted into the program). The decision of whether or not to take
USMLE involves weighing risks versus benefits: relatively straightforward for some but complicated for others.
• Students with a substantially high risk for underperforming are those who have low class rank (especially
bottom quintile), low first-time MCAT score, and high level of test anxiety.
• Students least likely to need to take USMLE are those who plan to stay in Michigan and are interested in
primary care.
• Students most likely to need to take USMLE are those seeking allopathic programs, especially those that
are competitive, outside of Michigan, and do not have a strong D.O. presence.