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Is the usmle really necessary?

Discussion in 'Medical Students - DO' started by Scorcher31, Jul 25, 2006.

  1. Scorcher31

    Scorcher31 Member
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    I'm a first year med student at umdnj-som, but haven't started yet and really want this cleared up for my own piece of mind. Obviously we only need to take the COMLEX exams if we want to match into a DO residency. Here is where my question arises. Do we need to take the USMLE exams if we want to match into a not very competitive MD residency such as ER or general surgery? Every student I've talked to says something different. I'm not sure if the USMLE exams are an actual requirement for all MD residencies or if COMLEX is ok unless the MD residency is super competitive.
     
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  3. JonnyG

    JonnyG IN the hospitals....
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    general surgery is now considered to competitive. It is easier to just take the USMLE to cover your bases then to find out later you needed to take it. ER would probably workwith the USMLE.

    You will get a million different answers on this.
     
  4. Buckeye(OH)

    Buckeye(OH) 5K+ Member
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    Why do you need piece of mind? Its not for another two years.

    Since when is allopathic surgery, 'not very competitive'?

    COMLEX = accepted; USMLE = generally preferred by allo schools.
     
  5. Scorcher31

    Scorcher31 Member
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    I guess you can consider general surgery very competitive, but there’s plenty of surgical residencies available at least compared to ortho, derm, etc. I always viewed im, family, psych, peds as less competitive. Next GI, ER and gen surgery as somewhat competitive. Highly competitive were like derm, radio, specialized surgery, ortho, etc. My divisions could be totally wrong. I guess it just depends how you look at it, and I really don’t want to get into too much of a discussion about how competitive certain residencies are because it really depends on how prestigious the residency program is that you are applying to. Long as your scores are good and you have good experience and references you are probably fine if you are flexible about where you want to go. I just wanted to focus on if it was actually necessary to take USMLE exams as an osteopathic student to get into MD residencies. So my take from what you said is it is usually recommended, but not required. I guess it must vary from place to place. If you’re wondering why, the only reason I am looking into MD residencies outside my school is I may have to change states depending on which city my longtime girlfriend gets a job in. In general there are less DO residencies around, which is obvious because there are less DO students. So it’s not that I’m looking to go to a prestigious MD surgery residency. I would just be going to any hospital’s gen surgery residency in the area that I could get. I was getting confused because I had heard that a lot of MD programs are fine with taking Comlex scores, and the AMA was getting much more accepting of DO's in general. For every time I hear this though, I hear someone say you need to take USMLEs for all MD residencies. If I did good on the Comlex, I wouldn't want to risk bring myself down on the USMLEs if I diddn't have to.
     
  6. Scorcher31

    Scorcher31 Member
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    BTW thanks for the input so far!
     
  7. Taus

    Taus .
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    you've got the right idea....most accept it, some don't...its location/hospital/specialty specific.....to me it just makes sense to take it and avoid any potential headaches later down the road....its really not that much of a big deal to take both...
     
  8. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    A couple of qiuck thoughts:

    1. ACGME general surgery is very competitive (one unfilled categorical porition nationwide this year). BTW, are you familiar with the difference between categorical and preliminary positions? This distinction is very important.

    2. Because the allo gen surg is tough to get into even for MD students, as a DO you will be starting at least a step behind. Unless you have a solid USMLE score, even a great COMLEX score likely won't make up that gap. (Of course, there are likely some who've made it, but they aren't a majority).

    3. If you are going to be locked ino a specific area because of personal reasons, you can take another two steps back. It's one thing to be a DO applying to a competitive MD specialty, and it's much, much harder to do if can't apply to a broad range of programs.

    4. Study as if you are going to take the USMLE. Then you're prepared for whatever you decide to do when you get into the latter part of your second year.

    5. The necessity of the USMLE for a DO student varies somewhat on the specialty you choose. If you're really interested in a paticular specialty, it may not be a bad idea to read the FAQS in those forums. Many of them have a lot of info for DO students.

    6. Bottom line, if you're a DO dead set on allopathic surgery in a paticular city/area, not having the USMLE will kill your already considerably decreased chances.

    Good luck.
     
  9. Scorcher31

    Scorcher31 Member
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    Sorry San Juan no I'm only going to be a first year, and I've never heard of the whole categorical/preliminary position thing. I looked it up and understand the difference now. I guess I was just under the impression that it was so equal now a do has just as good of a chance getting into an md residency as an md provided he took the usmle and did as well. It seems odd because schools like PCOM send huge chunks of their class into those residencies, yet they might only have 1 residency for a derm student. I guess thats why I thought it wasn't as hard to get into.
     
  10. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    In the allopathic world, general surgery programs offer categorical positions, which means you have a spot for the entire 5 year residency (barring a huge flameout by the resident).

    However, they also sometimes (depending on the program) offer preliminary positions. These are for one year, and are often utilized by student pursuing a residency that requires a year of training before the start of your official residency. For example, some folks match anesthesia for their PGY2 year, and then get a surgery PGY1 (prelim) year.

    This may explain why a school's match list seems so full of surgery residencies. They may in fact have a lot of people doing prelim years, and then moving on to something else for their PGY2 year. Many times, those PGY2 programs are competitive too, so if a school like PCOM has a bunch of people doing this, they probably are putting out competitive students.

    These prelim years also are used sometimes by people who were unable to match a categorical position, the idea being that they impress their bosses and get good letters of recomendation to pursue a PGY2 position in general surgery. Somtimes, they may even get lucky if a categorical decides to change specialites, opening up a spot for the prelim at that program.

    Allopathic general surgery is probably more competitive than osteopathic for a number of reasons. However, even osteopathic is said to be competitive. Give me 7-8 months, and I'll let you know what I think. I'm applying strictly osteo (20 programs) this year, in part because I did not take the USMLE.

    For anybody that cares, I submitted my ERAS on July 15th (I have everything but my 3rd LOR in). 7 of 20 programs have already downloaded my stuff! Woo hoo!
     
  11. Scorcher31

    Scorcher31 Member
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    Thanks for all the input. That clears up a lot. Now here's my last question. Say I take Comlex and USMLE. Say I do good enough on Comlex to get into a DO surgery residency with my school, but I do pretty poorly on the USMLE. Since I would be applying for a DO residency do they even get to see my USMLE score and would it pull me down?
     
  12. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    No. You do not have to submit a bad USMLE score to any DO programs. You really don't have to submit it to MD programs either, if you just want to go it alone with your COMLEX. If you take the USMLE and don't do well, you can just pretend it never happened, and you're just out $500.

    Feel free to post questions on these forums. We all have to learn at some point, nobody was born knowing this stuff.
     
  13. homeboy

    homeboy I'm super cereal.
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    I think the real question is "is the COMLEX necessary." It is ridiculous that 2 licensing exams even exist, but, of course, the AOA needs to maintain its autonomous state and foot-hold in the world of accreditation. It's never going to happen (merging to one licensing exam that is) but it sure would make things a hell of a lot easier.

    1.) DO students shouldn't be 'afraid' to take the USMLE, as if it would show a sign a inferiority to fail it. We don't learn anything less in yrs 1 and 2, but you have apply yourself a little more to take the USMLE.

    2.) The USMLE is hands down a better test, both in terms of question content and format. Is it harder? Probably...depends on your take...but the questions are definitely better written.

    3.) It is disturbing that DO students can cop-out and withhold their USMLE scores if they aren't to their liking. Sure, it doesn't matter if you're applying to AOA residencies, but if you're applying allo and withhold your step 1 because you don't like the score, you're full of crap.

    If you're willing enough to take step 1, you should have the fortitude to accept your score.
     
  14. melvin

    melvin Junior Member
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    You absolutely do not need to take the USMLE. Board scores are one component of your residency application package. Think of board scores not in the sense that good scores will get you in the door, but that bad scores can keep you from an interview..subtle difference but dynamic nonetheless.

    Take the COMLEX, chill out and realize that you will get into a good residency if you do well, are articulate, good LORs, etc. Think to yourself, if they don't accept your test, will they ever fully accept you?

    Best of luck guys,
    Melvin OUCOM class 2007
     
  15. DOCTORSAIB

    DOCTORSAIB Ophtho or bust!
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    I'm not quite sure I agree with this approach. Things are not always this black and white. If you're applying to a competitive field in the allopathic world, YOU WILL NOT BE CONSIDERED WITHOUT A USMLE SCORE! Simple as that. ("Competitive" = Derm, Rad Onc, Plastics, Ophtho, ENT, Rads, etc)

    For example, why would an allopathic Ophthalmology program with 500+ qualified applicants (for only 3-6 spots/year) try to compare a DO student with only a COMLEX score to the other 499 applicants with great USMLE scores? The reality is they won't! You want to play in their court. Respect them enough and take the USMLE. That's how I see it.
     
  16. VALSALVA

    VALSALVA sh*t or get off the pot
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    I completely agree with this post (with one minor exception being the last sentence)...especially now that I've actively entered the allopathic match process this year.

    However, a strong all-around candidate with great letters, great rotation evals, and, hopefully, a great personality (e.i. likeable and/or personable and/or funny) has a great chance of matching into anything - whether they are M.D. or D.O. I witnessed this last year as a few of my D.O. friends matched to highly competitive fields at places like John's Hopkins, Mayo, and U. Washington...with only their COMLEX scores in hand. All that being said, I'm jumping right into the match, confident that my total package will be appealing to several places.

    Additionally, do plenty of research; actually talk to attendings at the programs you're interested in. Example: U of Nebraska accepts COMLEX scores but only after actually talking to the program director did I discover that although they accept it, you must "rock it" to be considered. He doesn't know how to score the COMLEX but he figured if they did really well by NBOME standards, then the student must be good...that sort of thing.

    That's the sort of stuff D.O.'s MUST know before applying to allopathic programs. Is it more work? Oh yeah! I took a day off and literally called 30+ EM programs. However, if you want it...you'll do it!
     
  17. OSUdoc08

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    I've spoken to PD's at several EM residencies that require or strongly recommend USMLE (even for DOs.)
     
  18. Arch Guillotti

    Arch Guillotti Senior Member
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    This poster is quite obviously delusional. The subject has been discussed ad nauseum so I won't type much. My program fully accepts me (and a couple of other DO's as well as having some on staff) yet they strongly want to see USMLE scores (>220 I might add for Step I). Taking the USMLE only opens doors for you. COMLEX only for many allopathic residencies will leave these doors shut. Several PD's told me directly that taking the USMLE was the best thing I could have done to help my application.
     
  19. melvin

    melvin Junior Member
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    A lot of programs will list that they accept only the USMLE on their website, however, if you call them and ask they will tell you that they will take the COMLEX, just have your Deans letter mention the COMLEX percentile rank. I have to ask the question... why would you attend an Osteopathic institution and then spend the rest of your time treying to prove your good enough, would it have not been easier to attend an allopathic school from the beginning?
     
  20. VALSALVA

    VALSALVA sh*t or get off the pot
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    I firmly believe the answer to your last question is the following: osteopathic medical education is excellent (at least for me it was)/allopathic post-grad training is superior. For me, pursuing an allopathic residency is like gettting the best of both worlds. Oh by the way...there aren't enough osteo. post-grad spots to support all us grads - just wait until all the new schools start pumping out grads!!!! Above average osteo. students like myself will be runnin' to the allo world in increasing numbers!
     
  21. beastmaster

    beastmaster Senior Member
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    I've been curious about this, sort of the converse to the OP's dilemma. Do osteopathic residency programs get to see your USMLE scores if you want them to? It seems like if someone scored well they'd want to show the score off a bit. If so, would the DO program directors care at all about it? It's early and I may not be articulating this question appropriately but someone please take it and roll with it anyway. I don't know anything about the ERAS system, so I don't understand the options available to the applicants.
     
  22. OSUdoc08

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    It would have been, if they accepted you......
     
  23. group_theory

    group_theory EX-TER-MIN-ATE!'
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    On ERAS, you have to list your USMLE ID number, and also authorize the release of your USMLE score from NBME, and pay a $50 ... before programs can see your USMLE score/transcript. The same thing with COMLEX ... you need to list your COMLEX ID number, and authorize the release of your COMLEX score from NBOME, and pay a $50 fee. For the purpose of ERAS, if you don't fill out the info for USMLE, then your ERAS application will not have any usmle information.

    If you took both usmle and comlex and want to send both scores to residencies, then it's $100 ($50+$50).
     
  24. DireWolf

    DireWolf The Pride of Cucamonga
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    Your ignorance is disturbing.

    Sure - the program will ACCEPT your COMLEX score and then politely throw your application in the trash.

    It's not about a program ACCEPTING your score - it's about a program liking your score (USMLE) and then offering you an interview.
     
  25. beastmaster

    beastmaster Senior Member
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    well put
     
  26. Buckeye(OH)

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    As others have said, I really don't feel like I understand the logic behind this statement.

    Its about levelling the playing field. I dont give two ****s if an allopathic surgery program "respects" me, so long as I get into it.

    Acceptance into the program is "respect" enough for me.
     
  27. Osteodog

    Osteodog DO, DPM
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    How about if someone passed the USMLE (but only got around a 200 for step one) and wanted to apply to allopathic programs? Should they release their USMLE scores as well as their COMLEX scores or would a relatively low USMLE score be looked at as worse than not taking it at all?
     
  28. Buckeye(OH)

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    I wouldnt report it.
     
  29. kaikai128

    kaikai128 Yes SIR. ;-)
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    FYI:

    If you are military--they use the score from the type of school you attend. A USMLE score essentially won't even be considered if you went to an Osteopathic school. Focus on doing well on the COMLEX.
     
  30. Dr JPH

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    This is not true at all. I know many applicants, myself included, who are applying to and have matched into Allopathic GS slots without ever sitting for or reporting their USMLE I or II scores.

    The vast majority of ACGME training programs are familiar with the COMLEX. Program directors do get information from NBOME regarding the grading system for the COMLEX I and II so that they can make a better comparison of their osteopathic applicants to their allopathic applicants.

    The true bottom line is if you are concerned about a particular program of interest judging you differently as far as board scores go, then take the USMLE. The exam prep is nearly identical.
     
  31. Dr JPH

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    If your COMLEX score is significantly better than your USMLE score then I would recommend not reporting the USMLE on your ERAS application. However, be prepared if they do ask on an interview if you ever took the USMLE.
     
  32. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    A few thoughts:

    1. For obvious reasons, please quantify "many". And we are talking categorical matches, right?

    2. Just because you're applying to allo- spots this year proves jack squat. You aren't in yet!

    3. I'm sure there are some folks who only have COMLEX matching ACGME. However, these people are excellent students with excellent scores, many of whom applied widely (and many of whom nailed away rotations and/or knew somebody). Contrast this to the OP. He is very limited in his geographic availability, and unless you're in a city like New York with a billion surgery residencies, you're going to have a tough go, even if you're an MD.

    Obviously, program directors know what the COMLEX is. But just because the AOA sends stuff about the COMLEX doesn't mean alot of PD's read it. And even if they did, it's a stretch to beleive that they view the COMLEX as on par with the USMLE. In my experience, I've been told my two allo PDs (see, I quantify the number :) ), that if you want an allopathic residency,, you need to take the aloopathic boards. Their game, their rules, so to speak.

    I'm glad you agree with me on this, and I think you bring up a good point about exam prep. Good luck with your applications.

    For anyone interested, there are a couple of really good threads on the surgery forum about the DOs who applied allo this year. These folks were great applicants, and several of them had a very rough time. It's an enlightening read. Also, this forum had a good thread a year or two ago about DOs in allo surgery. I'll search for them later if I get some time.
     
  33. Dr JPH

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    San Juan

    I didnt want to come across like I was bashing you. I apologize if I did.

    I do agree with you that DOs matching into top Allo GS spots is an uphill battle. I dont know what city you are in, but in Philadelphia there doesnt seem to be much distinction between allo and osteo applicants in many programs...very blurry line. Every year PCOM sends grads to all types of residency spots in the city from large university affiliated to the smaller allo community hospitals.

    Good luck with your applications. Perhaps we will meet on the interview trail.

    :)
     
  34. San_Juan_Sun

    San_Juan_Sun Professor of Life
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    No problemo here. I do think you have a point about locale. It sure seems like west of the Mississippi, allo GS is a tough nut to crack.

    See you around this year.
     
  35. VentdependenT

    VentdependenT You didnt build thaT
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    If one is applying to any competative allopathic field then it would behoove the osteopathic applicant to take the USMLE.
     
  36. drusso

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    Yes, the USMLE is very helpful...not mandatory but very helpful. I've helped screen MD and DO applications for residency interviews and having USMLE scores as DO applicant avoids the whole "apples to apples" argument. Here are other things that really help as a DO applying to ACGME-programs:

    1) Letters of rec from academic physicians at ACGME programs, especially program directors, directors of education, and known physicians in your field of interest.

    2) Good personal statements that have been proof-read, are gramatically correct, succinct (but fill up the allowed space), don't ramble, and aren't goofy. Contrary to popular belief, your personal statement is not your place to "stand out;" don't be dramatic or "creative." Just write about your interests, experiences, and ambitions with clarity, integrity, and measured passion. Do include some pertinent details about your background and pre-med experiences.

    Your place to "stand-out" is at audition rotations and interviews. All you want your personal statement to do is nudge someone who is reading it (usually at 9PM after a long day at the hospital while their significant other is yelling at them for never paying attention to them or ever fixing the toilet "like you said you would" to say themselves, "Hmm, s/he sound interesting, let's put this one in the "yes" pile.")

    3) Dean's letters with specific comments from preceptors and grading data that show average scores, your score, other performance characteristics as well as some basic information about the characteristics of the class as a whole -- average MCAT, 1st time pass rate on the boards, undergrad GPA. Some DO schools' Dean's letters suck. It is true that "elite" medical schools (Harvard, UCSF, Hopkins, Penn, and precious few others do not follow these rules. Your DO school, and the other 115 MD schools are not on this list.) The best thing your school can do is write the most detail-oriented Dean's Letter possible. If you suspect that your school's Dean's letter suck, then you should get examples from other schools and bring them to the administration and say that future alumni donations will be directly proportional to Dean's Letter quality.

    4) A good ERAS picture. Again, try to look as "Young Republican" as possible.

    5) Wear a good suit to your interview. Not overly expensive and flashy, just something nice from the Men's Wearhouse. Black, Dark Brown, or Pin-stripes (unless you're short...and you know who you are).

    6) Nice shoes (leather). Black shoes with black suit and black socks. Ditto for brown.

    7) Clean shaven. The hair will grow back. No piercings (you can them back in later). Ladies, today is not the day to flash your sexy ankle or small of the back tattoo. Wear hosiery. They're hot and uncomfortable and you'll feel like your mother (or grand mother) but they're "corporately correct."

    8) Speak in complete sentences and minimize slang speech. Don't say "Dude" unless your interviewer says it or you're interviewing in Hawaii. Be exceedingly gracious to secretaries. Conjugate your verbs well.

    9) "Where do you see yourself in 10 years??"

    Answ: You're not exactly sure. You're attracted to academic medicine for sure, but you also like being out in the community as well because you really enjoy the day to day practice of medicine. Research has always fascinated you and that's you were 5th co-author on a paper published in the Journal of God Only Knows What. It's not much, but it really did wet your appetite.

    You get the picture?

    10) Be humble, humble, humble, humble. But, don't ever apologize or be sheepish about where you went to college, how old you are, your class-rank (unless you really do need to apologize for it), where you grew up, being a D.O., or your parent's educational or vocational background.

    11) Practice superb telephone manners. And, yes the "Thank-you" cards help. So do the occassional check-in, reminder, follow-up about how interested you are in their program.

    12) On interview day, everyone is watching you. The residents who help show you around and answer questions are watching you. If they say that they "have no say in your getting in here," that means, "Well, technically we don't...but if you're a real TOOL, then 'yes' we do." You should ask them the "hard" questions...work hours, respect, priority of teaching in the program, etc...but listen very carefully to their answers and pay more attention to what they DON'T say and their body language than what they do say. The program picks which residents gets to interact with applicants. Who do you think that they're going to pick??
     

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