JAOA article regarding osteopathic students taking the USMLE

[randomusername]

My question is how each match works. I'm wanting to do EM and my first choice residency is a DO residency. So if I enter the DO match, does that automatically exclude me from the MD match since the DO match takes place first?

You can still apply to MD residencies but if you match to a DO program you're automatically withdrawn from the MD match.

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[lokiperson]

Hmm.. so in other words, it's probably best for me to just save my $500 and not worry about the USMLE.

 

[DuxburyPembroke]

I would still take it, for these reasons:
- if your second choice (and remember that your choices may change as you rotate in these places) is an ACGME program then you will want to be in that match too - ranking only your #1 DO in the osteopathic match, then your #1 MD in the allopathic match if you don't match at the DO one.
- if a program gains dual accreditation, that USMLE score may make you more competitive.
- I don't know about EM, but what about the other DO programs? Would you be willing to go to your #2 DO choice? #3?
- $500 is a small investment to make toward increasing your options in what is arguably the most important part of your medical education and also where you are going to be spending three or four very intense years.

 

[thegame11]

You can read the comments from the participants here: http://surveymonkey.com/sr.aspx?sm=3KpgcJqKXsOcnMERdyIi9WozZyFGpwnftwJ8KtiTbEE_3d

 

[belfort226]

At the end of the day you have to make decision - Are you happy with an osteopathic residency or do you want to go allo? Let's face it; life isn't fair. You have to take control of your career and get where YOU want to be.

Secondly, when people talk about dermatology they forget that AOA has no connected derm programs. From what I understand you apply during your internship year. Moreover, many of the DO derm residencies are unfunded (Western, NSU, etc.). I've personally never met or even read about an osteopath who obtained a seat at an osteo program (very weird since there are posters on SDN who matched into allo derm). Of course it is possible but the entire process is more convoluted in the osteopathic world.

 

[DocEspana]

The matches for DO derm (at least at St. John's) are a handshake deal. No one matches from their internship year despite the program implying thats how you get in. They are told ahead of time that they will be in the derm program assuming they don't mess up during 3 years of family practice residency. So the match says that they matched FP and then 3 years later it says the same person matched derm. But they know ahead of time (even before the match) that this is the case. They're sort of cryptically told that if they were to get accepted they would be in the derm program too. Obviously this leads to them all putting SJEH #1 on their rankings. So far no one has complained of abuse of trust in the deal. The FP people who were told this stuff really do become the derm residents 3 years later.

The nice thing about SJEH is its funded, unlike some other programs.

 

[r90t]

I've said it before, if you do well it well help get you into a super competitive field.

I did allopathic radiation oncology. There is no DO equivalent. I know 3 DO students that matched rad onc. All took USMLEs. I did not take the USMLE and got in outside the match. I got lucky or my CV compensated for lack of USMLE. These DOs beat a bunch of MD/PhD applicants. I was on the interviewing process for my program and know how people did and what the screening criteria was. No USMLE scores, no interview, period.

Take the dang test, it is only $500 bucks, or so. Worst case, you blow it and end up matching primary care (not a bad thing), best case, you get in the 99th percentile, and you can pick whatever specialty that you would like. I know one of the DO students did this, and he was top of PD's radar.

 

[drpierre]

Thanks for the discussion guys it's very helpful & Dr. Hasty really appreciates it

 

[Sinfest]

I plan on taking USMLE Step 1, but what's the consensus on taking Step 2?

 

[aldosterone2]

Great article. About 70% said take the USMLE. Let's go with that.

 

[Dissected]

I plan on taking USMLE Step 1, but what's the consensus on taking Step 2?

It's a good idea for some specialties. In third year you might email some program secretaries/directors at programs you are interested in to see if they think it would help your application.

 

[TeamZissou]

For Allo EM and Anesthesia it typically only helps.

 

[Dissected]

For Allo EM and Anesthesia it typically only helps.

Surgery appears to favor it as well

 

[TeamZissou]

Surgery appears to favor it as well

Ah yeah for Allo GS it's one of the things that could make you.

 

[DC DOC]

As a fourth year osteo student who is currently and anxiously awaiting the allopathic match results next week, I would strongly recommend taking the USMLE step 1 at the very least. If you are unsure of what you want to do or are considering Gas, EM, Gen Surg, or even IM, it is in your best interest to take the beast. I would even put IM closer to the top because of the lurking requirements to have completed an ACGME approved residency for a cards, pulm, GI fellowships etc.. If it hasn't been approved yet, it will be by the time you are looking to apply. So consider the possibility in your decision.

I personally applied to only allopathic categorical anesthesia residencies and in the majority of my interviews, the PD's expressed that they were happy that I had taken the USMLE. I scored just above average and received plenty of interviews at great academic centers. Not sure how that would of played out if I hadn't taken the USMLE. I also didn't meet a single osteopathic applicant that hadn't taken it on the interview trail. This is my personal experience, so take it with a grain of salt. Anyone interested in further anesthesia info can PM me.

 

[scotchtapetest]

As a fourth year osteo student who is currently and anxiously awaiting the allopathic match results next week, I would strongly recommend taking the USMLE step 1 at the very least. If you are unsure of what you want to do or are considering Gas, EM, Gen Surg, or even IM, it is in your best interest to take the beast. I would even put IM closer to the top because of the lurking requirements to have completed an ACGME approved residency for a cards, pulm, GI fellowships etc.. If it hasn't been approved yet, it will be by the time you are looking to apply. So consider the possibility in your decision.

I personally applied to only allopathic categorical anesthesia residencies and in the majority of my interviews, the PD's expressed that they were happy that I had taken the USMLE. I scored just above average and received plenty of interviews at great academic centers. Not sure how that would of played out if I hadn't taken the USMLE. I also didn't meet a single osteopathic applicant that hadn't taken it on the interview trail. This is my personal experience, so take it with a grain of salt. Anyone interested in further anesthesia info can PM me.

It has ALWAYS been the policy of ABIM and continues to be the policy of ABIM that you MUST complete ACGME (allo) IM residency before entering ACGME (allo) IM subspecialty training if you want to become board certified in that subspecialty.

Here is a simple rule for USMLE: If you can score no less than 5 points below the average for whatever specialty you want to go into, then take it... Otherwise don't. Period.

 

[River Rat]

Take it. Being a second year medical student, you should absolutely have no clue of what you want to do with the rest of your professional life. You haven't been exposed to enough medicine to know what each specialty is like yet. With that degree of uncertainty, make the investment in your future, study hard for it, knock it out of the park. Open doors. You won't regret it, even if you're not aiming for a high powered specialty.

 

[DO_doctor]

yes if you match DO you will be excluded from MD match

 

[AD28]

I went to a hospital fair earlier this year and one of the program directors (at a D.O. residency, no less) said to take the usmle for one main reason - the comlex as a standardized exam, is not up to par with the usmle. and apparently program directors know this, but they have to be pro-D.O. and support the comlex. i have heard of students in my school who scored a 250 on the step 1 but barely got over a 500 on the comlex because the comlex is so variable in the questions you might see. they said that with the usmle, you know what you're getting into and in that respect its easier to prepare for since its a better exam. the comlex has some poorly written questions that seem like there could be more than one answer. and if you're not lucky you might get asked a whole lot of obscure things that are not covered in any of the board review books. one student who recently took his exam told me that he encountered a few questions on his comlex that he couldnt even find the answers to when he got home.

since that is the case, it is much easier to compare students with their usmle score than with their comlex scores.

 

[ensuii]

I've seen many opinions on COMLEX vs USMLE but just wanted to add my take.

Taking another test:In the course of your first two years, you'll probably take at least 40-50 major exams. I think at my school we counted 63. Personally, I kindof got used to taking tests so I didn't really see taking another exam as a big deal. The biggest downside was probably the extra $500 fee to take the test. Yay higher education fees!
How to study: I see frequently the sentiment that the two are different tests so you should study for them differently. Although it sounds perfectly sane, in my opinion they both test general medical knowledge appropriate for someone finishing the end of their 2nd year of medical school. As such, I feel like the best strategy is to study everything within the scope of the level of detail your classes have made you accustomed to. I feel like studying for the test with the mentality that "it's too general for X test" or "too specific for Y test" makes you more prone to miss things. Realistically, everything is fair game for both exams.
Exam difficulty/quality: The general opinion is that the USMLE has multistep questions and more clinical vignettes than the COMLEX. Similarly, I've seen it stated that the COMLEX has more "buzzword" type questions and is more straightforward. Maybe the test has changed considerably recently (I know the scoring parameters were altered a few years ago at least) but I really don't think the difference between the two is that large. Obviously there are significant differences in the practical elements of the tests (ie COMLEX being 400qs with structured breaktime vs USMLE being 336qs with unstructured breaktime) but aside from the OMM component I felt like there were a lot of questions that were on my USMLE that could've easily been on my COMLEX and vice versa.
d.240s USMLE/640s COMLEX for full disclosure. I took the COMLEX first and had some major drama before the USMLE because I was ******ed and thought I would need more time between the two for brain recharge (I took USMLE 8 days later)...ended up not studying as much after COMLEX and lost steam :-(
e.Feel free to contact me with specific test prep questions for either!

 

[DrPapa]

Full disclosure: 240's USMLE, 660's COMLEX

Every DO should take the USMLE, if not just to understand how HORRIBLE the COMLEX is. There are questions that made me laugh out loud in the testing room. As future physicians and educators, we should strive to better our profession, and one area that needs betterment is our licensing exam.

I also think that the highly competitive DO students are driven away from the ACGME programs because we are told all along that we have no chance in the ACGME for things like NS, ortho, rads, derm, etc. I was constantly told to not even bother with the ACGME for my specialty. I ended up splitting my Sub-I's between DO and ACGME programs and ended up matching in the ACGME.

I'm sure that one reason there are so few DOs in those fields is that, like me, we're told over and over that we have no chance, despite how competitive we might be. It's not like I rocked step 1 that much, but I took my chances and matched ACGME in a very competitive field. I think we should be encouraging the cream of the DO crop to enter the ACGME in competitive fields so we can continue to break down these barriers.

 

[MrBeauregard]

Full disclosure: 240's USMLE, 660's COMLEX

Every DO should take the USMLE, if not just to understand how HORRIBLE the COMLEX is. There are questions that made me laugh out loud in the testing room. As future physicians and educators, we should strive to better our profession, and one area that needs betterment is our licensing exam.

I also think that the highly competitive DO students are driven away from the ACGME programs because we are told all along that we have no chance in the ACGME for things like NS, ortho, rads, derm, etc. I was constantly told to not even bother with the ACGME for my specialty. I ended up splitting my Sub-I's between DO and ACGME programs and ended up matching in the ACGME.

I'm sure that one reason there are so few DOs in those fields is that, like me, we're told over and over that we have no chance, despite how competitive we might be. It's not like I rocked step 1 that much, but I took my chances and matched ACGME in a very competitive field. I think we should be encouraging the cream of the DO crop to enter the ACGME in competitive fields so we can continue to break down these barriers.

Good job, DrPapa! Mind telling us what field? I've always wanted ACGME general surgery and am constantly hearing how DOs have such little chance. I'm glad to hear you worked hard and paved your way.

 

[DrPapa]

Work hard and rock your Sub-I's and you should be able to do it. I matched at a place where I did a Sub-I, so make sure you prove yourself to be knowledgeable and hard working. Then have great board scores and grades to back up what they've seen in person.

Just don't get discouraged by all the naysayers you will encounter that will say you have no shot as a DO.

Edit: oh, and I'd rather not reveal my specialty right now.

 

[ensuii]

Work hard and rock your Sub-I's and you should be able to do it. I matched at a place where I did a Sub-I, so make sure you prove yourself to be knowledgeable and hard working. Then have great board scores and grades to back up what they've seen in person.

Just don't get discouraged by all the naysayers you will encounter that will say you have no shot as a DO.

Edit: oh, and I'd rather not reveal my specialty right now.

Is it neurosurgery?

 

[Anonymous2000]

Interesting response

http://www.jaoa.org/content/112/8/480.short

 

[Innokus]

[/B]

Is it neurosurgery?

Maybe he's the one person that match Integrated Plastic Surgery. I'd love to know what it took to get that spot.

 

[Dissected]

Interesting response

http://www.jaoa.org/content/112/8/480.short

Party line response. This is exactly what my school administrators would say.

My response: In an ideal world we wouldn't have to take both. We shouldn't have to take both. But with how things sit right now, we severely limit our options in many fields by not taking the USMLE Step 1 and in some cases Step 2. I think a survey of PD's like he suggests would be helpful, but there's no telling how many responses would be truthful about requiring/not requiring USMLE. I've heard directly from PD's mouth's that they like to see USMLE scores so they have an objective measure to compare Osteopathic students with the rest of their applicant pool; and it's not in any of those hyper-competitive fields he is talking about.

If you are prepared for it and you do respectably, it can only strengthen your application.

 

[coffeeeandtea]

Party line response. This is exactly what my school administrators would say.

My response: In an ideal world we wouldn't have to take both. We shouldn't have to take both. But with how things sit right now, we severely limit our options in many fields by not taking the USMLE Step 1 and in some cases Step 2. I think a survey of PD's like he suggests would be helpful, but there's no telling how many responses would be truthful about requiring/not requiring USMLE. I've heard directly from PD's mouth's that they like to see USMLE scores so they have an objective measure to compare Osteopathic students with the rest of their applicant pool; and it's not in any of those hyper-competitive fields he is talking about.

If you are prepared for it and you do respectably, it can only strengthen your application.

i agree with you completely. also, some of his response was confusing..

It is important to point out that graduating osteopathic medical students need not take the USMLE to better their chances of being accepted into an allopathic residency—with rare exceptions...The fact is that most allopathic residency program directors know nothing about the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA).

so... DO students don't need to take USMLE even though allopathic PDs don't know anything about the licensing exam that DOs are required to take. i suppose we don't NEED to do anything, but why wouldn't you just take a test that allopathic PDs do understand, especially if it's pretty much the same subject material?

Osteopathic medical students who score higher on COMLEX-USA than the USMLE will foster a belief that the former is not as rigorous as the latter.

well, considering everyone says that there's no exact conversion between the two exams, how do we know what score on the COMLEX is equivalent to a 220 on the USMLE? is it a 500? 600? i'm a DO student and i don't even know what a "good" score on the COMLEX is, except >500..

The American Osteopathic Association (AOA) should take a proactive role in ensuring that allopathic residency program directors understand the nuances of COMLEX-USA and that this test cannot be compared directly to the USMLE.

... so then how are allopathic PDs supposed to compare applicants who only took the COMLEX to those who only took the USMLE?

i just think his response is strange, given that he said he took the USMLE himself.

 

[james2333]

I feel like I'm somewhere in the middle and I'm not sure whether I should apply solely to ACGME or AOA for Rads

USMLE Step 1: 246
Comlex: 629 (crammed OPP in a day and knocked my score down )

Rank in class: top 10%

Two published articles

I'd like to think that Rads has become more DO friendly but at the same time I don't want to be stuck at a community program especially when the MD equivalent students with the same step 1 score as me are getting into top institutions

Thoughts about COMLEX: it was a joke, especially compared to the USMLE
I really came to appreciate the writers of the USMLE after taking the COMLEX. My exam had typos and I had exhibits that failed to show up. ALSO my exam disconnected from the COMLEX server and I lost about 30 mins from my exam by the time it restarted. The USMLE is a very different exam from the COMLEX and you'll know exactly what I'm talking about if you've taken both. I have several friends who scored very well on the COMLEX (>600) and ended up scoring less than average (<220) on the USMLE.

The selection for AOA fellowships are also very limited and if the new rule goes through in 2014, itll limit Osteopathic trained residents from obtaining fellowships in certain fields altogether.

 

[MRSAful Fate]

Several people in this thread have talked about how if you match AOA you're out of the ACGME match. Well yeah, but what about playing both sides of the fence and seeing how your interview invites stack up before pulling out of one or the other? I.E. apply both ACGME and AOA, get 15 ACGME interviews and 20 AOA interviews, decide you are quite likely to match ACGME and withdraw from the AOA match. Or get 4 ACGME interviews and 15 AOA and pull out of the ACGME match.

 

[pattr]

I.E. apply both ACGME and AOA, get 15 ACGME interviews and 20 AOA interviews, decide you are quite likely to match ACGME and withdraw from the AOA match. Or get 4 ACGME interviews and 15 AOA and pull out of the ACGME match.

In the second situation it would not be necessary to "pull out of the ACGME match." You could still stay in it in case you don't match AOA.

 

[MLT2MT2DO]

i agree with you completely. also, some of his response was confusing..

Yeah, this is really embarrassing they even published this guys response. I'd be surprised if this would have received a "C" in an English 101 class.

So Allopathic schools don't have a clue what to make of the COMLEX, yet there is no need to take the USMLE. With utterly no reasoning behind his train of thought

 

[thepoopologist]

Yeah, this is really embarrassing they even published this guys response. I'd be surprised if this would have received a "C" in an English 101 class.

So Allopathic schools don't have a clue what to make of the COMLEX, yet there is no need to take the USMLE. With utterly no reasoning behind his train of thought

Yeah I lost him there at the end.

 

[MRSAful Fate]

In the second situation it would not be necessary to "pull out of the ACGME match." You could still stay in it in case you don't match AOA.

True. Although someone in my hypothetical situation with 4 ACGME and 15 AOA interviews would be extremely likely to match AOA, so attending the ACGME interviews might be an unnecessary expenditure of time and money.

Are there any downsides to playing both sides of the fence like this? It seems like the best way to go about it to me.