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I sat for the COMLEX on June 22nd and the USMLE on July 13th. In fairness, I don't have my scores back yet from the USMLE so I may be completely wrong in assuming the following. That said, it felt like the COMLEX was harder by far than the USMLE. Before I make an MD's head explode, let me qualify the same by saying it wasn't for level of detail. Both exams seemed to have a significant amount of detail, but it seemed like the COMLEX much larger mental leaps needed for one to come to a conclusion on a specific answer. Whereas, the USMLE seemed to spell out the question perfectly, if you knew it, you knew it, if not... Move on. Does anyone know if the COMLEX recently stepped up their game due to the impending merger?
 
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racerwad

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I sat for the COMLEX on June 22nd and the USMLE on July 13th. In fairness, I don't have my scores back yet from the USMLE so I may be completely wrong in assuming the following. That said, it felt like the COMLEX was harder by far than the USMLE. Before I make an MD's head explode, let me qualify the same by saying it wasn't for level of detail. Both exams seemed to have a significant amount of detail, but it seemed like the COMLEX much larger mental leaps needed for one to come to a conclusion on a specific answer. Whereas, the USMLE seemed to spell out the question perfectly, if you knew it, you knew it, if not... Move on. Does anyone know if the COMLEX recently stepped up their game due to the impending merger?
The perceived difficulty is due to the poorly worded questions. The "mental leap" is a polite way to say the question writer expected you to read their mind. I agree that for these reasons, the COMLEX is a harder exam. I didn't think that it was a fair evaluation of my knowledge. And don't even get me started on the questions based in magical thinking...
 
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The COMLEX fires out disparate pieces of info, often in poor context, and expects the examinee to draw a conclusion. I also think the COMLEX requires a reliance on likelihood more so than the USMLE, i.e. success in answering a question often relies on looking at the exam’s notoriously terrible questions and being able to make an educated conclusion based on available answer choices, likelihood of a disease state, and a gestalt for what the question writer wants, or even finding and recognizing a single relevant factoid. I sometimes feel like the COMLEX is a “feelings” exam where gut instinct matters quite a lot. I would agree that it is the “harder” exam, but only in the context of pure stamina and frustration. You can draw your own conclusions about why the COMLEX is like that, but it probably comes down to some combination of available resources and a desire to create an exam that best reflects the “everyday” nature of information gathering on the wards. Medicine doesn’t have a vignette to slowly (and tediously, in the case of some USMLE questions) walk you through the patient presentation. You assemble pieces of info and try to recognize patterns.

In contrast, the USMLE wants to know how much and how detailed you know a subject. It’s probably a better test of your raw medical knowledge because it really flexes the details of a disease process. Another advantage of the USMLE is that it tends to stick to the script. It’s rare to encounter a truly terrible question, meaning you could typically find it somewhere in a known review source. With some exceptions, not knowing an answer is probably a reflection of some failing in your studying or learning. This one feature is why most people who take both call the USMLE the “fairer”, or better, exam. It's also why USMLE scores tend to be a direct result of how well you did during the preclinical years, the amount of time dedicated to studying, and the number of review questions (read: simulation) you completed. The COMLEX will straight up ask you random craziness, including details that some professor ranted about in class and you ignored at x 2 speed.

The COMLEX is also known to harp on certain subjects, which means that having an unfortunate weakness in your medical knowledge can be magnified out of proportion on test day. DO students will talk about having exams heavy in a few areas. This occurs in a way disproportionate to the USMLE. If you have a strength in that particular system, I’m a big believer that it definitely results in a boost come test day. This is probably why people routinely observe actual scores that are significantly higher or lower than the COMSAEs. I also think this is one, among many, explanations for the DO students who have high USMLE scores disproportionate to their COMLEX and vice versa. During the preclinical years, I remember faculty at our school occasionally reporting that some subjects were notoriously overrepresented and our school was big on highlighting these during the first two years. If you paid attention, you probably knew not to slack on those particular items, but it was unfortunate for those students with a particular weakness in grasping those subjects.

The exams are similar but different, mainly in the question style. The material is clearly the same, because high performing students routinely report solely studying for the USMLE, refreshing OMT, and then taking the COMLEX a few days later to good effect.
 
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Zero_Your_Hero
Jul 6, 2016
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The COMLEX fires out disparate pieces of info, often in poor context, and expects the examinee to draw a conclusion. I also think the COMLEX requires a reliance on likelihood more so than the USMLE, i.e. success in answering a question often relies on looking at the exam’s notoriously terrible questions and being able to make an educated conclusion based on available answer choices, likelihood of a disease state, and a gestalt for what the question writer wants, or even finding and recognizing a single relevant factoid. I sometimes feel like the COMLEX is a “feelings” exam where gut instinct matters quite a lot. I would agree that it is the “harder” exam, but only in the context of pure stamina and frustration. You can draw your own conclusions about why the COMLEX is like that, but it probably comes down to some combination of available resources and a desire to create an exam that best reflects the “everyday” nature of information gathering on the wards. Medicine doesn’t have a vignette to slowly (and tediously, in the case of some USMLE questions) walk you through the patient presentation. You assemble pieces of info and try to recognize patterns.

In contrast, the USMLE wants to know how much and how detailed you know a subject. It’s probably a better test of your raw medical knowledge because it really flexes the details of a disease process. Another advantage of the USMLE is that it tends to stick to the script. It’s rare to encounter a truly terrible question, meaning you could typically find it somewhere in a known review source. With some exceptions, not knowing an answer is probably a reflection of some failing in your studying or learning. This one feature is why most people who take both call the USMLE the “fairer”, or better, exam. It's also why USMLE scores tend to be a direct result of how well you did during the preclinical years, the amount of time dedicated to studying, and the number of review questions (read: simulation) you completed. The COMLEX will straight up ask you random craziness, including details that some professor ranted about in class and you ignored at x 2 speed.

The COMLEX is also known to harp on certain subjects, which means that having an unfortunate weakness in your medical knowledge can be magnified out of proportion on test day. DO students will talk about having exams heavy in a few areas. This occurs in a way disproportionate to the USMLE. If you have a strength in that particular system, I’m a big believer that it definitely results in a boost come test day. This is probably why people routinely observe actual scores that are significantly higher or lower than the COMSAEs. I also think this is one, among many, explanations for the DO students who have high USMLE scores disproportionate to their COMLEX and vice versa. During the preclinical years, I remember faculty at our school occasionally reporting that some subjects were notoriously overrepresented and our school was big on highlighting these during the first two years. If you paid attention, you probably knew not to slack on those particular items, but it was unfortunate for those students with a particular weakness in grasping those subjects.

The exams are similar but different, mainly in the question style. The material is clearly the same, because high performing students routinely report solely studying for the USMLE, refreshing OMT, and then taking the COMLEX a few days later to good effect.

I ended up doing the opposite. Studied for the COMLEX first, then waited a couple weeks to study up on the USMLE. I walked out of the COMLEX feeling like I failed, but through some miracle math I ended scoring in the 630's... But it didn't feel like a win, at no point did I feel like my medical knowledge was truly tested. I would also agree with you in regards to the "gut" instinct thing, I marked around 180 of 400 questions that I ended up answering on my gut... because I had no idea what they were really getting at. I wonder if the AOA merging will cause them to validate their exam in a way that makes it as well rounded a test as the USMLE.
 
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Zero_Your_Hero
Jul 6, 2016
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The perceived difficulty is due to the poorly worded questions. The "mental leap" is a polite way to say the question writer expected you to read their mind. I agree that for these reasons, the COMLEX is a harder exam. I didn't think that it was a fair evaluation of my knowledge. And don't even get me started on the questions based in magical thinking...
You certainly read my mind, I was attempting to be polite by using the words "mental leaps." I suppose it was a little more friendly than psychic abilities. lol
 
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PL198

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why are the questions poorly written? Like do they tolerate that? magical thinking? You guys wonder why DO gets flack, yet you're sitting here basically saying your overseeing body is a joke
 

jw3600

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why are the questions poorly written? Like do they tolerate that? magical thinking? You guys wonder why DO gets flack, yet you're sitting here basically saying your overseeing body is a joke
What do you want us to do dude? Look at Wall Street. Look at the presidential election. Look at fracking. Just because something is ****ed doesn't mean you can do anything about it. Let's just say we all agree the AOA is a scam organization (it is) what do you suggest the next course of action is?
 
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What do you want us to do dude? Look at Wall Street. Look at the presidential election. Look at fracking. Just because something is ****ed doesn't mean you can do anything about it. Let's just say we all agree the AOA is a scam organization (it is) what do you suggest the next course of action is?
Agreed. DO schools need to drop the comlex and stick to the USMLE and maybe add like 50 questions to test for the OMM crap. Call it a day. I for one do not see myself using OMM besides at cool dinner parties to show my fambam what I learned from med school.

Maybe throw in a few techniques for easy cash pay if I see the need for it.

but nope... AACOM want that $$$$. Bastards.
 

zero0

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Any chance we get rid of the COMLEX before I sit to take it in 2018? I'm guessing no cuz NBOME and moneys and such...
 

NimbleNavigator

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Are you new to SDN?

Quick primer: the AOA does not represent the interests of most DOs.
If you were in charge of the AOA, what changes would you make? Just curious.
 

racerwad

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If you were in charge of the AOA, what changes would you make? Just curious.
Honestly, it would be nice if they focused more on improving the quality of existing osteopathic education, rather than everything being not quite as good as the allopathic counterpart. Just look at the the NMS Match report vs the NRMP's, COMLEX vs USMLE, our clinical education vs theirs, osteopathic residencies vs allopathic ones, etc. I had an ok experience at my school, but that was more because of the effort I put in to optimize my education vs what the opportunities my school provided. The medical school my residency is affiliated with is not a top 20 kind of place, but the opportunities that they have for their students are orders of magnitude better than what any DO school has. Not knowing anything about how the AOA runs, I would rather see them focus on the above and less upon expansion of schools without adequate GME and ignoring the fact that what is important to DOs may not be what is important to the AOA.

To be fair, the AMA doesn't not fully represent MDs, either. The difference is that the AMA is not in (direct) control allopathic education.
 
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PL198

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Honestly, it would be nice if they focused more on improving the quality of existing osteopathic education, rather than everything being not quite as good as the allopathic counterpart. Just look at the the NMS Match report vs the NRMP's, COMLEX vs USMLE, our clinical education vs theirs, osteopathic residencies vs allopathic ones, etc. I had an ok experience at my school, but that was more because of the effort I put in to optimize my education vs what the opportunities my school provided. The medical school my residency is affiliated with is not a top 20 kind of place, but the opportunities that they have for their students are orders of magnitude better than what any DO school has. Not knowing anything about how the AOA runs, I would rather see them focus on the above and less upon expansion of schools without adequate GME and ignoring the fact that what is important to DOs may not be what is important to the AOA.

To be fair, the AMA doesn't not fully represent MDs, either. The difference is that the AMA is not in (direct) control allopathic education.
AMA? what that's not the same comparison at all. The AMA has nothing to do with education
 

PL198

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Are you new to SDN?

Quick primer: the AOA does not represent the interests of most DOs.
It's not about interests, it's about education. You guys make it sound like they do a horrible job with a very arbitrary and pointless way of examination which is pretty inexcusable IMO. While the NBME exams are difficult, I'd say they're relatively fair. I mean you're saying there's literally read my mind questions on your national exams. That's horrific
 

racerwad

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AMA? what that's not the same comparison at all. The AMA has nothing to do with education
Read much? That was literally my next sentence.

It's not about interests, it's about education. You guys make it sound like they do a horrible job with a very arbitrary and pointless way of examination which is pretty inexcusable IMO. While the NBME exams are difficult, I'd say they're relatively fair. I mean you're saying there's literally read my mind questions on your national exams. That's horrific
Your interpretation above is correct. The reason I said interests rather than education is because the AOA has influence over both COCA and licensing so their influence is much broader than similar allopathic organizations.

It is surprising that this is surprising to anyone who spends any time on SDN.
 

PL198

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So COCA is your equivalent to NBME?