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jumpmanv15

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How tough is to get into an IM residency and then a fellowship into Pulmonary or Endocrine for example if you JUST took the comlex step 1 and not the usmle step 1?

I may take step 2 usmle though, but usmle step 1 i probably will not take since im severely deficient in biochem and things of that nature.

if anyone has any experiences/advice on this issue please share. thank you guys!
 

SpecterGT260

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It will be dependent on individual programs and whether or not they accept COMLEX. The general consensus is that you are limiting yourself quite a bit. Also, I do not know all of the licensing requirements (I would assume a program that accepts comlex I would also take comlex III for licensing), but without USMLE step 1 you will not be allowed to take USMLE step 3 if that is an issue.
 

jumpmanv15

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It will be dependent on individual programs and whether or not they accept COMLEX. The general consensus is that you are limiting yourself quite a bit. Also, I do not know all of the licensing requirements (I would assume a program that accepts comlex I would also take comlex III for licensing), but without USMLE step 1 you will not be allowed to take USMLE step 3 if that is an issue.

your allowed to take step 2 without taking step 1 usmle from what i know, but u cant take step 3?
 
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SpecterGT260

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your allowed to take step 2 without taking step 1 usmle from what i know, but u cant take step 3?

correct. 1 and 2 can be taken out of order, but are both required for step 3.

Provision is made for incorporating applied basic and clinical science concepts, especially as they relate to justification for prognosis or management. It is assumed that basic science and clinical fundamentals have been assessed adequately in the prerequisite Step 1 and Step 2 examinations.

http://www.usmle.org/step-3/
 

scotchtapetest

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How tough is to get into an IM residency and then a fellowship into Pulmonary or Endocrine for example if you JUST took the comlex step 1 and not the usmle step 1?

I may take step 2 usmle though, but usmle step 1 i probably will not take since im severely deficient in biochem and things of that nature.

if anyone has any experiences/advice on this issue please share. thank you guys!

Endocrine and Pulm are not that competitive and the most important part is to get into residency. Generally speaking, unless you failed or did extremely poorly on the boards, it is not as important for fellowship (vs. residency) especially for the stated fellowships (cardio is a little different). The reputation of your residency program and your accomplishments (or lack thereof) during residency play a much, much bigger role.

There will be programs that won't look at your application without a USMLE score but there are a lot more programs that won't look at your application with a low/failing USMLE score.

It will be dependent on individual programs and whether or not they accept COMLEX. The general consensus is that you are limiting yourself quite a bit. Also, I do not know all of the licensing requirements (I would assume a program that accepts comlex I would also take comlex III for licensing), but without USMLE step 1 you will not be allowed to take USMLE step 3 if that is an issue.

Programs have nothing to do with licensing. State medical boards set regulations for licensing and in all 50 states the COMLEX series (1 thru 3) is a valid pathway for licensure regardless of what residency program one attends.
 

SpecterGT260

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yes, but completion of the residency program is also a requirement for certification (maybe licensure was the wrong word... pretty sure you only need to graduate med school for the license). I am too far out to know this completely, but I suspect that passing a step 3 is a requirement for completing a residency. ergo (hypothetically) if the residency requires USMLE and one did not take USMLE step 1, you would not be able to take step 3 to satisfy that requirement. but this seems odd and is why I said if a program accepts COMLEX for entry/matching I cannot see why they wouldnt allow the step 3 as well
 

scotchtapetest

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yes, but completion of the residency program is also a requirement for certification (maybe licensure was the wrong word... pretty sure you only need to graduate med school for the license). I am too far out to know this completely, but I suspect that passing a step 3 is a requirement for completing a residency. ergo (hypothetically) if the residency requires USMLE and one did not take USMLE step 1, you would not be able to take step 3 to satisfy that requirement. but this seems odd and is why I said if a program accepts COMLEX for entry/matching I cannot see why they wouldnt allow the step 3 as well

Fair enough.... But to let you know....

In most states, to be licensed as a physician only 1 year of PG training is required and in some states 2 years is required (This is only true for US DO/MD grads; IMGs/FMGs require 3 years of PG training in most states). Board certification or completing a program is not required for medical licensure as long as you meet their PG training requirements in a given state.

I don't know of any program that requires specific boards to complete the program (i.e. once they have accepted you). Although most programs require a medical license prior to completion which is issued by the state licensing board and requires either COMLEX or USMLE level/step 3.
 

SpecterGT260

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right. it is probably a moot point if the program has accepted you.
I think we are just getting caught up on my use of "license" though.... Even if you get your license, you need the approval of your residency to practice. The state will grand a license well before the average surgeon completes the 5+ year residency program, right? but if you go out to practice surgery at that point the board will yank your ability to practice. I am a little foggy on all the legal details here.
 

jumpmanv15

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thanks to both of u guys for the responses but i should have editted the thread title, i am going to BE taking the comlex in late june so in prep i wanted to know how difficult it would be to get an IM residency in a good program meaning many lanes towards a fellowship. my reach is Optho but with just a comlex score that seems very unlikely unless i can find a way to get into the very few DO optho residenices.
 

SpecterGT260

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yeah, I understood what you meant. I have heard via other threads that the PDs in ACGME residencies can choose to accept comlex, but that is at their discretion. I did a little looking around and it looks like the certification is done through ABMS. So, unless Bala corrects me, I think you can get your license after your first year, but you cannot practice in your specialty without the approval of the ABMS which has another test associated with it - so USMLE or COMLEX shouldnt really matter at this point.

I am still a little fuzzy why completion of the residency matters (unless it factors into ABMS eligibility) or what would happen if you started practicing something with only your license before completing your residency.
 

scotchtapetest

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yeah, I understood what you meant. I have heard via other threads that the PDs in ACGME residencies can choose to accept comlex, but that is at their discretion. I did a little looking around and it looks like the certification is done through ABMS. So, unless Bala corrects me, I think you can get your license after your first year, but you cannot practice in your specialty without the approval of the ABMS which has another test associated with it - so USMLE or COMLEX shouldnt really matter at this point.

I am still a little fuzzy why completion of the residency matters (unless it factors into ABMS eligibility) or what would happen if you started practicing something with only your license before completing your residency.

Board certification (thru ABMS or AOA) only matters for hospital privileges, insurance reimbursements, faculty appointment and medical-legal protection (civil suit as well as pt complaints). To be eligible to take ABMS/AOA board certification exams, you must complete their respective residency/fellowship training. However, technically speaking, you can practice whatever kind of medicine after you are licensed by your state's medical board (i.e. after 1-2 years of PG training for US DO/MD) as long as you feel comfortable/competent to do so even without board certification or additional residency training. However, do not expect to be doing it in someone else's hospital/facilities and don't expect to get paid for it or fully paid for it by the insurance companies and more importantly hire the best d**n lawyer in your state because you will need his/her services soon.
 

jumpmanv15

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well im not at your guys level yet but thanks for the help hopefully i am there.
 

SpecterGT260

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Board certification (thru ABMS or AOA) only matters for hospital privileges, insurance reimbursements, faculty appointment and medical-legal protection (civil suit as well as pt complaints). To be eligible to take ABMS/AOA board certification exams, you must complete their respective residency/fellowship training. However, technically speaking, you can practice whatever kind of medicine after you are licensed by your state's medical board (i.e. after 1-2 years of PG training for US DO/MD) as long as you feel comfortable/competent to do so even without board certification or additional residency training. However, do not expect to be doing it in someone else's hospital/facilities and don't expect to get paid for it or fully paid for it by the insurance companies and more importantly hire the best d**n lawyer in your state because you will need his/her services soon.

that was the catch that I couldnt remember :thumbup:
oddly enough google didnt have a ton of information on consequences for not having ABMS support... just a lot of stuff for patients on the reasons why to choose a doctor who is certified.
 

cabinbuilder

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Board certification (thru ABMS or AOA) only matters for hospital privileges, insurance reimbursements, faculty appointment and medical-legal protection (civil suit as well as pt complaints). To be eligible to take ABMS/AOA board certification exams, you must complete their respective residency/fellowship training. However, technically speaking, you can practice whatever kind of medicine after you are licensed by your state's medical board (i.e. after 1-2 years of PG training for US DO/MD) as long as you feel comfortable/competent to do so even without board certification or additional residency training. However, do not expect to be doing it in someone else's hospital/facilities and don't expect to get paid for it or fully paid for it by the insurance companies and more importantly hire the best d**n lawyer in your state because you will need his/her services soon.

I think I need to clear up some things since the medical students are trying to answer questions about a level they have not achieved yet.

Medical-legal protection comes down to how blantantly bad a doctor you are and how good your malpractice insurance is. BC is not involved.

During medical school you take Step I/StepII/Step IIPE (COMLEX, USMLE, or both)
Most medical schools now will not graduate you without passing of these three
I you fail any of these steps more than 3 times you will be hard pressed finding a residency who will take you and many states WILL NOT LICENSE YOU. Texas will not let you do residency there if you have failed 3 times.

You take step III during your intern year and need that in order to apply for a license in that state. You finish residency and take the Board Certification exam the third year

To say that you don't need to finish residency or only need board certification for hospital priviliges is COMPLETELY FALSE.

If you plan on getting hired anywhere, whether its locum tenens, or small medical practice, large medical practice, or hospital employee. You would be hard pressed to get hired. I have a few friends who didn't finish residency who work urgent care clinic but that really limits your job opportunities. I have worked approx 20 different sites in 5 states doing locums work and every single site required board certification. It's more important in the job market than is being expressed on this thread.

You apply for Fellowship after you finish residency. Each have their own criteria and you to look at each individual program to see what is necessary for consideration. Fellowship looks at boards scores but they also depend on a letter from your residency program director and your rotation evaluations in residency, competency, and your overall success as a resident physician. Do you "play well with others", etc. Again, just like every hoop on the journey comes down to the total package.
 
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jumpmanv15

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i feel like we are getting off topic here

all i really wanted to know was what other DOs experiences were applying to Allo IM programs with just COMLEX scores. i got a lil info as in depending on the residency program and how they wish to interpret your comlex score but if there is anyone who has already went thru this wish to share i would appreciate it
 

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You can do anything you want almost with just having the COMLEX. You don't need USMLE unless you are wanting to look at high end MD programs. Most places will take just the COMLEX. With that being said you might want to figure out which places you'd like to train and ask them if they recommend the USMLE. If you have a high COMLEX, that will suffice for the vast majority of IM programs. Also, if you're looking DO then getting pulm/cc fellow isn't that tough. Most places take fellows from thier existing IM program so my advice is do residency at a place with the fellowship that you want. I would also recommend the USMLE because why limit yourself for the price a $700 and 1 horrible day. Take both, do well and the options are there.
 

jumpmanv15

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You can do anything you want almost with just having the COMLEX. You don't need USMLE unless you are wanting to look at high end MD programs. Most places will take just the COMLEX. With that being said you might want to figure out which places you'd like to train and ask them if they recommend the USMLE. If you have a high COMLEX, that will suffice for the vast majority of IM programs. Also, if you're looking DO then getting pulm/cc fellow isn't that tough. Most places take fellows from thier existing IM program so my advice is do residency at a place with the fellowship that you want. I would also recommend the USMLE because why limit yourself for the price a $700 and 1 horrible day. Take both, do well and the options are there.

thats true, but this is in case i dont take the usmle. meaning i bomb my nbme and basically puss out lol
 

scotchtapetest

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With all due respect:

I think I need to clear up some things since the medical students are trying to answer questions about a level they have not achieved yet.

There is no need to get snippy! :nono:

Medical-legal protection comes down to how blantantly bad a doctor you are and how good your malpractice insurance is. BC is not involved.

So, hypothetically let's say I finish my intern year, drop out of residency, get my permanent license and decide to start practicing neurosurgery (assuming I have my own surgical suite which meets all legal requirements or my "uncle" hires me at his hospital and somehow I am fully competent to do so) and I end up killing a patient. At the neighboring hospital a BC neurosurgeon also kills a patient for the exact same reason under the same circumstances. So everything else being equal except BC status, who do you think the medical board or especially a court in a civil case will sanction more (assuming same lawyer represents us both)? Do you still think BC is not relevant to medical-legal protection?

To say that you don't need to finish residency or only need board certification for hospital priviliges is COMPLETELY FALSE.

If you plan on getting hired anywhere, whether its locum tenens, or small medical practice, large medical practice, or hospital employee. You would be hard pressed to get hired. I have a few friends who didn't finish residency who work urgent care clinic but that really limits your job opportunities. I have worked approx 20 different sites in 5 states doing locums work and every single site required board certification. It's more important in the job market than is being expressed on this thread..

The point I was making was that contrary to popular belief among medical students, BC or even completion of a residency program is not required for practice of a specialty as long as you are licensed (i.e. post intern year in most states). Even in your own post, the only reason you provided for BC is securing employment and not any particular legal requirements. If you read my posts, I mentioned multiple times that one will not get hired without BC. But if you own your practice/facilities, technically you don't need BC and also as previously mentioned in my post, reimbursement rates will differ.

So, in conclusion I still don't see what part of my post was inaccurate.

I'm not advocating for dropping out of residency or not becoming BC; I'm just pointing out technicalities.
 
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