Actually, it is really not their fault because people studied for the "wrong" exam. Assuming COMLEX and USMLE are the same exam is people's biggest mistake. This assumption is made by medical students who want to nail "two birds with one stone" to study 1 material for 2 different exams.
I'm not all surprised by people's result because they focus their study for USMLE and expected to do well at COMLEX. It's like saying You studied for bacteriology and expected to do well at parasitology.
For comlex, all you really need is just boards and wards, savarese, study for your 3rd year clinical end of service exams, and do some practice questions using COMSAE phase 2 form A and B. to get at least 550+ on COMLEX (knowing some buzz words, on clinical presentation, or signs. Boards and wards is awesome for this) plus you need to know the "Normal" variations and know when to just do "nothing" and reassur patients.
For USMLE, you need to use UW, secrets, NBME forms, boards and wards, do a lot of questions and know the treatment and management algorithms and potential differential diagnosis given some "evidences" that will tip you towards 1 dx vs another. Usually every scenario the patient has some sort of disease or another it force to come up with a dx every time.
I have taken USMLE Step 1, COMLEX 1, USMLE Step 2 and COMLEX 2. Seriously, they're totally two different exams. don't fall in the trap or be lazy try to study for 1 exam and expect to do well on both.
😱 this message should actually be a "Sticky" so people in the future can read and not ask the same question over and over again.