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Should DO take USMLE 1 & 2 or is STEP 1 no longer needed (so STEP 2 only) as it is P/F?

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Master Bone Wizard

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The specialty I want is not very competitive (PM&R or Community Neuro) so I am just wondering how many board exams I will have to take? Would applying with a P on COMELX 1 and a STEP 2 and COMLEX score be enough or will programs require I take get a P on STEP 1 as well as a STEP 2 score?
 

Kardio

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It might be sufficient to match into the field's you've mentioned, but you will be much better off beginning school with the intention of taking and passing Step 1.
 
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Master Bone Wizard

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It might be sufficient to match into the field's you've mentioned, but you will be much better off beginning school with the intention of taking and passing Step 1.
How important is it to have a P on step 1 if you get a decent STEP 2 score? Isn't the assumption that if your STEP 2 score is decent you would likely pass Step 1?
 

pigsinacloth

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How important is it to have a P on step 1 if you get a decent STEP 2 score? Isn't the assumption that if your STEP 2 score is decent you would likely pass Step 1?
You know what they say about assumptions. Also imagine they do use STEP 1 as some type of screening just to order how they want to view the applications where they start with everyone that has a P. Someone without a P would just not be included in the first group they review, which would be unfortunate.
 

Surgeon D.O.

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Just. Take. Step 1.

I wish this could be stickied at the top of the DO med student forum.
 
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Darrow O'Lykos

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How important is it to have a P on step 1 if you get a decent STEP 2 score? Isn't the assumption that if your STEP 2 score is decent you would likely pass Step 1?
Most PD's will only interview applicants that check all the boxes and then some. A lot of med school is about just checking the boxes.

Passing step 1 is checking a box.

Choosing to not take it is choosing to not check a box.

PD's have too many qualified applicants that checked all the boxes to begin making assumptions and conjure up a persona of your application on paper that you somehow measure up without checking that box.
 
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Kardio

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How important is it to have a P on step 1 if you get a decent STEP 2 score? Isn't the assumption that if your STEP 2 score is decent you would likely pass Step 1?
Nobody knows with certainty how PDs will react in the future to all of the various scenarios that we can imagine because there is not yet a precedent for P/F Step 1.

What we know for certain is that there is a very strong association between Step 1 performance and Step 2 performance. There is probably some confounding, but many have reported that their success on Step 2 is a direct consequence of taking Step 1 preparation seriously.

In short, the potential benefits of taking Step 1 (better Step 2 score, better impression on PDs, unknown unknowns of the future where Step 1 could be required) far outweigh the costs of skipping it (1 day of your live and a few hundred bucks). It is, more likely than not, in your best interest to plan on and take Step 1.
 
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Neopolymath

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OMG just take step 1. It's no big deal and mitigates risks.

Can we just have this in big, bold letters at the top of this subforum?!
 
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Angus Avagadro

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Maybe I missed something during the ACGME changes. Don't you need to pass all 3 boards, step or complex, to get a state license? Can you mix and match? Residencies used to want you to be able to get an unrestricted medical license after your first year.
 

xjustcuious

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Maybe I missed something during the ACGME changes. Don't you need to pass all 3 boards, step or complex, to get a state license? Can you mix and match? Residencies used to want you to be able to get an unrestricted medical license after your first year.
I thought DOs dont take Step 3 even if they took Step 1 and 2
 

Darrow O'Lykos

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I thought DOs dont take Step 3 even if they took Step 1 and 2
Isn't it up to the individual that takes both USMLE and COMLEX which series they wish to complete to gain state licensure?

Because I personally don't want to pay NBOME a single dime more than needed.
 
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Master Bone Wizard

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Isn't it up to the individual that takes both USMLE and COMLEX which series they wish to complete to gain state licensure?

Because I personally don't want to pay NBOME a single dime more than needed.
I wish but then the AOA would lose on $$ b/c no one would take COMLEX. To get their license and practice DO's needs the COMLEX lv 1, 2, and 3. USMLE is just taken so residency directors can compare STEP scores.
 
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Darrow O'Lykos

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I wish but then the AOA would lose on $$ b/c no one would take COMLEX. To get their license and practice DO's needs the COMLEX lv 1, 2, and 3. USMLE is just taken so residency directors can compare STEP scores.
Forgive my ignorance, but if a DO meets a state's requirements for licensure by completion of USMLE Steps 1-3, then who forces them to take COMLEX level 3? Licensure codes in all but 5 states dictate that either series is fine. I get that AOA schools require DO students to take COMLEX 1 & 2 in order to receive their degree, but they can't enforce anything beyond graduation (hence, COMLEX 3), right?
 

xjustcuious

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Forgive my ignorance, but if a DO meets a state's requirements for licensure by completion of USMLE Steps 1-3, then who forces them to take COMLEX level 3? Licensure codes in all but 5 states dictate that either series is fine. I get that AOA schools require DO students to take COMLEX 1 & 2 in order to receive their degree, but they can't enforce anything beyond graduation (hence, COMLEX 3), right?
Yeah I’m hoping to get a better answer to this too whether we can skip Level 3 completely. Multiple people online have told me that Level 3 is required and not to even bother taking Step 3 as well.
 

Ho0v-man

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Even if your interests are not competitive, you still should be. Nothing wrong with having more options than limitations.
 
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DrStephenStrange

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Forgive my ignorance, but if a DO meets a state's requirements for licensure by completion of USMLE Steps 1-3, then who forces them to take COMLEX level 3? Licensure codes in all but 5 states dictate that either series is fine. I get that AOA schools require DO students to take COMLEX 1 & 2 in order to receive their degree, but they can't enforce anything beyond graduation (hence, COMLEX 3), right?

For state License you may need Comlex PE or state OMM practical exam, depending on the state.

Yeah I’m hoping to get a better answer to this too whether we can skip Level 3 completely. Multiple people online have told me that Level 3 is required and not to even bother taking Step 3 as well.
Yes, you can skip COMLEX Level 3 and take Step 3 except for the handful of states that have the OMM requirement for DOs. I'd say just take COMLEX Level 3 and be done with it, there is no reason to limit yourself when it comes to State licensure no matter how deep your hate for the NBOME runs.
 
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DrStephenStrange

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Maybe I missed something during the ACGME changes. Don't you need to pass all 3 boards, step or complex, to get a state license? Can you mix and match? Residencies used to want you to be able to get an unrestricted medical license after your first year.
Yes, you have to complete one 3 board exam series of either COMLEX or USMLE for state licensure. But what OP was asking was whether it is even worth it for DOs to take Step 1 since it is P/F anyway, and since Step 1 completion is also not required to take Step 2 CK. It is not mix and match just trying to level the playing field for residency application. DOs are required by their schools to take COMLEX Level 1 and 2 anyway.

edit: OP yes, it is worth it to take Step 1, even if it's P/F, for all the reasons mentioned above.
 
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TragicalDrFaust

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My school recommends against the bottom 1/4 of the class taking Step. Usually about half the class ends up taking it. About 10% of them fail Step. Everyone here is saying take Step but wouldn't being in the 10% who fail put me in a worse position than not taking it at all?
 

FootballAndSkiing

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Alternatively, RVU has made it a requirement to graduate, so im interested to see how that goes.
 

DrStephenStrange

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My school recommends against the bottom 1/4 of the class taking Step. Usually about half the class ends up taking it. About 10% of them fail Step. Everyone here is saying take Step but wouldn't being in the 10% who fail put me in a worse position than not taking it at all?
DO students are not required to release their USMLE scores when applying on ERAS. Which means as a DO you get all the benefits by taking the USMLE exams, but almost none of the repercussions. Only downside is for the rare programs that require you to have passing USMLE exams. I only had a passing Step 1 but no Step 2 on my ERAS application, and had both COMLEX level 1 and 2, no program of my 13 interviews asked for Step 2 except for my number 1. I also know people who failed Step 1 and did not report it on their app and still matched. Although Neurology is not competitive, but I can tell you just having a passing Step 1 in there got me a look at many places that wouldn't have otherwise. I was also part of the bottom 1/4 for my class.
 
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Seabasstian

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At the moment, most all MD places for away rotations will only consider applicants that have passed step 1. I can't imaging that changing. So you'd be severely limiting yourself come 4th year.
 
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DrStephenStrange

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Side effect of Step 1 going P/F showing on Step 2 CK already, just 3 months in.
Screenshot_20220413-073300_Instagram.jpg
 
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MDMechEngr

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With the focus now on Step 2, the average score will jump at least 5 points initially if not more. They may even make Step 2 harder as the average score increase even more after a couple of years of implementation. Eventually, it will go pass/fail too, but not for awhile. LOL
 

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With the focus now on Step 2, the average score will jump at least 5 points initially if not more. They may even make Step 2 harder as the average score increase even more after a couple of years of implementation. Eventually, it will go pass/fail too, but not for awhile. LOL
I can't see it going pass/fail, what's next, a blind lottery for programs to select applicants. If that would occur, those from lower ranked schools would have an uphill battle to compete against those that go to top tier schools. While school prestige/ranking has always played a part of the selection process, it would be weighed that much more with a P/F Step 1 & 2. With step 2 CS gone, schools going P/F, elimination of AOA and so on, what's left to rank applicants......virtual Interviews, LOR, research?

I just hope that the selection process does not follow the way that some far left schools are going by eliminating AP classes, gifted & talented programs, etc., all in the interest of trying to say that everyone should be treated the same, regardless of intelligence, learning capacity, etc, almost like everyone deserves a trophy. Well, every medical student is not the same and without some objective criteria, you will have applicants who will apply to certain fields that would not otherwise be competitive, but may stand a chance of being selected over more qualified students.

Time will tell...........
 
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DrZoster

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Take step 1. A passing score is a very achievable goal. Audition sites will want to see it in your VSLO application. Residency PDs will screen for step 1. Step 2 has a lot of step1 material.

Even if you're convinced you'll be practicing FM in a rural area, things might change when you start rotations. You might realize ortho or ophtho is for you. Good luck matching without a step1 score then
 
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Redpancreas

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Take step 1. A passing score is a very achievable goal. Audition sites will want to see it in your VSLO application. Residency PDs will screen for step 1. Step 2 has a lot of step1 material.

Even if you're convinced you'll be practicing FM in a rural area, things might change when you start rotations. You might realize ortho or ophtho is for you. Good luck matching without a step1 score then

Disagree. Not DO but I can't imagine a DO going into Step 1 with a P/F FM Rural Area mentality and suddenly switching to Ortho. DOs match Ortho frequently, but they are usually looking for that from day 1.
 
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DrZoster

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Disagree. Not DO but I can't imagine a DO going into Step 1 with a P/F FM Rural Area mentality and suddenly switching to Ortho. DOs match Ortho frequently, but they are usually looking for that from day 1.
Not very common but it happens. Point is that people change their minds after experiencing their clerkships and it's better to keep other options available.
 
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Surgeon D.O.

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I'm just an n=1 and not the top of my class or a rockstar/ beast medical student but I will say this while preparing for Step 2 which I know most 1st and 2nd years are planning on doing:

1.) There is more basic science and Step 1 info on my Step 2 q banks (UWorld) than I initially thought.
2.) Even when it's not a basic science type of question, a lot of the questions ask about clinical scenarios in which it is implied you already know all that basic science info.
3.) Studying for Step 1 helped me make connections I did not make prior and has definitely helped me understand more medicine.

Again, just n=1.
 
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Dryad8212

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I'm just an n=1 and not the top of my class or a rockstar/ beast medical student but I will say this while preparing for Step 2 which I know most 1st and 2nd years are planning on doing:

1.) There is more basic science and Step 1 info on my Step 2 q banks (UWorld) than I initially thought.
2.) Even when it's not a basic science type of question, a lot of the questions ask about clinical scenarios in which it is implied you already know all that basic science info.
3.) Studying for Step 1 helped me make connections I did not make prior and has definitely helped me understand more medicine.

Again, just n=1.
This is true, idk if it just uworld or what? But about 60 percent of uworld step 2 is uworld step 1.
 
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Ho0v-man

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My first question on step 2 was clinical stem and then I had to identify the gene mutation most likely associated with it. Lots of crap like this on step 2.

For whatever reason, they barely care about drug MOA anymore which is really dumb imo.
 
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November42

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Should someone still take STEP 1 if they're a poor test-taker? I took the MCAT twice and my score wasn't that high. I'm on day 3 of dedicated and am exhausted. I just don't feel like I can do well on both COMLEX and USMLE. I'd be burnt out after USMLE and feel like I'd still fail COMLEX. Is it still worth it for me to try and take it? I'm only interested in family medicine and pediatrics.
 

DrStephenStrange

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Should someone still take STEP 1 if they're a poor test-taker? I took the MCAT twice and my score wasn't that high. I'm on day 3 of dedicated and am exhausted. I just don't feel like I can do well on both COMLEX and USMLE. I'd be burnt out after USMLE and feel like I'd still fail COMLEX. Is it still worth it for me to try and take it? I'm only interested in family medicine and pediatrics.
For FM and Peds, you don't necessarily need Step 1 and 2, but you never know what might happen. You might change your mind during clinicals. I didn't choose to apply neurology until late 3rd year. I was going to apply IM before I changed my mind after rotating in both specialties.

Also see my quoted message bellow that I posted earlier in this thread.
DO students are not required to release their USMLE scores when applying on ERAS. Which means as a DO you get all the benefits by taking the USMLE exams, but almost none of the repercussions. Only downside is for the rare programs that require you to have passing USMLE exams. I only had a passing Step 1 but no Step 2 on my ERAS application, and had both COMLEX level 1 and 2, no program of my 13 interviews asked for Step 2 except for my number 1. I also know people who failed Step 1 and did not report it on their app and still matched. Although Neurology is not competitive, but I can tell you just having a passing Step 1 in there got me a look at many places that wouldn't have otherwise. I was also part of the bottom 1/4 for my class.
 
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SharonShares

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I recommend you take both Step 1/Level 1 and Step 2/Level 2 if you want the possibility of being selected into an academic program. Many programs do not review applicants without Step 1/Step 2 even if you did well on Level 1/Level 2. As noted above, it is about checking the boxes. Not saying you won't get your #1 rank but you might not get your #1 interview without all the boxes checked.
 

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I'm a DO student and am probably going to be applying to IM. I fully intend to take both Level 1/Level 2 and Step 1/Step 2
 

PorcupineDoc

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kinda feel like all the DOs that still say take step 1 even after pass fail are part of the problem.

Like how will we ever advance if we do this even when the rules change. Like I understand the medical world we live in favors step. But at some point begging students to take step 1 is like begging the DO world to please look passed my degree and higher me.

Like how do we change the way some MDs view us if we never change from that mindset.

Sorry if that offended anyone. Just slightly venting after choosing to only take comlex. Then seeing someone else on here post that they failed step but passed comlex and thinking damn I could’ve easily done that too.
 
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PorcupineDoc

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kinda feel like all the DOs that still say take step 1 even after pass fail are part of the problem.

Like how will we ever advance if we do this even when the rules change. Like I understand the medical world we live in favors step. But at some point begging students to take step 1 is like begging the DO world to please look passed my degree and higher me.

Like how do we change the way some MDs view us if we never change from that mindset.

Sorry if that offended anyone. Just slightly venting after choosing to only take comlex. Then seeing someone else on here post that they failed step but passed comlex and thinking damn I could’ve easily done that too.
MD world*
 

Dr. Anonymouss

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kinda feel like all the DOs that still say take step 1 even after pass fail are part of the problem.

Like how will we ever advance if we do this even when the rules change. Like I understand the medical world we live in favors step. But at some point begging students to take step 1 is like begging the DO world to please look passed my degree and higher me.

Like how do we change the way some MDs view us if we never change from that mindset.

Sorry if that offended anyone. Just slightly venting after choosing to only take comlex. Then seeing someone else on here post that they failed step but passed comlex and thinking damn I could’ve easily done that too.
For starters, I think having two different tests is part of what stratifies MD applicants from DO applicants in the mind of program directors. OMM could have easily been a separate exam, but it was not designed this way. When MD program directors are familiar with USMLE step and not familiar with comlex then that sets up the notion that it may be easier (which by the subjective data I've seen seems to be slightly true, but who knows). So I think it all comes down to perceptions. The only way to beat the judgement will be to have applicants go through the same training i.e. both taking the step exam. Otherwise there will always be judgement and bias.
 
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HipiMochi

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kinda feel like all the DOs that still say take step 1 even after pass fail are part of the problem.

Like how will we ever advance if we do this even when the rules change. Like I understand the medical world we live in favors step. But at some point begging students to take step 1 is like begging the DO world to please look passed my degree and higher me.

Like how do we change the way some MDs view us if we never change from that mindset.

Sorry if that offended anyone. Just slightly venting after choosing to only take comlex. Then seeing someone else on here post that they failed step but passed comlex and thinking damn I could’ve easily done that too.

Not exactly sure what you’re upset about. Are you saying that DO students should unite and refuse to take Step? All that would do is put Caribbean graduates ahead of DO graduates.

There are plenty of DO students who took both COMLEX and STEP and crushed both exams. I’m sorry you weren’t one of them, but you still have the option of taking Step 1 during 3rd year to catch up.
 
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PorcupineDoc

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Not exactly sure what you’re upset about. Are you saying that DO students should unite and refuse to take Step? All that would do is put Caribbean graduates ahead of DO graduates.

There are plenty of DO students who took both COMLEX and STEP and crushed both exams. I’m sorry you weren’t one of them, but you still have the option of taking Step 1 during 3rd year to catch up.
Why do you think that not taking step puts DOs behind Caribbean graduates?

I agree with you. But the problem is I shouldn’t have to agree with you because a system that puts that much value in a test that doesn’t predict resident success is stupid. It shows that you’d value someone with inferior education just because they have a P on one exam even though the other has a P on an equivalent exam.

And I might regret not taking it some. I’m just going for PMR or rural FM. And PMR without step had the same Match rate with step.

And I’m not saying we should all revolt but there’s gotta be a way to make it better and more logical for everyone.

Like what’s the point of making it pass fail if it actually adds stress
 

PorcupineDoc

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Not exactly sure what you’re upset about. Are you saying that DO students should unite and refuse to take Step? All that would do is put Caribbean graduates ahead of DO graduates.

There are plenty of DO students who took both COMLEX and STEP and crushed both exams. I’m sorry you weren’t one of them, but you still have the option of taking Step 1 during 3rd year to catch up.
I also appreciate you having an opposing opinion to discuss and doing it civilly.
 

Lawpy

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Steps alone should be the default requirements for any specialty regardless of whether it’s scored or P/F. The only reason why COMLEX even exists is because the NBOME is fighting a losing battle to protect its cash cow no matter what and exploiting the divide between physicians. DOs are physicians and all should take Steps.
 
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PorcupineDoc

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Steps alone should be the default requirements for any specialty regardless of whether it’s scored or P/F. The only reason why COMLEX even exists is because the NBOME is fighting a losing battle to protect its cash cow no matter what and exploiting the divide between physicians. DOs are physicians and all should take Steps.
I agree with you here buddy. It’s hard for them to give up that 900 per person.

Should be step 1. Then a 120-150 question OMM test or something if they really want more
 
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