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PDs have an intuitive sense of what’s a ‘good’ USMLE score for their specialty. Why not capitalize on that intuition by reporting COMLEX results using the numbers that most PDs are more familiar with? Make me president of the NBOME, and the first thing I’ll do is start reporting COMLEX scores on the same scale used by the USMLE.
 

BorntobeDO?

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PDs have an intuitive sense of what’s a ‘good’ USMLE score for their specialty. Why not capitalize on that intuition by reporting COMLEX results using the numbers that most PDs are more familiar with? Make me president of the NBOME, and the first thing I’ll do is start reporting COMLEX scores on the same scale used by the USMLE.
Nice read, I agree with the table and I wish NBOME would just change the scale like he suggests. They won't for 'distinctiveness' reasons, but it would be good if they did.
 
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DrStephenStrange

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For people wondering why not just get rid of COMLEX:

"Several readers have asked why I didn’t entertain the idea of getting rid of COMLEX and having all osteopathic medical students take the USMLE instead. The reason is logistic. COMLEX is protected by law. Getting rid of it would require amending the medical practice act in every state – which seems like an insurmountable obstacle."
 
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jkdoctor

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For people wondering why not just get rid of COMLEX:

"Several readers have asked why I didn’t entertain the idea of getting rid of COMLEX and having all osteopathic medical students take the USMLE instead. The reason is logistic. COMLEX is protected by law. Getting rid of it would require amending the medical practice act in every state – which seems like an insurmountable obstacle."
This is not true in numerous states and no laws would have to be changed in numerous states.
Can you give examples of state medical boards that do not allow DOs to take USMLE instead of COMLEX for licensure?
Here is what is written for Wisconsin:
Commencing January 1, 1994, the board requires the 3−step USMLE sequence as its written or computer−based examination. The minimum passing score for Step 1, Step 2 CK, and Step 3 shall be not less than 75 on the 2−digit scale. Step 2 CS, which is scored as pass or fail, shall be passed. Applicants who have completed a standard M.D. or D.O. medical education program shall complete all 3 steps of the examination sequence within 10 years from the date upon which the applicant first passes a step, either Step 1 or Step 2.
The board shall waive completion of the 3−step USMLE sequence for an applicant who has passed all 3 levels of the Comprehensive Osteopathic Medical Licensing Examination, commonly known as the COMLEX−USA.
 

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This is not true in numerous states and no laws would have to be changed in numerous states.
Can you give examples of state medical boards that do not allow DOs to take USMLE instead of COMLEX for licensure?
Here is what is written for Wisconsin:
Commencing January 1, 1994, the board requires the 3−step USMLE sequence as its written or computer−based examination. The minimum passing score for Step 1, Step 2 CK, and Step 3 shall be not less than 75 on the 2−digit scale. Step 2 CS, which is scored as pass or fail, shall be passed. Applicants who have completed a standard M.D. or D.O. medical education program shall complete all 3 steps of the examination sequence within 10 years from the date upon which the applicant first passes a step, either Step 1 or Step 2.
The board shall waive completion of the 3−step USMLE sequence for an applicant who has passed all 3 levels of the Comprehensive Osteopathic Medical Licensing Examination, commonly known as the COMLEX−USA.
I was quoting what the author said at the very end.
 
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ciestar

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So... At what point can we as students completely, 100% abandon OMM forever? After you take Level 3, as long as you do an ACGME residency and not a former AOA one?
I believe you have to do CME stuff every year of your residency. During one of my rotations all that resident did was a presentation on occipital release and that was all that was necessary (OB).

Also depends on your specialty. FM will require you to do more.
 

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I believe you have to do CME stuff every year of your residency. During one of my rotations all that resident did was a presentation on occipital release and that was all that was necessary (OB).

Also depends on your specialty. FM will require you to do more.
That's easy though. You don't have to memorize anything for that. If it's like Chapman points and Counterstrain points where you have to remember exact location of different points and their treatment positions (F SARA, E SART, F, RA, F STRT, ect...) then I would hate it.
 
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ciestar

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That's easy though. You don't have to memorize anything for that. If it's like Chapman points, counterstrain points where you have to remember exact location of different points and their treatment positions (F SARA, E SART, F, RA, F STRT, ect...) then I would hate it.
Yup, very painless.

However, at almost all of the FM programs I’ve interviewed at they have required OMM clinic and general didatics for DOs. So, if you hate it, that is something to consider.
 
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There are a handful of states (they are a subset of the ones with DO state medical boards) that do require completion of the COMLEX series. I don't remember them all off the top of my head, but they exist. The best way to know if your state is one of them is to just contact the board directly.

To be completely honest, to graduate from a DO school, you have to complete 3 out of the 4 COMLEX exams anyways, so just take Level 3, honestly the easiest of them all, and be done. Compare that to having to take both the USMLE Step 2 CS and Step 3, which almost no DOs take.

Also depends on your specialty. FM will require you to do more.
This has nothing to do with specialty and everything to do with the state or program you are in. A couple Osteopathic state medical boards, specifically in PA and FL still require an "AOA-equivalent" internship for unrestricted licensure. The only way to fulfill this requirement is to either go to an AOA accredited program or to apply for Res. 42 approval indicating that your ACGME accredited internship is "AOA-equivalent". One of the stipulations of this approval is that you complete an osteopathic related activity, which can be submitting an osteopathic research paper, attending 8 hrs of osteopathic CME at a conference, or performing a presentation at your residency program, such as grand rounds or equivalent, about OMM/OMT. This is likely what you experienced, DOs fulfilling their requirements to be licensed in PA.

Honestly, I recommend everyone complete this so that they can be licensed as DOs in all 50 states. I'm going to a DO conference near my hometown this Spring to complete my requirements, but that's more an excuse to use conference days to visit home. Giving a presentation at noon conference on suboccipital release would be a pretty easy thing to do as well.

However, at almost all of the FM programs I’ve interviewed at they have required OMM clinic and general didatics for DOs. So, if you hate it, that is something to consider.
All of those program were either dual-accredited or have Osteopathic-focus certification. The vast majority of FM programs in PA were dual-accredited (now with osteopathic focus). As a result, they have a separate curriculum for DOs. FM programs that weren't dual-accredited and don't have osteopathic focus do not have such requirements.
 
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BorntobeDO?

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There are a handful of states (they are a subset of the ones with DO state medical boards) that do require completion of the COMLEX series. I don't remember them all off the top of my head, but they exist. The best way to know if your state is one of them is to just contact the board directly.

To be completely honest, to graduate from a DO school, you have to complete 3 out of the 4 COMLEX exams anyways, so just take Level 3, honestly the easiest of them all, and be done. Compare that to having to take both the USMLE Step 2 CS and Step 3, which almost no DOs take.



This has nothing to do with specialty and everything to do with the state or program you are in. A couple states, specifically PA and FL still require an "AOA-equivalent" internship. The only way to fulfill this requirement is to either go to an AOA accredited program or to apply for Res. 42 approval indicating that your ACGME accredited internship is "AOA-equivalent". One of the stipulations of this approval is that you complete an osteopathic related activity, which can be submitting an osteopathic research paper, attending 8 hrs of osteopathic CME at a conference, or performing a presentation at your residency program, such as grand rounds or equivalent, about OMM/OMT. This is likely what you experienced, DOs fulfilling their requirements to be licensed in PA.



All of those program were either dual-accredited or have Osteopathic-focus certification. The vast majority of FM programs in PA were dual-accredited (now with osteopathic focus). As a result, they have a separate curriculum for DOs. FM programs that weren't dual-accredited and don't have osteopathic focus do not have such requirements.
Unfortunately for the DO who doesn't want to do OMM and is applying for family, most of them seem to be trying to have an OMM track even if you don't want to do it. I have a couple family interviews as backup and did not apply to community programs, but I was asked about doing OMM at several of them. One was really insistant that they just needed one more DO faculty and they would get the osteopathic recognition. Ironically the only one that didn't talk about it was questioning my rotations. Which is fair enough, but I did get a chuckle out of FM asking about my inpatient experience. The whole point of most DO schools is preparing for primary care and heres an FM residency worried that I don't have enough experience to do it.
 
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Unfortunately for the DO who doesn't want to do OMM and is applying for family, most of them seem to be trying to have an OMM track even if you don't want to do it. I have a couple family interviews as backup and did not apply to community programs, but I was asked about doing OMM at several of them. One was really insistant that they just needed one more DO faculty and they would get the osteopathic recognition. Ironically the only one that didn't talk about it was questioning my rotations. Which is fair enough, but I did get a chuckle out of FM asking about my inpatient experience. The whole point of most DO schools is preparing for primary care and heres an FM residency worried that I don't have enough experience to do it.
It really is program dependent. A lot of programs have a "DO track", but don't require you to do it. Others had policies where they were like if you matched one of their AOA spots, you had to do the DO track, and others had policies that if you were a DO, you had to do the track. Its so program dependent that blanket statements about FM don't really apply. The multiple FM programs in my current state do not have a separate track and unless they are affiliated with the DO school, then they don't require DOs to do any OMM. The majority of FM programs in my previous state did require it of all DOs there. Its purely program dependent.

There are obviously also some IM programs that have those requirements as well, but they are less prevalent.

To be completely honest, I kind of wish an option (not requirement) existed for residents in the categorical FM program at my hospital. I occasionally throw out some OMM knowledge during an encounter with patients, mainly if I'm doing any Exercise Rx, but I feel the atrophy of not using it for 2 years. Obviously I don't miss Chapman's or cranial, but some of the neck, back and shoulder techniques, stretches and exercises, they come up so often in clinic.
 

ciestar

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There are a handful of states (they are a subset of the ones with DO state medical boards) that do require completion of the COMLEX series. I don't remember them all off the top of my head, but they exist. The best way to know if your state is one of them is to just contact the board directly.

To be completely honest, to graduate from a DO school, you have to complete 3 out of the 4 COMLEX exams anyways, so just take Level 3, honestly the easiest of them all, and be done. Compare that to having to take both the USMLE Step 2 CS and Step 3, which almost no DOs take.



This has nothing to do with specialty and everything to do with the state or program you are in. A couple Osteopathic state medical boards, specifically in PA and FL still require an "AOA-equivalent" internship for unrestricted licensure. The only way to fulfill this requirement is to either go to an AOA accredited program or to apply for Res. 42 approval indicating that your ACGME accredited internship is "AOA-equivalent". One of the stipulations of this approval is that you complete an osteopathic related activity, which can be submitting an osteopathic research paper, attending 8 hrs of osteopathic CME at a conference, or performing a presentation at your residency program, such as grand rounds or equivalent, about OMM/OMT. This is likely what you experienced, DOs fulfilling their requirements to be licensed in PA.

Honestly, I recommend everyone complete this so that they can be licensed as DOs in all 50 states. I'm going to a DO conference near my hometown this Spring to complete my requirements, but that's more an excuse to use conference days to visit home. Giving a presentation at noon conference on suboccipital release would be a pretty easy thing to do as well.



All of those program were either dual-accredited or have Osteopathic-focus certification. The vast majority of FM programs in PA were dual-accredited (now with osteopathic focus). As a result, they have a separate curriculum for DOs. FM programs that weren't dual-accredited and don't have osteopathic focus do not have such requirements.
Yeahh... they were all in PA hahaha
 
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Yeahh... they were all in PA hahaha
Of all the programs I interviewed at, virtually every one of them in PA had these requirements. I think part of it is a way to fulfill the PA state medical board "OMM experience" for Res. 42. Plus there's just so many DOs in PA.

FM in general does have more programs like this, but this mainly because FM in general was the specialty with the most AOA programs and dual-accredited programs. In regions without as many DOs, you never hear about this though.
 
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Of all the programs I interviewed at, virtually every one of them in PA had these requirements. I think part of it is a way to fulfill the PA state medical board "OMM experience" for Res. 42. Plus there's just so many DOs in PA.

FM in general does have more programs like this, but this mainly because FM in general was the specialty with the most AOA programs and dual-accredited programs. In regions without as many DOs, you never hear about this though.
But what happens to this requirement now that there are no AOA residencies? I've asked about this before since I'm interested in getting licensed in FL. Going to 8 hours of CME or doing a presentation doesn't seem bad, but still.
 

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But what happens to this requirement now that there are no AOA residencies? I've asked about this before since I'm interested in getting licensed in FL. Going to 8 hours of CME or doing a presentation doesn't seem bad, but still.
Honestly, I don't know. I think programs with "osteopathic focus" are still counted. When I was in med school there were initially 5 states with this requirement. One dropped it early, and the two others dropped it in light of the merger. I thought maybe PA or FL would drop it as well, but they haven't and if anything they've dug in their heals.

The good thing is that the AOA is all about making Res. 42 and 56 (getting your residency viewed as AOA-equivalent so that you can sit for DO boards if you wanted to) relatively easy to complete. Virtually everyone is approved as long as they fulfill the requirements. But they've talked about the resolutions becoming obsolete with the merger. I think we'll just have to attend a DO conference or give a presentation.
 
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I do not believe the author is correct about that. The major requirement for COMLEX comes from COCA.
COCA requires level 1, level 2 CE, and level 2 PE for graduation. Level 3 is not required by COCA.


Arkansas:
View attachment 289336
Connecticut:
View attachment 289337
This is the same for every state licensure? So even though COCA does not require you to take Level 3, there is still no getting around taking it for anyone?
 
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This is the same for every state licensure? So even though COCA does not require you to take Level 3, there is still no getting around taking it for anyone?
Not correct. You can take USMLE series in most states. One current problem, however, is that few DO students take USMLE Step 2 CS.
1576430361881.png
 
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Does anyone study for Level 3? I know people do for Step 3, and was wondering how easy Level 3 is going to be.
 

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But to take Step 3 you need to take Step 2 CS. So no matter what you're going to take either Level 3 or Step 3 to complete a residency.
I spoke with an ob/gyn intern once who said that her PD told her she should consider going back and taking Step 2 CS so that she could take Step 3 instead of Level 3, since some fellowships require you to have taken Step 3 and the PD didn't want her to be limited in anything. Another thing that would be solved by just eliminating COMLEX..
 
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I spoke with an ob/gyn intern once who said that her PD told her she should consider going back and taking Step 2 CS so that she could take Step 3 instead of Level 3, since some fellowships require you to have taken Step 3 and the PD didn't want her to be limited in anything. Another thing that would be solved by just eliminating COMLEX..
According to what I've heard, due to the merger and AOA now being part of the ACGME, programs shouldn't require one test or the other now. Although that doesn't stop them from favoring applicants with only Step scores, but to explicitly say it somewhere in their requirements is now cause for trouble or even legal actions. The new president of our school was the previous COCA secretary and also a judge, and he specifically tell us to report to him directly programs that explicitly mention those requirements (like require USMLE and don't accept COMLEX) on their websites. That's one of the reason NYU had to remove that they don't accept DOs from their website. I don't know how much that matters though.
 
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Does anyone study for Level 3? I know people do for Step 3, and was wondering how easy Level 3 is going to be.
So my studying consisted of doing Combank questions during down time for a week and a half (I think I got through 500-600 questions), reviewing the NBOME blueprint, scanning through Saverese for like an hour the night before, and watching the viscerosomatic videos on youtube in the parking lot of the testing center. I took it in spring of intern year. Scored 100 points above either of my previous levels.
 

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So my studying consisted of doing Combank questions during down time for a week and a half (I think I got through 500-600 questions), reviewing the NBOME blueprint, scanning through Saverese for like an hour the night before, and watching the viscerosomatic videos on youtube in the parking lot of the testing center. I took it in spring of intern year. Scored 100 points above either of my previous levels.
Same

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PDs have an intuitive sense of what’s a ‘good’ USMLE score for their specialty. Why not capitalize on that intuition by reporting COMLEX results using the numbers that most PDs are more familiar with? Make me president of the NBOME, and the first thing I’ll do is start reporting COMLEX scores on the same scale used by the USMLE.
I wouldn't call it "fleecing", more like "We at NBOME don't give a rat's ass about your career prospects, we just want to know that you're competent at Osteopathic Medicine".

I asked the very same question as you did when NBOME visited my school, and got a very dismissive answer. Something along the lines of "Then it would just be like Step. They [the PDs] could just look up the conversion numbers".

I never, ever came so close to punching a fellow medical education professional in the nose as I did when I heard that.

I believe that NBOME wants COMLEX to be "special", in the same way that the True Believers in the AOA believe that the profession is the same as MD, but yet...different.
 
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Deecee2DO

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I wouldn't call it "fleecing", more like "We at NBOME don't give a rat's ass about your career prospects, we just want to know that you're competent at Osteopathic Medicine".

I asked the very same question as you did when NBOME visited my school, and got a very dismissive answer. Something along the lines of "Then it would just be like Step. They [the PDs] could just look up the conversion numbers".

I never, ever came so close to punching a fellow medical education professional in the nose as I did when I heard that.

I believe that NBOME wants COMLEX to be "special", in the same way that the True Believers in the AOA believe that the profession is the same as MD, but yet...different.
This is so frustrating to hear i dont blame you for wanting to punch that person in the face smh lol
 

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Proposal 1, making USMLE pass/fail, has it's own thread, won't rehash here.
Proposal 3, making the conversion tool available to PD's, already happens. In ERAS when I look at any COMLEX score, there's a link to the NBOME's website tool right there. Do PD's use it? I have no idea.
The other proposals all have the same problem -- assuming that the two populations (MD and DO) are the same. Using percentiles, or changing COMLEX scoring to "match" USMLE scoring based on percentiles, assumes that the two populations are exactly the same. And in fact, the formula in the quoted paper (and every other formula to convert COMLEX to USMLE) shows that's probably not true:

1. The average USMLE Step 1 score is now 228-230. The average COMLEX score is 525 per the NBOME tool. But plugging 228 into the above formula would equate to a score just north of 600. This suggests that the two populations are different -- if the two tests were different, one wouldn't expect the linear correlation seen.

This leads to another uncomfortable likelihood:

2. The minimum pass for COMLEX is well below the minimum pass for USMLE. Using the formula, a minimum passing score of 194 converts to 466. This suggests that the two exams have set different standards for minimum competence. Which of those standards is "correct" is unknown.
 

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asked the very same question as you did when NBOME visited my school, and got a very dismissive answer. Something along the lines of "Then it would just be like Step. They [the PDs] could just look up the conversion numbers".

I never, ever came so close to punching a fellow medical education professional in the nose as I did when I heard that.

I believe that NBOME wants COMLEX to be "special", in the same way that the True Believers in the AOA believe that the profession is the same as MD, but yet...different.
I sat through the same presentation. My personal favorite was the opening statement, had absolutely nothing to do with anything about the COMLEX or NBOME and was instead a 10 minute rant about how SDN is the devil lol.

That individual is truly a champion for DOs everywhere....

/s
 

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Proposal 1, making USMLE pass/fail, has it's own thread, won't rehash here.
Proposal 3, making the conversion tool available to PD's, already happens. In ERAS when I look at any COMLEX score, there's a link to the NBOME's website tool right there. Do PD's use it? I have no idea.
The other proposals all have the same problem -- assuming that the two populations (MD and DO) are the same. Using percentiles, or changing COMLEX scoring to "match" USMLE scoring based on percentiles, assumes that the two populations are exactly the same. And in fact, the formula in the quoted paper (and every other formula to convert COMLEX to USMLE) shows that's probably not true:

1. The average USMLE Step 1 score is now 228-230. The average COMLEX score is 525 per the NBOME tool. But plugging 228 into the above formula would equate to a score just north of 600. This suggests that the two populations are different -- if the two tests were different, one wouldn't expect the linear correlation seen.

This leads to another uncomfortable likelihood:

2. The minimum pass for COMLEX is well below the minimum pass for USMLE. Using the formula, a minimum passing score of 194 converts to 466. This suggests that the two exams have set different standards for minimum competence. Which of those standards is "correct" is unknown.
In my experience the conversion tools are wildly inaccurate and under calculates the equivalent USMLE scores. To give you an idea, the calculator developed in 2014 under calculates my USMLE score by 10 points even though I took my Level 1 and Step 1 in 2015. The calculator one from 2006 under calculates it by 20 points.

I'm not sure which tool you're using, but I wouldn't be surprised if it was equally poor.
 

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There are a handful of states (they are a subset of the ones with DO state medical boards) that do require completion of the COMLEX series. I don't remember them all off the top of my head, but they exist. The best way to know if your state is one of them is to just contact the board directly.

To be completely honest, to graduate from a DO school, you have to complete 3 out of the 4 COMLEX exams anyways, so just take Level 3, honestly the easiest of them all, and be done. Compare that to having to take both the USMLE Step 2 CS and Step 3, which almost no DOs take.



This has nothing to do with specialty and everything to do with the state or program you are in. A couple Osteopathic state medical boards, specifically in PA and FL still require an "AOA-equivalent" internship for unrestricted licensure. The only way to fulfill this requirement is to either go to an AOA accredited program or to apply for Res. 42 approval indicating that your ACGME accredited internship is "AOA-equivalent". One of the stipulations of this approval is that you complete an osteopathic related activity, which can be submitting an osteopathic research paper, attending 8 hrs of osteopathic CME at a conference, or performing a presentation at your residency program, such as grand rounds or equivalent, about OMM/OMT. This is likely what you experienced, DOs fulfilling their requirements to be licensed in PA.

Honestly, I recommend everyone complete this so that they can be licensed as DOs in all 50 states. I'm going to a DO conference near my hometown this Spring to complete my requirements, but that's more an excuse to use conference days to visit home. Giving a presentation at noon conference on suboccipital release would be a pretty easy thing to do as well.



All of those program were either dual-accredited or have Osteopathic-focus certification. The vast majority of FM programs in PA were dual-accredited (now with osteopathic focus). As a result, they have a separate curriculum for DOs. FM programs that weren't dual-accredited and don't have osteopathic focus do not have such requirements.
Great post. This implies that PA and FL won't join modern times though, right? If resolution 42 is not needed due to merger then this would be unnecessary once their state law is changed to accept DOs who went to ACGME residencies (all of them.)
 
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I asked the very same question as you did when NBOME visited my school, and got a very dismissive answer. Something along the lines of "Then it would just be like Step. They [the PDs] could just look up the conversion numbers".

I never, ever came so close to punching a fellow medical education professional in the nose as I did when I heard that.
Let me guess -- John Gimpel. I've never left an NBOME presentation he has given without being angry at the condescending attitude, dismissive "answers", and outright lies he has delivered. The latest "strategy" I observed was comparing the PLACEMENT rate of DO vs the MATCH rate of MD students. BTW he also hates SDN, lol!!
 

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Let me guess -- John Gimpel. I've never left an NBOME presentation he has given without being angry at the condescending attitude, dismissive "answers", and outright lies he has delivered. The latest "strategy" I observed was comparing the PLACEMENT rate of DO vs the MATCH rate of MD students. BTW he also hates SDN, lol!!
I also loved the "I only took COMLEX and matched the program I wanted!" sales pitch that was entirely made up of people who matched to AOA programs lol.
 

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This leads to another uncomfortable likelihood:

2. The minimum pass for COMLEX is well below the minimum pass for USMLE. Using the formula, a minimum passing score of 194 converts to 466. This suggests that the two exams have set different standards for minimum competence. Which of those standards is "correct" is unknown.
This uncomfortable truth is the main reason the COMLEX is not going away. No one likes to admit it, but for the bottom of the classes (those who score <450) a good number of them would not be able to pass the USMLE. This would result in a much higher attrition rate and affecting the bottom line of the school, not to mention creating administrative nightmares trying to deal with all the students being pulled from rotations to try and repeat these exams. With many schools having pass rates in the 80s for the COMLEX Level I, can you imagine what that would be if all of those students were required to take Step 1?
 

ProfAnon

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I also loved the "I only took COMLEX and matched the program I wanted!" sales pitch that was entirely made up of people who matched to AOA programs lol.
The match vs. placement lie made me forget about this, but now that you mention it I caught that as well! It's embarrassing to have this guy representing the osteopathic profession.
 
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Goro

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Let me guess -- John Gimpel. I've never left an NBOME presentation he has given without being angry at the condescending attitude, dismissive "answers", and outright lies he has delivered. The latest "strategy" I observed was comparing the PLACEMENT rate of DO vs the MATCH rate of MD students. BTW he also hates SDN, lol!!
THAT'S the sonuvabitch!!!

I see that he's consistent with his arrogance. And you're right, he did thrown in a dig at SDN!
 

aProgDirector

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In my experience the conversion tools are wildly inaccurate and under calculates the equivalent USMLE scores. To give you an idea, the calculator developed in 2014 under calculates my USMLE score by 10 points even though I took my Level 1 and Step 1 in 2015. The calculator one from 2006 under calculates it by 20 points.

I'm not sure which tool you're using, but I wouldn't be surprised if it was equally poor.
The problem with any "conversion tool" is going to be scatter. If you look at the graph from the most recent publication: The paper

You'll see that the regression looks valid and accurate. However, there's enough scatter along the graph such that although the formula predicts the average USMLE score you would obtain at each COMLEX score, the actual range of scores is wide. For example, picking a COMLEX of 500, the formula/graph gives a USMLE of about 207 (the formula can be simplified to 1/4 comlex + 82). But looking at the graph, we can see that scores for that COMLEX seem to range from 170 to 225.

So, just because the tool doesn't predict your score doesn't make it "poor". It's poor for you -- because you did better on USMLE.

Why there's a discrepancy is unknown. Test takers might take the tests at different times and hence have more/less study time, the content of the tests might be different, or it could all be random variation. Or something else.
 
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hallowmann

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The problem with any "conversion tool" is going to be scatter. If you look at the graph from the most recent publication: The paper

You'll see that the regression looks valid and accurate. However, there's enough scatter along the graph such that although the formula predicts the average USMLE score you would obtain at each COMLEX score, the actual range of scores is wide. For example, picking a COMLEX of 500, the formula/graph gives a USMLE of about 207 (the formula can be simplified to 1/4 comlex + 82). But looking at the graph, we can see that scores for that COMLEX seem to range from 170 to 225.

So, just because the tool doesn't predict your score doesn't make it "poor". It's poor for you -- because you did better on USMLE.

Why there's a discrepancy is unknown. Test takers might take the tests at different times and hence have more/less study time, the content of the tests might be different, or it could all be random variation. Or something else.
I understand that any model will have scatter and range, but when a model estimates an "equivalent" USMLE score, but with a range of 170-225, to me that reaches the level of uselessness.

Which is actually interesting because it's basically what the authors of that paper concluded. They found that in general while there is a positive correlation between USMLE and COMLEX scores "Program directors of ACGME-accredited programs should use caution when using any formula to derive and calculate USMLE Step 1 scores from COMLEX-USA Level 1 scores...program directors are encouraged to familiarize themselves with, and evaluate the content of, USMLE Step 1 and COMLEX-USA Level 1 independently."

Plus that article only evaluated scores from one DO school, which absolutely lends itself to confounding variables.
 

aProgDirector

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Totally agree that there are all sorts of problems with the article.

Although the range is 170-225, the vast majority of scores fall in a smaller range.

But this is the nature of the beast. If there are two exams and you want PD's to compare them as equivalent, then some sort of comparison is necessary.
 

hallowmann

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Totally agree that there are all sorts of problems with the article.

Although the range is 170-225, the vast majority of scores fall in a smaller range.

But this is the nature of the beast. If there are two exams and you want PD's to compare them as equivalent, then some sort of comparison is necessary.
Honestly, it's part of the reason that taking both is necessary, and why I recommend it. Even just taking Step 1 will make it easier for people to truly compare applicants, and not taking it opens the applicants up to being underestimated with formulas like these.
 

Dissected

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It's a real shame that students are still discouraged to prepare for and take the USMLE. I remember our Dean getting up in front of our class and giving his ancient opinion on why just taking COMLEX is fine unless you are in the top 5% of the class. What a disservice to students, especially with the ACGME merger wrapping up and competition for residency spots at an all time high. We interviewed a few students that had only taken the COMLEX, had average scores, and weren't able to SOAP into anything (as in no internship) after they didn't match.

Primary care specialties and a few historical DO programs might be OK with COMLEX results with/without a conversion factor. Many specialty programs are going to shrug it off...actually they are going to filter these students out in ERAS and never even see their application.

Study like hell and take the USMLE kids.
 

Neurality

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Part of this may have to do with graduation requirements for a specific school. The program I am at now required completion of COMLEX 1 and 2 to graduate. That may change in the future because of the merger though..
 

DO2015CA

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It's a real shame that students are still discouraged to prepare for and take the USMLE. I remember our Dean getting up in front of our class and giving his ancient opinion on why just taking COMLEX is fine unless you are in the top 5% of the class. What a disservice to students, especially with the ACGME merger wrapping up and competition for residency spots at an all time high. We interviewed a few students that had only taken the COMLEX, had average scores, and weren't able to SOAP into anything (as in no internship) after they didn't match.

Primary care specialties and a few historical DO programs might be OK with COMLEX results with/without a conversion factor. Many specialty programs are going to shrug it off...actually they are going to filter these students out in ERAS and never even see their application.

Study like hell and take the USMLE kids.
Your deans opinion isn’t unique. It’s really nothing to do with the students or their future is what’s sad. They could careless if every single student placed into rural pc residencies. As long as they can post a 100% first time board pass and placement rate. So they discouraging you is just them only caring about themselves. They know if the pass rates or placement rates tank then they will get canned
 

hallowmann

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Part of this may have to do with graduation requirements for a specific school. The program I am at now required completion of COMLEX 1 and 2 to graduate. That may change in the future because of the merger though..
All DO schools require completion of COMLEX Level 1, 2 CE, and 2 PE. This is an accreditation level requirement by COCA. It's just like how US MD schools require USMLE Step 1, Step 2 CK, and Step 2 CS for graduation. This isn't ending anytime soon, regardless of the merger.

Your deans opinion isn’t unique. It’s really nothing to do with the students or their future is what’s sad. They could careless if every single student placed into rural pc residencies. As long as they can post a 100% first time board pass and placement rate. So they discouraging you is just them only caring about themselves. They know if the pass rates or placement rates tank then they will get canned
The even more nefarious plot that I suspected along with my classmates was that the goal was actually to pigeonhole us into specifically the affiliated OGME programs. That's the way it seemed to us at least. A bunch of people did end up going to affiliated programs mainly because of regional preference anyway.
 
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Neopolymath

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Your deans opinion isn’t unique. It’s really nothing to do with the students or their future is what’s sad. They could careless if every single student placed into rural pc residencies. As long as they can post a 100% first time board pass and placement rate. So they discouraging you is just them only caring about themselves. They know if the pass rates or placement rates tank then they will get canned
I try to explain this to people sometimes. The school at best is not aligned with your interests/goals/career and at worst is actively trying to interfere with your pursuit of said goals. They don't care if every single person got a 451 and matched to IM sweatshop. That is better than ten people getting derm and one person failing to match for their bottom line.
 

AnatomyGrey12

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The even more nefarious plot that I suspected along with my classmates was that the goal was actually to pigeonhole us into specifically the affiliated OGME programs. That's the way it seemed to us at least. A bunch of people did end up going to affiliated programs mainly because of regional preference anyway.
I am 100% convinced at this is true at my school.
 
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