Unsure if taking USMLE is worth it

[Jack Donaghy]

2nd year here. Conventional wisdom at my school is to take both exams, and I understand why. I also understand that holding off until 3rd year comes and goes to fully decide what I want to pursue is generally a smart decision.

That said, I am leaning heavily towards FM - due to shadowing just about every physician my school has to offer and also wanting the best lifestyle / family time that I can. I am also considering IM, as my time with our endocrinologist, cardiologist and gastroenterologist were all amazing and I have shadowed them in their respective practices several times over. At the end of the day, lifestyle is probably more important to me than anything else, and thus, my time shadowing and getting to know the plethora of FM docs has lead me to believe this is the specialty for me. FM is also the only "home" residency at my school (weird hospital-school partnership thing, not truly a residency of my school but might as well be).

So I am at: would love to do outpatient primary care but would also not mind doing IM and then subspecializing, if possible. Is taking the USMLE and doing poorly on it WORSE than not taking it at all? That is my biggest fear. Is having only COMLEX scores going to straight up deny me IM subspecialties? Is taking the USMLE even worth it considering that I most likely will do the FM residency here in town?

Advise is greatly appreciated.

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[BorntobeDO?]

NBMEs will tell you whether its a bad idea to take. If you are scoring over 220 consistently, I would do it. Uworld assessments overestimate for many people frequently, so I wouldn't rely on them.

 

[Stagg737]

Agree with above. Scoring 195 (or failing) is likely much worse than having a solid COMLEX and not taking Step. Mid-210's and above is likely better than no score for FM. Situational though and depends on where you're hoping to match as well as what your COMLEX and predicted Step scores are.

 

[Espressso]

Sorry to hijack the thread, but going off of OP's post and the comments above, when should one take the NBMEs? My understanding is that there's only a few (one, even?) available for purchase online. Should those be saved for dedicated period? Or should that be taken earlier?

 

[InternistDO]

Take your first NBME during the beginning of dedicated to get your baseline and then you can generally take 1ish a week (plus UW 1 and 2) up to the test.

Just taking (not passing) USMLE increases your chances of matching FM, according to the 2018 Charting Outcomes. As long as you're gonna break 210 just do it. COMLEX is a joke test anyway, and you never know what you're going to like. And whatever you do, don't postpone taking Step. Either take it around COMLEX 1 or don't take it.

 

[NecrotizingFasciitis]

Idk what school this individual was from, but whilst consuming unlimited refills of coffee at Panera, ballz-deep in a cardio/pulm study session, there was a girl who had just taken her first NBME & hit 230-240 (she was vocal about in on a phone call.) My assumption was that she went to a Caribbean school & was home studying for boards ('cause some of their schedules have the potential to be in dedicated during x-mas... there were a few people from Carib schools around x-mas last year home studying for boards that I know of.) But they may have been a killer student at another school around here.

Anyways, this kinda made me wanna take one for fun during x-mas break to see how much work I have to do through the winter semester. For my school's curriculum we'll technically be through pathology for neuro, GI, renal, & cardio/pulm, which is a solid chunk of material. Idk. I did it for the MCAT about 6 months ahead of time just for kicks & it didn't hurt anything.

Anybody done this for fun over winter break? If so, did you pass?

 

[Cranjis McBasketball]

24/26 DO's who scored between a 191 and 200 on USMLE matched in FM. 22/26 matched IM
http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf