Which first, COMLEX or USMLE?

[Redrox]

I'm going residency in an allopathic sort of way, which means that I want my USMLE score to rock biscuit and all I care about for COMLEX is getting a passing grade.

Which brings me to my question. Should I take the USMLE a week before COMLEX and just cram OMM inbetween, or take the COMLEX first as kind of a final practice for the allopath?

Thoughts, comments, drama? What's the buzz at your school? I'm in Las Vegas where we're a little too new for there to be much upperclass consensus.

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[BCLumas]

Why not work hard for both COMLEX and USMLE? I mean, doing well on both opens up a lot of doors through both the AMA and AOA matches. If you're bent on doing one then the other, I would probably take the USMLE since it focuses more on Biochemistry, Genetics, and Micro, but I'm unsure. Hopefully some other upperclassmen can give you better advice.

IMHO, don't just pass the COMLEX, rock it's socks off!!

Good luck!

 

[Redrox]

Well, the problem with the COMLEX is the 20% of the test that is OMM related. I have dim hopes. Reasons I will do poorly:

1) It is one thing to feel something under your hands and then treat it, guided by tactile feedback. It is another to answer a question that attempts to reduce a subjective process into an awkwardly worded text question. I have met many fine osteopaths who treat successfully but are unable to articulate what is they are doing. Can I do better?

2) Even if the questions were more clear, the practice of OMM across programs (or even within cities) varies dramatically. Will my work at my school translate into multiple choice success?

3) The program I want to get into only is interested in the USMLE. Why not prioritize my studying?

4) Studying the 80% of the test that is not OMM benifits both test results. Studying OMM helps one, and not the one that counts.

But whether you are of my opinions or not, which test did you take first; and how far apart? I was going to take the USMLE, study OMM for three days and then COMLEX.

 

[BCLumas]

Unfortunately I am only a first-year. Again, I do agree that you should probably take the USMLE first as it has been shown to be the more complex and comprehensive exam of the two. Since your residency is only offered by the AMA (Pathology, by chance?), I would go with that!

Sorry for being misleading. I was just trying to post and give a couple of pennies to you since nobody else was. Good luck, my friend!

 

[ironmaidenrules]

Take the USMLE first. I took the USMLE and only studied OMT for about 8 hours after I took it. I did good on both.

 

[FutureInternist]

I initially had scheduled COMLEX first & USMLE 2 weeks later. This was a mistake since, while doing UW, I would find myself not reading the explanations as thoroughly or taking as many notes since I was focused on COMLEX & thought I would go back over all the UW Qs again w/ USMLE in mind. Needless to say, I changed my COMLEX date to after the USMLE once I realised what I was doing.
If you are able to avoid this mind trap of leaving stuff for later then it really shouldn't make any difference.

My advice would be to to do USMLE first then do Savarese & "guaranteed to be on COMLEX" stuff (dermatomes, brachial, lumbar & sacral plexus, cerebral circulation etc) from FA, which should take no more than 2-3 days.

Good Luck

 

[eag]

I took COMLEX before USMLE and it worked for me. Taking COMLEX first increased my morale to further prepare for the USMLE 10 days later. Things that I realized that I missed, I made sure I knew it for the USMLE. Also after you take the USMLE, you will not want to continue to study for the COMLEX. All in all, COMLEX was easier to me so it was a great warm up and made me ready for the USMLE. Funny thing, I actually scored higher on the USMLE

 

[Lamborghini1315]

I initially had scheduled COMLEX first & USMLE 2 weeks later. This was a mistake since, while doing UW, I would find myself not reading the explanations as thoroughly or taking as many notes since I was focused on COMLEX & thought I would go back over all the UW Qs again w/ USMLE in mind. Needless to say, I changed my COMLEX date to after the USMLE once I realised what I was doing.
If you are able to avoid this mind trap of leaving stuff for later then it really shouldn't make any difference.

My advice would be to to do USMLE first then do Savarese & "guaranteed to be on COMLEX" stuff (dermatomes, brachial, lumbar & sacral plexus, cerebral circulation etc) from FA, which should take no more than 2-3 days.

Good Luck

This was exactly how i have it planned in my head but unfortunately my school has a deadline for taking the comlex test and we are obligated to take part in the comlex prep offered by kaplan. This leaves me with no choice but to get comlex exam out of the way...this severely compromises my study plan and how i intended to tackle both exams but at the end of the day the key is to be prepared before you start your hardcore prep. If you plan on studying everything you need to during the 4 week before usmle or comlex then it will be an uphill battle..being a DO student i know the challenges at hand so plan ahead, put in more work and try to get a head start in your board prep with a study plan pertinent to your exam. For instance if i am taking the comlex first i won't start putting all my effort in path, phys, biochem instead tackling bugs, drugs, omm and less of path, phys, biochem. I will probably come up with a game plan next semester to study for comlex in a way to solidify what would be low yield on usmle and leave time at the end for some high yield stuff on USMLE. Again given the choice i would take usmle first but unfortunately i don't have one...

 

[ado]

I personally thought that USMLE exams where easier (and in fact I did better on them than I did on Comlex). Fure sure though, Step 1 has more genetics/biochem than Comlex 1. Don't sweat about the OMM part. Just read green review book. It was all I needed.

By the way I am applying to MD residency as well.

Good luck.

 

[dbcuse23]

I took the COMLEX one week before the USMLE. This strategy worked well; If you prepared well for one you will likely score high on both. Dont span the two exams too far apart. After finishing one board, no matter what other one is left to take you will likely not have much drive to study much more.
USMLE will contain more biostat and biochem so its better to take the COMLEX first and then study up on biostat and biochem before the USMLE. If you are more concerned about the USMLE, taking COMLEX first is beneficial as a high stakes warm up. Also COMLEX is longer and will build your stamina (COMLEX is 8 blocks of 50 while USMLE is only 7 blocks of 48 qs). So at least in your mind if you take COMLEX first you know you have completed the lengthier questionwise test.

 

[Taus]

I highly recommend taking the USMLE first, with 2-3 days off before taking the COMLEX. I took the USMLE on a Monday and COMLEX that Friday and in hindsight I wouldn't have changed a thing. I took all of Tuesday off to relax, studied OMM on Wed. and did a quick review of micro and pharm Wed night/Thurs morning. If you are well prepared for the USMLE and do a decent OMM review you will be as prepared as you could be for the COMLEX.

If you were to do it the other way around I think you would need much more time in between. To peak for the USMLE after taking time off for OMM and the general stress that comes w/ taking the COMLEX, you would then need to refresh molecular, biochem, genetics, immuno and biostatistics. To do that in only a few days between tests seems a lot more daunting then just reviewing OMM.

 

[Lamborghini1315]

I highly recommend taking the USMLE first, with 2-3 days off before taking the COMLEX. I took the USMLE on a Monday and COMLEX that Friday and in hindsight I wouldn't have changed a thing. I took all of Tuesday off to relax, studied OMM on Wed. and did a quick review of micro and pharm Wed night/Thurs morning. If you are well prepared for the USMLE and do a decent OMM review you will be as prepared as you could be for the COMLEX.

If you were to do it the other way around I think you would need much more time in between. To peak for the USMLE after taking time off for OMM and the general stress that comes w/ taking the COMLEX, you would then need to refresh molecular, biochem, genetics, immuno and biostatistics. To do that in only a few days between tests seems a lot more daunting then just reviewing OMM.

I share your concerns..i would def not leave out a few days before usmle if you take comlex first vice versa may not be true. I am dead set on giving myself the best chance to do well on usmle even if that means i have to go on an overdrive mode and add couple more weeks to my studying time. But throughout your prep personally you should target usmle style questions and usmle material with more focus on subjects that are high yield on comlex..a few days for omm at the end. At the end of your comlex exam you have covered what you think would not benefit you tremendously on usmle..then you start adding more layers of path/phys/biochem/biostats and less review of micro, pharm. One thing you should do through out is uworld..possibly a repeat of few questions since you will be in an extended mode with 2 exams. Altogether i don't think i would go over 8 weeks...

 

[Lamborghini1315]

I highly recommend taking the USMLE first, with 2-3 days off before taking the COMLEX. I took the USMLE on a Monday and COMLEX that Friday and in hindsight I wouldn't have changed a thing. I took all of Tuesday off to relax, studied OMM on Wed. and did a quick review of micro and pharm Wed night/Thurs morning. If you are well prepared for the USMLE and do a decent OMM review you will be as prepared as you could be for the COMLEX.

If you were to do it the other way around I think you would need much more time in between. To peak for the USMLE after taking time off for OMM and the general stress that comes w/ taking the COMLEX, you would then need to refresh molecular, biochem, genetics, immuno and biostatistics. To do that in only a few days between tests seems a lot more daunting then just reviewing OMM.

Oh by the way i am so envious that you are in philly right now...god i want to be part of the phillies parade on friday!

 

[AmyO]

I took the COMLEX first and took USMLE 2 wks later. It worked out well for me since I was able to get all my test anxiety out during the COMLEX and I knew what I needed to brush up on for the USMLE. If you're prepared adequately, it really doesn't matter which test you take first imho. Lots more molecular bio on USMLE, I had so many darn transgenic mice ?s on my USMLE

 

[Lamborghini1315]

I took the COMLEX first and took USMLE 2 wks later. It worked out well for me since I was able to get all my test anxiety out during the COMLEX and I knew what I needed to brush up on for the USMLE. If you're prepared adequately, it really doesn't matter which test you take first imho. Lots more molecular bio on USMLE, I had so many darn transgenic mice ?s on my USMLE

I hear ya, but i don't think comlex exam can be used as a criterion to gauge your weaknesses. I would much rather focus on NBME's after the comlex test and see where you need more brushing up...

 

[bonesawz]

I highly recommend taking the USMLE first, with 2-3 days off before taking the COMLEX. I took the USMLE on a Monday and COMLEX that Friday and in hindsight I wouldn't have changed a thing. I took all of Tuesday off to relax, studied OMM on Wed. and did a quick review of micro and pharm Wed night/Thurs morning. If you are well prepared for the USMLE and do a decent OMM review you will be as prepared as you could be for the COMLEX.

If you were to do it the other way around I think you would need much more time in between. To peak for the USMLE after taking time off for OMM and the general stress that comes w/ taking the COMLEX, you would then need to refresh molecular, biochem, genetics, immuno and biostatistics. To do that in only a few days between tests seems a lot more daunting then just reviewing OMM.

I did the exact same thing. If you read through all the step I threads, you'll see that this plan of attack was more or less the consensus among those that did extremely well on both.

 

[GoBuckeyes913]

I'm going residency in an allopathic sort of way, which means that I want my USMLE score to rock biscuit and all I care about for COMLEX is getting a passing grade.

Which brings me to my question. Should I take the USMLE a week before COMLEX and just cram OMM inbetween, or take the COMLEX first as kind of a final practice for the allopath?

Thoughts, comments, drama? What's the buzz at your school? I'm in Las Vegas where we're a little too new for there to be much upperclass consensus.

You should aim to do well on both. If they interview you, any residency will grill you on why you bombed the COMLEX (which is supposed to be your "main" exam) and how the hell you got a good USMLE score (they may question if it was luck). Just throwin it out there. OMT on step 1 is not bad at all and is very basic.... even on step 2. You should be fine

 

[Lamborghini1315]

You should aim to do well on both. If they interview you, any residency will grill you on why you bombed the COMLEX (which is supposed to be your "main" exam) and how the hell you got a good USMLE score (they may question if it was luck). Just throwin it out there. OMT on step 1 is not bad at all and is very basic.... even on step 2. You should be fine

hmm programs are not naive, luck is not enough for a successful score on either board exams. It would hurt the candidate if he tries to go into the AOA match thats all..

 

[GoBuckeyes913]

hmm programs are not naive, luck is not enough for a successful score on either board exams. It would hurt the candidate if he tries to go into the AOA match thats all..

I'm not saying they are naive, but it will definitely be noticed. My friend is currently having this issue.... did crappy on comlex, and well on USMLE. 5 interviews have questioned him why his board scores don't correlate with eachother.

 

[Lamborghini1315]

I'm not saying they are naive, but it will definitely be noticed. My friend is currently having this issue.... did crappy on comlex, and well on USMLE. 5 interviews have questioned him why his board scores don't correlate with eachother.

I understand but more often than not...ACGME's only care about USMLE while AOA-COMLEX. If you did horrible on both it really speaks for itself..but tbh most program directors in the allopathic world don't quite know how to interpret your comlex score and will be elated to just see your USMLE score. AOA world has no relevance to concern themselves with your usmle score..so yea my point.

 

[GoBuckeyes913]

I understand but more often than not...ACGME's only care about USMLE while AOA-COMLEX. If you did horrible on both it really speaks for itself..but tbh most program directors in the allopathic world don't quite know how to interpret your comlex score and will be elated to just see your USMLE score. AOA world has no relevance to concern themselves with your usmle score..so yea my point.

I used to think this way, until interviews started. I did not take USMLE, and am applying allo, and so far everyone has commented on my COMLEX score. Where as before I would have completely agreed with you, this year my opinion has changed and I've been surprised by PDs knowing what my score means. I agree with you that this has not been the trend in the past, but I think it's changing based on my experience as well as my friends. Just making a note of it is all
I guess I should have elaborated more on my friend's situation.... I was referring to allo programs interviewing him, not osteo. They've asked him to explain the reasoning of why his scores don't correlate. Wanted to use it as an example for the OP, just to keep it in mind.

 

[Lamborghini1315]

I used to think this way, until interviews started. I did not take USMLE, and am applying allo, and so far everyone has commented on my COMLEX score. Where as before I would have completely agreed with you, this year my opinion has changed and I've been surprised by PDs knowing what my score means. I agree with you that this has not been the trend in the past, but I think it's changing based on my experience as well as my friends. Just making a note of it is all
I guess I should have elaborated more on my friend's situation.... I was referring to allo programs interviewing him, not osteo. They've asked him to explain the reasoning of why his scores don't correlate. Wanted to use it as an example for the OP, just to keep it in mind.

Well you didn't give your PD's any choice but to evaluate you on your comlex score..they know your score and may interpret in a way that makes sense to them but doesn't imply that they accurately infer your performance. They won't suggest that you should have taken usmle coz that would seem like alienating DO's...you are past the game of taking step-1 so there's not much you can do at this point. But for someone about to take their step-1's should absolutely take the usmle and let things play out. In regards to your friend what program is he applying? Do you know if his USMLE score is avg or above avg?

 

[GoBuckeyes913]

Well you didn't give your PD's any choice but to evaluate you on your comlex score..they know your score and may interpret in a way that makes sense to them but doesn't imply that they accurately infer your performance. They won't suggest that you should have taken usmle coz that would seem like alienating DO's...you are past the game of taking step-1 so there's not much you can do at this point. But for someone about to take their step-1's should absolutely take the usmle and let things play out. In regards to your friend what program is he applying? Do you know if his USMLE score is avg or above avg?

The progs I applied accepted COMLEX scores in place of USMLE (which I researched prior to applying). If they are accepting an alternative scoring system, I would hate to think they wouldn't know how to interpret it, at least regarding the programs I have applied and interviewed at thus far. The PDs know what my score means, they have commented on it during interviews, 2 even reiderated my percentile ranking which is not given on a score report and must be calculated as given on the NBOME website. I'm not saying the OP shouldn't take USMLE at all, if it's beneficial to him he should absolutely take it, and it's on a personal basis. Im getting annoyed that someone 2 years behind me that has not even gone through any application or interview process, let alone even taken a board exam yet is trying to tell me how the system works. You have a lot to learn, only being MS2.

The original point I was simply trying to state to the OP, was that he should aim to do well on both exams, and keep his head up regarding the COMLEX as a poor score may or may not affect him. Obviously the PDs of allo residencies will be able to relate to USMLE scores easier than COMLEX scores, but that doesn't mean they don't know how to interpret them as stated from my personal examples.

My friend is applying to allo Neuro. USMLE 240, COMLEX 490. An obvious difference which has been brought up on every interview he has been on.

 

[Lamborghini1315]

The progs I applied accepted COMLEX scores in place of USMLE (which I researched prior to applying). If they are accepting an alternative scoring system, I would hate to think they wouldn't know how to interpret it, at least regarding the programs I have applied and interviewed at thus far. The PDs know what my score means, they have commented on it during interviews, 2 even reiderated my percentile ranking which is not given on a score report and must be calculated as given on the NBOME website. I'm not saying the OP shouldn't take USMLE at all, if it's beneficial to him he should absolutely take it, and it's on a personal basis. Im getting annoyed that someone 2 years behind me that has not even gone through any application or interview process, let alone even taken a board exam yet is trying to tell me how the system works. You have a lot to learn, only being MS2.

The original point I was simply trying to state to the OP, was that he should aim to do well on both exams, and keep his head up regarding the COMLEX as a poor score may or may not affect him. Obviously the PDs of allo residencies will be able to relate to USMLE scores easier than COMLEX scores, but that doesn't mean they don't know how to interpret them as stated from my personal examples.

My friend is applying to allo Neuro. USMLE 240, COMLEX 490. An obvious difference which has been brought up on every interview he has been on.

Well don't get annoyed coz my responses were not to spooke you but instead to give my opinion on an issue that is quite familiar to me. I may not be in your shoes applying but i am not new to the residency process..i have plenty of friends, family who have matched or about to match. Its not rocket science to figure out the trends..if you ask me now or ask me 2 years from now my suggestion to take USMLE will remain the same. Your case is more of an exception than the norm...both you and your friend are unique in that him with a stellar score shouldn't have much of a problem especially neurology which isn't that competitive. Whereas yourself you argue about how your pds accepted your comlex score, well thats not the issue here..a lot of programs do accept comlex scores but it would be rather irresponsible to say your comlex score will be judged well by most programs in general..which is absolutely untrue thus why i say a usmle score is preferred that is all....i am generalizing my opinions unlike your anecdotal evidence.

 

[DragonWell]

Before investing too much time in debating the optimum schedule for taking the tests, you may want to check and see what dates are actually available - COMLEX dates were fairly limited, at least in my locale.

I had originally planned to follow Taus' advice and take USMLE first, then hit OMM and do COMLEX a week or so later. Due to availability, it ended up the exact opposite, but I don't think it affected my scores at all. Once you've invested months of studying, by the end you're pretty much just trying to maintain a plateau, and there's plenty of last minute cramming to fill the final days for either test. As long as you take them close together, taking one test sooner or later doesn't make much of a difference IMHO.

 

[Redrox]

Glad to hear that the OMM is pretty straightforward on the Comlex, I was kind of expecting third order questions or something ridiculous. My school is not really strong on the subject, we have been scoring low on that section with some people passign USMLE and failing COMLEX.

 

[DrWBD]

COMLEX first, then USMLE ~ 2 weeks aftwerwards. My reasoning was that:

1. In general, COMLEX scores tend to not be weighed as heavily for AOA residencies as USMLE scores are for ACGME residencies. Again, in general.

2. You're taking the USMLE to impress ACGME programs, and you need to perform fairly well in order to do so. Taking the COMLEX first is like a trial run to see if you really know your material as well as you should.

 

[FutureInternist]

Taking the COMLEX first is like a trial run to see if you really know your material as well as you should.

The problem w/ that is if you do find you have a problem, it's too late since most people have a week or so b/w the exams regardless which one is first. So you have to end up postponing the USMLE.
But as long as you can avoid the trap of studying for the COMLEX & then "catching up" on the Biochem. Biostats etc in the week in b/w you should be OK.

 

[Khia18]

I took both and I would say take the USMLE first. COMLEX is very poorly written, and you often feel like you need 3 more pieces of info to answer the question. That said, the comlex has a ton of gimmes. As for the OMM on COMLEX, its mostly a joke. You need to know your innervations, reflexes, Chapmans points and maybe some basic counterstrain. I stress innervations (like this organ has this nerve root), they beat those to death. I took the USMLE on a friday and the COMLEX on a Monday and studied only OMT in between. Nothing can prepare you for the question style of COMLEX, take the COMSAE to try. Studying for USMLE first is basically studying everything you need for COMLEX, although it will be asked in indirect, crappy questions. Good luck!