Why did those who did not take USMLE choose to do so?

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ari202

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I'm just curious why some of you guys chose not to take USMLE? For the record, not using this as an attack tactic, I just want to know as I, too, did not take it. I am glad that I did not do so as it was not a requirement for me to become a physician.

The reason I bring this up is because I feel like I'm the only DO student in my school and in the west coast who has not taken it at all. I am auditioning and interviewing for psychiatry allopathic programs and at a recent interview, I was given the impression that I was not really considered a "real doctor" because I chose not to spend $500 , spend $300 for uworld, to take one test.

Passing and taking the COMLEX was all that was required of me to earn my degree and to practice medicine. I do not see any point in taking another exam (for me at least).

Some may disagree with me saying the comlex is vague, but it is all that you need to get your DO degree and when you applied to DO schools, you knew that you were getting a DO degree, not an MD degree.
 
It sounds odd to me that a program would invite someone to interview and then give them guilt about being a DO, but I've heard it before. If you think you'd be treated like a second-rate resident there, don't rank it highly.

I can't say why people don't take USMLE. I took both because I was applying only to allopathic programs, and I wanted to maximize my options, be compared on a more objective basis 'apples-to-apples' and I didn't think it would be that much more work on top of preparing for COMLEX. That said, many of my classmates didn't take USMLE -- I think most were applying AOA only, and chose to put all their efforts into the COMLEX. Because I was studying for both, I deprioritized OMM and know I could have done better if I'd spent more time on Savarese and COMBANK.
 
I didn't take the USMLE. The reason is that I was in the military and the military residencies didn't care. So why spend the money and go through the extra time and effort to take another test?

But in hindsight it was a mistake. I ended up picking a specialty (PM&R) that is not a need for the Navy, and now I am applying civilian. I am still relatively competitive for PM&R with only a COMLEX, and have received a good number of interviews (all being MD programs)...but PM&R tends to be a DO friendly profession and I think that many programs likely overlooked my lack of a USMLE because of my excellent work experience. But I am sure that there were still a handful of programs out that in which I didn't meet their admission criteria without a USMLE.

I recommend that every DO takes the USMLE unless they are struggling on COMLEX prep. If you are struggling with COMLEX prep, you will likely only be competitive for primarily primary care residencies at AOA program. But otherwise...take the USMLE and it will open doors for you.

My wife and I went to LECOM-B (two different graduating classes) which tends to do better on boards. The majority of students who took the COMLEX and USMLE did BETTER on the USMLE. Most of my class felt that the COMLEX was convoluted and that our PBL exams were far more similar to USMLE.
 
The reasons listed for not taking the USMLE have been pretty well covered. I'm of the belief that if you're going to apply to ACGME programs, it is in your best interest to make it easy for the program to decide that you're a candidate they want to interview. One reason is that not everyone knows how to interpret COMLEX scores. From the perspective of an ACGME program, why should they care about interpreting an Osteopathic board exam? It's not required for them. There's definitely no accepted conversion calculator between COMLEX and USMLE.

With respect to your interview, the question should not be taken as an attack on you as a person. Good interviewers may throw you a curve ball to see how you think. It gives them insight into how you may respond under pressure. Remember, both sides are a cost when interviewing. They have given up money and a potential spot on their rank list to assess their fit for their program. In light of that, it makes no sense for them to drag you in and then cast you down. Your differential could be that the interviewer is "anti-DO" but you should also consider that he could be evaluating your response to a difficult question.

Of course, as a future psych resident, you know that it's not just the question that tells the tale. It's also the interviewer's body language and demeanor. That's something to think about when considering your experiences during that day.

It is in your best interest to not just read your application, but know your application. Most interviewers will pull their questions based on what you submitted to ERAS and apparently, that is something they wanted to address. Could you give them the answer as you stated above? Sure. It's up to you. I would come up with something a bit more diplomatic though.
 
kbeitz said:
Three most likely reasons would be disinterest in allopathic programs, lack of time or desire to study, and not wanting to spend additional money.

Some risks and benefits are outlined here:
http://com.msu.edu/Students/Academic_Guidance/USMLE_FAQ_12_2013 .pdf
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A fourth, and very important, reason would be that some students have borderline grades and would probably score well below the average on the USMLE.

I have a firm belief in that if you are applying to allopathic programs as a DO student, it would be in your best interest to take the USMLE, especially if you want to apply to some of the more competitive programs.
 
Lack of time was my main deterrent for step 1. I had to take the test by a certain date because I had summer classes for my master's degree starting in early June. I didn't think I could study for and do well on both in the time I had. Most people tell me that if I didn't take step 1, there's little point in just taking step 2 ck.
 
Ok, well I guess I could be honest and say that the 1 month my school gave me was insufficient and I needed 2 months.
 
Koan said:
It sounds odd to me that a program would invite someone to interview and then give them guilt about being a DO, but I've heard it before. If you think you'd be treated like a second-rate resident there, don't rank it highly.
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Oh I guarantee you they did. They have done this to another applicant as well just to torture us and put us down for being "different" because we did not go the allopathic route.
 
ari202 said:
Oh I guarantee you they did. They have done this to another applicant as well just to torture us and put us down for being "different" because we did not go the allopathic route.
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What field were these interviews in? I only applied to ACGME residency programs almost exclusively to university programs and never once did I experience this.
 
meliora27 said:
What field were these interviews in? I only applied to ACGME residency programs almost exclusively to university programs and never once did I experience this.
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One of my interviewers in Chicago said he "felt sorry" for me because he was certain if I wasn't a DO I would have been in their top 20.
 
cliquesh said:
One of my interviewers in Chicago said he "felt sorry" for me because he was certain if I wasn't a DO I would have been in their top 20.
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Did you take the USMLE?

I honestly think if a program is not DO friendly that's fine. But I think if you are going to accept DO's you should accept them with the COMLEX. Our curriculum is our curriculum. I wish I had gone to LECOM-B, perhaps I would have had more time to prepare for boards and done better. There is no way that I could justify sitting for the USMLE without completing Uworld 2-3 times.

If someone is DO friendly, then they should be fine with your COMLEX. The NBOME website even says that 75% of ACGME programs accept COMLEX.
 
Being a DO closes doors, taking only COMLEX closes some of the remaining open doors. Take the USMLE.

As for time to prepare, if you know early on, that you're only going to be applying to ACGME programs, then USMLE should be your top priority. Prep for it like none other. Some people who do this even view the COMLEX as a pass/fail exam knowing that they're only going to apply ACGME where their USMLE score will matter so the only need to pass COMLEX to satisfy their school's requirement. I think if you did a COMLEX q-bank and ran though the Savarese book a day or two before the COMLEX you would easily pass COMLEX while prepping for the USMLE.

Just my $0.02
 
ari202 said:
Did you take the USMLE?

I honestly think if a program is not DO friendly that's fine. But I think if you are going to accept DO's you should accept them with the COMLEX. Our curriculum is our curriculum. I wish I had gone to LECOM-B, perhaps I would have had more time to prepare for boards and done better. There is no way that I could justify sitting for the USMLE without completing Uworld 2-3 times.

If someone is DO friendly, then they should be fine with your COMLEX. The NBOME website even says that 75% of ACGME programs accept COMLEX.
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Totally disagree. The COMLEX is a shoddy test with a huge margin of variability. I took both and if I was a PD I'd want to see USMLE scores and compare apples to apples. The USMLE is the gold standard of medical student evaluation and the COMLEX is unreliable.
 
I think there's something to be said for the fact that whether you go to medical school in Indiana or Iceland and want to practice in the US, you take the USMLE. I feel that all doctor's who want to practice in the US should be held to the same standard vis a vis the USMLE. Of course, I don't think the Osteopathic establishment would ever do away with COMLEX...
 
I took both, and I wondered if I could study for and do well on both in the short amount of time I was given.

So I prioritized studying for USMLE using UWorld and Goljian and figured I'd cram some OMM into the last week. Seems many hard taken this tactic before me and done well.

I can honestly say that after taking both levels of both exams I'd choos the USMLE every day of the week. I did comparitively better on USMLE and I feel it really opened a few doors to programs I wouldn't have been considered at otherwise.
 
meliora27 said:
I think there's something to be said for the fact that whether you go to medical school in Indiana or Iceland and want to practice in the US, you take the USMLE. I feel that all doctor's who want to practice in the US should be held to the same standard vis a vis the USMLE. Of course, I don't think the Osteopathic establishment would ever do away with COMLEX...
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Something like 40 DOs took CS last year and ~16 took step 3. Let's not pretend we're keeping a standard. We take the test as it might selfishly further our own interests in opening up certain doors. Nothing wrong with that. If we're keeping a standard then we're doing an abysmal job as a profession
 
I don't think that the COMLEX is a perfect test. But regarding some of the posts, should someone who did not take USMLE and only took COMLEX, be considered incompetent or inadequate to practice medicine in spite of successfully passing (or even excelling) at the classes and rotations?

I will be honest and say that a big reason why I did not take USMLE is because of my poor history with standardized exams (I always manage to change right answers to wrong answers, or I spend too much time on questions)...which is why I didn't feel like taking a chance and doing poorly on the exam (I would not have failed but I would not have gotten the average score according to the NBME's I took).

Regardless, I still respect all of you for taking the USMLE. I just hope that people don't disregard those who have not taken the exam. My school gave me very limited time to study for boards and I did not feel confident in my knowledge base to take a chance. Perhaps in hindsight, I should have requested a vacation of somesort, but I thought the biggest objective at the time was to hurry up and finish medical school at my age.
 
I will say this, in reference to the above post.

I'm of the opinion that DO's who are applying ACGME should take the USMLE. But only if they feel they can do at least average.

If you feel you'll do poorly, then I think the USMLE is a bad idea, and you'd be better served by having PD's that will look at COMLEX try to interpret it.
 
ari202 said:
Did you take the USMLE?

I honestly think if a program is not DO friendly that's fine. But I think if you are going to accept DO's you should accept them with the COMLEX. Our curriculum is our curriculum. I wish I had gone to LECOM-B, perhaps I would have had more time to prepare for boards and done better. There is no way that I could justify sitting for the USMLE without completing Uworld 2-3 times.

If someone is DO friendly, then they should be fine with your COMLEX. The NBOME website even says that 75% of ACGME programs accept COMLEX.
Click to expand...

I took the usmle and did better than average.

If I were a PD I wouldn't take sub-600 Comlex scores. I'd be fine with upper 220 usmle scores.
 
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Kevin Baker said:
Something like 40 DOs took CS last year and ~16 took step 3. Let's not pretend we're keeping a standard. We take the test as it might selfishly further our own interests in opening up certain doors. Nothing wrong with that. If we're keeping a standard then we're doing an abysmal job as a profession
Click to expand...
It's not about "keeping a standard", taking the USMLE is a smart career choice. If CS and step 3 aren't going to open a few extra doors, what's the point?
 
SLC said:
I will say this, in reference to the above post.

I'm of the opinion that DO's who are applying ACGME should take the USMLE. But only if they feel they can do at least average.

If you feel you'll do poorly, then I think the USMLE is a bad idea, and you'd be better served by having PD's that will look at COMLEX try to interpret it.
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I agree with you. The ironic thing is that most ppl who take the USMLE do around 210-215 at my school yet score around 550-600 on COMLEX.
 
ari202 said:
I agree with you. The ironic thing is that most ppl who take the USMLE do around 210-215 at my school yet score around 550-600 on COMLEX.
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Yeah, which brings up another point...

If you are taking USMLE and applying straight ACGME as a DO, you need to go all in. I always knew I wouldn't apply AOA; so I realized USMLE was more important to me than COMLEX. I ended up taking COMLEX first to use it as a practice run for USMLE, to identify any last minute things I should brush up on etc. I knew that in reality all I needed to do with the COMLEX was pass.

I ended up with a ~230 USMLE-1 and ~560 COMLEX 1.
 
ari202 said:
I agree with you. The ironic thing is that most ppl who take the USMLE do around 210-215 at my school yet score around 550-600 on COMLEX.
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Then perhaps your school is not adequately preparing people to do well on the USMLE or the people who take it just aren't preparing well enough seeing as that score is well below the national average.

I think it's clear there is great variability in the various COM's stance on the USMLE. Some I've been told downright discourage it while others practically gear their curriculum towards it and encourage everyone to take it.
 
meliora27 said:
Then perhaps your school is not adequately preparing people to do well on the USMLE or the people who take it just aren't preparing well enough seeing as that score is well below the national average.

I think it's clear there is great variability in the various COM's stance on the USMLE. Some I've been told downright discourage it while others practically gear their curriculum towards it and encourage everyone to take it.
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I think 210-215 is pretty typical for most DO students. The average mcat for DOs is lower than MDs, so you'd expect the average usmle to be lower, too. Maybe 20-30 people in my class got in the 220-240s. Four or five of us got above a 240. The rest were below average. My school didn't teach for the boards or encourage us to take the usmle, though.
 
cliquesh said:
I think 210-215 is pretty typical for most DO students. The average mcat for DOs is lower than MDs, so you'd expect the average usmle to be lower, too. Maybe 20-30 people in my class got in the 220-240s. Four or five of us got above a 240. The rest were below average. My school didn't teach for the boards or encourage us to take the usmle, though.
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Same story with my school. We actually were given a graphical depiction of our classes performance on the COMLEX and USMLE, there were only one or two who did better than 230. Most didn't take it, and most who did either didn't pass or barely passed. I chalk that up to focusing too much on COMLEX. Many cited COMLEX performance being part of our class ranking as reason to study to it rather than USMLE. I felt like a solid USMLE was more important than whatever percentage of my class-ranking might be affected by the COMLEX.
 
I knew I wasn't going to do good on the exam, so I decided why risk a failing score. I'm bad with standardized exams but my medical knowledge is decent I just feel that I'd be better of not taking a risk.
 
Heck, it's a month's rent for many students at my school - many of whom don't have rich parents. In fact, cost is a major reason people skip Step 2 CS which is about $1,200. The problem is most schools - and the feds - don't let you apply for extra financing until 4th year (for residency interviews).
 
costales said:
Heck, it's a month's rent for many students at my school - many of whom don't have rich parents. In fact, cost is a major reason people skip Step 2 CS which is about $1,200. The problem is most schools - and the feds - don't let you apply for extra financing until 4th year (for residency interviews).
Click to expand...

We couldn't even get extra federal money for interviews. School wouldn't approve it.

That being said, I'm not sure why anyone would take USMLE step 2CS, it's pass or fail and I don't think there are any programs out there who even imply that DO's need to take it.
 
There are some e.g. UT Houston IM which is actually a DO friendly program.
 
JRO38 said:
Personally, I don't think a program which requires COMLEX 1, 2, PE and USMLE 1, 2, and CS meets the idea of "DO friendly." DO friendly (to me) means they respect and use the COMLEX version of standardized tests, not just that they take DO students. Once a DO student takes all of the same tests an MD student would take, they should effectively be viewed the same as an MD student (minus a few things like school prestige). a DO student who scores a 240 performed better (which suggests more clinical knowledge) than an MD student who scores a 239 - no need to bring degree into the discussion at that point - so there is no need to be friendly to DO candidates since they should be evaluated on a more level playing field.

I guess there is a spectrum of DO friendly so I may be too semantic here. Just made me laugh at the idea of requiring 6 standardized examinations for a subset of applicants translates to friendly. Maybe I'm just naive.
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They probably meant friendly in the sense that they regularly take DOs, as opposed to the programs that simply don't as a matter of policy.

There certainly is a spectrum from the really friendly ones that view them as the same or even prefer DOs (*cough**cough* some in PM&R), to the ones who view them as the same provided they can compare their test scores 1-to-1, and to the ones that consider DOs, but obviously prefer MDs. All of these are more "DO friendly" than the ones who don't consider DOs at all and throw our apps in the trash.
 
I'm not reading through this thread. Only read OPs comment so my apologies if this has been expressed already:

TAKE THE USMLE. Period. Go in to day 1 of med school KNOWING you will. No bailing. No b-ing out last minute.

WHY? Because when it comes time to Match and you're aiming at an ACGME program… and it comes down to you (the student who took the USMLE) and another DO student (who didn't), guess who looks better.

And I don't want to hear about all of these ACGME programs that "accept" the COMLEX. Great. Doesn't mean they prefer it. Regardless, you'll still be competing against those of us who sat for the more difficult exam and showed a little more UMPH! by doing so. No offense. But that's how it is.

Choose wisely.
 
Dharma said:
I'm not reading through this thread. Only read OPs comment so my apologies if this has been expressed already:

TAKE THE USMLE. Period. Go in to day 1 of med school KNOWING you will. No bailing. No b-ing out last minute.

WHY? Because when it comes time to Match and you're aiming at an ACGME program… and it comes down to you (the student who took the USMLE) and another DO student (who didn't), guess who looks better.

And I don't want to hear about all of these ACGME programs that "accept" the COMLEX. Great. Doesn't mean they prefer it. Regardless, you'll still be competing against those of us who sat for the more difficult exam and showed a little more UMPH! by doing so. No offense. But that's how it is.

Choose wisely.
Click to expand...

I generally agree with what you have said, and I actually plan on taking the USMLE myself. However, if someone ends up scoring say 530 or so on COMLEX, but only projects to score about a 200 or so on USMLE according to NBME practice tests would they still be advised to take the USMLE? I think in a scenario such as this it is debatable because taking the USMLE might actually hurt the applicant. I know this is just a hypothetical situation, but I am sure there are DO students that have been in this situation before.
 
FutureDO22 said:
I generally agree with what you have said, and I actually plan on taking the USMLE myself. However, if someone ends up scoring say 530 or so on COMLEX, but only projects to score about a 200 or so on USMLE according to NBME practice tests would they still be advised to take the USMLE? I think in a scenario such as this it is debatable because taking the USMLE might actually hurt the applicant. I know this is just a hypothetical situation, but I am sure there are DO students that have been in this situation before.
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As I mentioned in my post early on in the thread, that would be a good reason to not take the exam. I think that the only time you should take the USMLE is if you are projected by the NBME practice exams to score above the average. I'm sure that there are some people who disagree with me, but I just think that if you take the USMLE and score well below average, you are showing the ACGME programs that you aren't comparable to an average MD student. I believe that when an ACGME program is "DO friendly," they have a history of taking DO students that are slightly more competitive (in terms of USMLE scores) than an MD applicant.
 
We already have to take the COMLEX to graduate

Some people can probably shell out more money to take more tests that can help further their career interests but it probably isn't necessary for me
 
FutureDO22 said:
I generally agree with what you have said, and I actually plan on taking the USMLE myself. However, if someone ends up scoring say 530 or so on COMLEX, but only projects to score about a 200 or so on USMLE according to NBME practice tests would they still be advised to take the USMLE? I think in a scenario such as this it is debatable because taking the USMLE might actually hurt the applicant. I know this is just a hypothetical situation, but I am sure there are DO students that have been in this situation before.
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I agree. I just don't see why someone cannot hit an average score if they prepare properly. Train for the USMLE… not the COMLEX… regardless of curriculum or what your school's administration tries to feed your brain with.
 
I'm an HPSP student, and after talking with multiple military PD's, they've all told me not to take USMLE. They've said it's totally not necessary and that I should save my money.
I saw someone else's post earlier where he ended up choosing a speciality that the navy didn't need so he ended up applying in the civilian world. I understand that's always a risk.
I'm still on the fence. Finances ARE a factor for us, and that is a very tempting factor to not take the USMLE. However, it would be nice to keep all options open.

Other thought:
I wonder if focusing on USMLE prep can reduce ones potential COMLEX score?
 
dudeliness said:
I'm an HPSP student, and after talking with multiple military PD's, they've all told me not to take USMLE. They've said it's totally not necessary and that I should save my money.
I saw someone else's post earlier where he ended up choosing a speciality that the navy didn't need so he ended up applying in the civilian world. I understand that's always a risk.
I'm still on the fence. Finances ARE a factor for us, and that is a very tempting factor to not take the USMLE. However, it would be nice to keep all options open.

Other thought:
I wonder if focusing on USMLE prep can reduce ones potential COMLEX score?
Click to expand...
I don't think so. Most of the people I know that took both exams focused solely on USMLE, then crammed OMM in the gap between the USMLE and COMLEX. I didn't take that approach, but I know it does work.
 
Beargryllz said:
We already have to take the COMLEX to graduate

Some people can probably shell out more money to take more tests that can help further their career interests but it probably isn't necessary for me
Click to expand...

Ok for you (maybe). I wouldn't endorse this POV though. It's not THAT much more money.
JRO38 said:
Realize that if everyone simply "prepares properly" there will be a new elevated average with 50% of students still below it. You should be happy for every single medical student who scores below you because that makes your score that much better. Most PDs don't really care what the new average # is, they just want to know where you rank in relation to the current cohort of applicants. Everyone is trying to "prepare properly" and that's why the USMLE and COMLEX averages have increased nearly every single year. It's not just as easy as simple preparation - be glad your intellect, learning abilities, hard work, and preparation put you in the top half of the bell curve (at this point in time with our specific cohort of medical students currently enrolled). Your advice is good for you - it likely won't apply to some so be careful with such absolute statements like "take the usmle. period."

That being said, I wish I did take the USMLE. I only took COMLEX and did well but prepared only for the COMLEX and didn't want to have to buy UWorld, get new books, and pay $600 for it. I'm certain I could have gotten above average and maybe even top quartile. However, I prepared poorly and we'll see if I regret it come match day. Unfortunately, my school downplayed the value of USMLE, my advisor did as well, only 10% of my study group were planning to take it (competitive residencies), and I don't have any family in medicine so I think I had poor guidance on the subject - I should have been more proactive to research if it was right for me (I only learned that SDN existed 6 months ago and how great of a resource it is) and if I did, I would have taken the USMLE - it would certainly alleviate some of the anxiety i'll have for the next 2.5 months before the match.
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Realize that. I still think folks should go in with the intention of taking the USMLE (and only bail if/when a couple NBME's show it's not a good idea, i.e. <220 or so). COMLEX is a joke. USMLE shows where you really stand. My opinion.
 
zany_brainy said:
I don't think so. Most of the people I know that took both exams focused solely on USMLE, then crammed OMM in the gap between the USMLE and COMLEX. I didn't take that approach, but I know it does work.
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It works. Didn't even need to cram OMM and bailed on COMBANK early on. Just a few Chapman points and some cranial for a couple of hours the afternoon before. But our school did a pretty good job prepping us for OPP during preclinical.
 
Was also not doing good on NBME exams, but interestingly the uworld exams were good, I think I have ADHD as well and would not be able to focus so long on the question stems.
 
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