DOs -- why take both USMLE COMLEX?

…in nut shell, could you please state your reasons for doing this?

Sorry, I have been out of the loop for quite some time.

Thanks very much.

Mike S.

Re-posted from the list-serve

Reply by Rachel Wakum:

If you know that as a D.O. student you will be going into an osteopathic residency program, then all you need is the COMLEX. However, there are people that want to do a certain allopathic residency in a certain location or in a certain program. Or they may not know what they want to do when they grow up. Those people need to take the USMLE. A lot of allopathic programs do take the COMLEX. The only way to find out is to talk to the programs early. However, that
has to be before the end of 2nd year, and may not always be easy to do. Sometimes you may not know if you want to go into a certain program until later after a rotation. Therefore, to keep your options open, D.O. students usually take both exams.

Hope that helps


In essence, I chose to take both exams for a couple of reasons. First, you must understand that even though the same basic information is being tested on both exams it is done so in significantly different manners <see thread on this under “Board Exams”>. And, there is no way to convert, equilibrate or compare a USMLE score with a COMLEX score – prior to this year, the USMLE included a %-ile rank score in addition to the 2- & 3-digit scores, but they have dropped that score. The COMLEX provides a gross score (# correct/# questions) and a %-ile rank score (where you stand among those who PASSED the COMLEX). When both had a %-ile rank, you could do some cross comparison, but no longer.

I originally planned to subspecialize in either Peds Cardiology or Peds Intensive Care – neither of these realms has too many DOs in it and both of these tend to be pretty competitive fellowships. So, in an effort to minimize the potential confusion and difficulty in comparing my COMLEX scores to a bunch of folks with USMLE scores, I decided to take both series.

Now, since I have decided to enter anesthesiology instead, I have not come across a single program who will not take my COMLEX in lieu of the USMLE. The worst I have come across were a couple of programs who had not had too many DOs come through, but are open to us, and were not used to interpretting COMLEX scores – easily addressed, I’ll send them a copy of the same interpretation directions that I was provided with my score results.

The other reason, KCOM’s President has told the last couple of classes that he feels it is inevitable, within the next 5 ~ 10 years, that the DO schools will begin offering both the DO & MD degrees. In that context, he said that we should all consider taking the USMLE so that we could be awarded an MD retroactively, but only if we had taken that exam series too.

Will that actually occur? I dunno. Was that sufficient motivation to take the USMLE? Not in and of itself…however, I had already paid for the silly thing and even though it was looking like I really was not going to need the USMLE scores - I refused to simply blow off the &#36420 it costs to register for it.

How does this apply to you or any other DO student? Essentially, the decision will come down to individual needs. There are areas of the country where they simply are not familiar with DOs. Subsequently, it can be a little harder to get training slots there – for example, the Pacific NW and the old South – but even those areas are beginning to open up, esp the old South.

When your time comes to make this choice, if that choice even exists then, you will need evaluate this is terms of the specialties that interest you & the regions of the country you may wish to train in.

There is a growing sentiment w/i the NBME [USMLE folks] & NBOME [COMLEX folks] – according to a couple of reps from both groups who spoke to my class – in support of authoring a common licensure exam and simply adding an osteopathic component to it for the DO students. Will that actually occur? Again, I dunno…personally, I think it will.

I’ve been kicking around this decision for some time so, let me be honest and put my fears right out on the table :)
— I would hate to kick on the COMLEX and get so-so on USMLE…that cruddy score will “follow me”, correct? The few DO students I’ve spoken with that took the most recent bout of exams are split on the comparison between the 2 exams.
My discussions with current DO EM Residents in the allo pgms I’m looking at seriously (all 5 I’ve spoken with so far) are telling me “no, you don’t need USMLE to get in here – the PM luv’s us DO’s…we’ve proven ourselves here”, etc. And are telling me to make sure I put in my Transition Year – that seemed to be the more marketable point (vs. USMLE) for them.
[sigh] what a decision…
Kat :O

You’ve highlighted a very important point – the decision on whether or not to take both exams as a DO lies in investigating the specialty you plan to enter. The answer will vary by specialty, by geography and somewhat by individual programs. I have a classmate who is seeking an ACGME ER slot. He is discovering a similar story…apparently in most regions, the COMLEX is fine; some regions favor the USMLE.
So, before you plop down the extra $20 take the USMLE Step 1, do yourself and your pocketbook a favor and make some phone calls. For me, largely the USMLE was a waste of my $$…but I did not know that I would going into anesthesia then either…