COMLEX and/or USMLE

[Sherry]

I am going to AZCOM (class of 2004). My best friend is an MSII at TCOM and has told me that I need to take both COMLEX and USMLE, especially if I want to do an allopathic residency. I definitely want to do Internal Medicine but have no idea where yet.

AZCOM does not require both for graduation. But should I plan to take both any way to "be safe"?

My friend also suggested to get a review book early on and tag special topics along the way for easy cross reference later on. Has this worked for any one and if so what review books would you suggest?

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[PCSOM2002]

There is no reason to waste another $250-300 on the USMLE unless you want to practice in Louisiana. Only a few residencies will want to see USMLE scores from a DO. I have personally talked to a few DMEs at allopathic programs and they said the USMLE was not needed and that COMLEX would be fine. These programs were in IM and FM. A recent article in the American College of Osteopathic Internist newsletter stated that DO graduates are increasingly being recruited to ACGME IM residencies because the new limitations on FMGs at US residencies is kicking in and DOs are needed to fill these programs. In this year's match only 58% of IM positions were filled with US graduates. There are opportunities out there. Many people will tell you that you must take the USMLE to be "accepted" by ACGME programs. This is nonsense and builds an inferiority complex within the profession. If you have any doubts, call the DME of some programs and just ask. If they do not respect our licensing exam, do you really think they will respect you as a DO physician? Think about it! Hope this helps.

 

[wheatfarmer]

I don't agree. I can't think of any reason why you shouldn't take the USMLE except if you unbelievably short of cash or if you have some sort of family emergency.

Listen, the USMLE is the gold standard for medical licensing in the US...period. Why give ANYONE a reason to doubt your skills.
I am not going to harp on this issue, but you don't HAVE to take it. Hell, you don't have to get straight A's to graduate...but that isn't a reason not to try.

You will do fine on it, and when it is said and done, you will be glad that you did.

 

[PCSOM2002]

You are correct. The USMLE, just like the COMLEX, is a licensing exam. That is it, nothhing else. It shows nothing more than a certain level of competency. The score on either exam will in no way indicate what type of clinician you will be. Therefore, I can get a medical license in any state, except Louisiana, with the COMLEX and also be admitted to an ACGME program. A person does not need to take the USMLE to prove himself to anyone. The only people we should care about impressing is our patients, and believe me not a one of them is going to care what D-MN licensing exam you took. If one feels they must take the USMLE to get into a certain residency, then by all means cough up the money, run down to the Sylvan Learning Center and take it. But, in my opinion and as I mentioned before the opinion of several DMEs of allopathic programs, it absolutely is not necessary unless, once again, you want to practice in Louisiana.

 

[wheatfarmer]

You are acting like you need to take another student loan to pay for the USMLE!
What I am stating is this...the USMLE is THE licensing exam for medicine in the US, it is the GOLD STANDARD. No, you don't have to take it to get a job, and of course you can feel whole and complete as a human, without taking the USMLE.
Why open yourself to possible criticism by anyone? With the AOA's stellar record, who knows what they'll do next to complicate the lives of graduating DO's. Having passed the USMLE provides for a back-up that stands regardless of the future of COMLEX exams or the AOA in general.
Sure you may never need it, but wouldn't it be nice to have if you ever did?

 

[wheatfarmer]

Oh and by the way, do you think a DME would say "Hell I think the COMLEX is an awful test! We want all our students to take the USMLE...it is easier to compare them side by side." over the phone to you? They will say anything to protect themselves and their programs from discrimination. I say, we should also cover OURSELVES from discrimination (said or unsaid).

 

[PCSOM2002]

The issue with the USMLE is not the cost. That is one factor, but not the major one. If people are going to use lack of taking the USMLE as a point to criticize you, then they will probaly find something else to focus their criticism on.

However, I believe a largest portion of the allopathic profession today accepts DOs as equals. Some of the older physicians might not, but as a whole we are looked upon as equals.

Nothing is going to happen to the COMLEX. Even if it does, then it will be several years down the road and those who have already taken COMLEX will be grandfathered in. At that point in time, then it will be necessary to take the USMLE or whatever exam the National Board of Medical Licensure decides will be used for licensing purposes by the individual states in the US. Both COMLEX and USMLE are gold standard licensing exams in the US. If they were not then no state would grant you a license with the COMLEX.

As for the DMEs, I didn't talk to them over the phone. I went to there office and talk to them face to face, and I also spoke to the osteopathic residents in those programs, none of which took the USMLE. One of these programs is in my hometown hospital. I have seen numerous DO residents come and finish from this program over the years. It is always the same-USMLE not required! They are not telling me this to appease me or the osteopathic profession. They actually see these exams for what they truly are, licensing exams not validity of medical prowess.

I am by no means trying to tell people that they should not take the USMLE. If they want to and a certain program requires or "strongly suggests" that they take it, then that is fine by all means do what is best for you and your future--that's the bottom line. I wish them the best of luck. Actually, I hope they make the 99th%. I just want to let osteopathic students know that the USMLE IS NOT REQUIRED to get into most ACGME programs, especially those in FM and IM. But decide for yourself what is best.

 

[John DOe]

Taking the USMLE is a personal decision that needs to be taken for specific reasoning for your situation. Letting someone tell you that the gold standard of licensing is the USMLE and that is why you should take it is ludicrous. The GOLD STANDARD for DO's is the COMLEX. The COMLEX is the only exam that leads you to receiving a degree and practice (including Louisiana where you need both). You have to identify the reasons for you taking the exam and decide on that. Don't listen to this GOLD STANDARD rhetoric. I have friends with reasons from "specific residency programs said they would like to see it", clear to "I just want to be able to say I passed 'their exam'." Whatever the reasoning, make sure it is yours and go with that. Good luck in your decision.

 

[happy]

I've been told by several DO students to please take the USMLE. You don't want to cut your nose off in spite of your face. COMLEX is great, just let the allo's see we are just as competitive. If both exams represent the same back ground, no need to worry. Take them and get over it!

 

[Lwoods18]

Basically, it's an individual decision. I know many people taking the USMLE and many taking the COMLEX only...it's a decision that is not etched in stone, but either way you WILL be able to get a residency.
It is true, however, that some more competitive residency programs may PREFER that you do have USMLE grades in order to have a common ground to compare you against all medical students. Again, it's a personal preference, but if you can do well, then go for it! I am taking the USMLE to make sure i allow myself every opportunity to get the residency spot i want.
p.s. we all have a common goal, so let's help rather than confront each other

 

[mafanah4]

ACT vs. SAT?
COMLEX vs. USMLE?
The only way to fairly evaluate an individual D.O. against an M.D. candidate for a residency position is if they take the same exam. It would be nice if MDs were required to take the COMLEX to compare themselves to us.

 

[RBorhani]

When I went through the match (I only applied to ACGME/MD residencies for Emergency Medicine), there was only one hospital in Calif that asked me why I did not take the USMLE during my interview. There were also couple of hospitals (in Calif) that did not interview me because I had not taken the USMLE. Other programs did not have any problems with my lack of USMLE scores and I ultimately matched at my top choice.

A friend of mine interviewed at one of the California programs that did not interview me and she matched with them (she was applying for Family Med and IM and she had only taken the COMLEX). If you want to apply for a competitive residency in the west coast it might not be a bad idea to take the USMLE. However, if you are sure about Internal Med/Family med then you are fine with your COMLEX score.


[This message has been edited by RBorhani (edited 05-30-2000).]

 

[dcdo]

R Borhani-

Who required it or asked about it in CA, if you don't mind me asking?

Thanks.

 

[Lennox]

"It would be nice if MDs were required to take the COMLEX to compare themselves to us."

Why would MDs need to compare themselves to DOs? Unless they are trying for an osteopathic residency--which is currently impossible--MDs go for allopathic residencies. It is the osteopaths who are trying for allopathic residencies, so they are the ones on which the onus rests to present the easiest possible means of comparison. In this present discussion, this means taking the USMLE.

How ironic it is that pre-DOs bash MDs for being so uninterested in their patients' well-being, only to see graduating DOs scrambling to get into MD residencies once they graduate.

 

[mafanah4]

lennox: I wasn't serious about MDs wanting to compare themselves to us.
I don't see anything wrong with wanting an allopathic residency. It's not like there is that much selection in osteopathic residencies. Let's be realistic-the only way to really compare yourself to an MD in a quantitative way is to take the USMLE.
Half the people in DO schools are in school just to get a medical license. They really don't care if they go allopathic or not.

 

[HW]

These are my thoughts on why taking the USMLE is a good idea.
I just graduated from a DO school and will be starting my residency in Louisiana at Tulane this summer. I only applied to allopathic residency programs, and was told at least a few times by the DMEs that they appreciated having a USMLE score by which to compare me with MD applicants. It has nothing to do with bias against the COMLEX, they simply don't know how to interpret COMLEX scores. Outside of DO-heavy areas in the northeast, I doubt if many allopathic DMEs know much about the COMLEX. SO WHY NOT study and take the exam? Especially if specialty and program aren't set in stone for you...why not give yourself the best advantage?
Also, Louisiana only requires USMLE. (and technically steps 1 & 2 of COMLEX because my school required them for graduation). I could choose not to take step 3 of the COMLEX and be liscensed in Louisiana (but not in lots of states like AZ & CA).
Besides the new computer based testing is great (only 1 day, self-paced)

Did anyone else who took both exams like the USMLE better? I certainly did. Now that the USMLE is shorter, most of the poorly worded questions are gone (unlike the COMLEX which has many many absurdly badly written questions)

good luck to you all.

------------------
hw

 

[RBorhani]

Univ of California programs !

 

[dcdo]

Thanks!!!

I thought so. Time to take the plunge on the 12th!!

 

[spunkydoc]

two more cents here--

i struggled with this issue last summer when there was this big old panic because it got out that the COMLEX exam was not even yet statistically validated..at that time we all went haywire b/c kcom subsidized and asked its students to take the USMLE as did many other schools to protect themselves from what was projected to be inevitable failure.

i only took the COMLEX and will be applying for EM residencies.

the bottom line is this:
the COMLEX is the most poorly written exam i have ever taken in my life. it is long, arduous, and many questions don;t make sense, some don't have correct answers.

but you are required to take it, period.

does any MD program out there really know what the COMLEX exam is made up of? NO

do these MD programs know how to interpret COMLEX? some say they don't..in fact i have run into quite a few DMEs who say to take the USMLE b/c they don't know what COMLEX means..neither do i. however, i figure that if an allopathic program is interviewing DOs for its residency staff, it better get off its lazy butt and figure out what the COMLEX means b/c it is the DO standard exam.

if some program does not want to review the COMLEX exam and interpret it and would rather you take USMLE, at some level i think this is discrimination against DOs...if they ask you to do one thing to "fit into the crowd," what will be next? Do you really want to go to a program like that?

like it or not as a DO you are different..the difference may not amount to a whole hill of beans--great you can fix things with your hands--you have a few extra tricks up your sleeve--but you are still different.

if we are to succeed in this competative world of medicine as different, we must stand tall and stand by the standards we are setting for ourselves as DOs

i did not take the USMLE but i used all the review books and practice questions..i thought those questions were a bit more academic, less clinical.

my friends who took the USMLE did not find it much different from COMLEX, just shorter, on computer, and not as exhausting..they scored around the same on each..

if you want to practice on the west coast, take the USMLE--you need it--undisputed--same for louisianna..

otherwise, there are plenty of people you will meet at incredibly competative programs who took COMLEX and still managed to land harvard.

good luck

 

[jdaasbo]

I took USMLE on Friday. It was not such a big deal. I took it one day after COMLEX. To compare the two: 1) USMLE had very very few anatomy questions. 2) they had about the same amount of biochem and of roughly the same difficulty. 3) Yes, USMLE was written better. 4) the length of USMLE was a blessing. 5) USMLE felt easier to me (but many of my classmates felt otherwise). 6) USMLE had a lot more visual aids (slides, pathways, etc). 7) USMLE was less picky and required more thought.

I am 90% sure that for what i want to go into, i will not need USMLE. However, I was not willing to take chance otherwise. I have met a few now fourth years at CCOM who now a year after taking COMLEX I are now studying again for USMLE I b/c the programs that they are interested recommend USMLE.

In my opinion, it is well worth it to spend 300 bucks, one extra day of testing and half a day studying biostatistics and behavioral sciences in return for piece of mind.

 

[Sherry]

Thanks to everyone for all your advice. I am leaning towards being prepared for both. When the time comes for me to actucally make the decision I want to have all options open to me.

jdaasbo,
I took bio-statistics in graduate school, is that on the USMLE? Was there a large percentage of biostats covered or were there just random quips.

 

[bhl]

For the most part, I agree with jaasbo about the USMLE except for a few things. Overall, my general feel was:

1. USMLE was NOT written better. I counted 3 spelling errors, and at least 2 incomplete sentences. This actually made one of the questions difficult to understand, since a semicolon appeared to be randomly thrown in the; sentence. As far as content, both tests require a good deal of narrowing down then guessing.

2. The Pharm on USMLE was WEAK. I can only recall one or two antibiotics questions, a few CNS, and maybe some hypertension/heart stuff. It wasn't at all comparable to COMLEX pharm questions. Mostly mechanisms/side effect style questions.

3. Physiology was fairly heavily focused upon compared to COMLEX. Especially in graph interpretation.

4. Few anatomy, and only pseudo-Psych questions.

Overall, both tests sucked. I probably did better on USMLE type questions, but I expect my COMLEX percentage to be higher because I think the OMT questions boosted my score.

 

[UHS2002]

Originally posted by bhl:
As far as content, both tests require a good deal of narrowing down then guessing.
[/B]

I love it!

That is the way I felt:
hmmmmm, let me see, no it can't be B nor C nor D, but it could be A or E, sort of depends how you interpret the question. Oh, oh , here,(the light going off in my head 5 minutes after I began staring dumbly at the question) this tiny little detail in the question, just thrown in the middle of 3 lines of distractors, seem to exclude E (if I was so lucky to find it, otherwise, it was just a guess between A and E).

 

[Vegeta]

I'm under the impression that the COMLEX and USMLE examinations are not timed. Can someone please verify that statement? I'd hate to have to rush through such an abundance of questions resulting from being pressured by the clock. Does everyone have the opportunity to answer all the questions? (I'm hoping there are no time-constraints similar to the presentation of the MCAT).

 

[UHS2002]

Surely Thou jest...

both are timed. The COMLEX consists of 4 booklets, with 200 questions each. You have 4 hours to complete each booklet. So, 4 hours in the morning, then 1 hour lunch break, and 4 more hours in the afternoon. The next day you come back and do it all over...

The USMLE is also timed, but it is taken in smaller blocks, 60 questions per block. You get 45 min break for the entire day, it is up to you how you want to take it, all at once, or 15-20 min at the time. If you finish a block early, then you get some extra "break time".

 

[dcdo]

Actually, the USMLE is 50Q/block in an hour, with 7 blocks. (I know that's what you meant)

 

[jdaasbo]

Sherry,

yes biostatistics is on USMLE. If you had it in grad/undergrad school then in should not present too much of a problem at all with a bit of review. There were probably ten (of 350) biostatistics questions on my test. There were also a lot of questions about ethics, about how HMOs work, and things that don't neccesarily fall into any category. Interestingly questions on finasteride and trenitoin (relatively obscure drugs) were asked on both USMLE (my version at least) and COMLEX. Go figure!?!?

 

[kgDO]

I agree with "bhl" for the most part except that my USMLE had a substantial amount more of biochem (supper detailed stuff that we don't really need to know for clinical work). I assumed that it would be similar the the supplied practice USMLE exams. Unfortunately for me it wasn't even close. They kept reapeating topics that I didn't know as if to say, "just checking to see if your as stupid as you seem."

As for the COMLEX, the firs section seemed like a cake walk compaired to my USMLE exam, of course it did get harder after that. I was a bit annoyed that it seemed like they didn't have anyone go through the exam to see if there was a disproprtionate amout of questions on less important material. Some of us don't even get diddly for information on OB/GYN until this summer. Vaginissmus twice, whatever!

In the end though I would have to say that the USMLE was more difficult and frustrating, because it just seemed that we weren't tought some of the subject matter that they tested on. I know that it is supposed to be more of a thinking exam, but I haven't had enzyme kinetics for 5 years and It certainly didn't deserve 6 questions I thought. I still don't feel comfortable with the fact that everyone gets different questions either, but not much I can do about that.

Just my two cents worth.

 

[DrStacey69]

I took the USMLE as well as the COMLEX and to be honest, I found the USMLE to be slightly easier than the COMLEX. Not that I think I did so spectacularly well on it, but the USMLE questions seemed to be more to-the-point, shorter and not nearly as convoluted as some of the questions on COMLEX. However, some of my friends who took the USMLE had a very different experience, because each person gets a different USMLE exam (as opposed to the standard COMLEX). I lucked out in that mine had a lot of stats, epidemiology, and microbiology, while some of my friends had a lot of biochem and neuroanatomy. Basically, it's all a crap shoot, no matter how you look at it.