Do all DO students graduating 2020 or later need to take USMLE or for competitive?

[DOFOSHO]

I don't understand the point in arguing this.

If you think "only COMLEX is fine" this only take COMLEX. Who cares what strangers on the internet say?

If you think "you absolutely need the USMLE", why wouldn't you just let the "only COMLEX" people not take the USMLE and allow your new (perceived or real) advantage be just that?

Sometimes I think this whole site is just about d*** measuring

I may not have the biggest d*** in the world, but definitely the biggest on this thread.

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[cryhavoc]

So I’ve decided I’ll take a practice Step 1 but unless I surprise myself, just taking COMLEX. Rather have a decent COMLEX score and take what I can get.

Not only does failing step 1 look super bad, I literally have nothing left in the budget between bills, prep material and the COMLEX registration.

Would need a part-time job to afford another exam and why even risk myself like that? I’m not beating hundreds of people for top resident spots. I have to be realistic. I’m not the top DO student in my class stealing residencies from MD’s at top places.

But maybe I can shoot for middle and a failed step 1 would guarantee bottom. Not going to bankrupt myself while also risking a worse outcome. Too practical to pull that noise.

Still not even sure how I’m eating in June, let alone registering for a test I’d probably do bad on.

I can become a doctor and help people anywhere. Why risk learning little in the middle of nowhere, when I can learn enough somewhere decent? The top places, can’t be too terribly different. They’re more about ego than anything in my opinion and I don’t have that problem.

 

[BorntobeDO?]

So I’ve decided I’ll take a practice Step 1 but unless I surprise myself, just taking COMLEX. Rather have a decent COMLEX score and take what I can get.

Not only does failing step 1 look super bad, I literally have nothing left in the budget between bills, prep material and the COMLEX registration.

Would need a part-time job to afford another exam and why even risk myself like that? I’m not beating hundreds of people for top resident spots. I have to be realistic. I’m not the top DO student in my class stealing residencies from MD’s at top places.

But maybe I can shoot for middle and a failed step 1 would guarantee bottom. Not going to bankrupt myself while also risking a worse outcome. Too practical to pull that noise.

Still not even sure how I’m eating in June, let alone registering for a test I’d probably do bad on.

I can become a doctor and help people anywhere. Why risk learning little in the middle of nowhere, when I can learn enough somewhere decent? The top places, can’t be too terribly different. They’re more about ego than anything in my opinion and I don’t have that problem.

I think this is the quintessential attitude of many students in DO schools. After getting beat down for so long, they say &%$* it, and decide to just go with the flow. Probably end up happier that way.

 

[cryhavoc]

I think this is the quintessential attitude of many students in DO schools. After getting beat down for so long, they say &%$* it, and decide to just go with the flow. Probably end up happier that way.

I barely could afford to take my MCAT once and I had to take a year off to work a job to afford to apply to med school. When I got into DO schools and no MD schools, I had a choice. Take another year off and work over-time at a minimum wage job and retake a dumb test I didn’t have time to prep for and for what? So the initials after my name would be different?

I didn’t ever decide to become a doctor for prestige. I did it from experiences I had in my life with people who were sick that I wished I could help.

I’ve never gave a damn about bells and whistles, so why start now? Let the insecure people kill themselves for gold stars and pats on head. I’m only concerned with playing the hand I got and achieving things I find meaningful.

I’m sure a Johns Hopkins residency looks great but I could achieve my goal of helping people and becoming a doctor in rural Alaska.

What I can’t do is make money appear out of nowhere or risk failure when I don’t got parents to bail me out. There are plenty of people fighting tooth and nail for ribbons at top places, I say let them have them. If that makes them happy. I’m not going to make myself miserable for something I find zero meaning in.

I’m going to be a great psychiatrist because I genuinely have an interest in it and want to help people. I’m not repulsed by the mentally-ill like 90% of the medical field I encounter because I’ve known many people who suffered that I loved.

I don’t care about prestige. Nobody I help is going to give a hoot where I did my residency, they probably never even heard of a residency. And I’m sure my grandparents were alive when those “top places” were giving lobotomies. I’m honestly over the rat race.

 

[BorntobeDO?]

I barely could afford to take my MCAT once and I had to take a year off to work a job to afford to apply to med school. When I got into DO schools and no MD schools, I had a choice. Take another year off and work over-time at a minimum wage job and retake a dumb test I didn’t have time to prep for and for what? So the initials after my name would be different?

I didn’t ever decide to become a doctor for prestige. I did it from experiences I had in my life with people who were sick that I wished I could help.

I’ve never gave a damn about bells and whistles, so why start now? Let the insecure people kill themselves for gold stars and pats on head. I’m only concerned with playing the hand I got and achieving things I find meaningful.

I’m sure a Johns Hopkins residency looks great but I could achieve my goal of helping people and becoming a doctor in rural Alaska.

What I can’t do is make money appear out of nowhere or risk failure when I don’t got parents to bail me out. There are plenty of people fighting tooth and nail for ribbons at top places, I say let them have them. If that makes them happy. I’m not going to make myself miserable for something I find zero meaning in.

I get it completely. Many of us are in DO school because we had no interest in doing a 'second' cycle and didn't care about the letters. And I had to save up a year to apply as well. What you state is exactly how I felt when I started, and still do feel somewhat. Prestige wasn't very important to me.

But as I go thru med school I am changing my mind, what comes with prestige does matter somewhat. I want to be treated better than I feel DO schools treat their students, and while many community programs may be great, they might also be full of faculty with a chip on their shoulder trying to make up for 'perceived' inadequacy by making life tougher on their grads.
I have some faculty at my school right now who I believe fall in this mindset. Its almost like they are thinking 'That will show 'em, now the world knows that middle of nowhere U is the school of hard knocks!' when no one else really cares how hard you make students life's, your still a DO school.

It sucks, and honestly is what is motivating me to look at university programs more, cause I don't want to have this experience again. I would rather deal with an academic doofus with their heads up their butts than faculty with chronic inferiority complexes. And unfortunately many doctors are great at lying/recruiting perspective students/residents, and I don't feel like trying to sort through the nonsense. I am sure there are non-pretentious great community programs out there that treat their residents well and have great training. But at this point, I feel like I got burned going that route for med school (less competitive), and I am not looking to do that again.

 

[cryhavoc]

I get it completely. Many of us are in DO school because we had no interest in doing a 'second' cycle and didn't care about the letters. And I had to save up a year to apply as well. What you state is exactly how I felt when I started, and still do feel somewhat. Prestige wasn't very important to me.

But as I go thru med school I am changing my mind, what comes with prestige does matter somewhat. I want to be treated better than I feel DO schools treat their students, and while many community programs may be great, they might also be full of faculty with a chip on their shoulder trying to make up for 'perceived' inadequacy by making life tougher on their grads.
I have some faculty at my school right now who I believe fall in this mindset. Its almost like they are thinking 'That will show 'em, now the world knows that middle of nowhere U is the school of hard knocks!' when no one else really cares how hard you make students life's, your still a DO school.

It sucks, and honestly is what is motivating me to look at university programs more, cause I don't want to have this experience again. I would rather deal with an academic doofus with their heads up their butts than faculty with chronic inferiority complexes. And unfortunately many doctors are great at lying/recruiting perspective students/residents, and I don't feel like trying to sort through the nonsense. I am sure there are non-pretentious great community programs out there that treat their residents well and have great training. But at this point, I feel like I got burned going that route for med school (less competitive), and I am not looking to do that again.

I mean, there are people like that everywhere. Top programs doesn’t mean nice people. It means constantly needing to prove yourself and very arrogant people.

Just nod, smile and do what they tell you. If you’re ever in their position, don’t be nasty like them. I’m a fan of keeping your head down and once you’re through, doing the opposite of how you were treated. No need to perpetuate the cycle of people who obviously aren’t in it for the right reasons.

There should be a psychological test for doctors to see if their motivation is ego or a genuine interest in humanity.

Regular doctors though, I don’t care if my surgeon has an ego as long as I make it out alive. I’ll be knocked out anyway and will never know if he or she is a narcissist.

But most specialties should require an average IQ, empathy and a good worth ethic. Not sure why people who do it for achievement and ego should be allowed in the system.

 

[IsWhat]

I barely could afford to take my MCAT once and I had to take a year off to work a job to afford to apply to med school. When I got into DO schools and no MD schools, I had a choice. Take another year off and work over-time at a minimum wage job and retake a dumb test I didn’t have time to prep for and for what? So the initials after my name would be different?

I didn’t ever decide to become a doctor for prestige. I did it from experiences I had in my life with people who were sick that I wished I could help.

I’ve never gave a damn about bells and whistles, so why start now? Let the insecure people kill themselves for gold stars and pats on head. I’m only concerned with playing the hand I got and achieving things I find meaningful.

I’m sure a Johns Hopkins residency looks great but I could achieve my goal of helping people and becoming a doctor in rural Alaska.

What I can’t do is make money appear out of nowhere or risk failure when I don’t got parents to bail me out. There are plenty of people fighting tooth and nail for ribbons at top places, I say let them have them. If that makes them happy. I’m not going to make myself miserable for something I find zero meaning in.

I’m going to be a great psychiatrist because I genuinely have an interest in it and want to help people. I’m not repulsed by the mentally-ill like 90% of the medical field I encounter because I’ve known many people who suffered that I loved.

I don’t care about prestige. Nobody I help is going to give a hoot where I did my residency, they probably never even heard of a residency. And I’m sure my grandparents were alive when those “top places” were giving lobotomies. I’m honestly over the rat race.

At least one person has it figured out.

It’s easy to get caught up in the pursuit of prestige - it is a tale as old as time. The prestige factor of medicine vanishes so fast you won’t even know. By the time you hit 35 you’ll call up your best friend and all he will care to talk about is how his little princess took her first steps last week. It is at this point you realize the cold reality that nobody cares you trained at Johns Hopkins. Nobody cares you are an all-star nuerosurgeon. All they know is you work 80+ hours a week and are never around.

 

[68PGunner]

Here's a link to all people participating in the ACGME match with their respectable USMLE Step scores and specialties:



A good find in order to get a taste of reality instead of the regular bs about you need this and that to get trained at Johns Hopkins.

 

[BorntobeDO?]

I mean, there are people like that everywhere. Top programs doesn’t mean nice people. It means constantly needing to prove yourself and very arrogant people.

Just nod, smile and do what they tell you. If you’re ever in their position, don’t be nasty like them. I’m a fan of keeping your head down and once you’re through, doing the opposite of how you were treated. No need to perpetuate the cycle of people who obviously aren’t in it for the right reasons.

There should be a psychological test for doctors to see if their motivation is ego or a genuine interest in humanity.

Regular doctors though, I don’t care if my surgeon has an ego as long as I make it out alive. I’ll be knocked out anyway and will never know if he or she is a narcissist.

But most specialties should require an average IQ, empathy and a good worth ethic. Not sure why people who do it for achievement and ego should be allowed in the system.

My goal isn't top program, but rather university program. I am trying for the middle tier who hopefully will not be snooty, but will avoid the inherent insecurity that seems to come with being bottom tier.

At least one person has it figured out.

It’s easy to get caught up in the pursuit of prestige - it is a tale as old as time. The prestige factor of medicine vanishes so fast you won’t even know. By the time you hit 35 you’ll call up your best friend and all he will care to talk about is how his little princess took her first steps last week. It is at this point you realize the cold reality that nobody cares you trained at Johns Hopkins. Nobody cares you are an all-star nuerosurgeon. All they know is you work 80+ hours a week and are never around.

While I generally agree with your premise, having worked in healthcare for a few years prior to med school, I know that people do care that you trained at Mass General or John Hopkins. Its not the be all end all, but to say no one cares is false, even in a non-academic community setting. And quite frankly the surgeons I worked at that came from 'brand name' fellowships or residencies where actually some of my favorites to work with due to excellent bedside manner, and staff treatment. The top programs are not all jerks.

 

[cryhavoc]

Here's a link to all people participating in the ACGME match with their respectable USMLE Step scores and specialties:



A good find in order to get a taste of reality instead of the regular bs about you need this and that to get trained at Johns Hopkins.

So you only need four publications to get family medicine at the Mayo Clinic as an osteopath. Okay.

 

[cryhavoc]

My goal isn't top program, but rather university program. I am trying for the middle tier who hopefully will not be snooty, but will avoid the inherent insecurity that seems to come with being bottom tier.

While I generally agree with your premise, having worked in healthcare for a few years prior to med school, I know that people do care that you trained at Mass General or John Hopkins. Its not the be all end all, but to say no one cares is false, even in a non-academic community setting. And quite frankly the surgeons I worked at that came from 'brand name' fellowships or residencies where actually some of my favorites to work with due to excellent bedside manner, and staff treatment. The top programs are not all jerks.

I’m not saying they’re jerks, I’m saying it is delusional to think only a few programs in the world produce competent doctors and not to kill yourself in pursuit of that delusion. It is a waste of time. Do you if you think a university program has better people but I wouldn’t let the prestige be a factor.

 

[IslandStyle808]

Here's a link to all people participating in the ACGME match with their respectable USMLE Step scores and specialties:



A good find in order to get a taste of reality instead of the regular bs about you need this and that to get trained at Johns Hopkins.

The DO that matched PM&R with a lower end 400 COMLEX to U of Arkansas is making me believe anything is possible . Now back to my jaded reality...

 

[popopopop]

Here's a link to all people participating in the ACGME match with their respectable USMLE Step scores and specialties:



A good find in order to get a taste of reality instead of the regular bs about you need this and that to get trained at Johns Hopkins.

This is awesome! Where'd you get this?

 

[68PGunner]

So you only need four publications to get family medicine at the Mayo Clinic as an osteopath. Okay.

Those pubs were done in undergrad, not med school.

 

[sab3156]

Top programs doesn’t mean nice people. It means constantly needing to prove yourself and very arrogant people.

This is a gross generalization. I doubt you've ever even spoken to anyone at a top hospital. The kind of mentality you're demonstrating seems to be perpetuated by people who have either never worked in a top hospital with leaders in their specialty, or are trying to come up with excuses to tell their peers why they didn't go to a top program for residency (trying to say it was a choice they consciously made because they didn't want to be "bullied", when the reality is that they didn't have the means to even get interviews there). Welcome to medicine - you're going to find arrogance at every block. It's not limited to top programs.

The top places, can’t be too terribly different. They’re more about ego than anything in my opinion and I don’t have that problem.

You really think there is not much difference between residency training at the top ACGME residency programs and *insert random DO hospital here*, and the only difference, in your opinion, is the ego? It seems that you are just bitter about not having the stats and research to match at the programs that you're hating on.

I’m not saying they’re jerks, I’m saying it is delusional to think only a few programs in the world produce competent doctors and not to kill yourself in pursuit of that delusion. It is a waste of time. Do you if you think a university program has better people but I wouldn’t let the prestige be a factor.

The training at strong ACGME programs is going to be worlds apart from whatever random places you're talking about (by "rural Alaska", I'm guessing random AOA community hospitals in the middle of nowhere that refer their complex cases out to the same physicians and hospitals you're talking down on?) Thankfully AOA GME has breathed its last, and a lot of these programs will be gone soon so we won't even have to hear about them.

 

[Chibucks15]

This is a gross generalization. I doubt you've ever even spoken to anyone at a top hospital. The kind of mentality you're demonstrating seems to be perpetuated by people who have either never worked in a top hospital with leaders in their specialty, or are trying to come up with excuses to tell their peers why they didn't go to a top program for residency (trying to say it was a choice they consciously made because they didn't want to be "bullied", when the reality is that they didn't have the means to even get interviews there). Welcome to medicine - you're going to find arrogance at every block. It's not limited to top programs.



You really think there is not much difference between residency training at the top ACGME residency programs and *insert random DO hospital here*, and the only difference, in your opinion, is the ego? It seems that you are just bitter about not having the stats and research to match at the programs that you're hating on.



The training at strong ACGME programs is going to be worlds apart from whatever random places you're talking about (by "rural Alaska", I'm guessing random AOA community hospitals in the middle of nowhere that refer their complex cases out to the same physicians and hospitals you're talking down on?) Thankfully AOA GME has breathed its last, and a lot of these programs will be gone soon so we won't even have to hear about them.

I wish I could be as smart, powerful, and all-knowing as you. There are pros to many different settings, I mean community hospital doesn't have all the bells and whistles but that doesn't stop sick people with all sorts of diseases from strolling in to see ya. I worked as a CNA at a community hospital and sure we didn't always have crazy cases but there were certain a few. And being at a community hospital most of the time meant we had people with chronic conditions from the community as frequent flyers. Some were nice to have around, some were not, but getting a longer term relationship with a patient is a plus in my book. But I'm just a lowly DO student gunning for community IM so what do I know.

 

[Chibucks15]

This is a gross generalization. I doubt you've ever even spoken to anyone at a top hospital. The kind of mentality you're demonstrating seems to be perpetuated by people who have either never worked in a top hospital with leaders in their specialty, or are trying to come up with excuses to tell their peers why they didn't go to a top program for residency (trying to say it was a choice they consciously made because they didn't want to be "bullied", when the reality is that they didn't have the means to even get interviews there). Welcome to medicine - you're going to find arrogance at every block. It's not limited to top programs.



You really think there is not much difference between residency training at the top ACGME residency programs and *insert random DO hospital here*, and the only difference, in your opinion, is the ego? It seems that you are just bitter about not having the stats and research to match at the programs that you're hating on.



The training at strong ACGME programs is going to be worlds apart from whatever random places you're talking about (by "rural Alaska", I'm guessing random AOA community hospitals in the middle of nowhere that refer their complex cases out to the same physicians and hospitals you're talking down on?) Thankfully AOA GME has breathed its last, and a lot of these programs will be gone soon so we won't even have to hear about them.

Woah I just took a peek at your post history just because I was curious and you REALLY hate DOs, OMM, AOA residencies, literally anything to do with being a DO. If you are a DO student, that's a lot of self-hate for something that could be changed by hard work on your end and if you're an MD student you really love trolling the DO forum telling us how bad everything about our profession is. Is there a reason why?

 

[Drrrrrr. Celty]

I’m not saying they’re jerks, I’m saying it is delusional to think only a few programs in the world produce competent doctors and not to kill yourself in pursuit of that delusion. It is a waste of time. Do you if you think a university program has better people but I wouldn’t let the prestige be a factor.

There are plenty of doctors who trained in different circumstances to reach where they are now. Plenty awful ones graduated high tier programs and so have plenty graduated from low tier places.

But please don't present the argument in the context of prestige. The training is better in university settings and they'll offer you more tools to be a better doctor ( if you so wish to).

But honestly you're becoming whinny and you're spending too much of this thread trying to rationalize this false dichotomy of jack asses on the top being afraid of touching patients type and saintly community doctors. I recommend you focus less on your intrinsic qualities and recognize that you're going to be molded into an entirely different human over the next decade. You need to just choose whether you want the best mold you can to grow or not.

 

[sunshinefl]

By definition, someone has to be the bottom third of their class, one standard deviation below the median on boards, two standard deviations below the median on boards, etc. It’s literally impossible for everyone to beat that. Why all the hate and demands on medical students who recognize that they will likely be in this group? I know that I beat out enough people to get to this level, but I can’t beat out that many people at this level. A lot of people in this thread are acting like the lower DO students should be clamoring to escape the bottom and somehow magically knock USMLE Step 1 out of the park. A lot of people in this thread are also acting like if you are in the bottom third you will be lucky to match, as though 1/3 of graduating DO students don’t match, which is not accurate. Some people, like myself, are doing their best, but our best just isn’t better than everyone else’s best.

 

[cryhavoc]

There are plenty of doctors who trained in different circumstances to reach where they are now. Plenty awful ones graduated high tier programs and so have plenty graduated from low tier places.

But please don't present the argument in the context of prestige. The training is better in university settings and they'll offer you more tools to be a better doctor ( if you so wish to).

But honestly you're becoming whinny and you're spending too much of this thread trying to rationalize this false dichotomy of jack asses on the top being afraid of touching patients type and saintly community doctors. I recommend you focus less on your intrinsic qualities and recognize that you're going to be molded into an entirely different human over the next decade. You need to just choose whether you want the best mold you can to grow or not.

Okay, I’ll start worrying that if I don’t get the best residency, all that remains in my future is to grunt incoherently at my patients until someone from Johns Hopkins can see them in a few years.

 

[Drrrrrr. Celty]

Okay, I’ll start worrying that if I don’t get the best residency, all that remains in my future is to grunt incoherently at my patients until someone from Johns Hopkins can see them in a few years.

That's not what I said. I said that your rationalization of mediocrity is not an attitude that is conducive towards medicine and learning. You should always be seeking to be sharper, more educated, not just to check off the box and call it a day.

That doesn't mean going to JHU. That doesn't mean not going to Rural program Barrows Alaska either. It means you shouldn't look at adversity or the stratification of life with a chip. But that's all that you have done in this post. You've acted poorly.

 

[cryhavoc]

That's not what I said. I said that your rationalization of mediocrity is not an attitude that is conducive towards medicine and learning. You should always be seeking to be sharper, more educated, not just to check off the box and call it a day.

That doesn't mean going to JHU. That doesn't mean not going to Rural program Barrows Alaska either. It means you shouldn't look at adversity or the stratification of life with a chip. But that's all that you have done in this post. You've acted poorly.

Thank you for your opinion. I disagree with your interpretation of my posts. I was simply stating that you can be a good doctor even if you don’t go the best residencies and that the best residencies tend to attract people who are concerned with prestige.

None of those statements are false. If I acted “poorly” that’s only because you have a different set of values than me. I do think socioeconomic status is a huge barrier to entry for many people for many different types of programs and career routes. I don’t have a chip on my shoulder, I recognize and accept that reality. My children will be luckier than me when it comes to pursuing their career of choice as they will have my support.

And realizing that makes you less likely to beat yourself up when you have to make decisions in a practical manner. If, like me, your parents don’t provide any assistance and you are struggling to pay the bills in medical school, and you still think you need to take the step 1 exam or you’re not maximizing your education, you aren’t very practical or good with money.

I personally want to eat and pay my bills in June and doubt step 1 would help me at all with my career goals. I also don’t think that it will doom me to be a bad doctor.

Hence asking if you “need” to take it. If it was a requirement, I could try to see if my school would let me get a part-time job. Or perhaps live in a homeless shelter for the month of June.

But I’m not going to waste money and time on something that isn’t required and would probably hurt my application.

Don’t feel like making the “passed COMLEX but failed step 1 thread” I see all the time in a few months.

 

[Drrrrrr. Celty]

They do, they also attract people who are not and seek out the best training that they can. Are we going to say that lower tier residencies attract bottom barrel students too next? No. People make decisions on where to go based on many factors. And like I said, I'm not saying anyone is going to be inadequate by any stretch. However the reality stands that at higher up programs you'll be dealing with more opportunities that can offer you the chance to advance your education.

It's got nothing to do with whether or not you'll take your usmle or not. You can get into plenty of good solid programs with a good COMLEX. But honestly, i'll drop it for now.

 

[IsWhat]

That's not what I said. I said that your rationalization of mediocrity is not an attitude that is conducive towards medicine and learning. You should always be seeking to be sharper, more educated, not just to check off the box and call it a day.
That doesn't mean going to JHU. That doesn't mean not going to Rural program Barrows Alaska either. It means you shouldn't look at adversity or the stratification of life with a chip. But that's all that you have done in this post. You've acted poorly.

I’ve never understood why people use Alaska in this context. They have one residency and it produces some of the best full-scope family medicine docs in the country.

 

[cryhavoc]

I’ve never understood why people use Alaska in this context. They have one residency and it produces some of the best full-scope family medicine docs in the country.

Probably because few people have memorized statistics on every residency program in the United States and because remoteness, coldness and proximity to Russia is often equated with something being undesirable.

 

[Drrrrrr. Celty]

I’ve never understood why people use Alaska in this context. They have one residency and it produces some of the best full-scope family medicine docs in the country.

Because he referenced wanting to go back to Alaska. I have utterly no knowledge of this state.

 

[hallowmann]

I think everyone here is overgeneralizing. I also think that those of you in preclinicals seem to have this view that its either JHU or the 100-bed community program. Its not a dichotomy. There's a ton of different programs with varying sizes, prestige, university input, arrogance, poor vs. excellent training, in places that are either very desirable, desirable, mediocre, undesirable, and very undesirable.

As a DO, you have the ability to go to plenty of desirable or excellent academic institutions. You also have the ability to go to excellent community programs. You will also absolutely find crappy people at both. Choose where you want for a variety of reasons, but don't eliminate programs because of your perception of their "prestige", whether that's eliminating all university programs due to "prestige" or eliminating all community programs due to perceived lack of "prestige".

 

[Mad Jack]

If you want to match well, take the USMLE. If you'd be fine not matching well, whatever I guess. And if you're struggling with the COMLEX, a bad COMLEX is better than a bad COMLEX and a failed USMLE.

 

[meliora27]

My opinion is that all physicians who want to practice in the United States should have to take the SAME licensing exams (USMLE). That being said, there is a growing cohort of academic programs that will take DO's, however their institutional GME policy is that they CANNOT rank any candidates to match, who have not taken USMLE Step 1 and Step II CK. Therefore, DO's who want to match at these programs, would have to take Step 1 and II CK. I wouldn't be surprised if this policy, at least at academic (university) institutions, becomes even more commonplace.

 

[ClinPathDO]

My opinion is that all physicians who want to practice in the United States should have to take the SAME licensing exams (USMLE). That being said, there is a growing cohort of academic programs that will take DO's, however their institutional GME policy is that they CANNOT rank any candidates to match, who have not taken USMLE Step 1 and Step II CK. Therefore, DO's who want to match at these programs, would have to take Step 1 and II CK. I wouldn't be surprised if this policy, at least at academic (university) institutions, becomes even more commonplace.

I highly recommend taking USMLE at one of my interviews the PD didn’t even have my COMLEX scores forwarded to her, She was asking about step 2 CS and I had to explain that I took the DO version. COMLEX should really just go away waste of time and money for all, only the AOA/NBOME is making money off it.

 

[cryhavoc]

But osteopathic physicians learn OMT and their boards have questions on OMT. It wouldn’t be fair to make the only, singular licensing exam have questions that allopaths never learned about.

But I doubt that is what you’re suggesting. You’d probably want it be an exam without OMT for everyone. Which is fine by me, but the more militant osteopaths would not take that lying down.

Additionally, the allopathic board exams focus more on biochemisty whereas the osteopathic exam is more clinical. I’m sure a lot of doctors on both sides think memorizing biochem pathways that don’t affect daily practice is a waste of time. Go up to any licensed doctor and I bet 90% of them would struggle to produce biochemical pathways after their boards.

So why not just make one licensing exam for both and make it more clinically relevant? Or just keep two. I’m fine with either.

But I’m not going to pay for two exams and cram excessive biochemistry I could easily look up if I can get away with one exam that is easier. That is just more practical.

Plus how many allopaths are actually going to learn OMT and take COMLEX just to get into our residencies?

 

[sab3156]

Plus how many allopaths are actually going to learn OMT and take COMLEX just to get into our residencies?

"Our residencies", meaning AOA? AOA GME is now a thing of the past... It will be great when LCME basically pulls the same move on COCA as the ACGME did on AOA, forcing COCA to fold so that we can get rid of COMLEX. It's just a money grab - the COMLEX has no relevance anymore whatsoever, but the millions of dollars made off of the COMLEX series each year means it's not a battle which NBOME will give up on easily.

 

[cryhavoc]

"Our residencies", meaning AOA? AOA GME is now a thing of the past... It will be great when LCME basically pulls the same move on COCA as the ACGME did on AOA, forcing COCA to fold so that we can get rid of COMLEX. It's just a money grab - the COMLEX has no relevance anymore whatsoever, but the millions of dollars made off of the COMLEX series each year means it's not a battle which NBOME will give up on easily.

I’m confused, why would DO schools have students taking COMLEX if it isn’t “relevant” anymore? Will the students who take COMLEX be unable to get a residency at all with it?

 

[gamerEMdoc]

I know it will never happen, but since the AOA residencies will be a thing of the past very soon, I'd love to see DO schools find a way to use the USMLE boards. Maybe have an added "osteopathy" board (step 2-Osteo or something) that tests that component. Its absurd for schools to have their students take two sets of boards, and with the merger, its obvious that a large portion of students are going to feel compelled to take both. Don't get me wrong, I doubt this will happen anytime soon, I'm sure the COMLEX exams make the AOA some money, and I doubt they are going to really want to give up any more power and money after they were gutted by the merger.

As an aside, from a program leadership standpoint, I think making students take two sets of boards is silly. I'm probably in the minority, but I'm totally fine just looking at comlex scores and extrapolating them. Seems unreasonable to make students spend a fortune taking two sets of boards examining similar content.

 

[sab3156]

I’m confused, why would DO schools have students taking COMLEX if it isn’t “relevant” anymore? Will the students who take COMLEX be unable to get a residency at all with it?

For a bunch of specialties you can't apply with COMLEX, period, unless you want to risk not getting any interviews at all. It is not a reputable exam for many programs, so the fact that it is still around is ridiculous. There are many other reasons to get rid of it.

 

[hallowmann]

But osteopathic physicians learn OMT and their boards have questions on OMT. It wouldn’t be fair to make the only, singular licensing exam have questions that allopaths never learned about.

But I doubt that is what you’re suggesting. You’d probably want it be an exam without OMT for everyone. Which is fine by me, but the more militant osteopaths would not take that lying down.

Additionally, the allopathic board exams focus more on biochemisty whereas the osteopathic exam is more clinical. I’m sure a lot of doctors on both sides think memorizing biochem pathways that don’t affect daily practice is a waste of time. Go up to any licensed doctor and I bet 90% of them would struggle to produce biochemical pathways after their boards.

So why not just make one licensing exam for both and make it more clinically relevant? Or just keep two. I’m fine with either.

But I’m not going to pay for two exams and cram excessive biochemistry I could easily look up if I can get away with one exam that is easier. That is just more practical.

Plus how many allopaths are actually going to learn OMT and take COMLEX just to get into our residencies?

The best option would be to have the USMLE series, and simply use something like the COMAT shelf for OMM to be the requirement to pass the OMM portion of medical school curriculum.

However, this simply won't happen anytime soon. The NBOME makes far too much money on the COMLEX series, too many states have it written explicitly into law for the sake of state medical licensure, and there is not enough incentive for the other medical institutions (NBME, ACGME, LCME, AOA, COCA, etc.) to push getting rid of it. Half of DOs are already taking the USMLE 1 and 2 CK anyways.

... It will be great when LCME basically pulls the same move on COCA as the ACGME did on AOA, forcing COCA to fold so that we can get rid of COMLEX...

I personally wouldn't have an issue with this occurring, but I do not believe that it will necessarily work out the way you think. The LCME doesn't have a whole lot of incentive to take over or merge with COCA. Plus, if the LCME wanted they could simply make it even more seamless by creating DO school requirements that are separate from MD school requirements, and just replace the USMLE with the COMLEX. Its not like there's anything really stopping them from doing that, if they actually wanted to.

...As an aside, from a program leadership standpoint, I think making students take two sets of boards is silly. I'm probably in the minority, but I'm totally fine just looking at comlex scores and extrapolating them. Seems unreasonable to make students spend a fortune taking two sets of boards examining similar content.

Voices of reason do exist.

 

[jw3600]

I’m confused, why would DO schools have students taking COMLEX if it isn’t “relevant” anymore? Will the students who take COMLEX be unable to get a residency at all with it?

Money. Are you serious ?

 

[gamerEMdoc]

how would you view a student with comlex only but did quite well (650) vs. a student who took both and did below average on both (say 500 and 220). would the usmle weight more heavily in student B's favor, despite student A doing much better on comlex?

Personally, as an MD who trained at an allopathic site, but has been leadership at a former AOA turned ACGME EM residency for sometime, I'm pretty comfortable looking at either board, and for the most part judging the two against each-other. So of course, I'd rather have the candidate with the 650 over the 500/220 assuming all else is equal. But, I also realize that may not be the majority opinion out there. At least it does exist though!

As always, I maintain that boards are really a small part of the application for my specialty (EM) and I think students sometimes over stress the importance of them. This isn't an excuse to bomb the boards, but people can overcome bad results and still match just fine if they are clinically good. I just think board scores act as a scapegoat. A student that is clinically really average or worse who doesn't match in a competitive specialty can point to their 500/215 and say "well, I'm a great doctor and I just didn't match because everyone only cares about test scores." It provides a scapegoat that allows the graduate to not have to face the fact that they clinically aren't as great as they think they are. In reality, the EM data for match rates for what people would consider lower board scores aren't that bad. It's not the boards that are holding people back most times. Once you get past the minimums at places to secure a rotation, the bulk of the match process surrounds performance on ED rotations and SLOE rankings, and boards become far less relevant. Obviously EM is a unique specialty in that we are the only one (that I know of) that uses standard letters of evaluations (SLOEs) to help rank students. But consistantly in PD surveys for EM, boards fall much lower on the list in terms of what they think is important when weighing applicants.

 

[zero0]

I know it will never happen, but since the AOA residencies will be a thing of the past very soon, I'd love to see DO schools find a way to use the USMLE boards. Maybe have an added "osteopathy" board (step 2-Osteo or something) that tests that component. Its absurd for schools to have their students take two sets of boards, and with the merger, its obvious that a large portion of students are going to feel compelled to take both. Don't get me wrong, I doubt this will happen anytime soon, I'm sure the COMLEX exams make the AOA some money, and I doubt they are going to really want to give up any more power and money after they were gutted by the merger.

As an aside, from a program leadership standpoint, I think making students take two sets of boards is silly. I'm probably in the minority, but I'm totally fine just looking at comlex scores and extrapolating them. Seems unreasonable to make students spend a fortune taking two sets of boards examining similar content.

The NBOME and AOA will fight tooth and nail to prevent this. Honestly, I can sit through a couple weekly hours of OMM no problem. But taking 2 sets of boards is where I really start to feel the sting of the DO difference. Then again, I haven't gone through the match yet. That'll leave a few bruises for sure.

 

[hallowmann]

The NBOME and AOA will fight tooth and nail to prevent this. Honestly, I can sit through a couple weekly hours of OMM no problem. But taking 2 sets of boards is where I really start to feel the sting of the DO difference. Then again, I haven't gone through the match yet. That'll leave a few bruises for sure.

I don't know, you'd be surprised. I think it really depends on what you end up in and where you match. For a lot of competitive specialties or surgical specialties that's probably the case. When I matched I actually felt that the outcome couldn't have been better even if I was at a low-tier MD school. The place higher on my ROL wouldn't have taken me over the people they actually matched. I also got interviews at all the most important places on my app list, and in the end I ended up somewhere I love.

To be clear, I know people where it seems like it really did hurt them, but I also know others that don't feel that way either (and they're not all in non-competitive specialties).

 

[sab3156]

Then again, I haven't gone through the match yet. That'll leave a few bruises for sure.

At least you aren't like some of my classmates who think they will be matching Ortho with simply a good step 1. They're about to have a rude awakening in a couple of years.

To be clear, I know people where it seems like it really did hurt them, but I also know others that don't feel that way either (and they're not all in non-competitive specialties).

While I agree with and see what you're saying in general, I think the real hurt that @zero0 is alluding to is the feeling when you hear pin-drop silence from a huge amount of programs that are interviewing students from MD schools with stats way lower than yours. It can be painful to see the MDs with 230s interview and match at excellent IM program, while the DO counterpart with the 240 struggles with getting any of those same interviews, and maybe ends up at a community program that they didn't want to go to.

There are a lot of reasons why someone may not have felt the DO hindrance was applicable to them during the match - they could have had a seat basically ready for them due to connections or they had their sights set on a program that has consistently taken DOs. Those types of people, of course, would have felt that they had no problems during the match.

 

[AnatomyGrey12]

But osteopathic physicians learn OMT and their boards have questions on OMT. It wouldn’t be fair to make the only, singular licensing exam have questions that allopaths never learned about.

Bruh what? It would be so easy to simply have an additional omt section for DOs...

Plus how many allopaths are actually going to learn OMT and take COMLEX just to get into our residencies?

Um none because they won’t have to. A few programs will require them to learn OMT and a few probably will.

Additionally, the allopathic board exams focus more on biochemisty whereas the osteopathic exam is more clinical. I’m sure a lot of doctors on both sides think memorizing biochem pathways that don’t affect daily practice is a waste of time. Go up to any licensed doctor and I bet 90% of them would struggle to produce biochemical pathways after their boards.

So why not just make one licensing exam for both and make it more clinically relevant? Or just keep two. I’m fine with either.

The USMLE is a much better exam. By far.

I’m confused, why would DO schools have students taking COMLEX if it isn’t “relevant” anymore?

Um for money? Also it’s legally required for DOs to practice medicine...

Will the students who take COMLEX be unable to get a residency at all with it?

No they will still get one but it won’t be a competitive one, unless it’s one of the former AOA programs that doesn’t care about the USMLE.

 

[gamerEMdoc]

No they will still get one but it won’t be a competitive one, unless it’s one of the former AOA programs that doesn’t care about the USMLE.

To be fair, its not only former AOA programs that are ok with only looking at COMLEX scores. Places that match a decent percentage of DOs usually are. Places that don't probably require USMLE. But then, if they really don't take DO's anyways, then taking the USMLE probably isn't going to change that. Kind of a catch 22.

 

[Neopolymath]

But osteopathic physicians learn OMT and their boards have questions on OMT. It wouldn’t be fair to make the only, singular licensing exam have questions that allopaths never learned about.

But I doubt that is what you’re suggesting. You’d probably want it be an exam without OMT for everyone. Which is fine by me, but the more militant osteopaths would not take that lying down.

Additionally, the allopathic board exams focus more on biochemisty whereas the osteopathic exam is more clinical. I’m sure a lot of doctors on both sides think memorizing biochem pathways that don’t affect daily practice is a waste of time. Go up to any licensed doctor and I bet 90% of them would struggle to produce biochemical pathways after their boards.

So why not just make one licensing exam for both and make it more clinically relevant? Or just keep two. I’m fine with either.

But I’m not going to pay for two exams and cram excessive biochemistry I could easily look up if I can get away with one exam that is easier. That is just more practical.

Plus how many allopaths are actually going to learn OMT and take COMLEX just to get into our residencies?

Based on your recent posts it seems like you have a fundamental misunderstanding of how all this stuff works and goes together. Did your school confuse you or something?

 

[cryhavoc]

Based on your recent posts it seems like you have a fundamental misunderstanding of how all this stuff works and goes together. Did your school confuse you or something?

It was actually posts on here that taught me three things.

1) A decent COMLEX is better than a decent COMLEX and a failed step 1. In fact, failing step 1 severely limits your options.

2) Someone in the bottom third of their class probably shouldn’t be taking step 1 and should focus on COMLEX.

3) Most psychiatry residencies, except for the very most competitive ones, accept COMLEX.

All things I learned on here. But that in combination with I don’t even have the money to take step 1, seems obvious to only to COMLEX.

And by looking at excel sheets, it seems like most DO students who match psych only take COMLEX.

I don’t know about other specialities though. Perhaps step 1 is required for those and that’s why people with different interests seem so insistent on risking step 1.

 

[zero0]

At least you aren't like some of my classmates who think they will be matching Ortho with simply a good step 1. They're about to have a rude awakening in a couple of years.

Yeah there's quite a few of those in my class as well. I weep for them. Not really, they're insufferable as I'm sure you'd guess.

 

[Neopolymath]

It was actually posts on here that taught me three things.

1) A decent COMLEX is better than a decent COMLEX and a failed step 1. In fact, failing step 1 severely limits your options.

2) Someone in the bottom third of their class probably shouldn’t be taking step 1 and should focus on COMLEX.

3) Most psychiatry residencies, except for the very most competitive ones, accept COMLEX.

All things I learned on here. But that in combination with I don’t even have the money to take step 1, seems obvious to only to COMLEX.

And by looking at excel sheets, it seems like most DO students who match psych only take COMLEX.

I don’t know about other specialities though. Perhaps step 1 is required for those and that’s why people with different interests seem so insistent on risking step 1.

I don't think you have seen anyone disagree with what you said above or said you should take step 1 if you are in that situation. I don't think you could produce a quote of a post saying that here. I was mostly referring to your rant that you plan on going to a worse program to somehow receive better training and that you don't understand why we would get rid of comlex in the ideal world not the usmle lol. That's strategy that just screams of rationalization and naivety more than anything.

 

[cryhavoc]

I was being purposely naive for the sake of sarcasm/playing devil’s advocate. Should have added an emote. Of course only one exam would be better. Most practicing DO’s don’t even use OMT and most patients can’t even tell the difference between them.

As for one test, the reality is, that isn’t going to happen for a long time.

 

[jw3600]

I was being purposely naive for the sake of sarcasm/playing devil’s advocate. Should have added an emote. Of course only one exam would be better. Most practicing DO’s don’t even use OMT and most patients can’t even tell the difference between them.

As for one test, the reality is, that isn’t going to happen for a long time.

I don’t understand. Are you trolling? Your posts in this thread have been steaming hot garbage.

 

[cryhavoc]

I don’t understand. Are you trolling? Your posts in this thread have been steaming hot garbage.

“Garbage”? From 10 seconds of browsing your post history, all of your posts are generally a sentence long and consist of poor grammar, cussing, chat speak and knee jerk negative reactions to someone else’s posts. Hello pot, my name is kettle.

I could understand why anything not incredibly simplistic and straight-forward would be considered garbage.

I have two pieces of advice to all the people purposely trying to provoke me in this thread with rude comments like my posts being garbage, I’m ranting, acting poorly or that I am naive or confused. You guys really like to pile on the criticism, so here is some criticism and advice for you.

1) Get a life.

2) Learn to disagree without coming off as condescending and rude. If not for my sake, but for the sake of the hundreds of patients and coworkers you’ll interact with on a weekly basis in the future. It completely causes someone to ignore your advice and just generally dislike you. It isn’t what you say but how you say it. It is a very valuable skill not just for a physician but for any human-being.