DOs taking step 1 for PM&R - is it needed

[PorcupineDoc]

Just had a meeting about this. Are there any program directors on here that have opinion here?

So with it being pass fail, will program directors care if I only have COMLEX? Or if I have step 2 but not step 1?

So many mixed opinions at my school.

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[JBM16BYU]

Not a program director, but... I personally took both. If you are a DO student, you have to take COMLEX I, II, PE, III. While many, if not most, PM&R residency programs will accept the COMLEX, the test itself, compared to the USMLE, is apples to oranges. I recommend taking USMLE Step 1 and 2CK. You do not need to take USMLE Step 3. USMLE Step 1 is pass/fail, but Step 2 is still score-based. What that means in the future, whether Step 2 will be the new Step 1, I have no idea. I have heard, from program directors, that it looks odd if you take Step 1 and not Step 2. I do not believe you can take Step 2 if you did not complete Step 1, but I may be wrong there.

 

[j4pac]

I personally don’t think it’s necessary for PM&R. Very few programs require it, and I don’t think that it necessarily will make you more competitive for the programs that don’t. The programs that do require it are archaic and frankly, you’ll probably be at a disadvantage at those programs either way because you’re a DO. I wouldn’t take the test to appease that insanely small minority of programs.

Ways that the USMLE could help you include: 1) it could help with transitional year matching, 2) it will be incredibly valuable if you change your mind away from PM&R. Though USMLE is unnecessary for PM&R, it is pretty much required for any other residency. 3) if you are a part of the tiny minority of applicants that do better on USMLE than COMLEX.

Here are a few reasons I do think there is a real downside of taking USMLE. 1) It’s been my experience that DOs going into PM&R test well on OMT, which increases your COMLEX when compared to USMLE. 2) I think there is a real chance that taking the USMLE could potentially lower the COMLEX. They are different tests and most spend more prep time on USMLE, and COMLEX is an afterthought and something you spend a week on after completing your USMLE. 3) taking an extra test gives you another opportunity to fail. I see lots of people who fail USMLE, but do fine on COMLEX. So preventable and unnecessary. 4) financial loss, 5) burnout.

I know lots of people who increased their COMLEX 3 over 100 points more than their COMLEX 2. The difference in their minds was the ability to focus on one test.

 

[333ta333]

I agree with j4pac. I think he truly nailed it with his response. I remember reading his advice a few years ago regarding USMLE vs COMLEX. I ended up taking only COMLEX. I matched the cycle before last to my top program and top transitional year. I truly believe I did better on COMLEX because I only focused on one exam.

I had no issues getting interviews, and it was never even brought up on my interviews. I was even extended an interview to a program that stated they required USMLE (not sure how that happened). I do think TY programs and pre-lim medicine programs do care more about USMLE scores, but again, it was not an issue for me.

I happy to answer any other specific questions if you PM me!

 

[PMRorBUST]

I’m a pm&r resident applying for pain fellowships and I took both Comlex and step.

I spoke to the pain fellowship associate program director at our hospital who recommends DOs take their step exams.

I know there are some pm&r programs when I was applying for programs (uc Irvine and Loma Linda come to mind) who do require the step exams.

It sucks taking two exams, but I would recommend taking both, especially if you plan on applying for fellowships.

 

[j4pac]

I’m a pm&r resident applying for pain fellowships and I took both Comlex and step.

I spoke to the pain fellowship associate program director at our hospital who recommends DOs take their step exams.

I know there are some pm&r programs when I was applying for programs (uc Irvine and Loma Linda come to mind) who do require the step exams.

It sucks taking two exams, but I would recommend taking both, especially if you plan on applying for fellowships.

I’ve known tons of DOs who have matched to exceptional fellowships without a USMLE. Very few fellowship directors care about USMLE or COMLEX, beside knowing that you passed. On the whole, Step scores matter less to fellowship than residency.

Pain is a little bit of an odd ball in PM&R fellowships because there are so many anesthesia heavy programs. Anesthesia is relatively DO friendly but not near to the degree as PM&R. So there may be some more reluctant to take a DO, with or without a USMLE. So whereas about 5% of PM&R residencies require USMLE…that number may be slightly higher for Pain fellowships. But honestly, this is based on anecdotal evidence and on a much smaller sample.

But I don’t think that it’s enough to justify taking USMLE. A much bigger factor in if you land a fellowship is your residency, and how you do in residency. And in my experience with mentoring, the risks typically outweigh the benefits for the average applicant.

 

[PorcupineDoc]

@j4pac

Hey I wanted to reach out and let you know I really valued your input.

I cancelled my step 1 yesterday. I may have passed. My scores were on the fence. It would’ve been a low pass to a barely fail. The amount of stress it was causing me was insane.

I got to the point where I thought since it’s pass fail, a pass may help my chances just a little but a fail would crush them.

Yes I may want a pain fellowship one day. There are pain fellowships sponsored by PM&R. But with it going pass fail I’ll be astounded if 6 years from now any fellowships are still requiring step 1.

My plan is to pass comlex which I believe I can do. Then take step 2 and comlex 2 one day with the intention that programs will now favor step 2 as the main requirement.

I may be totally wrong and screw my self into only matching rural family or IM. But I’m in a rural scholar program and took a look at myself and decided I would love PMR and pain but also wouldn’t hate rural primary doctor life either.

I believe this may have slightly changed the avenues I take or the uphill battles but not drastically for PMR as my school has a match at UT San Antonio with only comlex. And again thanks for the input

 

[PorcupineDoc]

@j4pac

Hey I wanted to reach out and let you know I really valued your input.

I cancelled my step 1 yesterday. I may have passed. My scores were on the fence. It would’ve been a low pass to a barely fail. The amount of stress it was causing me was insane.

I got to the point where I thought since it’s pass fail, a pass may help my chances just a little but a fail would crush them.

Yes I may want a pain fellowship one day. There are pain fellowships sponsored by PM&R. But with it going pass fail I’ll be astounded if 6 years from now any fellowships are still requiring step 1.

My plan is to pass comlex which I believe I can do. Then take step 2 and comlex 2 one day with the intention that programs will now favor step 2 as the main requirement.

I may be totally wrong and screw my self into only matching rural family or IM. But I’m in a rural scholar program and took a look at myself and decided I would love PMR and pain but also wouldn’t hate rural primary doctor life either.

I believe this may have slightly changed the avenues I take or the uphill battles but not drastically for PMR as my school has a match at UT San Antonio with only comlex. And again thanks for the input

If some pain fellowship literally only doesn’t want me because I didn’t pass step 1 6 years earlier but did well on every other aspect. Then I’m better off somewhere else anyways

 

[JBM16BYU]

If some pain fellowship literally only doesn’t want me because I didn’t pass step 1 6 years earlier but did well on every other aspect. Then I’m better off somewhere else anyways

One thing I might check on is whether you can take Step 2 without taking Step 1. From my understanding, it is a sequential exam test, so in order to take Step 2 you have to take (and pass) Step 1. Otherwise you would just stick with the COMLEX. Does anyone have insight into this?

 

[PorcupineDoc]

One thing I might check on is whether you can take Step 2 without taking Step 1. From my understanding, it is a sequential exam test, so in order to take Step 2 you have to take (and pass) Step 1. Otherwise you would just stick with the COMLEX. Does anyone have insight into this?

Currently you can take them out of order. Now who knows if one day right before I plan to do it they stop that. But yes right now you can choose to just take step 2 for a score.

A lot of future DOs will be betting on this staying like this. Had 7 friends at school tell me they also canceled and plan to just try to score well in step 2

 

[j4pac]

@j4pac

Hey I wanted to reach out and let you know I really valued your input.

I cancelled my step 1 yesterday. I may have passed. My scores were on the fence. It would’ve been a low pass to a barely fail. The amount of stress it was causing me was insane.

I got to the point where I thought since it’s pass fail, a pass may help my chances just a little but a fail would crush them.

Yes I may want a pain fellowship one day. There are pain fellowships sponsored by PM&R. But with it going pass fail I’ll be astounded if 6 years from now any fellowships are still requiring step 1.

My plan is to pass comlex which I believe I can do. Then take step 2 and comlex 2 one day with the intention that programs will now favor step 2 as the main requirement.

I may be totally wrong and screw my self into only matching rural family or IM. But I’m in a rural scholar program and took a look at myself and decided I would love PMR and pain but also wouldn’t hate rural primary doctor life either.

I believe this may have slightly changed the avenues I take or the uphill battles but not drastically for PMR as my school has a match at UT San Antonio with only comlex. And again thanks for the input

I highly doubt that your decision will have much of an impact at all on whether you get into PM&R. Just work hard and do well on COMLEX