COMLEX vs USMLE percentiles (2024)

http://www.jgme.org/doi/pdf/10.4300/JGME-D-13-00302.1

Here's an article publsihed comparing students who took both USMLE and COMLEX (n = 1016). Although the goal of the article was not only to compare COMLEX vs USMLE scores, but also determine if various "score conversion" formulas available were actually valid. There's a nice figure in there showing USMLE vs. COMLEX scores that's worth a peak. They found that you really can't use any score converter, and- as @atomheart said- it is best to compare apples to apples. Different number of questions, different content (I think USMLE is better at testing on more discrete subjects where COMLEX seems to hammer the same subjects more than others.)

I'm another n=1, but my USMLE and COMLEX percentile scores are way off from one another, with my COMLEX being far higher (*shocking* COMLEX vs USMLE percentiles (1)) However, from looking at FREIDA, it seems most residency programs basically account for this themselves. For residencies listing the Step 1 average as 221-240, they frequently have the COMLEX level 1 average as 551-650. FREIDA likely isn't the best source of information on the issue, since it's up to the PDs to select the ranges, and they're just pre-set ranges at that. Also, some of those programs take USMLE only yet list COMLEX anyway; these students likely self-selected as having a better shot of doing well on the USMLE to begin with.

Finally, you can't really compare DO students taking both USMLE and COMLEX to MD students only taking USMLE for just that reason. MD students don't take the COMLEX. For all we know, they could score lower on average on the COMLEX than their DO counterparts. This is unlikely since they're statistically more likely to be better test takers, but nonetheless, it cannot be ruled out. They could score such that there is no significant difference between MDs and DOs, or they could outscore DOs as they tend to do on the USMLE. However, until some MD takes the COMLEX (controlling for the OMT shenanigans, which is a whole different can of worms) there is really no way to accurately compare between scores.

This leads into the whole other argument- should there be a single exam for both MDs and DOs, with DOs having an extra OMT bonus section of sorts. Arguments can be made easily for one side or the other- we're moving towards single accreditation, we should have one licensing exam vs. this would probably stratify students the same way as the MCAT did, MD and DO are different enough curriculums that they should not take the same test.

All that aside, the whole MD vs DO/ USMLE vs COMLEX debate really grinds my gears at times. It's important to note that I likely feel this way because my 230 is not always going to be viewed the same as an MD's 230, so I got the short end of the stick here and I'm bitter. Boo hoo hoo. Ideally, everyone will remember that who you will be as a doctor comes down to way more than your USMLE/COMLEX score. Let's be real, some of us were just not cut out to be neonatal dermatologists when we came out of the womb and our APGAR score was only an 8. You could be dumb as a sack of rocks and have patients who think you're awesome because you take the time to listen and hear them out. You could also be a total USMLE ~*RoCkStAr~* and still have patients who love you for the same reasons. And patients can dislike you as a doctor whether you're subjectively smart or dumb as well. I'd be willing to bet that 99% of the time, people don't chose where to live based on what hospital they're next to ("ohhh this is the best [insert specialty here] residency in the country, I will only live within driving distance of this hospital!" ... I don't think so.) Patients likely don't give two ****s about what your step score was or where you went to school, as long as you make them feel like a human and make them "better."
"But runthiscity! It matters for specialties!!" Yes, yes it does. And you better know your **** if you plan on being a good doctor no matter what specialty you do. But at the end of the day, the comparison of scores all just a pissing contest to make ourselves feel superior to our colleagues, and those in other professions- because med school is just *the hardest* and no one else could *ever* take board exams like we do. "But runthiscity! Your scores matter for where you get interview offers! And thus, where you end up living semi-/totally- permanently!" Yes, yes they do. And how else are programs going to sift through thousands of applications to figure out who to interview? So, we must play the game. But I would personally prefer someone who got a 220/530 and is compassionate than someone who got a 276/920 and has an ego the size of Jupiter. But that could just be me.
/rant

COMLEX vs USMLE percentiles (2024)

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