Compare USMLE Step 1 vs. COMLEX Level 1 Scores | MedSchoolCoach (2024)


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Why should medical students take on the added stress of preparing for two board exams despite the unified match? Is taking USMLE Step 1 as a DO student still worth it when they already have the COMLEX Level 1? Yes!

Many DO students have continued to take USMLE Step 1 in addition to the COMLEX Level 1 to improve the competitiveness of their residency applications. Here’s why.

Most Program Directors Are More Familiar With the USMLE Grading Scale

Last year’s merger of the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) resulted in a unified ACGME match for both MD and DO candidates.

Yet, though all medical programs are now open to both MD and DO applicants, there are many more allopathic (MD) students than osteopathic (DO) students. This means there are more students applying for residency using USMLE scores than COMLEX scores.

Likewise, there are more original ACGME programs than original AOA programs. As such, most program directors are more familiar with the USMLE grading scale than the COMLEX grading scale. This means they are more likely to feel comfortable accepting an equally qualified applicant who submits a USMLE score with a COMLEX score than an applicant who submits a COMLEX score alone.

No COMLEX Level 1 to USMLE Step 1 three-digit score conversion formula has been widely accepted. (Even though some attempts can be found online). In fact, many residency programs have been advised to use caution when utilizing any such formula to derive a USMLE Step 1 score from a COMLEX Level 1 score. As such, providing a valid USMLE Step 1 score remains a competitive advantage in the residency application process for test takers.

Still, as a study published by the ACGME in The Journal of Graduate Medical Education shows, there is a strong positive correlation between COMLEX Level 1 scores and USMLE Step 1 scores. The following graph provides an estimate as to where you might fall on Step 1 based on your Level 1 score or most recent COMSAE, based on exam percentiles.

Compare USMLE Step 1 vs. COMLEX Level 1 Scores | MedSchoolCoach (5)

A Successful Match Often Requires a Higher COMLEX Percentile Than USMLE Percentile

If ever there was a reason to undergo the grueling process of simultaneously preparing for two board exams, it’s this: based on data released by the National Residency Match Program (NRMP), applicants who submit a COMLEX score alone may be expected to score in a higher percentile than those who submit a USMLE score.

For example, the average applicant to match into anesthesiology scored approximately a 232 on USMLE Step 1, placing them in the 47th percentile overall. In contrast, the average COMLEX Level 1 score required to match is approximately a 570, placing that examinee in the 66th percentile overall.

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Likewise, the average applicant to match into Emergency Medicine scored approximately a 234 on USMLE Step 1, placing them in the 52nd percentile overall. In contrast, the average COMLEX Level 1 score required to match is approximately a 580, placing that examinee in the 70th percentile overall.

Compare USMLE Step 1 vs. COMLEX Level 1 Scores | MedSchoolCoach (7)

Should DO students take the USMLE Examinations?

The short answer is maybe. According to the AAMC, across almost all medical specialties, a successful match often requires an osteopathic student to score significantly better amongst their peers than an allopathic medical student. Since program directors are far more likely to understand a USMLE score, it can be a great advantage for an osteopathic student to have taken the USMLE exams. It is a way for DO students to further increase competitiveness within a given specialty. With USMLE Step 1 soon going pass/fail, osteopathic students maybe left having to take Step 2 for a score in order to become as competitive as possible for their desired residency spots.

Get Your USMLE Step 1 Score While You Can

The USMLE Step 1 is scheduled to go pass/fail for all students testing on or after January 26th, 2022. Meanwhile, the COMLEX Level 1 is scheduled to adopt the same pass/fail scoring system as of May 1st, 2022.

For near-term osteopathic students who want to boost their chances of a competitive match, it would be helpful to get a numeric Step 1 score for future years. If you’re eligible to sit for Step 1 this year, secure that competitive edge by earning your numeric USMLE Step 1 score while you still can.

Boost Your Board Exam Scores with Our Webinars

Want to learn more? Our physician tutors and advisors have created webinars designed to help students improve both their USMLE Step 1 and COMLEX Level 1 scores. Tune in!

Setting Yourself Up for Success on Step 1

Mastering OMM and COMLEX

Considering a USLME Step 1 Online Course? Interested in a personal tutor to help you improve your scores? Find a USMLE tutor or Find a COMLEX tutor. We’d be happy to help you improve your score so you can match into your desired residency!

Compare USMLE Step 1 vs. COMLEX Level 1 Scores | MedSchoolCoach (2024)


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