May 28, 2024
It's Time for Equal Acceptance of COMLEX and USMLE
By Katina Rue, DO
It's been a few years since I was a doctor of osteopathic medicine student, but I still remember the anxiety and stress I felt as I moved through the medical school and residency process. These feelings increased tenfold as I prepared to take the Comprehensive Osteopathic Medical Licensing Examination-the three-level nationally standardized examination for licensure to practice osteopathic medicine.
Fast forward to today. As the program director of Trios Health Family Medicine Residency Program in Kennewick, I've noticed a troubling trend among DO residents. To improve their chances of matching, DO students are taking both the COMLEX and the United States Medical Licensing Examination-the equivalent three-step licensure exam for allopathic physicians (MDs). By contrast, their MD colleagues are only taking the USMLE. In fact, more than half (56%) of graduate medical education programs that consider DOs mandate the USMLE-meaning DO students wishing to attend those programs are required to take both exams.
As physicians, we all know how significant and exciting the time we spend in both medical school and residency is. It shapes who we become as physicians, the specialties we choose, and the care we ultimately deliver. While we all know how deeply important this experience is, we also know how uniquely challenging, even grueling, it can be. This seminal period in a physician's development should not be additionally burdened with unnecessary challenges.
And make no mistake: This is a burden to osteopath students, and the burden isn't limited to the 32 hours of exam time required to take two exams. DO students foot the bill to take both of these exams. The price to complete all three levels of the COMLEX currently stands at $2,340. The price to complete all three levels of the USMLE is $2,265. These figures do not include the cost of travel to the test sites (transportation, lodging, etc.), preparation costs, rescheduling fees, and other factors. Altogether, DO students spend more than $3,000 to take an exam that is not designed for the osteopathic profession or necessary for licensure.
Medical school and residency are challenging enough. We don't need to make it harder. Let's remove the additional barriers currently facing our DO students.
In 2018, the American Medical Association passed policy to encourage equal acceptance of the COMLEX and the USMLE. I and other physicians working as mentors in residency programs across the state are uniquely positioned to educate our colleagues on the COMLEX and advocate for removing this unnecessary barrier for DO students.
We are all acutely aware of the unique physician workforce shortages we face, and DO students are critical to meeting these challenges. In 2023, 55.9% of DO seniors went into primary care. Moreover, 43% of graduating 2021-2022 osteopathic medical students plan to practice in a medically underserved or health shortage area; of those, 40% plan to practice in a rural community. More than 73% of DOs practice in the state where they do residency training, so additional barriers impact rural and primary care access.
I encourage you to learn more about your residency program's requirements and advocate for removing duplicative and unnecessary requirements for DO students. Lifting these barriers will enable DOs to more effectively pursue their preferred residency programs and serve the communities that need them most.
Katina Rue, DO, FAAFP, FACOFP, is the program director of Trios Health Family Medicine Residency Program in Kennewick and the immediate past president of the WSMA.
This article was featured in the May/June 2024 issue of WSMA Reports, WSMA's print magazine.