title: Should osteopathic students applying to allopathic emergency medicine programs take the USMLE Exam?
abstract: BACKGROUND
  Board scores are an important aspect of an emergency medicine (EM) residency application. Residency directors use these standardized tests to objectively evaluate an applicant's potential and help decide whether to interview a candidate. While allopathic (MD) students take the United States Medical Licensing Examination (USMLE), osteopathic (DO) students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). It is difficult to compare these scores. Previous literature proposed an equation to predict USMLE based on COMLEX. Recent analyses suggested this may no longer be accurate. DO students applying to allopathic programs frequently ask whether they should take USMLE to overcome this potential disadvantage. The objective of the study is to compare the likelihood to match of DO applicants who reported USMLE to those who did not, and to clarify how important program directors consider it is whether or not an osteopathic applicant reported a USMLE score.
  
  
  METHODS
  We conducted a review of Electronic Residency Application Service (ERAS) and National Resident Matching Program (NRMP) data for 2010-2011 in conjunction with a survey of EM residency programs. We reviewed the number of allopathic and osteopathic applicants, the number of osteopathic applicants who reported a USMLE score, and the percentage of successful match. We compared the percentage of osteopathic applicants who reported a USMLE score who matched compared to those who did not report USMLE. We also surveyed allopathic EM residency programs to understand how important it is that osteopathic (DO) students take USMLE.
  
  
  RESULTS
  There were 1,482 MD students ranked EM programs; 1,277 (86%, 95% CI 84.3-87.9) matched. There were 350 DO students ranked EM programs; 181 (52%, 95% CI 46.4-57.0) matched (difference=34%, 95% CI 29.8-39.0, p<0.0001). There were 208 DO students reported USMLE; 126 (61%, 95% CI 53.6-67.2) matched. 142 did not report USMLE; 55 (39%, 95% CI 30.7-47.3) matched (difference=22%, 95% CI 11.2-32.5, p<0.0001). Survey results: 39% of program directors reported that it is extremely important that osteopathic students take USMLE, 38% stated it is somewhat important, and 22% responded not at all important.
  
  
  CONCLUSIONS
  DO students who reported USMLE were more likely to match. DO students applying to allopathic EM programs should consider taking USMLE to improve their chances of a successful match.
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Moshe
authors.initials: M
authors.lastname: Weizberg
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Dara
authors.initials: D
authors.lastname: Kass
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Abbas
authors.initials: A
authors.lastname: Husain
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Barry
authors.initials: B
authors.lastname: Hahn
mesh_terms: D003625:Data Collection; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008007:Licensure, Medical / Q000592:standards; D010021:Osteopathic Medicine / Q000193:education* / Q000592:standards; D012570:School Admission Criteria; D014481:United States