Single GME news

AMA officially recognizes COMLEX as equivalent to USMLE

AMA HOD resolution calls for the association to help educate residency program directors on using and interpreting COMLEX scores.


The American Medical Association’s House of Delegates recently voted unanimously to approve a resolution promoting equal acceptance of the COMLEX and USMLE exams by all U.S. residency programs. The resolution calls for the AMA to work with appropriate stakeholders to educate residency program directors on using and interpreting COMLEX scores.

AMA to work with residency program directors

The new policy also calls for the AMA to work with residency program directors to promote higher utilization of COMLEX for DO applicants to American Council for Graduate Medical Education residency programs as the medical profession transitions to a single GME accreditation system.

Administered by the National Board of Osteopathic Medical Examiners (NBOME), COMLEX-USA provides the pathway to licensure for U.S. DOs and is a graduation requirement for earning a DO degree from colleges of osteopathic medicine, according to a statement released by NBOME and the American Association of Colleges of Osteopathic Medicine. Currently, most ACGME residency and fellowship program directors, teaching hospitals, and all of the nation’s state licensing boards accept, use, and/or require COMLEX-USA for DOs.

The ACGME, AOA and the Federation of State Medical Boards, among others, have official policy recognizing COMLEX’s validity.

Great news for DO students

The AMA’s decision to recognize and promote COMLEX and USMLE on an equal basis is great news for DO students, said AOA President William S. Mayo, DO.

“Although studies have shown that the exams are comparable for residency program directors’ use in assessing applicants, osteopathic students have been confused by misinformation in the era of the single accreditation system for GME, many electing to also take USMLE,” Dr. Mayo said. “Knowing that the ACGME accepts COMLEX and USMLE, and now that the AMA also supports equal acceptance of COMLEX and USMLE, helps to clarify the issue.”

The AMA’s new position also represents a major moment for patients and the practice of osteopathic medicine, noted NBOME President and CEO John R. Gimpel, DO, MEd, in a statement.

“MD and DO medical students stood together in solidarity for osteopathic distinctiveness, DO students and residents, and their unique, valid and distinctive credentials,” Dr. Gimpel said.

Further reading:

Single GME update: More than 6,600 AOA residency positions are now ACGME-accredited

DO elected to leadership position on ACGME Board of Directors


    1. Daniel Kinsey

      DO students are tested on osteopathic manipulative medicine and principles, which would not be on USMLE. There’s a significant part of the exam that tests us on this. Many DO students believe they need to take both boards to be competitive, but we’ll see if that’s the case moving forward.

    2. Jim

      COMLEX will never be cancelled because it is making so much money for them. Step 1 800 step 2 close to 2k step 3 another 1k. Add all these up and multiply all the DO students and you get a multi-million dollar business!!!!

  1. Mark

    If you are applying for an MD residency position why not take the standardized examination your peers take? Regardless of the equality of exam.

    1. Devon

      Because if you’re DO that requires taking time (and money) to take two tests when in the end we all have practicing rights in the country. Setting them equal removes some of the barrier for DO students face which if we’re moving to single accreditation seems fair

    2. Devon

      The requires DO students to spend time (and money) to take another test. Making them equal removes the extra barrier DO students face, which if we’re moving to a single accreditation seems fair.

    3. Matt

      That would defeat the whole purpose of the merger between the AOA and the ACGME. The whole point is so DOs don’t have to take two board examinations. When this merger completes there aren’t going to be MD and DO residencies. There will be one residency system that recognizes both MD and DO equally.

    4. James

      Since the merger there shouldn’t be such a thing as an “MD residency” position, just residencies that favor one over the other. This ruling should (in a perfect world) reduce if not entirely remove the bias against DO’s who otherwise had to pay, study and take BOTH tests in the same time it would take an MD to just study and take one test.

  2. Richard

    This resolution is meaningless, as the AMA has no authority over this matter. Unfortunately, the AOA did a poor job of negotiating the single accreditation deal. There has been very little movement on the part of the ACGME in adjusting their accreditation standards to the realities of community hospital-based residencies. DO students remain at a competitive disadvantage compared to their MD peers, as they now have little choice but to take the USMLE on top of their required COMLEX as more and more traditional DO residencies disappear. At this point the die is cast and there is no going back. The best thing AOA/AACOM could do for its students would be to dump the COMLEX, require all DO students to take USMLE, and adopt a separate, OMM-only exam. The likelihood of this happening is probably equivalent to NBOME decreasing the cost of COMLEX PE.

  3. Matt

    That would defeat the whole purpose of the merger between the AOA and the ACGME. The whole point is so DOs don’t have to take two board examinations. When this merger is complete there won’t be MD and DO residencies. There is only going to be one residency system that recognizes both MD and DO graduates as equal.

  4. Jon

    The AMA saying comlex is equivalent to the USMLE and residency directors respecting that are two very different things

  5. James Stephens

    As someone who has taken both exams, both steps 1 and 2, the exams are not equal. The USMLE is much better written with more clear and more appropriate questions. The Comlex had grainy images and questions that did not make sense. They should fold the comlex completely. Manipulation/osteopathic principles are adequately tested in medical schools.

    1. EyeDocDo

      This isnt absolute proof but my 2 digit score on USMLE (2002) step 1 was 95 and my 2 digit score on COMLEX Step 1 was also 95

  6. Tucker

    What would make the most sense would be for everyone to take the USLME and then to add a portion specific for OMT. This would make it easier to compare applicants and to reduce costs. Plus after taking both exams, the USLME is honestly just a better written exam – sorry, but it is true. I thought it did a better job testing my medical foundation. However I know that won’t ever happen due to money and pride; but wishful thinking is hopefully allowed.

  7. John

    “Misinformation” regarding the acceptability of the COMLEX? ACGME program directors are pretty clear when they say although their official “policy” is to accept COMLEX, they almost never do because the scoring system is poorly understood and with more MD applications than DO, it is simply easier to look at the generalizable USMLE scores to determine if a DO is equivalent to an MD candidate. Unfortunately, this notion that they will be held equal is peddled by the AOA and school faculty in public (in private is a different story), yet the ones who decide on who matches overwhelmingly say the opposite. Agreed with the comments above. As long as there is money to be made, two boards will exist. All under the guise of “distinction.”

  8. Ryan

    This is menaingless and honestly if you are a DO you should take the USMLE to better compare yourself to Allos. Don’t listen to the bravado that you should only take the comlex now because you will honestly get screwed over during your residency application season. There is and always will be a bias against DOs simply because the admission standards to get into a DO school is lower. Same goes with Caribbean who are often seen as lower quality applicants than DOs. You need to distinguish yourself and the only way of clearly doing that is through the USMLE.

  9. Nathaniel Snerpus

    The “COMLEX is poorly understood” argument is hilarious given the test was introduced 24 years ago. I thought physicians were supposed to be an adaptable intelligent lot.

  10. V

    I think more credit should be given to DO students who are hustling and taking two (very different) board exams instead of focusing all their energy on one. It is of course going to already put you at a disadvantage, as you don’t get more time to study for both – and yet PDs hardly acknowledge this fact and just look at the raw scores. They are not the same test but with different names. I feel like it’s an uphill battle – give everyone one exam and level the field. Having taken both Step & COMLEX (1 & 2), I can say they are very different exams in primarily the way they are written and how you need to practice and approach the problems. Step is almost easier for it’s clarity.

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