Predictors of scoring at least 600 on COMLEX-USA Level 1: successful preparation strategies

Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores are an important criterion used by residency directors to make residency placement decisions.

To explore the association between scoring at least 600 on COMLEX-USA Level 1 and grade point average (GPA), scores on the Medical College Admission Test (MCAT), and different test preparation strategies.

Third-year osteopathic medical students at Nova Southeastern University were invited to complete a self-administered survey regarding their COMLEX-USA preparation strategies and to provide consent for the researchers to access their preclinical GPA and their MCAT and COMLEX-USA scores. Descriptive analyses were conducted to understand examination preparation procedures and resources used, and bivariate analyses were conducted to identify the statisically significant predictors of scoring 600 or higher. Two separate logistic regressions were also run. The first included all of the statisically significant factors that emerged from the bivariate analyses, and the second examined which candidate predictors remained statistically significant once the effects of GPA and MCAT scores were removed.

One hundred twenty-two students completed the survey, and 113 (93%) provided informed consent to access their preclinical GPA and their MCAT and COMLEX-USA scores. In the first regression, scoring 600 or higher was associated with a higher GPA (P<.02), a higher MCAT score (P<.05), earlier preparation initiation (P<.05), and not ranking the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) as the most helpful practice examination (P<.04). In the second regression, scoring 600 or higher was associated with earlier initiation of examination preparation (P<.01) and not ranking COMBANK (question bank for COMLEX-USA) as the most helpful question bank (P<.03). Among the different examination preparation methods, the specific resources ranked as most helpful were First Aid for the USMLE (United States Medical Licensing Examination) (review book), the COMSAE (practice examination); COMBANK (question bank); and Kaplan USMLE (lecture videos).

Preclinical GPA and MCAT scores continue to be important predictors of scoring at least 600 on COMLEX-USA Level 1. However, the findings underscore the importance of maintaining a high GPA during the first 2 years of medical school and initiating COMLEX-USA preparation early.