A Concordance Study of COMLEX-USA and USMLE Scores

Under the single GME accreditation system, residency programs receive applicants from MD- and DO-granting medical schools, each of which have their own set of licensing examinations, making concordance studies increasingly relevant. Previous studies comparing Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) and United States Medical Licensing Examination (USMLE) scores have been limited in sample size and examinee composition and have yielded comparisons that may not be generalizable across all applicants. Some osteopathic medical students take USMLE in addition to COMLEX-USA, often at considerable cost and effort, with the aim of making themselves more desirable to potential residency programs. Having more reliable comparisons of COMLEX-USA and USMLE scores would allow program directors to better estimate a score on the alternate examination.

To derive an accurate concordance between COMLEX-USA and USMLE scores, based on a large sample of osteopathic students who took both examinations.

Five colleges of osteopathic medicine, representing various regions of the United States, participated in this study. The data included demographics and COMLEX-USA and USMLE scores from September 2015 through August 2020 for students who took both examinations. We derived the concordance between COMLEX-USA and USMLE scores using equipercentile matching.

Comparisons of demographic characteristics showed only minor differences between the sample and the overall population for COMLEX-USA takers, although scores for the study sample were, on average, greater.

A strong association exists between the scores on the COMLEX-USA and USMLE examinations, allowing prediction of performance on USMLE from COMLEX-USA.