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D.O. students will take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) of the United States on their way to becoming a doctor. When applying for residency, many D.O. students will apply to programs that are accredited by either the American Osteopathic Association (AOA) or the Accreditation Council for Graduate Medical Education (ACGME). Previously, D.O. students could apply to either AOA or ACGME programs, and M.D. students could only apply to ACGME programs. While both D.O. and M.D. students will be able to apply to both AOA and ACGME programs under the upcoming AOA and ACGME merger, most ACGME residency program directors prefer that D.O. applicants also take the United States Medical Licensing Examination (USMLE) as they are more familiar with this test.

Students who have taken the COMLEX Level 1 may wonder how they can use this score to predict their USMLE Step 1 score. While the administrators of the COMLEX are currently developing a study plan for the development of a valid and reliable conversion formula of the COMLEX Level 1 score to the USMLE Step 1 score, we at EliteMedicalPrep did a survey of the literature to help you all answer this question.

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While there is no formal conversion between the COMLEX Level 1 and USMLE Step 1 Score there is published that COMLEX Level 1 scores and USMLE Step 1 scores are highly correlated (Figure 1.) (Chick et al., Teaching and Learning in Medicine, 2010 and Sandella et al., Journal of Graduate Medical Education, 2016 and Kane et al., The Journal Of Emergency Medicine, 2016).

However, in 2006, Philip Slocum, DO and Janet Louder published a paper titled “How to Predict USMLE Scores from COMLEX-USA Scores: A Guide for Directors of ACGME-Accredited Residency Programs” in the Journal of the American Osteopathic Association. In this paper, they looked at 155 students at a single medical school who took both the COMLEX Level 1 and USMLE Step 1 and concluded the following:

There was a statistically significant correlation between COMLEX Level 1 Scores and USMLE Step 1 Scores
One can estimate the USMLE Step 1 Score from the COMLEX Level 1 score with the following equation:
USMLE Step 1 Score = 67.97 + 0.24 X COMLEX LEvel 1 Score (R2=0.68)