Graduating osteopathic medical students' perceptions and recommendations on the decision to take the USMLE.

To the Editor: As an osteopathic physician who took the United States Medical Licensing Examination (USMLE) and an associate program director of one of the nation’s largest allopathic internal medicine residency programs, I read the medical education article by Robert T. Hasty, DO, and colleagues1 in the February issue with great interest. On the basis of a survey of graduating osteopathic medical students, Hasty et al1 attempted to evaluate students’ perceptions related to the USMLE. As the primary reason for taking the USMLE, 46% of the respondents cited keeping their options open, and 35.5% cited enhancing their chances of getting into an allopathic residency.1 It is important to point out that graduating osteopathic medical students need not take the USMLE to better their chances of being accepted into an allopathic residency—with rare exceptions. These exceptions include training programs in highly competitive fields, such as neurosurgery, ophthalmology, dermatology, and orthopedic surgery. The fact is that most allopathic residency program directors know nothing about the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA). They do not know about the general validity of COMLEX-USA, and they do not know what information is tested or how to accurately compare this test’s scores to those of the more familiar USMLE. Thus, allopathic residency program directors typically make baseless, assumed, and subjective comparisons between the 2 examinations. Osteopathic medical students who score higher on COMLEX-USA than the USMLE will foster a belief that the former is not as rigorous as the latter. As a result, some allopathic residency program directors may direct students to take the USMLE in order to be considered for residency training. The motivation for this recommendation is a lack of knowledge about COMLEX-USA, an unwillingness to accept osteopathic medical students (by using the test as an obstacle to overcome), or a lack of trust in the scores of COMLEX-USA. I disagree with the contention of Hasty et al1 that “the present study represents the first reasonably objective findings specific to this issue that might aid faculty in their ability to counsel osteopathic medical students on this topic.” If their study described a survey of allopathic residency program directors—as they suggest be done in the future—then this statement could be valid. However, a survey of osteopathic medical students who have no role in making allopathic residency acceptance deciAs the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at colleges of osteopathic medicine, and others within the healthcare professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA’s editors are particularly interested in letters that discuss recently published original research. Letters to the editor are considered for publication in the JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication. All accepted letters to the editor are subject to editing and abridgment. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified. Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that readers email letters to [email protected]. Mailed letters should be addressed to Gilbert E. D’Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. Letter writers must include their full professional titles and affiliations, complete preferred mailing address, day and evening telephone numbers, fax numbers, and e-mail address. In addition, writers are responsible for disclosing financial associations and other conflicts of interest. Although the JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless letter writers provide self-addressed, stamped envelopes with their submissions. All osteopathic physicians who have letters published in the JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5AOA Category 1-B CME credits. Authors of published articles who respond to letters about their research receive 3 Category 1-B CME credits for their responses. Although the JAOAwelcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows. LETTERS