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J Emerg Med. 2017 Feb;52(2):216-222. doi: 10.1016/j.jemermed.2016.06.060. Epub 2016 Nov 15.

Correlation Between United States Medical Licensing Examination and Comprehensive Osteopathic Medical Licensing Examination Scores for Applicants to a Dually Approved Emergency Medicine Residency.

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Department of Emergency Medicine, Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine, Allentown, Pennsylvania.



It is important for emergency medicine (EM) residency programs to be able to correlate the United States (US) Medical Licensing Examination (USMLE) and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) scores of applicants.


We sought to determine the correlation between USMLE and COMLEX scores for EM residency applicants.


Retrospectively, from 2006 through 2013, USMLE and COMLEX examination scores for applicants to our 4-year, 56-member, dually approved EM residency were analyzed. Using the COMLEX score as the outcome variable and USMLE score as the predictor, multiple linear regression models, stratified by test step, were created.


There were 556 students representing 25 discrete medical schools included. Pair 1 consisted of applicants submitting COMLEX Level-1 and USMLE Step-1 scores (n = 486). Pair 2 were those with COMLEX Level-2 and USMLE Step-2 scores (n = 356). For Pair 1, mean, standard deviation, and median scores on the COMLEX were 551, 69, and 548, respectively; for the USMLE, scores were 216, 16, and 217, respectively. Results for Pair 2 on COMLEX were 566, 80, and 562, respectively; USMLE results were 228, 18, and 229, respectively. A strong correlation was observed for Pair 1 (r = 0.78; p < 0.001). A 1-point increase in USMLE Step-1 is associated with a 3.55-point increase in the COMLEX Level-1 score (β = 3.55; 95% confidence interval [CI] 3.30-3.80; p < 0.001). A similar strong correlation was observed for Pair 2 (r = 0.72; p < 0.001), where a 1-point increase in USMLE Step-2 is associated with a 3.29-point increase in the COMLEX Level-2 score (β = 3.29; 95% CI 2.96-3.62; p < 0.001).


A strong positive correlation between Steps 1 and 2 of the USMLE and COMLEX was found.


ACGME; COMLEX; USMLE; application; residency

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