1. EDWARD VIA COLLEGE OF OSTEOPATHIC medicine COMLEX Level 1/USMLE Step 1
preparation

2. COMSAE

3. What is COMSAE?
The NBOME's Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) is a self-assessment exam intended as an education resource and preparation aid for COMLEX-USA. Osteopathic students and residents use their three-phase COMSAE to prepare to take a COMLEX-USA cognitive examination.
VCOM utilizes COMSAE Phase 1 as the Block 8 end of course Comprehensive Exam
VCOM utilizes COMSAE Phase 2 as the OMS 3 Comprehensive Exam
A passing score is 480 or above
A conditional passing score is
COMLEX is created by the National Board of Osteopathic Medical Examiners. COMLEX is a series of licensure examinations taken by all osteopathic students. VCOM does not create the COMLEX.

4. COMLEX

5. What is COMLEX?
The NBOME's Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a three-level, national standardized licensure examination designed for licensure for the practice of osteopathic medicine. COMLEX-USA is designed to assess osteopathic medical knowledge, knowledge fluency, clinical skills, and other competencies essential for practice as an osteopathic generalist physician. It is also a graduation requirement for attaining a DO (Doctor of Osteopathic Medicine) degree from colleges of osteopathic medicine in the United States, and for entry into and promotion within graduate medical education (residency) training programs.
It is also designed to protect the public by providing the means to assess competencies for osteopathic medicine and related health care professionals.
COMLEX is created by the National Board of Osteopathic Medical Examiners. COMLEX is a series of licensure examinations taken by all osteopathic students. VCOM does not create the COMLEX.

6. What is COMLEX? OMS 2 OMS 3 OMS 3/4 Post Graduate
VCOM students take COMLEX Level 1 at the end of Block 8.
Then, the COMLEX Level 2 is usually taken after third year. There are 2 parts of the Level 2: the Cognitive Evaluation (“CE”) and Performance Evaluation (“PE”).
Also, there is a third level of boards, which is taken after graduation from VCOM.

7. What is COMLEX? Exam blueprint at: http://www.nbome.org
COMLEX-USA Level 1 is a problem- and symptom-based assessment, administered in a time-measured environment that integrates the foundational and basic biomedical sciences and other areas of medical knowledge relevant to solving clinical problems and promoting and maintaining health in providing osteopathic medical care to patients. Students should visit the NBOME website to review the test blueprint, which tells students the % of content that is on each exam.
Exam blueprint at:

8. The Importance of COMLEX
VCOM Graduation Requirement
Scholarship Component
Factor for Audition Rotations
Factor for Residency Interview Selection
State Requirement for Licensure (# of attempts is important for many states)
VCOM helps students pass boards on their 1st attempt because it is a big deal. Passing boards is a VCOM graduation requirement. Additionally, it impacts residency opportunities and the ability to be licensed in some states.
Want to know more about state requirements for licensure?

9. COMLEX Level 1 score at or Above the National Mean (531)
# of students: 230
Average COMSAE score: 611
Scores at or above the national mean were achieved by students with a variety of GPAs:
# of students in GPA range : 153
# of students in GPA range : 48
# of students in GPA range : 23
# of students in GPA range : 5
# of students in GPA range < 3.0: 1
The national mean score for COMLEX Level 1 is currently at a 563. The season is not over yet so this will likely decrease as more scores are posted.
But, in general, VCOM hopes to prepare students to achieve a board sore that is PASSING and higher than the national average. This is so students can be more competitive for residencies.
Each student at VCOM has the ability to score above the national mean. This presentation is to help you achieve this.
Key point: You are more likely to get an excellent score on COMLEX Level 1 if you have a higher GPA. So, learn the VCOM curriculum now. Focus on Block 5 while you are in Block 5. Focus on Block 6 while you are in Block 6. Focus on Block 7 while you are in Block 7. It will help you do better on COMLEX Level 1.
But the good news is you have time to improve knowledge gaps before taking boards. There were students who worked very hard and achieved an excellent COMLEX score even though he or she had previous academic difficulties.

10. USMLE

11. What is USMLE?
The United States Medical Licensing Examination ® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®).
The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

12. What is USMLE?
Step 1 classifies test items along two dimensions, system and process.
Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy. The disciplines include:
anatomy
behavioral sciences
biochemistry
biostatistics and epidemiology
microbiology
pathology
pharmacology
physiology
The Step 1 examination also covers content related to the following interdisciplinary areas:
genetics
aging
immunology
nutrition
molecular and cell biology
In addition to being organized by organ systems, the Step 1 exam is organized by physician task and competency:
medical knowledge/scientific concepts
patient care: diagnosis
patient care: management
communication
practice-based learning and improvement

13. Want to know more about state requirements for licensure?
USMLE?
Why do some D.O. students want to take USMLE Step 1 when it is not required?
To be eligible for certain audition rotations depending on specialty
To be competitive with medical students from other colleges when applying for certain ACGME residency programs
Want to know more about state requirements for licensure?

14. How do students
prepare for boards?

15. How do students prepare for boards?
510 students in the Class of 2020 at VCOM took COMLEX Level 1 during the summer of 2018
199 students (39%) in the Class of 2020 at VCOM took USMLE Step 1 during the summer of 2018
468 students answered a survey about their board preparation and the resources they used.
This presentation will share the survey data
This information is collected from all 3 VCOM campuses

16. Start of preparation
for all gpa groups

17. When did students start preparing for boards?
Regardless of GPA or score the start date of board preparation was almost exactly the same!
All Students
Students at or Above the Mean
There was no significant difference in the timing of when students started preparing for boards among students with different GPAs or among the highest and lowest scoring students.

18. What did board prep look like in Block 5?
Regardless of GPA or score, the board prep that started in Block 5 was almost exactly the same!
There was no significant difference in what students were doing in block 5 for boards among students with different GPAs or among the highest and lowest scoring students.

19. resources

20. Most Recommended Resources by All GPA Groups
Question Banks:
COMBANK
Uworld
Online study aids:
COMQUEST
Pathoma
USMLE-RX
Sketchy Micro/Pharm/Path
Picmonic
Books/Flashcards:
KISS Pharm
OMT Review by Robert G. Savarese
Osmosis
First Aid for the USMLE Step 1 by Tao Le
Cramfighter
Lange Pharm Cards
OMGOMT
Anki
Review Programs:
Physeo
Doctors in Training
Dirty USMLE
Usmle-Rx 360
Goljan Path
Boards and Beyond
RCMedReview/Dr. Rizk (Block 8)
There was no difference at all in the main resources used among students with different GPAs or among the highest and lowest scoring students.
There was no difference in the main resources used among GPA or score groups.

21. Core Resources
While the previous slide listed the most recommended and utilized resources, there were quite a few of them.
Many students who answered the survey cautioned against using too many resources.
Most students have a core set of resources that consists of the following:
OMT Review by Robert G. Savarese
First Aid for the USMLE Step 1 by Tao Le
Pathoma
Something for Micro and Pharm (i.e. sketchy, flash cards, tables)
2 question banks
A board prep program with videos (i.e. DIT, USMLE Rx)
There was no difference at all in the main resources used among students with different GPAs or among the highest and lowest scoring students.

22. Practice questions

23. How many questions did they do?
All Students
Students at or Above the Mean

24. Percentage of Students Completing Ranges of Questions by GPA
GPA Group
GPA Group
GPA Group
GPA Group
Below 3.0 GPA Group
Notice that the majority of the below 3.0 GPA students did higher amounts of questions just like the GPA students!!

25. Start of Practice Questions by GPA
GPA Group
GPA Group
GPA Group
GPA Group
Below 3.0 GPA Group
The data for almost all GPA groups looks very similar. While a lot of students start questions in block 5, the majority start after block 5, except for 2 groups – the GPA group was about half and half (half starting before block 6 and half starting in block 6) and the below 3.0 GPA group where a hefty majority started in block 5 (better than any GPA group!).

26. Question Banks
The use of specific question banks was not related to GPA or score.
Notice that even though most students do not take USMLE, 81% of students used Uworld. Students say that even though the questions are different from COMLEX, Uworld questions help them shore up their basic science knowledge. Students who answered the survey had mixed responses about this. Many were glad they used Uworld even if they just took comlex and say it helped but some say it was not helpful because of the difference in question format and that uworld questions shook their confidence.

27. Question Banks Uworld Combank Comquest
Which question bank did students feel best matched/prepared them for the COMLEX Level 1?
Uworld
Combank
Comquest
Notice that even though most students do not take USMLE, 81% of students used Uworld. Students say that even though the questions are different from COMLEX, Uworld questions help them shore up their basic science knowledge. Students who answered the survey had mixed responses about this. Many were glad they used Uworld even if they just took comlex and say it helped but some say it was not helpful because of the difference in question format and that uworld questions shook their confidence.

28. Test dates

29. Duration of Study
How many weeks did you prepare for COMLEX Level 1 AFTER you took COMSAE Phase 1?
The majority of students tested 6/18/2018 – 7/27/2018

30. When did students take the USMLE?
VCOM recommends that students take USMLE after COMLEX. Many students recommend taking USMLE before COMLEX so they can get it over with and then cram their OMM for a week before taking COMLEX. The Center recommends taking COMLEX first because students will have to have studied their OMM for the COMSAE so it just makes sense to go on and take COMLEX.

31. Advice
The advice that follows is the advice that was stated over and over again so for every bullet point imagine 50 + students telling you that same advice!
The advice given was not different between GPA ranges or scores – the advice was the same regardless of GPA or score.

32. Advice About How to Prepare for Boards
Follow your own plan. You know how you study successfully at this point, do not change your habits because of what you hear is working for another classmate.
Take practice tests (400 questions) leading up to the exam in a similar setting to the exam. This forces one to concentrate and make wise decisions for extended time periods.
Start early. But by starting early you need to realize and make time towards the end to review some of the first things that you started studying because you will forget a lot of the details from that material. Find your resources early and stick with them.
When you do practice questions, never say "Oh, I'll really get this straight tomorrow". You run out of tomorrows. If you get a questions wrong say "I will master this today" - then the next time you get a question on the subject, it is a review!

33. Advice About How to Prepare for Boards
Start sketchy early – know it! Do it early and do it often. It's hard to get through Sketchy pharm, but it covers 95% of pharm on both USMLE and COMLEX. As we all know, COMLEX loves bugs and drugs. Sketchy is free points. Turn your computer background/screensaver into random Sketchy Micro pictures
Start early and don't be afraid to do questions. Your averages may not be where you want them to be at the beginning but they WILL improve if you're actively studying.
Take care of yourself – step into the sunshine and don’t stop your passions during studying
Start studying in block 5 and do questions. Make sure they know and understand that they don’t need to worry about wasting time learning how systems and equations work. They need to KNOW THE BASICS AND JUST LEARN FROM Qs.

34. Advice About How to Prepare for Boards
Sleep
Don't let others stress you out. Get a study partner, and do your own thing.
Make a schedule and stick to it, start off with cramfighter if this is overwhelming to you! There are staple resources for a reason, use them (First Aid, Pathoma, Sketchy, question banks, savarese). Do NOT neglect OMM.
QUESTIONS, QUESTIONS, QUESTIONS! The more questions you get through, the better off you will be. They can only ask the material so many ways, and you will start to pick up on trends. And I think it is better to complete 2-3 banks, rather than complete 50% of 6 different ones
Don’t get stressed out about what others are studying. Do what is best for YOU and feel good about it. Take personal time every day and do what you need to do to be your best.

35. Advice About How to Prepare for Boards
Annotate First Aid with only the most relevant information, do not go overboard. Read as many times as possible
You have to do some sort of spaced repetition to constantly refresh the material in your mind.
Stay in check with yourself. Each day is a new one. Don’t waste time
Do not listen to what other people are doing for studying. There is already enough pressure to pass this exam and comparing yourself to others will only increase anxiety.
Don’t freak out, if you’re preparing you’re going to be fine.
If you are struggling with mental health, please seek help as soon as possible. There is nothing more detrimental to your board study period than poor mental health.
Don’t rush through the day of studying just to check things off your list. Go at your own pace and LEARN the material well. You will be more confident in your abilities.

36. Advice About How to Prepare for Boards
DO NOT GET DISCOURAGED!!! Questions are meant to help you learn... who cares if you get 1/10 on a practice set; review the questions and learn from them. Try not to focus on performance until 2 months out and it will help with stress
No one told me the majority of the OMM would be videos, not stems with descriptions, so get comfortable watching what someone is doing and being able to describe it.
Do not go into COMLEX thinking it is the "easier" exam. It was not. Prepare for it like you are preparing for the USMLE. There was a lot of biochem/physio/path on my exam.
Start doing questions early but also work on timing! The question stems on the actual exam tend to be longer than the practice exams offered by NBME/NBOME. There's lab values, graphs, videos, and images to interpret during the time reading the questions as well. So it's important to make sure you have your timing down.

37. Advice About How to Prepare for Boards
Do not give up your social life, hobbies, relaxation to study non-stop for boards. Those are so important to your mental health, and if your mental health is not okay you will not perform well on boards anyways.
Do not be afraid to switch resources. If you try one resource and the information doesn't seem to be clicking, don't keep wasting time with that resource. Find the one that works the best for YOU and don't feel like you have to compare yourself to other students.
You will have classmates who finish resources before you and boast amazing averages. Don't listen to them. They are doing their own thing. If you feel like you are still on schedule then keep it up and finish strong

38. Advice About How to Prepare for Boards
Do as many questions as possible. Finish a bank and then go to another one. Always review the answer choices (all of them and not just the right one). Books are meant to be referenced, not used as primary study tool (don’t just read the 1st Aid book and expect to know how to apply it to questions). Take practice exams. When you get closer to test day, do two practice exams in a row to get the feel of a full exam. If not, you will feel exhausted in the last 2 hours on the actual exam.
Everyone puts so much stress on themselves during the preparation for the Level 1/Step 1, but I think one of the most important aspects of preparing for the exams is realizing that you won't be able to learn everything. Despite what you might think, this is okay. Do the best that you can everyday, and don't stop doing things that you enjoy! You don't have to be perfect to succeed, but you do need to be in a good head space.

39. regrets
The regrets that follow were stated over and over again so for every bullet point imagine 50 + students telling you that same thing!
The regrets given was not different between GPA ranges or scores – the advice was the same regardless of GPA or score.

40. What would you change if you could do it over again?
There were tons of comments from students with regrets about not doing this or that during their OMS 1 year. Since your OMS 1 year is over, those regrets are not listed here but they will be shared with the OMS 1 students.

41. What would you change if you could do it over again?
Questions, questions, questions-if I had to do it over again then I would have focused more on my questions earlier on because that was the biggest help for me
For the love of all that is holy, START QUESTIONS EARLY! Biggest mistake I made was not doing enough questions
Learned to review my questions better and more effectively earlier in my study process
Learned more OMM, my test had so much OMM and anatomy. I was told Renal was SOO "High Yield". Spent hours learning every detail, I had 1 Renal question...yes I'm a little salty about that
Gone through Pathoma more than one time
I wish I had began Pathoma earlier

42. What would you change if you could do it over again?
Reviewing drugs and bugs every week a little at a time.
I regret not having started questions earlier (I started in block 7). Even doing 5 questions a day would have been very beneficial and eased some of my anxiety
Using Anki for high yield topics earlier
I wish that I had made more time to exercise and maintain a healthy lifestyle while board studying. While you may feel like you're wasting time, these things go a long way in maintaining the stamina and energy needed for these exams.
Started an in-depth review earlier (~block 5)
Not saved questions for after I was done with a subject
I wish I had stuck closer to my study plan

43. What would you change if you could do it over again?
I didn't have enough time to get through all the Boards and Beyond videos and wish that I started using it earlier during the appropriate blocks. For example, going through all the B&B GI/Renal videos alongside studying for Block 5 classes. I think it would've helped with learning the Block 5 material as well I wish I had found a good study group to work with. Quizzing each other is an awesome way to learn
I wished I had started annotating my First Aid book sooner
Started watching DIT and pathoma videos from the very beginning- these are short and really give you the big picture which will help you down the line to remember minute details in different ways
I wish I had been more disciplined. I wish I would've gotten serious earlier

44. What would you change if you could do it over again?
I wish I would have recognized and taken care of myself in a personal aspect sooner
I wish that I had studied harder for my actual classes. I remember thinking that it was alright that I didn't understand something during class because I would learn it before boards. This is a bad habit to get into because class is the best time to study.
Go over the explanations to questions whether you got them right or wrong.
I wish I took all the practice exams
Work on test day anxiety

45. What would you change if you could do it over again?
Summary of Regrets:
I wish I had done _____________ earlier!

46. Who can help you?
VCOM’s Center for Institutional, Faculty, and Student Success (Debbie West, Alexandria Brice, and Robert Campbell)
VCOM’s Counseling Services (Dr. Fadel, Dr. Magalhaes, Dr. Taylor)
Your Faculty Advisor
Associate Dean for Pre-Clinical Medical Education

47. Your next steps....
Do well in VCOM curriculum. If you know that material you are preparing for boards!
Visit the NBOME and NBME websites to learn more about the board exams
Set up your COMBANK account and start doing questions (VCOM purchased this for you)
Make a plan! If you don’t know what your resources are yet or if you haven’t done anything yet, please visit the Center!
Your well-being contributes to your success, so take care of yourself. 
Read your VCOM .
Look for information about COMLEX tutoring.
December 2018: NBOME will be sending information about how to setup your NBOME account.
January 2019: You will select your date for June/July 2019 to take COMLEX Level 1.

48. Your GPA does not have to predict your board score!
Your next steps....
Your GPA does not have to predict your board score!
If you focus on learning the material presented in the Blocks and have a solid plan and consistently work your plan from now till boards you can have a solid score, regardless of GPA!

49. Questions?