As an osteopathic student, the decision to take the USMLE, COMLEX, or both is one of the hardest decisions to make as a second year student. While I wish this post could provide an algorithm to give you the answers, sadly that just does not exist. The decision to take both exams is an extremely personal choice, but I hope to give you some insight to help you make your decision.
First of all, do not give in to peer pressure, rumors, and fear. Many students end up taking both exams because they heard from a fourth year, who knew a resident, who once talked to a program director at a coffee shop or some similarly outrageous story. Like any good research, your information needs to come from primary sources. Some of the best people to ask, especially this time of year, are the fourth year students at your school. Most are fresh off applying to residencies and interviews, so they know what programs are looking for. The best question to ask is “Do you regret taking/not taking the USMLE?” Try to find those students that are interested in the fields you are interested in and be sure to ask if they are applying osteopathic, allopathic, or both. If your school has an alumni list readily available, try to contact interns and current residents to see what those individuals did to get where you eventually want to be. The closer they are to the application process, the better their advice. Many people may think that program directors are the best source, and this may very well be true if there is a specific hospital you have your heart set on. At the same time, program directors have a hard time speaking in generalities and what they may prefer at their institution may not hold up across the board.
Other major factors to consider are location and specialty. Areas that have a large number of DOs practicing are more likely to accept COMLEX scores regardless of whether you are applying osteopathic or allopathic. Also, primary care specialties such as pediatrics, family medicine and internal medicine are more likely to accept a COMLEX score. There are always rumors floating around that it is impossible to get an allopathic spot without a USMLE score, but this is simply not true. Policy, of course, varies by institution, but a strong audition rotation at the residency program of your dreams will far outweigh a standardized exam.
When students eventually make the decision to take one or both exams, many will be outspoken about their decision, almost trying to campaign to get others to join them. The biggest piece of advice is to stick to your guns. Your career goals are yours and yours alone. Falling for the propaganda of either side of the debate will only cause unwanted stress and take away from your ultimate goal: achieving the highest score (or scores) you can.