PHILADELPHIA, PENNSYLVANIA / ACCESS Newswire / August 8, 2025 / In the last five years of the National Residency Match Program Main Match, the number of DO seniors who matched into general surgery programs increased from 275 in 2021 to 325 in 2025. Among DO graduates, surgery consistently ranks in the top five specialties to which they match, and surgery is among the top five non-primary care specialties in which DOs practice, according to the American Osteopathic Association.

In addition, the Association for Program Directors in Surgery (APDS) recently released its recommendations to program directors, calling for them to "consider COMLEX-USA or USMLE exams when engaging in holistic review of applications."

Despite some significant gains in the past few years, a number of general surgery residency programs that accept DOs still require those applicants take USMLE Step 1 and Step 2-CK, according to the 2025-2026 Program Recruitment Requirements published by the APDS.

A study just published in the Journal of Surgical Education aims to change that, by illustrating the positive correlations between COMLEX-USA performance and performance on the American Board of Surgery (ABS) In-Training Examination (ABSITE) and the ABS Qualifying Examination (QE) for board certification.

By demonstrating these positive relationships, the study, titled, "The Use of COMLEX-USA Performance When Considering DO Applicants to General Surgery Residency Programs," provides program directors with evidence for how COMLEX-USA performance can predict success in surgical programs, as measured by performance on the ABSITE and ABS QE.

"This research provides surgery program directors with evidence and understanding of COMLEX-USA scores, so they will no longer ask DOs to take USMLE," said Jeanne M. Sandella, DO, lead author of the study and vice president for professional development initiatives and communications at the NBOME.

The study examined the performance of 2,300 graduates of osteopathic medical colleges who were currently enrolled in or had completed a general surgery residency program and had taken ABSITE and/or ABS QE at least once. Performance on both COMLEX-USA Levels 1 and 2-CE was predictive of performance on ABSITE and passing ABS QE.

"Our DO students collectively spend over $7 million a year to take USMLE, and even more in preparation, travel, lodging, with impact on their mental health," said Sandella. "COMLEX-USA is aligned with their osteopathic education and practice, is required for graduation, and is accepted by all state licensing boards. Taking USMLE is simply not necessary. Program directors can use COMLEX-USA scores confidently as part of a holistic residency application review for DOs - this research demonstrates that clearly."

Co-authors on this study were: Grace Young DO, surgical resident at the Cleveland Clinic and former member of the NBOME Student Experience Panel; Jack Boulet, PhD, MA, NBOME senior research consultant; and Kristen Conrad-Schnetz, DO, general surgery residency program director at the Cleveland Clinic.

A portion of the research was presented at the Association for Program Directors in Surgery Annual Meeting in May by Young.

SOURCE: National Board of Osteopathic Medical Examiners