Relationships between the comprehensive osteopathic medical achievement test (COMAT) subject examinations and the COMLEX-USA level 2-cognitive evaluation

Abstract

Context: The relationship between the Comprehensive Osteopathic Medical Achievement Test (COMAT) series of subject examinations and the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Cognitive Evaluation (COMLEX-USA Level 2-CE) has not been thoroughly examined. Objective: To investigate the factors associated with performance on COMAT subject examinations and how COMAT scores correlate with COMLEX-USA Level 2-CE scores. Methods: We examined scores of participants from 2 COMAT examination cycles in 2011 and 2012. According to surveys, most schools used COMAT scores in clerkship and clinical rotation evaluation, which were classified as being used for “high-stakes” purposes. We matched first-attempt COMAT scores with first-attempt COMLEX-USA Level 2-CE scores, and we conducted correlation analyses between the scores from the 7 COMAT subject examinations, as well as between COMAT and COMLEX-USA Level 2-CE scores. Multiple linear regression analyses were performed to investigate how much variance in COMLEX-USA Level 2-CE scores was explained by COMAT scores. Results: In 2011 and 2012, respectively, 3751 and 3786 COMAT candidates had COMLEX-USA Level 2-CE scores (53.0% and 93.9%, respectively, had 1 high-stakes COMAT score). Intercorrelations between COMAT scores were low to moderate (r=0.27-0.53), as hypothesized. Correlations between COMAT and Level 2-CE scores were moderate to high, with the highest correlations for internal medicine COMAT scores (r=0.63-0.65). All regressions showed internal medicine scores as the strongest predictor of Level 2-CE performance. Groups with high-stakes scores had larger adjusted coefficients of determination than those with low-stakes scores (eg, R2=0.63 vs 0.52, respectively, in 2011). For 2012 candidates with high-stakes scores, all predictors were statistically significant. Conclusion: The COMAT subject examination scores were moderately inter-correlated, as hypothesized, with higher correlations between COMAT and COMLEX-USA Level 2-CE scores. The COMAT performance was predictive of COMLEX-USA Level 2-CE performance.