Volume 112, Issue 2

Context: Osteopathic medical students have a choice to take the United States Medical Licensing Examination (USMLE) in addition to the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA). However, taking the USMLE requires additional commitments of time, effort, and expense, often for uncertain return. No data are available about the attitudes of graduating osteopathic medical students toward their options regarding the USMLE and how they decide whether to take this examination. Objective: To uncover attitudes among graduating osteopathic medical students on taking the USMLE. Method: Using an Internet-based questionnaire, the authors surveyed graduating osteopathic medical students about their experiences with deciding whether to take the USMLE and whether they would advise other students to take the examination. Results: Nineteen osteopathic medical colleges agreed to participate in the survey. Of the 2744 graduating students at those schools, 978 (35.7%) completed the survey. Students in higher quintiles (ie, top 40%) of class rank were more likely to take the USMLE than those in lower quintiles (ie, bottom 40%) ( P <.001). The most common reason cited by students for taking the USMLE was to “keep [their] options open” for residencies (233 of 507 respondents [46%]). Of the 474 students who did not take the USMLE, 171 respondents (36.1%) reported experiencing discrimination for not taking the examination. Four hundred seventy of 981 respondents (47.9%) reported finding residency programs that specifically require the USMLE, and 689 of 981 respondents (70.2%) recommended that future students take at least 1 step of the USMLE. Conclusion: The majority of graduating osteopathic medical students polled in the present study believed that osteopathic medical students should take the USMLE.

Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a type III hypersensitivity reaction characterized by urticaria with persistent acquired hypocomplementemia. Although HUVS is uncommon, it is important for physicians to be familiar with this disease, as the initial presentation is often life-threatening angioedema. The author reports the case of a 47-year-old white woman with a history of HUVS. She presented to an outpatient clinic complaining of a rash and difficulty swallowing. Urticaria and angioedema were diagnosed. The patient was given epinephrine in the clinic and then transferred to the hospital. Laboratory testing confirmed urticaria, and the patient was given intravenous methylprednisolone sodium succinate and an additional dose of epinephrine. After 1 week, the patient's angioedema improved.

Osteopathic physicians were denied the same rights and privileges that were granted to allopathic physicians by the US government regarding voluntary and compulsory service in World War I and World War II. Even after changes to the examination process allowed osteopathic physicians to take the examinations required to obtain commission as a physician in the army, osteopathic physicians' service was still rejected. The US government's decision to ban DOs from serving in the war was a blessing in disguise that led to tremendous changes in osteopathic medicine, education, and public acceptance of osteopathic physicians. Using primary documents from military officials, congressional hearings, and archived publications of the American Osteopathic Association, the author recounts the battle osteopathic physicians fought to serve their country during war and the challenges they faced while obtaining both legal and social equality in the eyes of the government and the public.