The American Osteopathic Academy of Orthopedics (AOAO) joins an ever-growing list of leading medical and surgical specialty organizations that have come forward in support of DO applicants to residency programs, holistic review, and equivalent use of COMLEX-USA scores for DO applicants.
The AOAO recently released a statement recognizing the unique strengths that DOs bring to orthopedic surgery, particularly with their focus on the musculoskeletal system and structural anatomy.
The statement reads, in part:
“We strongly encourage all Orthopedic Surgery residency and subspecialty fellowship programs to recognize COMLEX-USA results as equivalent to USMLE scores when conducting holistic application reviews. Osteopathic applicants should not face discrimination in the application process, and programs should neither require nor recommend that DO applicants take additional licensing examinations beyond the COMLEX-USA.”
As part of its guidance to orthopedic surgery program directors, the AOAO also offered the COMLEX-USA Percentile Score Converter as a tool to provide more context on understanding examination scores.
In addition, the 2025-2026 Orthopaedic Surgery Program Directors Association Guide for Residency Applicants provides specific guidance, application information, and resources, and advises applicants that USMLE scores are not required for DO applicants.
This public support from the specialty of orthopedic surgery furthers the advocacy success the NBOME has had within the larger field of surgery; in August, the NBOME published research in the Journal of Surgical Education, which found positive correlations between COMLEX-USA performance and performance on the American Board of Surgery (ABS) In-Training Examination and the ABS Qualifying Examination for board certification.
“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.
Earlier this year, the Association for Program Directors in Surgery (APDS) released its 2026 recommendations to program directors, broadening their support for DO applicants and calling for them to “consider COMLEX-USA or USMLE exams when engaging in holistic review of applications.”
“While match results have continued to strengthen in numerous surgical specialties, there have been considerable concerns about equity and fairness for DO applicants in these fields,” said NBOME President and CEO John R. Gimpel, DO, MEd.
“This strong statement by AOAO and the 2026 Orthopaedic Surgery Guidelines for Residency Applicants that specify that COMLEX-USA is accepted and that USMLE transcripts are not required for DO applicants are two giant steps towards expanding opportunities for DOs in this important specialty.”