College of Osteopathic Medicine (COM) programs across the nation and the AOA are very proud of producing high quality primary care physicians.  However, from Touro University California in Vallejo, CA, the nearest AOA family medicine residency program and the nearest AOA internal medicine residency program are 300 miles away, while the nearest AOA pediatrics residency program is a whopping 1750 miles away per the AOA.  23% of ACGME residency programs officially do not take the COMLEX series, the combined official and unofficial number that do not take COMLEX is significantly higher, and the programs that do not take COMLEX are concentrated in desirable areas to live, such as the San Francisco Bay Area.  When Touro's COM 2017 class began medical school, they did so with a stronger proportion of students from the San Francisco Bay Area than ever before, as well as the highest average MCAT score, being the first COM class in the nation with an average MCAT >30.  With the single GME residency merge of the ACGME and AOA, NBME and NBOME dovetailing would make for a natural evolution.  Compared to the NBOME's COMLEX, the USMLE Step series administered by the NBME is more difficult, fair, offers higher quality examinations, returns scores one week faster, and allows residency program directors to evaluate MD or DO applicants with one common denominator.  Taking both the USMLE and COMLEX examinations, often within days of one another, represents an unnecessary burden on osteopathic medical students from a number of different angles.  First, while in theory both exams should be nearly identical, they require the student to prepare for each exam's nuances which, by definition, decreases the amount of preparation time and, undoubtedly, our potential scores.  Additionally, exam fatigue and burnout from having to take and prepare for two exams also lowers potential scores. Lastly, the COMLEX exam fees ($615 for Level 1, $615 Level 2 CE, $1295 for Level 2 PE) represent a substantial expense. This financial burden undoubtedly played a role in Touro University California's students having the highest student debt in the nation per US News.  The US News notes several other COM programs, including West Virginia School of Osteopathic Medicine, Western University Health Sciences, Nova Southeastern University, and University of New England, also having enormous student debt and were among the top ten for highest debt.  If such a change is made, the osteopathic manipulative medicine (OMM) component that is not tested by the USMLE could still be assessed once, as an OMM COMAT-type shelf exam either in the second or third year of medical school.  Herein, please support Touro's COM 2017 class in leading the change where osteopathic medical students take the complete USMLE Step series and one additional OMM national board exam with dissolution of the COMLEX as it is known today.