What is COMLEX Exam?

Comprehensive Osteopathic Medical Licensing Examination

COMLEX-USA Practice Test

What is COMLEX Exam?
The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX USA) is a series of medical licensure examinations for osteopaths. It is designed to evaluate osteopathic medical expertise and clinical skills considered necessary for osteopathic general practitioners in the practice of osteopathy.

The COMLEX exam series follows a progressive series broken down into three levels: Level 1, Level 2 (CE/PE), and Level 3. It is administered continuously throughout the year by the National Board of Osteopathic Medical Examiners (NBOME) and is accepted in all the 50 states.

The COMLEX-USA concept is focused on the osteopathic theory of general health care, self-healing and self-regulatory processes, the basic structure-function relation as well as the interdependence of body systems, and the full extent of the osteopathic method to patient care, including osteopathic coercive treatment.

COMLEX Format and Test Structure

As mentioned above, the COMLEX is a series of licensing examination broken into three levels:

COMLEX Level 1

A problem-and-symptom-based test, conducted in a time-based setting that combines fundamental biomedical sciences and other fields of medical knowledge related to the resolution of clinical issues and the promotion and preservation of health in the delivery of osteopathic medical treatment to patients.

Foundational Biomedical Sciences:
       ● Anatomy
       ● Behavioral Science
       ● Biochemistry
       ● Genetics
       ● Health Promotion and Disease Prevention
       ● Immunology
       ● Microbiology
       ● Osteopathic Principles and Practice
       ● Pathology
       ● Pharmacology
       ● Physiology

COMPLEX Level 1 Prep

Here are the best COMLEX Level 1 Prep resources:
       1. COMBANK
       2. Uworld
       3. First Aid for Step 1
       4. COMSAE and NBME practice exams
       5. OMT Review by Savarese

SubsectionNo. of Questions                                             Description
150Morning Session: 4 Hours Total Testing Time
250
           Authorized 10-minute break
350
450
                                                                    Authorized 40-minute lunch break
550Afternoon Session: 4 Hours Total Testing Time
650
           Authorized 10-minute break
750
850
Total4008 hours

Note: Questions can be answered, reviewed, and changed one subsection at a time. Individual subsections are not timed.

COMLEX Level 2

1. Cognitive Evaluation (CE) – a one-day computer-based test that combines the integration of expertise in clinical science and basic biomedical and osteopathic disciplines with other medical skills relevant to patient care and health promotion in regulated clinical settings.

Clinical Sciences Disciplines
       ● Emergency Medicine
       ● Family Medicine
       ● Health Promotion and Disease Prevention
       ● Internal Medicine
       ● Neurology
       ● Obstetrics/Gynecology
       ● Osteopathic Principles and Practice
       ● Pediatrics
       ● Psychiatry
       ● Surgery

SubsectionNo. of Questions                                            Description
150Morning Session: 4 Hours Total Testing Time
250
           Authorized 10-minute break
350
450
                                                                    Authorized 40-minute lunch break
550Afternoon Session: 4 Hours Total Testing Time
650
            Authorized 10-minute break
750
850
Total4008 hours

Note: Questions can be answered, reviewed, and changed one subsection at a time. Individual subsections are not timed.

2. Performance Evaluation (PE) – a patient-based evaluation of the core clinical skills measured across 12 sessions with regular patients. The applicant must personally conduct the clinical skills of standardized clients in a timely, secure, effective, and safe way, as necessary.

Fundamental Clinical Skills Assessed
● Humanistic Domain
       ○ Physician-Patient Communication
       ○ Interpersonal skills
       ○ Professionalism

● Biomedical/Biomechanical Domain
       ○ Medical History-Taking and Physical Examination Skills
       ○ Osteopathic Principles and Osteopathic Manipulative Treatment (OMT)
       ○ Documentation Skills (including synthesis of clinical findings, integrated differential diagnosis, and                              formulation of a diagnostic and treatment plan)

SectionAmount Per SegmentLength
Registration30 Minutes
Candidate Orientation50 Minutes
Standardized Patient (SP) Case Encounters4 Cases14 Minute Encounter with SP + 9 Minute eSOAP (Subjective Objective Assessment Plan format) completion per case
                                             Lunch30 Minutes
Standardized Patient Case Encounters4 Cases14 Minute Encounter with SP + 9 Minute eSOAP (Subjective Objective Assessment Plan format) completion per case
                                             Break15 Minutes
Standardized Patient Case Encounters4 Cases14 Minute Encounter with SP + 9 Minute eSOAP (Subjective Objective Assessment Plan format) completion per case
Closing Survey
Total12 cases194 minutes (3 hours and 14 minutes)

COMLEX Level 3

A two-day computer-based assessment of competence in the field of basic competence needed for general practitioners to provide effective and safe osteopathic medical treatment and to improve health in unmonitored clinical settings.

 SubsectionQuestions                                 Description
Day 1170 multiple-choice questionsMorning Session: 3.5 Hours Total Testing Time
Authorized 10-minute break
270 multiple-choice questions
                                                     Authorized 40-minute lunch break
370 multiple-choice questionsAfternoon Session: 3.5 Hours Total Testing Time
Authorized 10-minute break
470 multiple-choice questions
Day 2513 clinical decision-making casesMorning Session: 3.5 Hours Total Testing Time
Authorized 10-minute break
613 clinical decision-making cases
                                                     Authorized 40-minute lunch break
713 clinical decision-making casesAfternoon Session: 3.5 Hours Total Testing Time
Authorized 10-minute break
813 clinical decision-making cases
Total   

Note: Questions can be answered, reviewed, and changed one subsection at a time. Individual subsections are not timed.

COMLEX Level 3 Prep

How to study for COMLEX Level 3? Here are the best resources to use:

       1. First Aid and Step 2/Level 2 Review Books
       2. OMM Review
       3. Qbanks: Uworld and Comquest
       4. Practice Exams
       5. NBOME Resources

COMLEX Scoring System

Scoring for the COMLEX tests is determined by the number of questions answered correctly (raw COMPLEX scores), which is converted to a standard score for the sake of reporting the results and providing the pass-fail rating.

COMLEX LevelCOMLEX Passing Scores
COMLEX-USA Level 1400
COMLEX-USA Level 2-CE400
COMLEX-USA Level 2-PEPass
COMLEX-USA Level 3350

NBOME does not disclose percentile scores in the applicant’s score reports. When the evaluation process is finished, percentile scores are measured and can be obtained using the Percentile Conversion Tool.

To get your COMLEX percentile score, you must:
       1. Open the Percentile Score Converter on the NBOME website.
       2. Enter your 3-digit score into the respective field
       3. Select the examination level being converted
       4. Pick the date of the test using the drop-down menu
       5. Click the ‘CONVERT’ button
       6. The numbers appearing to the right will be the corresponding percentile scores.

Applicants will be notified via email once their scores have been posted. Applicants may view their pass/fail status and/or scores for any COMLEX test via the CRS portal on the NBOME website (Account Access Login could be found at the upper right corner of the homepage).

Score Reports are usually published to the applicant’s account under the “View Score Report” and the protected school site of the NBOME CRS portal.

LevelCOMLEX Score Release
Level 1Approximately 4 to 6 weeks from the date of examination administration.
Level 2-CEApproximately 4 to 6 weeks from the date of examination administration.
Level 2-PEApproximately 8 to 10 weeks from the date of examination administration.
Level 3Approximately 8 to 10 weeks from the completion of the examination.

Note: After the initial score release, please see the score release schedule on the NBOME website.

COMLEX Registration and Fees

Before you can enroll for and schedule a COMLEX-USA test, you will have to create your personal NBOME login credentials-protected account in the NBOME Client Registration System (CRS) following the instructions sent to you via email. Once an account has been created, registrants may:

       ● Confirm examination eligibility & requirements
       ● Select & purchase examinations
       ● Change an existing examination date
       ● Manage payment & personal information
       ● Read & agree to the required terms & conditions for registration

To take a COMLEX-USA test, the name on your registration form and the valid government-issued photo ID shown at the test center must be the same. If the candidate’s name has changed, he/she must download and submit a name change request form along with a copy of the supporting document stating the name change (e.g. divorce decree, marriage license, naturalization document). Documents may be scanned and emailed to clientservices@nbome.org or faxed to 773-714-0606.

Note: Name changes should be made five business days prior to the test date. If applicable, submit the name-change request and the documents before applying for the test.

COMLEX Cognitive ExaminationsJULY 2019-JUNE 2020JULY 2020-JUNE 2021
Level 1$660$675
Level 2-CE$660$660
Level 2-PE$1,295$1,300
Level 3$875$890

Additional Fees

                                          Computer-based ExamsLevel 1Level 2-CELevel 3
Reschedule or Cancellation FeeMore than 30 days before the scheduled date$0$0$0
Reschedule or Cancellation Fee6 to 30 days before the scheduled date$85$85$170
Cancellation Fee1 to 5 days before the scheduled date$190$190$290
No Show FeeWithin 24 hours of the scheduled date$225$225$340
                                                      Computer-based ExamsLevel 2-PE
Reschedule or Cancellation FeeMore than 90 days before the scheduled date and time of the exam$0
Reschedule or Cancellation Fee15 to 90 days before the scheduled date and time of the exam$50
Reschedule or Cancellation Fee48 hours to 14 days before the scheduled date and time of the exam$400
   
Reschedule or Cancellation Fee24 to 48 hours before the scheduled date and time of the exam$750
Reschedule or Cancellation FeeWithin 24 hours of the scheduled date and time of the exam$1295

Note: Examinations cannot be rescheduled later than 5 days before the scheduled date. Cancellations must be made online through the candidate’s NBOME account.

                            Non-Examination RelatedLevel 1Level 2-CELevel 2-PE
Score Confirmation Fee$50$50$50
Insufficient Funds Checking Fee$20$20$20
Transcript Fee$60$60$60
Score Report Fee$5$5 

Frequently Asked Questions

What are good COMLEX scores?

The majority of test-takers score between 250 and 800. The minimum COMLEX Level 1 passing score and 2 is 400, and 350 for level 3 of COMLEX-USA.

Can you retake the COMLEX?

Applicants who have failed COMLEX examination may retake the test at a total of four times in any 12-month span.

What are the differences between the USMLE and the COMLEX?

The most significant difference between COMLEX and USMLE is the number of questions in the test. COMLEX has 400 questions, which make it 42% greater than the USMLE; however, it must be taken in a similar time period. With USMLE, you can go through each section twice.

What is an osteopath?

A Doctor of Osteopathic Medicine (DO), also known as an osteopath, is a licensed doctor whose mission is to enhance people’s general health and wellbeing through osteopathic therapeutic medicine, which includes stretching, massaging, and shifting the musculoskeletal system.

Why aren’t chiropractors considered doctors?

Chiropractors don’t possess medical degrees, so they’re not medical doctors. Nonetheless, they have comprehensive chiropractic treatment training and are licensed professionals.

Could MD students take part in COMLEX?

Yes, you may. You have to complete either COMLEX or USMLE to have a license, however, since osteopathic medical schools require COMLEX, you don’t need to take both.

COMLEX Prep Guide

1. Set a goal – Pick a score for each exam level that you think is attainable and set it as your goal. This will help keep you driven to study and work hard to meet and surpass your goal.

2. Start COMLEX study as soon as possible – The ideal preparation for the COMLEX is 8 to 12 months before you take the tests. If you’re studying for your first COMLEX, you have to make sure that you’re going to be as over-prepared as possible because not knowing what to expect could add some stress.

3. Do a minimum of 5 practice questions each day – In order to be adequately prepared for a test of 400 questions, you would need to review more than 400 questions. Doing at least 5 each day will enable you to absorb the amount of information you require. It is important to set up a study schedule, choose a starting date, and then stick to it.

4. Do not use too many resources to study – Limit your study resources to 1-2 online question banks and 1-2 books for additional study materials. This guarantees that you get the most from your study resources rather than stretching yourself thin and gaining very little from each study tool.

5. Take notes – Taking notes while reviewing helps imprint information into your brain more than memorization does.

6. Do at least one timed COMLEX practice exams – To feel totally prepared for the test date, you must take at least one timed, 400-question practice test to make you feel better about what answering the questions would be like on the test day.

COMLEX Prep course:

       Kaplan — Top Pick
       • Wolf Pacc — Best Live Online Course
       • Killexams — Most Affordable
       • Med Learnity — Best Instructors
       • PASS Program — Best Tutoring Program
       • True Learn — Best Online Course
       • National Board of Osteopathic Medical Examiners (NBOME) — Best Free Practice Exams