The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) series of tests are the board exams that students in osteopathic medical schools must take in order to receive their license to practice.
Broken into 3 parts, this licensure examination tests your comprehension of what you've learned during your medical education and how well you can apply that knowledge to clinical practice.Similar to USMLE, the COMLEX exams are used by residency program directors to select applicants for their graduate medical education training programs (residency programs).
You must pass the COMLEX-USA examination series to graduate with a Doctor of Osteopathic Medicine degree and be fully licensed to practice in the United States.
There are three levels in the COMLEX-USA medical licensure examination series of DO board exams.
Level 1 focuses on foundational biomedical sciences and osteopathic principles. Level 2-CE is a Cognitive Evaluation (CE) and tests clinical knowledge and skills. Level 3 assesses the advanced clinical competencies required for unsupervised osteopathic medical practice.
| COMLEX Level 1 | COMLEX Level 2-CE | COMLEX Level 3 | |
| What is tested? | Application of osteopathic medical knowledge, patient care, osteopathic principles and practice, communication skills, professionalism, and ethics | Assesses osteopathic medical knowledge concepts as they relate to clinical sciences and patient care | Assesses patient presentations, seven defined competency domains, and the ability to independently practice as a osteopathic generalist physician |
| When to take it | Near the end of your second year of medical school (M2) | During your third or fourth year of medical school (M4) | During residency |
| Exam length | 8 hours (two computer-based sessions, 4 hours each) | 8 hours (two computer-based sessions, 4 hours each) | 14 hours (four computer-based sessions, 3.5 hours each) |
| Number of questions | 352 multiple-choice questions | 352 multiple-choice questions (some involving audio-visual components) | 420 multiple choice questions, 26 Clinical Decision-Making cases with 2-4 questions each |
| Score reporting | Pass/Fail | Scaled score | Scaled score |
Each level of the COMLEX (Comprehensive Osteopathic Medical Licensing Examination) is scored based on the number of correctly answered multiple-choice questions. The raw score (the number of questions answered correctly) is converted into a standard 3-digit scaled score to allow for small variations in individual test questions.
For the Level 1 exam, you will receive a report comparing your results with other test takers and a pass/fail designation. Levels 2 and 3 provide your scaled score as part of your score report.
For all levels, the National Board of Osteopathic Medical Examiners (NBOME) ensures that the scoring process is fair and reflects a candidate’s ability to practice osteopathic medicine. The NBOME establishes the passing standard for each level through a rigorous process that involves panels of practicing osteopathic physicians.
Want to be sure you pass your COMLEX exams? Get guidance and tutoring from our experts and impress residency directors with your score.
Studying begins with planning. Making a schedule for studying is the best tip we can give you for preparing for exams. If you have a realistic view when you need to know all your material, you can work in time to study and know how far out you’ll need to start your routine for each level.
More study tips you can use include:
Related: How to Use COMSAEs to Excel on COMLEX: Study Tips & FAQs
Both the United States Medical Licensing Examination (USMLE) and COMLEX are licensing exams for medical students, but they cater to different medical programs.
USMLE is the exam that allopathic (MD) medical students will take for NBME accreditation, whereas COMLEX is designed for students attending colleges of osteopathic medicine (DO) and is overseen by the NBOME. COMLEX emphasizes osteopathic principles and manipulative treatment methods.
Related: What Are the Key Steps in Becoming a Doctor?
Passing the COMLEX exams is a huge milestone in the practice of osteopathic medicine. Make sure you’re prepared to succeed with a proper study schedule.
Our experienced tutors have mastered COMLEX Levels 1 and 2 and specialize in particular areas of the examinations. Students who study with our tutors increase their scores by 105-220 points on average! Learn how you can benefit from COMLEX tutoring.