The COMLEX-USA program, administered by the NBOME (National Board of Osteopathic Medical Examiners), is designed to assess the osteopathic medical knowledge considered essential for osteopathic generalist physicians to practice medicine without supervision. Its M.D. equivalent is the USMLE exam.

The NBOME's COMLEX assessment program is administered in three parts, or Levels. Level 1 is taken upon completion of the second year of medical school, Level 2 is taken during the fourth year of medical school, and Level 3 is usually taken after beginning residency. The content of each examination is based on the COMLEX-USA Examination Blueprint. Each examination, to varying degrees depending on the expected level of competency, covers the following content areas:

• Asymptomatic & General Symptoms
• Symptoms & Disorders of Digestion & Metabolism
• Symptoms & Disorders of Sensory Alternations
• Symptoms & Disorders of Motor Alternations
• Symptoms & Disorders Related to Human Sexuality & Urination
• Symptoms & Disorders of Respiration & Circulation
• Symptoms & Disorders of Thermoregulation
• Symptoms & Disorders of the Tissues and Trauma
• Symptoms & Disorders of Human Development

These content areas are integrated into the following categories of questions:

• Health Promotion & Disease Prevention
• History & Physical
• Diagnostic Technologies
• Management
• Scientific Understanding of Mechanisms
• Health Care Delivery

COMLEX Level 1

Questions on the Level 1 exam focus on the student's ability to solve clinical medical problems through knowledge of scientific principles in the following areas:

• mechanisms of health
• medical problems
• disease processes

The examination draws on the student's knowledge of anatomy, behavioral science, biochemistry, microbiology, osteopathic principles, pathology, pharmacology and physiology.

COMLEX Level 1 is an eight-hour exam broken into two, four-hour segments. Both segments are administered on the same day, with a 40-minute break in between. Additionally, there is a ten-minute break within each segment.

COMLEX Level 2

COMLEX Level 2 consists of two parts: the original Level 2-CE exam and the Level 2-PE exam which was introduced in 2005.

COMLEX Level 2-CE

The Level 2-CE exam demonstrates the student's ability to make appropriate medical diagnoses using patient history and findings recorded from physical examinations.

This examination draws on the student's knowledge of the following clinical specialties: emergency medicine, family medicine, internal medicine, obstetrics & gynecology, osteopathic principles, pediatrics, psychiatry and surgery.

The format of the Level 2-CE is similar to that of the Level 1 exam. It is an eight-hour exam broken into two, four-hour segments, with both segments administered on the same day.

COMLEX Level 2-PE

The Level 2-PE exam is administered at the NBOME’s National Center for Clinical Skills Testing located in Conshohocken, Pennsylvania (near Philadelphia).

Each candidate will see 12 "patients" over the course of a seven-hour day. The patients are actors who are trained to present clinical symptoms. The twelve standardized "patients" present distinct clinical symptoms, problems, or complaints that are commonly seen in a primary care osteopathic medical practice. Candidates must consider the patients' demographic and cultural profiles when developing their medical case. Symptoms or problems presented may be categorized as neuromusculoskeletal, respiratory, gastrointestinal, cardiovascular, or other.

According to the NBOME, candidates are evaluated for their clinical skills in the following areas of the biomedical/biomechanical domain:

• Osteopathic Principles and/or Osteopathic Manipulative Treatment
• History-taking and Physical Examination Skills
• Integrated Differential Diagnosis and Clinical Problem-Solving
• Written Communication and Synthesis of Clinical Findings (SOAP note format)

Candidates are also evaluated for their clinical skills in the following humanistic domain:

• Physician-Patient Communication, Interpersonal Skills, and Professionalism

In order to pass the COMLEX Level 2-PE, a candidate must receive a passing score in the biomedical/biomechanical domain as well as in the humanistic domain.

COMLEX Level 3

The Level 3 exam demonstrates the candidate's ability to solve medical problems as an independent, practicing osteopathic generalist physician.

The format of the Level 3 exam is similar to that of the Level 1 and 2 exams. It is an eight-hour exam broken into two, four-hour segments, with both segments administered on the same day.

NBOME COMLEX Resources

The following resources will help you understand the tests in more depth, get some practice and even find online review courses to help improve your scores.

• Raise your COMLEX scores by practicing with sample COMLEX questions
• USMLE Test Sampler, 60 test questions
• Purchase a Comprehensive Osteopathic Medical Self-Assessment Examination, or COMSAE, from the NBOME
• COMLEX Preparation from Kaplan Test Prep
• Find COMLEX Books at Amazon.com

For more detailed information, including how to register for the COMLEX, visit the NBOME's "For Candidates" page. From there, you can review the Bulletin of Information.