Resident Physicians Exam Prep COMLEX 3


Exam Prep

What to expect and how to prepare

COMLEX-USA Level 3 assesses your clinical and decision-making skills in providing patient care.

COMLEX-USA Level 3 is a two-day computer-based examination consisting of multiple choice questions. You’ll also be tested on clinical decision-making cases that could include short answer items to images, video or audio questions.

Before the exam

Most DOs take COMLEX-USA Level 3 during their first year of residency. Before you can take the exam, you’ll need to:

NBOME also requires attestation from an AOA- or ACGME-accredited residency program director that you are in good academic and professional standing. While it’s not required, NBOME also will recommend waiting until you’ve completed six months of residency training before taking COMLEX-USA Level 3.

Visit NBOME for more information, including registration and fees and upcoming test dates.

On exam day

The COMLEX Level 3 exam is split into two 3.5-hour sessions per day. You’ll complete the exam in a workstation at a Prometric Testing Center. On each exam day, you’ll receive two optional 10-minutes breaks as well as an optional 40-minute lunch break. You’ll need to leave the testing room during your break and show your ID to gain reentry. During the breaks, you can access a locker for food, drink, medications or other stored items.

You’ll need to bring the following with you to the exam:

  • Your driver’s license or other current government-issued ID with your full name.
  • Any snacks and drinks you’ll need throughout the day.

Test items include extended multiple choice questions, extended matching items, and short answer questions, as well as questions with audio and visual images. You can prepare in advance by taking practice examinations.

You’ll be able to review your answers for each section of exam questions before you advance to the next section. Questions will test your medical knowledge and decision-making skills to provide care in clinical science areas, including:

  • Emergency medicine
  • Family medicine
  • Health promotion and disease prevention
  • Internal medicine
  • Neuromusculoskeletal medicine
  • Obstetrics/gynecology
  • Osteopathic principles
  • Pediatrics
  • Psychiatry
  • Surgery

The last section, clinical decision-making (CDM) cases, will test your patient management skills. Through a series of clinical scenarios, you’ll be tested on your ability to:

  • Acquire patient data.
  • Interpret data, such as a patient’s history or test results, to make a diagnosis.
  • Develop a treatment plan.

After the exam

You will receive an email approximately one month after you complete the exam that your scores are available through your COMLEX-USA account. You’ll need a score of at least 350 to pass COMLEX-USA Level 3. Typically the three-digit score for all levels of COMLEX is 500-550. All test questions count equally toward your final score, except the pretest or “tryout” questions you take at the very beginning of the exam.

Visit NBOME for more information on examination scoring.

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