Students Prepping for COMLEX COMLEX 1

COMLEX 1

Exam Prep

Your first step toward medical licensure

Level 1 measures your knowledge of foundational and basic biomedical sciences relevant to solving clinical problems and promoting osteopathic medical care.

Upcoming changes: Exam updates will be released beginning with COMLEX-USA Level 3 in September 2018. New test specifications for each level of COMLEX-USA are not yet available to the public, but updated format specifications can be found on the NBOME website.

COMLEX-USA is a three-level standardized licensure examination administered by the National Board of Osteopathic Medical Examiners (NBOME). You’ll take the first level of the exam near the end of your second year of osteopathic medical school, the second exam during your third or fourth year and the third during your residency training.

You can prepare for Level 1 by becoming familiar with the reference materials and resources on the NBOME website.

Exam registration

Visit the NBOME website to register, submit payment and schedule COMLEX-USA Level 1. If you have trouble registering, contact the Dean’s Office of your school because eligibility is initiated by your dean through a secure web page.

Be sure to read the “Bulletin of Information” before registering for the test. The NBOME has strict regulations regarding confidentiality and irregular conduct prior to, during and after the administration of any COMELX-USA examination.

On exam day

The exam is split into a four-hour session in the morning and four-hour session in the afternoon. You’ll complete the exam in a workstation at a Prometric Testing Center. You’ll need to bring:

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

During the exam, you will be asked a series of 400 multiple choice questions assessing your medical knowledge and clinical problem solving skills. The exam consists of a two four-hour exam sessions separated by a 40-minute break. Each session allows an optional 10-minute break during which you can access a locker for food, drink, medications or other stored items.

The exam will test your knowledge in the following areas: anatomy, behavioral science, biochemistry, health promotion and disease prevention, microbiology, osteopathic principles, pathology, pharmacology and physiology.

After the exam

You’ll need to pass COMLEX-USA Level 1 in order to advance in the examination series. A passing score is based on how many questions you answer correctly on the total examination, not individual content areas. Note that scores are not adjusted or based on any curve due to the performance of others who tested at or about the same time.

You will receive an email providing access to your scores approximately one month after the exam. The mean score for Level 1 is approximately 500-550. All test questions count equally toward your final score, except the pretest questions you take at the very beginning of the exam.

Visit NBOME for more information on examination scoring.


  • Pro Tip: To convert your score from three digits to a two-digit percentile, open NBOME's Percentile Score Converter and enter your three-digit score. Next select the examination level and testing cycle of the exam before pressing the Convert button.

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