Student Doctors Prepping for COMLEX COMLEX 2


Exam Prep

Demonstrate your clinical knowledge

This two-part exam emphasizes the medical concepts and principles necessary for making appropriate medical diagnoses.

Upcoming changes: Updates to Level 2-PE, Level 2-CE and Level 1 are expected to launch in spring 2019. Updates to COMLEX-USA Level 3 were launched in September 2018. Learn more on the NBOME website.

COMLEX-USA is a three-level standardized licensure examination administered by the National Board of Osteopathic Medical Examiners (NBOME). All osteopathic medical schools require that osteopathic medical students pass the first and second levels of COMLEX-USA to graduate.

COMLEX Level 2 is typically completed during the third or fourth year of medical school. It’s a two-part exam composed of the following:

  • Level 2-Cognitive Evaluation (CE) measures your clinical skills and problem-solving techniques over the course of a day-long computerized exam.
  • Level 2-Performance Evaluation (PE) tests your clinical examination skills through physical examinations you’ll conduct on standardized patients.

The two parts of the Level 2 exam can be taken in any order, but both must be completed before you can take Level 3. Here’s how to prepare for COMLEX 2:


Before taking either Level 2 exam, you’ll need to:

  • Pass COMLEX-USA Level 1.
  • Complete your second year of study at an accredited college of osteopathic medicine.
  • Obtain attestation from your COM that you are a student in good standing.

Level 2-CE

The COMLEX Level 2-CE is a day-long computerized exam that measures your clinical skills and problem-solving techniques. Level 2-CE is split into a four-hour session in the morning and a 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.
  • Snacks and drinks.

On testing day, you will be asked a series of 400 multiple choice questions testing your ability to make problem- and symptom-based assessments. You’ll be tested in the following clinical areas: emergency medicine, family medicine, health promotion and disease prevention, internal medicine, neuromusculoskeletal medicine, obstetrics/gynecology, osteopathic principles, pediatrics, psychiatry and surgery.

On exam day, you can take 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 return to the testing room. During the breaks, you can access a locker for food, drink, medications or other stored items.

Visit NBOME for more information, including the COMLEX-USA Level 2-CE blueprint and the practice exam.

Level 2-PE

The Level 2-PE portion of the exam will test your clinical examination skills through encounters with actors posing as patients during a seven-hour exam at an NBOME National Center for Clinical Skills Testing in Philadelphia or Chicago. You should arrive at least half an hour early to allow time for registration. Students then meet for orientation before beginning three separate rounds of examining four patient cases. The first round will end with a 30 minute lunch break and the second round will end with a 15 minute break.

You’ll need to bring:

  • Your driver’s license or other current government-issued ID with your full name.
  • Your white lab coat and a standard stethoscope.
  • Snacks and drinks.

You’ll be scored in two examination domains:

  • Humanistic Domain: Physician/patient communication, interpersonal skills and professionalism.
  • Biomedical/Biomechanical Domain: Medical history-taking and physical examination skills; osteopathic principles and osteopathic manipulative treatment; and documentation skills, including synthesis of clinical findings, integrated differential diagnosis and formulation of a diagnostic treatment plan.

You’ll be allotted 14 minutes for each patient encounter. You can use this time to take the patient’s history, perform a physical exam, talk to the patient and perform OMT if indicated. After each encounter, you’ll be given nine minutes to document your findings.

Visit NBOME for more information, including the COMLEX-USA Level 2-PE blueprint.

After the exam

Each level of the COMLEX-USA is important because you cannot progress to the next level until you pass the previous level, with the exception of Level 2-CE/PE which may be taken in any order.

You will receive an email providing access to your scores approximately one month after completing Level 2-CE. Your scores for Level 2-PE will be available within eight to 10 weeks.

The mean score for Level 2 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 about Level 2-CE scoring and Level 2-PE 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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