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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:
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:
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:
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.
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:
You’ll be scored in two examination domains:
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.
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.
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.