In the Room Where It Happens: What You Need to Prepare for COMLEX-USA
Sydney Moriarty, a rising fourth-year osteopathic medical student at the Edward Via College of Osteopathic Medicine – Virginia campus and an at-large member of the NBOME Student Experience Panel, spent months preparing to take COMLEX-USA Level 1, but mentioned how she hadn’t been sure how to take it—what she would need, bring, and even wear. Here, she shares her and her peers’ experiences in taking COMLEX-USA Level 1 and advice for traveling along the Road to DO Licensure.
You are currently in medical school and are now facing the idea of licensure exams. While they may be intimidating, keep in mind that you’ve made it this far. Since the moment you took your first step into your institution, you’ve been dreaming of and dedicating yourself to becoming a physician. This is just your next milestone.
Plan Your Exam Day
While your mind is filled with everything from biochemistry to pathology, dedicate some time to planning and preparing for your day. If you’re booked at a testing site you’ve never been to, and if you can, drive to your testing site a few days before you take the test so you can experience the traffic patterns around the same time you are scheduled to take it. Additionally, read over the confirmation email sent when you scheduled your test and make sure you have all the required documentation and identification, as COMLEX-USA and USMLE may require different things.
Next, you’ll want to think about your body’s fuel. COMLEX-USA Level 1 is a long test. You may feel nervous and have no appetite, but everyone I’ve talked to agrees: you need to eat. You won’t be able to think if you don’t have the energy you need. This is especially true when you hit your 300th question of the day.
[Editor’s note: Pearson VUE, the NBOME’s testing partner, does not allow food or beverages in the testing room, but these items can be stowed in a locker. Test-takers are allotted 60 minutes of break time to use as they see fit over three scheduled break periods. This time can be used for food, water, restroom use, or to take a brief rest if need be. Learn more.]
Find some snacks that leave you full but not tired. For example, heavy, sugary, carb-filled snacks leave me sleepy, so I opted for protein or fig bars. Some of my peers recommended beef jerky, fruit, or even a pick-me-up like a candy bar after a brutal section. I brought a turkey sandwich for lunch, which is enough to leave me full and not put me in a food coma. If you need to, bring some floss if the jerky gets stuck in your teeth or gum if you need your breath freshened up.
You will also need hydration. Water is a great option, but some of my peers chose Gatorade or Pedialyte. You can bring both and store them in your locker or car, as they cannot be in the testing room with you.
For those who need their caffeine, consider energy drinks or caffeinated gum. The last option may be helpful if you are sensitive to energy drinks because the last thing you need is to be running to the bathroom. Under stress, our bodies can do funky things, so plan for them. Also bring some medication for headaches, stomach issues, dry eyes, or menstruation. Also remember to bring any prescription meds. Do not try anything you haven’t tried before on test day; it can interact with your body in ways you aren’t expecting.
[Editor’s note: Pearson VUE allows for certain “comfort items” to be brought into the testing room.]
Lastly, you will have dry-erase board/booklets in the room, and you can use them to write down mnemonic or memory tools that may help when you get into your exam and start second-guessing. Think about what you want to write before you even go to your exam.
For example, I used a tool where I drew a few lines to divide up my systolic versus diastolic heart sounds and linked them with disease states, like aortic stenosis or mitral regurgitation. I also wrote out my renal tubule and where each drug acted, so if I was tired and lost on a question, I could jog my memory or work backward. I also included some epidemiology equations for things like sensitivity and specificity.
Other things I’ve heard people use include the coagulation cascade or write out rubella, rubeola versus roseola.
This is to say, while you’re taking your practice exams, try and find a combination of tools you can write down from memory to help you if you plan to do this on test day. By the 200th question, you may be tired and grateful you’d taken the time to write these out.
On Test Day
You wake up after an ideal night’s sleep and are ready to take the exam. You’ve worked your whole life for this point, as for any milestone in medical school. For breakfast, try and eat something—even if it’s small. I had a protein shake and a balanced break snack pack with almonds, cranberries, and cheese.
Next, you think to yourself, “What should I wear?” I chose comfy clothes: pair of leggings I could easily roll up in case the room was hot, a loose-fitting t-shirt, and a hoodie that zipped up and down. This made it easier to cool off without pulling off my headphones. I also wore my Crocs to slip my feet out of if they were bugging me. Additionally, if you like to wear your hair up, do not bring a claw clip. Some places only allow hair ties!
Now you’ve arrived at your testing site, ideally 30 minutes early. You go through the process of checking in, fingerprinting, and storing your stuff in a locker. Try and use the bathroom before the test if you can. Before you start, check with the testing center staff to see where you can go for your breaks.
The exam is broken down into two 4-hour sessions. Each 4-hour session has four sections, with 44 questions per section. My peers have told me they also take a 15-minute snack break between sections 2 and 3, a 30-minute lunch break between sections 4 and 5, and then another 15-minute snack break between sections 6 and 7. Take these breaks even if you aren’t hungry or don’t feel tired—the adrenaline of taking your board exam will run out.
After you finish the exam and hit submit, you may feel relief or feel like it was the most challenging exam of your life. Either or both are normal. Focusing for 8+ hours is no easy task, but you did it. Regardless of what happens, you did your best. You will be one step closer to becoming an osteopathic physician.
