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COMLEX-USA Examination Format
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COMLEX USA Level 1 & Level 2-CE
COMLEX-USA Level 1 is a one-day, computer-based assessment that integrates foundational biomedical sciences with other areas of osteopathic medical knowledge relevant to clinical problem-solving and the promotion of health maintenance.
COMLEX-USA Level 2-CE is also a one-day, computer-based assessment. It integrates the application of clinical and foundational biomedical sciences knowledge with other osteopathic physician competencies related to the clinical care of patients and promoting health in supervised clinical settings.
Format
- Two computer-based test sessions of four hours each taken on one day (8 hours’ exam time) administered in a secure, time-measured environment.
- 352 questions based on the competency domains and clinical presentations for osteopathic medical practice.
- Test questions are single-best answer, multiple-choice format and may include audio-visual elements.
- Breaks are only permitted as outlined in the COMLEX-USA Bulletin of Information.
Schedule
| Session | Time | |
|---|---|---|
| MORNING | 4 hours | Total testing time for sections 1-4 |
| Section 1: 44 Questions | ||
| Section 2: 44 Questions | ||
| Scheduled Break | ||
| Section 3: 44 Questions | ||
| Section 4: 44 Questions | ||
| Scheduled Break | ||
| AFTERNOON | 4 hours | Total testing time for sections 5-8 |
| Section 5: 44 Questions | ||
| Section 6: 44 Questions | ||
| Scheduled Break | ||
| Section 7: 44 Questions | ||
| Section 8: 44 Questions |
COMLEX USA Level 3
COMLEX-USA Level 3 is a two-day, computer-based examination assessing competence in the foundational competency domains required for generalist physicians to deliver safe and effective osteopathic medical care and promote health in unsupervised clinical settings.
COMLEX-USA comprises both multiple-choice questions (MCQ) and clinical decision-making (CDM) cases. CDM cases assess the ability to make appropriate patient management decisions as an independently practicing osteopathic generalist physician. The cases are meant to assess not only factual knowledge but also the ability to apply knowledge and skills in caring for patients. This ability is especially important in the Level 3 examination because it is the pathway to licensure for osteopathic generalist physicians to practice in an unsupervised setting.
The CDM portion of the examination contains a series of clinical scenarios, each typically followed by two to four questions. The cases focus on key, critical decisions or challenges related to patient care that are routinely faced by osteopathic generalist physicians. CDM cases ask about data acquisition (e.g., obtaining history or physical exam findings, ordering tests), data interpretation (e.g., generating a diagnosis), and treatment (e.g., prescribing medication, counseling, planning follow-up care).
Format
- Four computer-based test sessions of 3.5 hours each, taken over two days
- Both days must be administered within a 14-day window
- 420 MCQs in a single-best answer format which may include audio-visual elements. Learn more.
- 26 CDM cases of two to four questions each which are either extended multiple choice (more than one correct answer) or short answer formats. CDMs may also include audio-visual elements.
- Breaks are only permitted as outlined in the COMLEX-USA Bulletin of Information.
Schedule
Day 1
| Session | Time | |
|---|---|---|
| MORNING | 3.5 hours | Total testing time for sections 1 and 2 |
| Section 1: 70 MCQ items | ||
| Scheduled Break | ||
| Section 2: 70 MCQ items | ||
| Scheduled Break | ||
| AFTERNOON | 3.5 hours | Total testing time for sections 3 and 4 |
| Section 3: 70 MCQ items | ||
| Scheduled Break | ||
| Section 4: 70 MCQ items |
Day 2
| Session | Time | |
|---|---|---|
| MORNING | 3.5 hours | Total testing time for sections 5 and 6 |
| Section 5: 13 CDM items | ||
| Scheduled Break | ||
| Section 6: 13 CDM items | ||
| Scheduled Break | ||
| AFTERNOON | 3.5 hours | Total testing time for sections 7 and 8 |
| Section 7: 70 MCQ items | ||
| Scheduled Break | ||
| Section 8: 70 MCQ items |
Available Examination Features
Audio-visual Exhibits
You may need to access audio-visual exhibits via an “Exhibit” button. These may include images, videos, and/or audio content. Multiple exhibits may be associated with a single question. Headphones will be provided. The audio function should be tested during the tutorial. If the headphones are not working properly, please notify a TA as soon as possible.
Examination Review Screen
Each section has a review page, which displays the status of your responses to questions, including those that have been flagged or are incomplete. You can comment on questions and review those notes as part of the section review. Time used for section review or commenting on questions is taken from the available testing time.
Additional Tools
A standard calculator, text highlighting, and text strikeout are available for use during the examination. The text font size and the color of the text and/or screen background may be adjusted to your preference during the tutorial or at any point during the examination. These features can be found in the sample questions for each Level.
COMLEX-USA Practice Resources
View sample questions and resources to practice for Level 1, Level 2-CE, and Level 3 examinations.
Highlight Functionality
Learn more about how to use the highlight functionality during a COMLEX-USA examination.
