Skip to main content


Saturday, March 9, 2019
By The TrueLearn Team

The National Board of Osteopathic Examiners (NBOME) has announced fundamental changes to COMLEX-USA Level 1 that will go into effect in May of 2019.

To experience the changes to COMLEX Level 1 first-hand, click here. For existing customers, you will get all of these updates in your account automatically!

Second-year Osteopathic medical students from the Class of 2021 will be the first to experience the NEW COMLEX-USA Level 1 this year at Prometric Centers throughout the country. While it’s normal to feel some increased anxiety over these changes (and hopefully you’re not learning about them for the first time), by the end of this article, hopefully you’ll feel a little more at ease.

The good news is that we’ve updated COMBANK this year to incorporate these changes so you should have experienced most of them long before you arrive at the testing center. For the better part of the past year, we’ve been writing new test items, mapping topics to the new COMLEX-USA Blueprint, adding features, and redesigning COMBANK’s testing interface to make sure students are locked in for 2019.

Here are some of the major changes you can expect this year on the NEW 2019 COMLEX-USA Level 1.

1. A New Examination Blueprint

Exam blueprints are fundamental to standardized examinations and serve as frameworks to guide all item-writing and exam composition. If you look at NBOME’s publicized item-writing process, you’ll note that it all starts at the level of the blueprint.

Historically (and through April of 2019), the NBOME has utilized a two-dimension blueprint for all COMLEX-USA exams, consisting of Dimension 1: Patient Presentations and Dimension 2: Physician Tasks. In this blueprint model, between 70-85% of all test items on COMLEX-USA Level 1 fell within the Dimension 2 subheading of “Scientific understanding of health and disease mechanisms,” which is not surprising, given the high proportion of Level 1 test items revolving around the basic sciences.

What to know for 2019

After years of staging and development, the new blueprint for COMLEX-USA is finally here and will be implemented for the first time in May of 2019. The new blueprint is also designed in a two-dimension model but items will now fall under the dimensions of Competency Domains and Clinical Presentations. Under the Dimension 1 heading of Competency Domains, roughly 60% of test items on COMLEX-USA Level 1 are slated to fall under the 3.1 subheading of “Foundational Basic Sciences Knowledge Base.” Although Dimension 2: Patient Presentation categories are more evenly distributed with regards to item representation, it’s not surprising most heavily weighted category is “Patient Presentations Related to Musculoskeletal System” at 13%.

What you’ll see in COMBANK

We have fully integrated the new blueprint for COMLEX-USA into COMBANK for 2019 by mapping all test items into their respective categories. When creating an exam, you can now choose to test by “Blueprint” and create exams by cross-selecting different blueprint categories. What better way to familiarize yourself with the new blueprint than to use it to create all of your practice exams. To learn more about the new Blueprint directly from the NBOME, go here.

2. A New Testing Interface

In May of 2019, the NBOME will be retiring the current testing interface for COMLEX-USA Level 1 and moving toward a fully updated testing environment. So if you show up to the Prometric center for your COMLEX-USA Level 1 exam anytime during or after May, you should encounter a much cleaner interface that is updated from previous iterations.

What to know for 2019

While the new Prometric interface is much cleaner in its appearance, it does take some getting used to. The more you can familiarize yourself with the exam experience in the months leading up to test day, the better off you’ll be. Anytime you find yourself in a high-stakes performance situation, it’s beneficial to try and replicate that experience ahead of the event itself. Athletes and sports teams do this all of the time to prepare for those critical moments when the pressure is on. It’s a great way to deal with performance anxiety and alleviate distractions when things matter the most. When the game is on the line and you’re standing at the free throw line, it should be nothing but net.

What you’ll see in COMBANK

COMBANK’s testing interface has been fully updated to replicate the look and feel of the new Prometric interface for COMLEX-USA Level 1. Even though we are months out from the updated interface being released into the actual exam for the new testing season, we have already introduced it into COMBANK (as of March 1st) for students to use now. Our goal is to ensure that when you show up to the testing center this year to sit for your COMLEX-USA Level 1 exam, you feel like you are at home using COMBANK on your couch. Here is a sneak peek at COMBANK’s new testing interface for 2019.

3. New Question Types

Now that we’ve hit on the important Blueprint and interface changes that are coming for this year’s New COMLEX-USA Level 1, we’ll highlight the most important of them all – the questions. Over the years the NBOME has made consistent updates to their exam items. In recent years, we’ve seen some key structural changes to the exam items such as the incorporation of lab values, vital signs, and key findings into table-formats within the stems, along with their respective ‘normal’ ranges. We’ve also seen a higher proportion of A-type items than years past, coupled with a decrease in other item-types. The NBOME has announced some new item-times for 2019, with limited insight into how or in what format they might appear on the exam.

What to know for 2019

For 2019, expect to see lab values and vital signs (with their respective normal values) contained within tables embedded throughout the stems. Additionally, the NBOME has announced some new item-types designed to help assess aspects of specific competency domains outside of the application of osteopathic medical knowledge. These might include the interpretation of research abstracts, mock pharma ads, and other novel items. Lastly, you can expect to see more items containing multimedia with a higher proportion of items containing video, audio, avatars with heart or lung sounds and other media formats.

What you’ll see in COMBANK

Over the past year, our physicians have worked hard to include novel test item formats into COMBANK. You’ll encounter new multimedia items designed to simulate the style of those tested on COMLEX-USA Level 1. COMBANK has been refreshed with focused enhancements to mirror the new changes coming to COMLEX this year. We have lengthened our stems, increased the percentage of 2nd and 3rd-order items, and upgraded our item explanations to be more robust with new figures, tables, and insights. On test day, we don’t want there to be any surprises.

In summary, we know that major changes are coming to COMLEX-USA Level 1 this year. Rather than letting them stress you out, learn how to get comfortable with them. Learn to become ‘test-wise’ by logging into your COMBANK account today and testing under the new blueprint in a simulated Prometric environment. Then when test day arrives, make it count!

Now that you have learned all about the changes to COMLEX Level 1, click here to check them out yourself!


Contact Us

Feel free to reach us with any comments or questions! Need technical support? Visit our contact page and complete the tech support form.

109 Professional Park Drive

Mooresville, NC 28117

[insert_ajaxcontact id=456]