September 29, 2023

COMLEX Level 1 Exam Format: Everything You Need to Know

Written By: The TrueLearn Team | Share:

Aspiring doctors face a series of rigorous exams on their path to becoming licensed physicians. The COMLEX exams are critical milestones for all osteopathic medical students. In this blog post we’ll provide an in-depth overview into all things COMLEX Level 1, taken during your second year of medical school, so you can feel ready to conquer it!

COMLEX Level 1, administered by the National Board of Osteopathic Medical Examiners (NBOME), aims to test a second-year osteopathic medical student’s knowledge and competency. It assesses a candidate’s ability to apply their knowledge to clinical situations and is a crucial step in becoming a practicing doctor of osteopathy.

COMLEX Level 1 vs USMLE Step 1

While COMLEX Level 1 and USMLE Step 1 share similarities in assessing medical knowledge, they differ in certain aspects. COMLEX emphasizes osteopathic manipulative medicine (OMM), while USMLE focuses solely on allopathic medicine. Understanding these distinctions will help you tailor your preparation strategies accordingly.

COMLEX Level 1 Exam Format

COMLEX Level 1 is a computer-based exam consisting of 352 multiple-choice questions. The exam covers a wide variety of material and is designed to test your osteopathic medical knowledge and clinical skills. It is broken into two dimensions, competency domains and clinical presentations, that simulate real world patient encounters. Below is the percentage breakdown of the different question types.

Dimension 1 (Competency Domains)	Minimum %
Osteopathic Principles, Practice, and Manipulative Treatment	11%
Osteopathic Patient Care and Procedural Skills	6%
Application of Knowledge for Osteopathic Medical Practice	60%
Practice-Based Learning and Improvement in Osteopathic Medical Practice	5%
Interpersonal and Communication Skills in the Practice of Osteopathic Medicine	3%
Professionalism in the Practice of Osteopathic Medicine	3%
Systems-Based Practice in Osteopathic Medicine	2%
Dimension 2 (Clinical Presentations)	Minimum %
Community Health and Patient Presentations Related to Wellness	12%
Human Development, Reproduction, and Sexuality	5%
Endocrine System and Metabolism	5%
Nervous System and Mental Health	10%
Musculoskeletal System	13%
Genitourinary/Renal System and Breasts	5%
Gastrointestinal System and Nutritional Health	10%
Circulatory and Hematologic Systems	10%
Respiratory System	10%
Integumentary System	5%

Taking COMLEX Level 1

As of May 2023, the cost to take Level 1 is $715. Level 1 is given in two sessions that are four hours each, so be prepared to dedicate a full day to the exam. During the exam you are allocated 60 minutes worth of break time. Breaks are scheduled at the two, four, and six hour mark. You can use as much or as little of allotted break time as you’d like. Be aware that if you go over the 60 minutes worth of break time, time will be deducted from your exam.

How Long Do I Need to Study?

The length of time needed to study for Level 1 will vary amongst students based on things like prior knowledge, study habits, personal commitments, etc. We recommend anywhere from 3-6 months of dedicated study time.

Is Level 1 Pass/Fail?

NBOME has moved away from a numeric grading system for COMLEX Level 1, and has opted for pass/fail scoring. Along with your pass/fail report, you will receive a “Formative Performance Profile” that details how you performed in different areas in comparison to other first-time Level 1 test takers. This allows for less competition among students and a more holistic assessment of the student’s capabilities.

Top 3 Things You Need to Know If You’re Taking The Exam

Know what to expect on exam day: Such an important exam is sure to create some testing anxiety. Knowing what to expect when you arrive can help lessen your anxiety and put you at ease. Learn what to expect on exam day from the NBOME’s website.
Focus on understanding and applying fundamental concepts: The exam tests your ability to apply your knowledge in real-world scenarios. You cannot rely on fact recall alone. You need a comprehensive understanding of core concepts to succeed.
Recognize the importance of practice questions: Answering practice questions is a great way to engage in active studying! Active studying is highly effective and helps you better retain the information. When answering practice questions, always read through the rationales, as they are a great resource and will help deepen your knowledge.

Looking For a Level 1 Question Bank?

Our Level 1 SmartBank comes with over 2,500 practice questions and hundreds of OMM videos! All questions are aligned with the COMLEX-USA blueprint so you can be sure the questions will fit your needs. Our platform tracks your progress over time so you can have a clear understanding of where to focus your attention and review commonly missed items. You’ll have access to analytics that show you where you stand in comparison to other students in the nation. With our first-time pass guarantee, you can rest easy knowing TrueLearn’s got your back!Test your best with TrueLearn.

Sign up today to begin studying smarter for your upcoming COMLEX Level 1 exam.