How to Study for COMLEX Level 3

You’ve reached the end of your first year of residency, and it’s time to take the COMLEX Level 3. This is a huge milestone in your osteopathic medicine journey! You’ll be tested on your clinical skills, knowledge, decision-making, and your ability to provide unsupervised patient care. In this blog we’ll go over some helpful information so you can feel prepared for this huge exam.

Step 1: Learn the Exam Format and What to Focus on

The first step in preparing to pass any exam is learning the exam format and content. The COMLEX Level 3 comprises four computer-based test sessions over a two-day period. Each session is three-and-a-half hours long. Day one consists of only multiple-choice questions (MCQs) and day two consists of both MCQs and clinical decision-making (CDM) cases. Altogether, there are 420 MCQs and 26 CDM cases that typically include two to four questions each. CDM questions may be in either select-all-that-apply or short-answer format. Be sure to review the CDM exam tutorial.

The high yield clinical disciplines to focus on for Level 3 include:

• Emergency Medicine
• Family Medicine
• Internal Medicine
• Obstetrics/Gynecology
• Osteopathic Principles and Practice
• Pediatrics
• Psychiatry
• Surgery

You will be assessed on two dimensions, Competency Domains and Clinical Presentations, that integrate:

• Osteopathic philosophy of whole-person health care
• Underlying structure-function relationships
• Interdependence of body systems
•  Self-healing and self-regulatory mechanisms, and
•  Osteopathic approach to patient care, including osteopathic manipulative medicine and osteopathic manipulative treatment (OMT)

The breakdown of the two dimensions can be found on the NBOME website. Be sure to check it out to help focus your study efforts. 

Level 3 assesses your ability to apply clinical knowledge in realistic scenarios. So, strengthen your understanding of common clinical conditions, treatment guidelines, and evidence-based medicine. It goes without saying that the exam will test your osteopathic knowledge. Maintain a solid understanding of osteopathic principles and focus on OMT techniques, clinical reasoning, and application in patient-care scenarios. Allocate more study time to the high-yield clinical disciplines listed above to maximize your chances of success.

Step 2: Create a Study Schedule

You’ll need to know yourself to determine how long you’ll need to study for COMLEX Level 3. On average, most students dedicate 4-6 months to preparing for the exam. Below is a sample study schedule but be sure to tailor the schedule to your specific needs. Remember to always incorporate osteopathic principles and practice where appropriate and relate your studies to the two dimensions listed above.

• Month 1: Familiarize yourself with the exam content and structure. Take timed practice tests to analyze your areas of strengths and weaknesses. Do a comprehensive review of internal medicine that focuses on common conditions, treatment guidelines, and clinical decision-making.
• Month 2: This month starts by focusing on obstetrics/gynecology and pediatrics. Review diseases and preventive guidelines, and practice case-based scenarios. Then move on to emergency medicine. Review surgical emergencies, triage, resuscitation, and critical care protocols. 
• Month 3: First spend time studying psychiatry and neurology. Refresh your knowledge of psychiatric and neurologic disorders, and diagnostic and treatment options. Then move on to high-yield topics in family and preventive medicine. Review diseases, health maintenance, and screening guidelines.
• Month 4: Start with reviewing information from the previous months of studying. Then, take a mock exam to evaluate your knowledge progress. Review your results and decide what you need to really focus your efforts on for the next two months.
• Month 5: Use this time to review areas of weakness identified on practice exams. The more practice questions you can get in, the better.
• Month 6: You should use the final month of preparation for intense review and fine-tuning your knowledge. In the final weeks leading up to your exam, take a timed assessment so you’ll be prepared for the pressure of test day.

Step 3: Utilize Practice Questions

At this point in your DO journey, you know just how important practice questions are! Practice questions help you better retain the information you are studying. In your study schedule, it is important to make plenty of time for practice questions. As you study a certain subject, answer practice questions that correlate with that subject. Before you do a new set of practice questions, review questions you previously got wrong. 

As you make your way through the questions, always be sure to thoroughly read the rationales to help further your knowledge retention. As you get closer to your exam, be sure to answer more and more questions in one sitting to increase your test-taking stamina. With over 1,850 practice questions, and a first pass guarantee on 90-day (or longer) subscriptions, our COMLEX Level 3 SmartBanks are just what you need to succeed! Our practice questions are written by content experts to align with the exam blueprint and our CDM cases are formatted to mirror those you will see on exam day.

Level 3: The Key Differences and Unique Preparation

While Level 1 and Level 2 put an emphasis on foundational knowledge and clinical problem solving, Level 3 focuses on evaluating your clinical decision-making skills and patient care management. There is a focus on assessing your judgment, prioritization, and patient safety. You are tested on your ability to provide unsupervised osteopathic medical care. 

Level 3 challenges your ability to handle multiple patients simultaneously. Practice managing multiple clinical encounters, organizing priorities, and maintaining a systematic approach to ensure patient safety. Since COMLEX Level 3 is taken after your completion of medical school, preparing for it will be quite different. You will now be tasked with studying while working the grueling hours of intern year, so be sure to stick with your study schedule and prioritize study time. 

With dedication and perseverance, you can conquer COMLEX Level 3 and embark on a successful career as an osteopathic physician. Good luck!