The National Board of Osteopathic Medical Examiners, Inc. (NBOME) began delivering its written examinations by computer in July of 2005.   The last paper-pencil COMLEX-USA Level 2-CE examination was administered in January of 2005 and the last paper-pencil COMLEX-USA examination for Level 3 was administered in June of 2005.  The last paper-pencil COMLEX-USA Level 1 examination will be administered in October of 2005.  This FAQ sheet is intended to provide a brief description of the computer-based COMLEX-USA examinations. 

What type of computer-based testing will the COMLEX-USA be?
In general, there are two types of computer-based testing:  computer-adaptive testing and computer-delivered non-adaptive testing.  In adaptive testing, the computer selects questions based on an examinee’s responses to the previous questions.  The COMLEX-USA examinations are not computer-adaptive.  They are computer-delivered non-adaptive tests.  The questions selected for each COMLEX-USA examination are determined before the tests are administered.  The number of questions and time limit for the examinations are also predetermined and, under normal administration conditions, are the same regardless of when and where the examinations are administered.  As with non-adaptive testing, the computer displays questions one at a time.  Only after an examinee takes an action on the first question will the computer display the next question. 
 

Do the computer-based COMLEX-USA examinations require substantial computer skills?
No.  Substantial computer experience is not required to take computer-based COMLEX examinations.  Examinees only need to know how to click the computer mouse to select answers or other labeled options.  Literature suggests that performance on computer-based tests is not related to the level of computer literacy.

A CBT Tutorial and Practice Items are now available on the website.  Candidates are encouraged to review those materials to familiarize themselves with taking the computer-based COMLEX-USA.
 

Why are COMLEX-USA examinations going to be computer-based?
Computer-based testing is more efficient, effective, secure and convenient.  Compared with the 2-day paper-pencil COMLEX-USA written examinations, the computer-based COMLEX-USA examinations are only one-day examinations.  The total number of questions per Level has been reduced from 750 to 400.  The total testing time has been reduced from 16 hours to 8 hours, yet the scope of the content covered by the examinations is very similar.  Because the overall psychometric quality of questions in the computer-based COMLEX-USA examinations is higher than that of questions in paper-pencil COMLEX-USA versions, shortened COMLEX-USA examinations delivered by computer can still achieve a measurement precision comparable to that of paper-pencil COMLEX-USA examinations.

Is the content of the computer-based COMLEX-USA examinations different from the current paper-pencil COMLEX-USA examinations?
The content of the computer-based COMLEX-USA examinations is similar to the paper-pencil examinations.  The content categories of Dimension II of COMLEX-USA are exactly the same.   For Dimension I, the nineteen categories of paper-pencil COMLEX-USA are now grouped into nine new categories for the computer-based COMLEX-USA.  For example, the two categories of Bleeding and Respiratory Difficulties in the paper-pencil COMLEX-USA are now combined into a category of Symptoms & Disorders of Respiration & Circulation for the computer-based COMLEX-USA.  Therefore, the topic categories for Dimension I are still considered the same between the two formats of COMLEX-USA.  The table below illustrates how the Dimension I topics for paper-pencil COMLEX are grouped into Dimension I topics for computer-based COMLEX.

Are the question formats of the computer-based COMLEX-USA examinations different from the formats of the paper-pencil COMLEX-USA questions?
All computer-based COMLEX-USA questions are multiple-choice questions.  Question formats for the computer-based COMLEX-USA examinations are the same as that for the paper-pencil COMLEX-USA examinations.  Most of the questions are one-best-answer questions, while a small number of questions are matching-type questions.  Most of the one-best-answer questions are single, stand-alone items, while the remainder use two or more one-best-answer items following a case history.  New question formats using multi-media may be introduced gradually.  Candidates will be notified in advance as new question formats are introduced.
 

What are the differences between the computer-based and paper-pencil COMLEX-USA examinations?
First, the number of questions is reduced in the computer-based COMLEX examinations.  Instead of 750 questions as in the paper-pencil COMLEX examinations, there are only 400 questions for each Level of the computer-based COMLEX examinations.  As a result, the computer-based COMLEX examinations are 8-hour examinations instead of 16-hour examinations.  Secondly, with paper-pencil COMLEX examinations, candidates can review and change answers to the questions in an entire book.  With the computer-based COMLEX examinations, questions are grouped into sections of 50 questions.  A candidate can only review and change answers to the 50 questions in the current section. Once a candidate confirms ending a section, answers to the 50 questions of that section become final and the candidate can no longer go back to review or change any answers within that 50-question section.  A clock is provided to assist the candidate with time management.  Warnings are given to remind the candidate of the time remaining before the end of each four-hour session.

An additional difference is that candidates may be required to use an “Exhibit” button in order to see graphic materials related to a test question.  In some cases, there may even be two (2) “Exhibits” for the candidate to use in order to answer a question.  A “Lab Values” button, which will be available throughout the examinations, provides reference adult laboratory values to the candidate in lieu of referring to the table formerly found at the end of the test booklets.

As there is no answer sheet in the CBT version, a review page is presented for each section.  This provides the candidate with information about the status of the items in the current section. The candidate is advised of questions completed, questions marked for further review, and incomplete questions for which no answer is given.
 

Are there any breaks during the examination?
Candidates are permitted to take two optional breaks during the test session. One optional 10-minute break is permitted during the morning exam session and one optional 10-minute break is permitted during the afternoon exam session. The two optional breaks are permitted midway through the two exam sessions, after completion of Section 2 and Section 6.  If candidates choose to take the break, the actual time candidates spend on the break will be deducted from the time allocated to complete the examination.  During the break, candidates must leave the testing room.  Upon re-entering the testing center, candidates must show a valid ID.  If candidates choose not to take breaks, they can continue taking the examination.

An optional lunch break is also permitted following the morning session. The time permitted for the lunch break is 40 minutes.  This time does not count against the total exam time. The lunch break begins when the morning exam session is completed (following section 4).  The afternoon exam session will begin once the 40 minutes given for the lunch break have passed. Candidates must return to the test center promptly by the end of the lunch break to avoid losing any time for the afternoon exam session.  Any other break, unless approved as part of an ADA accommodation provided to the candidate in writing by the NBOME, shall be considered unauthorized and subject to review by the NBOME.
 

What will happen if my computer freezes in the middle of testing?
Occasionally computers will malfunction and the test center staff will need to reboot the computer for you.  You will not lose any answers already entered.  The computer system in the testing centers stores all your answers instantly.  After rebooting, the computer will come back exactly to where you were before the crash.
 

Are there any penalties for tardiness, late registration or cancellation of an examination?
Candidates who arrive at the test center on the specified scheduled test date more than 15 minutes after the scheduled start time will not be permitted to take the examination under any circumstance and will be penalized the full cost of the examination.  There are significant economic penalties for late registration, and for cancellation of a previously scheduled examination 30 days or less from the test date arranged by the candidate.  All candidates are advised to check the information available on our website for complete details.
 

How do candidates register for a computer-based COMLEX-USA examination?
In the spring of 2005, the NBOME implemented an electronic on-line registration system to facilitate candidate registration and to provide the most up-to-date information to candidates about the COMLEX-USA examination and the NBOME.  All candidates MUST use this system in order to register, pay for an examination, schedule an examination, cancel an examination, withdraw from an examination, be withdrawn from an examination, reschedule an examination, receive refunds or credits, obtain the schedule of test dates, and choose a location at which to test. 

For more complete instructions regarding how to register, please review the “Registration Information” section of the CBT Tutorial

How do candidates schedule their computer-based COMLEX-USA examinations?
Following registration through the electronic on-line registration system, candidates may schedule an examination date through the NBOME website.

For more complete instructions regarding how to register, please review the “Registration Information” section of the CBT Tutorial.

What types of score reports will candidates and schools receive from their computer-based COMLEX-USA examinations?  When and how will the scores be reported?
For the computer-based COMLEX-USA examinations, candidates will still receive an official printed copy of their score reports from the NBOME by mail.  The student score report will provide 3-digit standard scores, 2-digit standard scores, and a pass/fail designation. The 2-digit scores are linear transformations of the 3-digit scores so that 75 is designated as the minimum 2-digit passing score.  Percentile rank will no longer be reported due to the fact that candidates will be taking the examination throughout the year.  In addition, candidates will also be provided with a graphical performance profile according to the COMLEX-USA content categories.  This is similar to the reports for paper-pencil COMLEX-USA examinations. 

In general, candidates can expect to receive test results 4 to 6 weeks after the test is taken.  However, for the candidates who take the first several administrations of the computer-based COMLEX-USA examinations, test results will not be available until a reasonable national norm is achieved.  Therefore, it may take 3-4 months to report the results for those first candidates.

Since computer-based COMLEX-USA will be administered continuously throughout the year, osteopathic medical schools will receive summary reports annually at the end of a school year.  The school summary report will still include school information compared with the national average performance.

Scores for computer-based COMLEX-USA examinations will also be available via secured student and school web accounts.  Every COMLEX-USA candidate will be able to establish a secured web account provided by the NBOME during the registration process for the examinations.  When scoring is finished, the NBOME will post a 3-digit score, a 2-digit score, and a pass/fail designation to each individual candidate account.  Candidates will be able to access the test results immediately after they are available along with their examination history.  Similarly, osteopathic schools will have secure web accounts.  The NBOME will post test results to school accounts immediately after the results are available, and schools may go to their individual accounts to obtain up-to-date information about their students’ test-taking activities and test results at any time.

What is the cost of computer-based COMLEX-USA?
The cost associated with the CBT version of the COMLEX-USA is higher than for the paper-pencil examinations due to changes in administrative and delivery processes that are associated with a computer-based examination. 

The NBOME has attempted to keep the cost as low and competitive as possible, while providing a high-quality and thoroughly secure examination.  Please refer to the current fee schedule posted on the NBOME website.

Are accommodations for the computer-based COMLEX examinations available for those with impairments?
The NBOME is fully compliant with Federal regulations for those individuals with properly documented impairments.  All candidates who wish to request an accommodation must contact the Chicago office directly to receive an application requesting an accommodation.  All applications that are filed for accommodation must meet NBOME guidelines, and provide the requested current supportive information in order to be considered for an appropriate accommodation.  Each application is reviewed on a case-by-case basis.  Prior accommodation does not necessarily guarantee accommodations in the future.

Is there more information and an opportunity to see what the CBT test is like?
Yes.  It is suggested that candidates view the CBT information and tutorial examinations available on the CD posted on the NBOME website.

More Questions?
For those candidates with questions regarding registration or scheduling for the computer-based COMLEX-USA, the NBOME provides a Help Desk that can be reached at 1-866-479-6828.

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