COMAT FBS Comprehensive
About COMAT FBS Comprehensive
The COMAT Foundational Biomedical Sciences Comprehensive (FBS-C) examination is a summative and formative assessment designed to evaluate knowledge of foundational biomedical sciences among first- and second-year osteopathic medical students in advance of taking COMLEX-USA Level 1. It may also be used by schools and colleges of osteopathic medicine (COMs) for formative purposes.
Format
COMAT FBS-C is given in two, 2-hour sections with 100 items in each section. Between each section is an optional break, the length of which is at the discretion of each COM. Unused test time from section 1 will not be added to section 2.
The FBS-C examination is offered in multiple forms, all of which are psychometrically equivalent in content covered, level of difficulty, and reliability, allowing COMs to administer FBS-C exams multiple times per year.
Why COMAT-FBS?
Michael L. Smith, PhD, year 1 curriculum director and director of multidisciplinary programs at the Texas College of Osteopathic Medicine, discusses how COMAT-FBS can help schools measure student progress toward COMLEX-USA Level 1.
Examination Blueprint
Content Outline and Assessment Objectives
The FBS-C examination may be used for end-of-course assessment for students enrolled at a school or college of osteopathic medicine (COM). Individual COMs may also administer the examination at other times in accordance with their curriculum goals and mission.
This examination emphasizes core knowledge and elements of osteopathic principles and practice in the foundational biomedical sciences disciplines that are essential for the predoctoral osteopathic medical student.
The exam blueprint below contains the FBS topics covered in two dimensions: Dimension 1 – Body Systems and Dimension 2 – Disciplines.
Dimension 1: Body Systems
| Topic | Percentage |
|---|---|
| Human Development, Reproduction, and Sexuality | 3-9% |
| Endocrine System and Metabolism | 8-12% |
| Nervous System and Mental Health | 10-15% |
| Musculoskeletal System | 8-12% |
| Genitourinary/Renal System | 6-10% |
| Gastrointestinal (GI) System and Nutritional Health | 8-12% |
| Cardiovascular and Hematologic Systems | 10-15% |
| Respiratory System | 9-14% |
| Integumentary System | 3-6% |
| Foundational Biomedical Principles | 12-17% |
Dimension 2: Disciplines Blueprint
| Topic | Percentage |
|---|---|
| Biochemistry and Genetics | 12-20% |
| Foundational Anatomical Sciences | 12-20% |
| Microbiology and Immunology | 12-20% |
| Physiologic Basis of Health and Disease | 12-20% |
| Pharmacologic Principles and Concepts | 12-20% |
| Foundational Neurosciences | 12-20% |
General Learner-Centered Objectives
Based on the general learner-centered objectives outlined in the FBS examination blueprint, the examinee will be required to demonstrate the ability to apply:
- Knowledge and clinical problem-solving as related to the application of knowledge for medical practice in the Fundamental Osteopathic Medical Competency Domains.
- Foundational content knowledge to situations and patient presentations encountered in clinical settings and important to foundational biomedical science disciplines.
- Foundational content knowledge and clinical problem-solving ability related to physician tasks critical to medical practice.
Selected Specific Learning Elements
Please note that selected specific learning elements are included for disciplines only due to the overlap between these learning elements and what would be included with body systems.
- Describe gene function, including structure, replication, transcription, translation, exchange, and the functional and/or morphologic expression of genetic conditions.
- Describe the cellular and molecular components related to biochemical processes in both normal and pathologic states.
- Describe cell signaling including receptors, ligands, and signaling cascades and their effects on cells.
- Utilize knowledge of cellular responses to injury, including the underlying etiology, to explain therapeutic interventions.
- Explain how metabolic pathway regulation contributes to health and disease.
- Describe the principles of bioenergetics and energy metabolism in homeostatic and pathologic states.
- Describe digestion, absorption, transport, and metabolism of nutrients in health and disease states.
- Describe the normal function of blood cells and other blood components as well as various hematological disorders, including anemias, coagulopathies, and jaundice.
- Apply the principles of prevalence, incidence, sensitivity, specificity, predictive value, and confidence intervals to populations and individuals.
- Apply principles of inheritance and mechanisms of genetic disorders to risk assessment, testing, therapy, and counseling.
- Distinguish between the normal and abnormal development at the level of the cell, tissue, organ, system, and organism.
- Identify anatomical processes as they relate to sex, reproduction, and embryology.
- Identify microscopic and gross anatomical structures, functions, and their interrelationships in health and disease based on assessments, including imaging and examination.
- Describe the structural and functional neuroanatomy of the peripheral nervous system, including motor, sensory, sympathetic, and parasympathetic systems and its relevance to clinical scenarios.
- Describe the organization of blood supply, venous drainage, and lymphatic systems as they relate to the constituents of each anatomical compartment or cavity and its relevance to clinical scenarios.
- Describe the structure and functions of the components of the innate and adaptive immune responses.
- Apply the principles of immunodiagnostic assays and immunotherapies.
- Identify the process leading to the activation of the immune system and its effector mechanisms.
- Explain the immune responses to control infectious agents; the development of immunologically mediated diseases; and the immune response to transplants and cancer.
- Explain the mechanisms of action of physical and chemical methods used to control microbial growth.
- Describe the methodology used for the isolation and identification of microbial pathogens.
- Describe the following aspects of diseases caused by microbial pathogens:
- Epidemiology and mode of transmission
- Unique structural and life cycle characteristics of each pathogen
- Mechanisms of pathogenesis
- Primary disease manifestations
- Diagnostic methodology
- Mechanism of treatment and prevention
- Explain the physiological basis of cell excitability, general principles of synaptic transmission, and mechanisms underlying the neuromuscular junction.
- Explain mechanisms of muscle contraction, excitation-contraction coupling, and distinguishing characteristics of smooth, cardiac, and skeletal muscle function.
- Explain the function and regulatory processes for each body system in health and disease.
- Describe physiological responses to acid-base disturbances.
- Explain the integrative physiological mechanisms involved in the regulation of extracellular fluid volume and composition.
- Explain the compensatory responses to physiological stressors.
- Explain reflex control mechanisms including humoral and neural feedback and feedforward mechanisms underlying homeostasis and their alterations in disease.
- Apply pharmacokinetic and pharmacodynamic concepts with consideration of human health and disease.
- Describe mechanisms of action, target organ responses, and physiologic responses to drugs.
- Identify indications, contraindications, and adverse outcomes of pharmacotherapy.
- Apply knowledge of individual variability to select therapeutic regimens.
- Describe the structure, function, and embryology of the central nervous system in normal and pathological states.
- Describe the regulation of central nervous system neurotransmitters in health and disease states.
- Describe the importance of blood flow and cerebrospinal fluid in the normal and abnormal function of the central nervous system.
- Utilize neurological exam findings to localize lesions in the central nervous system.
- Interpret imaging studies in identifying normal and abnormal structure/function of the nervous system.
Supplementary Resources
In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the FBS exams are listed below.
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Atlas of Anatomy | Gilroy, et al. | 5th | 2025 |
| Atlas of Human Anatomy | Netter | 9th | 2026 |
| Snell’s Clinical Anatomy by Regions | Wineski | 11th | 2024 |
| Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation | Frontera & Silver | 5th | 2025 |
| Gray’s Anatomy for Students | Drake, Vogl, & Mitchell | 5th | 2013 |
| Gray’s Anatomy: the Anatomical Basis of Clinical Practice | Standring | 43rd | 2026 |
| Histology: A Text and Atlas | Pawlina & Ross | 9th | 2023 |
| Junquiera’s Basic Histology Text and Atlas | Mescher | 18th | 2026 |
| Langman’s Medical Embryology | Sadler | 15th | 2023 |
| Clinically Oriented Anatomy | Moore, Dalley, & Agur | 10th | 2026 |
| Neuroanatomy through Clinical Cases | Blumenfeld | 3rd | 2021 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Harper’s Illustrated Biochemistry | Rodwell, et al. | 33rd | 2026 |
| Lippincott Illustrated Reviews: Biochemistry | Ferrier | 9th | 2025 |
| Mark’s Basic Medical Biochemistry | Lieberman & Marks | 6th | 2022 |
| Medical Genetics | Jorde, Carey, & Bamshad | 7th | 2026 |
| Thompson & Thompson Genetics in Medicine | Nussbaum | 9th | 2019 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| AccessMedicine | Numerous titles | ||
| Current Medical Diagnosis & Treatment | Papadakis & McPhee | 65th | 2026 |
| Cecil Textbook of Medicine | Goldman & Schafer | 27th | 2024 |
| DynaMed Plus | Regularly updated | ||
| Textbook of Family Medicine | Rakel | 10th | 2026 |
| Harrison’s Principles of Internal Medicine | Jameson, Fauci, Kasper, Hauser, Longo, & Loscalzo | 22nd | 2025 |
| Nelson’s Textbook of Pediatrics | Kliegman & Geme | 22nd | 2024 |
| Essentials of Obstetrics and Gynecology | Hacker | 6th | 2016 |
| Tintinalli’s Emergency Medicine: A Comprehensive Study Guide | Tintinalli et al. | 9th | 2019 |
| Diagnostic and Statistical Manual of Mental Disorders (DSM) | APA | 5th (DSM-5-TR) | 2022 |
| Synopsis of Psychiatry | Kaplan & Saddock | 12th | 2021 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Jawetz, Melnick, and Adelberg’s Medical Microbiology | Riedel, Morse, Mietzner, & Miller | 29th | 2026 |
| Medical Microbiology | Murray, Rosenthal, & Pfaller | 10th | 2025 |
| Principles and Practice of Infectious Diseases; Volume 1 & 2 | Bennett, Dolin, & Blaser | 10th | 2025 |
| Principles and Practice of Infectious Diseases; Volume 2 | Mandell, Bennett, & Dolin | 10th | 2025 |
| The Sanford Guide to Antimicrobial Therapy | Gilbert, Eliopoulos, & Chambers | 55th | 2025 |
| Cellular and Molecular Immunology | Abbas, Lichtman, and Pillai | 11th | 2025 |
| Immunology | Male, Peebles, & Male | 10th | 2025 |
| Janeway’s Immunobiology | Murphy & Weaver | 10th | 2022 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Basic Clinical Neuroscience | Young, Young, Tolbert | 3rd | 2015 |
| The Central Nervous System | Brodal | 5th | 2016 |
| Snell’s Clinical Neuroanatomy | Splittgerber | 9th | 2024 |
| Essential Neuroscience | Siegel & Sapru | 4th | 2018 |
| Fundamental Neuroscience | Haines & Mihailoff | 6th | 2025 |
| Neuroanatomy Atlas in Clinical Context | Haines | 11th | 2024 |
| Neuroanatomy through Clinical Cases | Blumenfeld | 3rd | 2021 |
| Adams and Victor’s Principles of Neurology | Ropper, Samuels, Klein, & Prasad | 12th | 2023 |
| Bradley and Daroff’s Neurology in Clinical Practice; Volumes 1 & 2 | Jankovic, Mazziotta, Pomeroy, & Daroff | 9th | 2026 |
| Localization in Clinical Neurology | Brazis, Masdeu, & Biller | 8th | 2021 |
| Orthopaedic Neurology: A Diagnostic Guide to Neurologic Levels | Hoppenfeld & Hoppenfeld | 2nd | 2017 |
| Practical Neurology | Biller | 5th | 2019 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Basic and Clinical Pharmacology | Katzung | 16th | 2023 |
| Drug Facts and Comparisons | Kastrup | 70th | 2016 |
| Goodman & Gilman’s The Pharmacological Basis of Therapeutics | Brunton, Chabner, & Knollman | 14th | 2022 |
| Lippincott’s Illustrated Reviews: Pharmacology | Whalen, Radhakrishnan, & Feild | 8th | 2022 |
| Pharmacotherapy: A Pathophysiologic Approach | Dipiro, Talbert, Yee, Matzke, Wells, & Posey | 13th | 2026 |
| Stahl’s Essential Psychopharmacology | Stahl | 5th | 2021 |
| Title | Author/Editor | Edition | Year |
|---|---|---|---|
| Berne & Levy Physiology | Koeppen, Stanton | 8th | 2023 |
| Ganong’s Review of Medical Physiology | Barrett, Barman, Yuan, & Brooks | 27th | 2025 |
| Guyton and Hall Textbook of Medical Physiology | Hall & Hall | 15th | 2025 |
| Medical Physiology | Boron & Boulpaep | 4th | 2026 |
| Physiology | Costanzo | 8th | 2026 |
Additional References
Biochemistry
- DNA Replication Objectives. Association of Biochemistry Educators (ABE). 2011
- Blood Objectives. ABE. 2011
- Carbohydrate Metabolism Objectives. ABE. 2011
- Lipid Metabolism Objectives. ABE. 2011
- Signaling Hormones and Diabetes Objectives. ABE. 2011
- Protein and Amino Acid Metabolism Objectives. ABE. 2011
- Nucleotide Metabolism Objectives. ABE. 2011
- Medical Biochemistry Competencies (with UME appendix). ABE. 2011
Resources
Genetics
“Medical School Core Curriculum in Genetics.” Association of Professors of Human and Medical Genetics. 2013.
Microbiology and Immunology
“General Principles of Foundational Science: Microbial biology. Immune System.” USMLE Content Outline (pp. 3-5). National Board of Medical Examiners. 2015.
Pharmacology
“Pharmacology Knowledge Objectives.” American Society for Pharmacology and Experimental Therapeutics and Association of Medical School Pharmacology Chairs. 2022.
Physiology
“Medical Physiology Learning Objectives.” The American Physiological Society and the Association of Chairs of Departments of Physiology. 2012.