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About COMAT FBS Comprehensive

The COMAT FBS Comprehensive (COMAT FBS-C) 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.

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Format

COMAT FBS-C is given in two, 2-hour sessions with 100 items in each session. Between each session 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 exam 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.

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Examination Blueprint

Content Outline and Assessment Objectives

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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.

  1. Describe gene function, including structure, replication, transcription, translation, exchange, and the functional and/or morphologic expression of genetic conditions.
  2. Describe the cellular and molecular components related to biochemical processes in both normal and pathologic states.
  3. Describe cell signaling including receptors, ligands, and signaling cascades and their effects on cells.
  4. Utilize knowledge of cellular responses to injury, including the underlying etiology, to explain therapeutic interventions.
  5. Explain how metabolic pathway regulation contributes to health and disease.
  6. Describe the principles of bioenergetics and energy metabolism in homeostatic and pathologic states.
  7. Describe digestion, absorption, transport, and metabolism of nutrients in health and disease states.
  8. Describe the normal function of blood cells and other blood components as well as various hematological disorders, including anemias, coagulopathies, and jaundice.
  9. Apply the principles of prevalence, incidence, sensitivity, specificity, predictive value, and confidence intervals to populations and individuals.
  10. Apply principles of inheritance and mechanisms of genetic disorders to risk assessment, testing, therapy, and counseling.
  1. Distinguish between the normal and abnormal development at the level of the cell, tissue, organ, system, and organism.
  2. Identify anatomical processes as they relate to sex, reproduction, and embryology.
  3. Identify microscopic and gross anatomical structures, functions, and their interrelationships in health and disease based on assessments, including imaging and examination.
  4. Describe the structural and functional neuroanatomy of the peripheral nervous system, including motor, sensory, sympathetic, and parasympathetic systems and its relevance to clinical scenarios.
  5. 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.
  1. Describe the structure and functions of the components of the innate and adaptive immune responses.
  2. Apply the principles of immunodiagnostic assays and immunotherapies.
  3. Identify the process leading to the activation of the immune system and its effector mechanisms.
  4. Explain the immune responses to control infectious agents; the development of immunologically mediated diseases; and the immune response to transplants and cancer.
  5. Explain the mechanisms of action of physical and chemical methods used to control microbial growth.
  6. Describe the methodology used for the isolation and identification of microbial pathogens.
  7. Describe the following aspects of diseases caused by microbial pathogens:
    1. Epidemiology and mode of transmission
    2. Unique structural and life cycle characteristics of each pathogen
    3. Mechanisms of pathogenesis
    4. Primary disease manifestations
    5. Diagnostic methodology
    6. Mechanism of treatment and prevention
  1. Explain the physiological basis of cell excitability, general principles of synaptic transmission, and mechanisms underlying the neuromuscular junction.
  2. Explain mechanisms of muscle contraction, excitation-contraction coupling, and distinguishing characteristics of smooth, cardiac, and skeletal muscle function.
  3. Explain the function and regulatory processes for each body system in health and disease.
  4. Describe physiological responses to acid-base disturbances.
  5. Explain the integrative physiological mechanisms involved in the regulation of extracellular fluid volume and composition.
  6. Explain the compensatory responses to physiological stressors.
  7. Explain reflex control mechanisms including humoral and neural feedback and feedforward mechanisms underlying homeostasis and their alterations in disease.
  1. Apply pharmacokinetic and pharmacodynamic concepts with consideration of human health and disease.
  2. Describe mechanisms of action, target organ responses, and physiologic responses to drugs.
  3. Identify indications, contraindications, and adverse outcomes of pharmacotherapy.
  4. Apply knowledge of individual variability to select therapeutic regimens.
  1. Describe the structure, function, and embryology of the central nervous system in normal and pathological states.
  2. Describe the regulation of central nervous system neurotransmitters in health and disease states.
  3. Describe the importance of blood flow and cerebrospinal fluid in the normal and abnormal function of the central nervous system.
  4. Utilize neurological exam findings to localize lesions in the central nervous system.
  5. Interpret imaging studies in identifying normal and abnormal structure/function of the nervous system.

Selected Student and Faculty Learning 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. 4th 2020
Atlas of Human Anatomy Netter 7th 2019
Snell’s Clinical Anatomy by Regions Wineski 10th 2019
Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation Frontera & Silver 4th 2020
Gray’s Anatomy for Students Drake, Vogl, & Mitchell 4th 2019
Gray’s Anatomy: the Anatomical Basis of Clinical Practice Standring 42nd 2020
Histology: A Text and Atlas Pawlina & Ross 8th 2018
Junquiera’s Basic Histology Text and Atlas Mescher 16th 2022
Langman’s Medical Embryology Sadler 14th 2018
Clinically Oriented Anatomy Moore, Dalley, & Agur 9th 2022
Neuroanatomy through Clinical Cases Blumenfeld 3rd 2021
Title Author/Editor Edition Year
Harper’s Illustrated Biochemistry Rodwell, et al. 32nd 2022
Lippincott Illustrated Reviews: Biochemistry Ferrier 8th 2021
Mark’s Basic Medical Biochemistry Lieberman & Marks 6th 2022
Medical Genetics Jorde, Carey, & Bamshad 6th 2019
Thompson & Thompson Genetics in Medicine Nussbaum 9th 2019
Title Author/Editor Edition Year
AccessMedicine Numerous titles
Current Medical Diagnosis & Treatment Papadakis & McPhee 61st 2022
Cecil Textbook of Medicine Goldman & Schafer 26th 2019
DynaMed Plus Regularly updated
Textbook of Family Medicine Rakel 9th 2016
Harrison’s Principles of Internal Medicine Jameson, Fauci, Kasper, Hauser, Longo, & Loscalzo 21st 2022
Nelson’s Textbook of Pediatrics Kliegman & Geme 21st 2019
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) 2013
Synopsis of Psychiatry Kaplan & Saddock 12th 2021
Title Author/Editor Edition Year
Jawetz, Melnick, and Adelberg’s Medical Microbiology Riedel, Morse, Mietzner, & Miller 28th 2019
Medical Microbiology Murray, Rosenthal, & Pfaller 9th 2020
Principles and Practice of Infectious Diseases; Volume 1 & 2 Bennett, Dolin, & Blaser 9th 2019
Principles and Practice of Infectious Diseases; Volume 2 Mandell, Bennett, & Dolin 9th 2019
The Sanford Guide to Antimicrobial Therapy Gilbert, Eliopoulos, & Chambers 48th 2018
Cellular and Molecular Immunology Abbas, Lichtman, and Pillai 10th 2021
Immunology Male, Peebles, & Male 9th 2020
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 8th 2018
Essential Neuroscience Siegel & Sapru 4th 2018
Fundamental Neuroscience Haines & Mihailoff 5th 2017
Neuroanatomy Atlas in Clinical Context Haines 10th 2018
Neuroanatomy through Clinical Cases Blumenfeld 3rd 2021
Adams and Victor’s Principles of Neurology Ropper, Samuels, Klein, & Prasad 11th 2019
Bradley and Daroff’s Neurology in Clinical Practice; Volumes 1 & 2 Jankovic, Mazziotta, Pomeroy, & Daroff 8th 2021
Localization in Clinical Neurology Brazis, Masdeu, & Biller 7th 2016
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 15th 2020
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 11th 2020
Stahl’s Essential Psychopharmacology Stahl 5th 2021
Title Author/Editor Edition Year
Berne & Levy Physiology Koeppen, Stanton 7th 2018
Ganong’s Review of Medical Physiology Barrett, Barman, Yuan, & Brooks 26th 2019
Guyton and Hall Textbook of Medical Physiology Hall & Hall 14th 2020
Medical Physiology Boron & Boulpaep 3rd 2016
Physiology Costanzo 7th 2021

Supplementary Resources

The NBOME uses many supplementary resources to inform the development of the FBS exams, some of which are listed below.

Title Author/Editor Edition Year
Atlas of Anatomy Gilroy, et al. 4th 2020
Atlas of Human Anatomy Netter 7th 2019
Snell’s Clinical Anatomy by Regions Wineski 10th 2019
Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation Frontera & Silver 4th 2020
Gray’s Anatomy for Students Drake, Vogl, & Mitchell 4th 2019
Gray’s Anatomy: the Anatomical Basis of Clinical Practice Standring 42nd 2020
Histology: A Text and Atlas Pawlina & Ross 8th 2018
Junquiera’s Basic Histology Text and Atlas Mescher 16th 2022
Langman’s Medical Embryology Sadler 14th 2018
Clinically Oriented Anatomy Moore, Dalley, & Agur 9th 2022
Neuroanatomy through Clinical Cases Blumenfeld 3rd 2021
Title Author/Editor Edition Year
Harper’s Illustrated Biochemistry Rodwell, et al. 32nd 2022
Lippincott Illustrated Reviews: Biochemistry Ferrier 8th 2021
Mark’s Basic Medical Biochemistry Lieberman & Marks 6th 2022
Medical Genetics Jorde, Carey, & Bamshad 6th 2019
Thompson & Thompson Genetics in Medicine Nussbaum 9th 2019
AccessMedicine Numerous titles
Current Medical Diagnosis & Treatment Papadakis & McPhee 61st 2022
Cecil Textbook of Medicine Goldman & Schafer 26th 2019
DynaMed Plus Regularly updated
Textbook of Family Medicine Rakel 9th 2016
Harrison’s Principles of Internal Medicine Jameson, Fauci, Kasper, Hauser, Longo, & Loscalzo 21st 2022
Nelson’s Textbook of Pediatrics Kliegman & Geme 21st 2019
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) 2013
Synopsis of Psychiatry Kaplan & Saddock 12th 2021
Title Author/Editor Edition Year
Jawetz, Melnick, and Adelberg’s Medical Microbiology Riedel, Morse, Mietzner, & Miller 28th 2019
Medical Microbiology Murray, Rosenthal, & Pfaller 9th 2020
Principles and Practice of Infectious Diseases; Volume 1 & 2 Bennett, Dolin, & Blaser 9th 2019
Principles and Practice of Infectious Diseases; Volume 2 Mandell, Bennett, & Dolin 9th 2019
The Sanford Guide to Antimicrobial Therapy Gilbert, Eliopoulos, & Chambers 48th 2018
Cellular and Molecular Immunology Abbas, Lichtman, and Pillai 10th 2021
Immunology Male, Peebles, & Male 9th 2020
Janeway’s Immunobiology Murphy & Weaver 10th 2022
Basic Clinical Neuroscience Young, Young, Tolbert 3rd 2015
The Central Nervous System Brodal 5th 2016
Snell’s Clinical Neuroanatomy Splittgerber 8th 2018
Essential Neuroscience Siegel & Sapru 4th 2018
Fundamental Neuroscience Haines & Mihailoff 5th 2017
Neuroanatomy Atlas in Clinical Context Haines 10th 2018
Neuroanatomy through Clinical Cases Blumenfeld 3rd 2021
Adams and Victor’s Principles of Neurology Ropper, Samuels, Klein, & Prasad 11th 2019
Bradley and Daroff’s Neurology in Clinical Practice; Volumes 1 & 2 Jankovic, Mazziotta, Pomeroy, & Daroff 8th 2021
Localization in Clinical Neurology Brazis, Masdeu, & Biller 7th 2016
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 15th 2020
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 11th 2020
Stahl’s Essential Psychopharmacology Stahl 5th 2021
Title Author/Editor Edition Year
Berne & Levy Physiology Koeppen, Stanton 7th 2018
Ganong’s Review of Medical Physiology Barrett, Barman, Yuan, & Brooks 26th 2019
Guyton and Hall Textbook of Medical Physiology Hall & Hall 14th 2020
Medical Physiology Boron & Boulpaep 3rd 2016
Physiology Costanzo 7th 2021

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

“Knowledge Objectives in Medical Pharmacology.” Association of Medical School Pharmacology Chairs. 2012.

Physiology

“Medical Physiology Learning Objectives.” The American Physiological Society and the Association of Chairs of Departments of Physiology. 2012.