Contact Us: 866.479.6828

COMAT Test Administration Guide


I. Overview

The purpose of this guide is to provide a reference to the colleges of osteopathic medicine (COMs) for the Comprehensive Osteopathic Medical Achievement Test (COMAT) Clinical, Foundational Biometrical Sciences Comprehensive and Targeted administrations.

II. Description of the COMAT Series

The National Board of Osteopathic Medical Examiners (NBOME) COMAT series includes eight core clinical subject examinations (COMAT Clinical), a comprehensive foundational biomedical sciences (COMAT FBS-C) examination, fourteen targeted FBS examinations (COMAT FBS-T), and self evaluation (COMAT-SE).

The COMAT Clinical examinations are designed for standardized assessment in core osteopathic medical disciplines, such as end-of-course or clinical rotation student assessment, and assess an osteopathic student's achievement level on those disciplines. Each Clinical examination in the series has osteopathic principles and practice integrated throughout, making it the obvious choice for COMs for student assessment needs. The Clinical examinations are also the only osteopathically distinctive discipline-specific examinations available.

The FBS-C examination is designed for standardized assessment in overall basic sciences, as studied in the first and second years of medical school, and assesses an osteopathic student’s achievement level across both basic science disciplines and body systems.

The FBS-T examinations are designed for standardized assessment in specific basic science disciplines and body systems, as studied in the first and second year of medical school, and assess an osteopathic student’s achievement in individual basic science disciplines and body systems.

COMAT-SE is designed to assist osteopathic medical students in preparing for COMAT Clinical examinations.

All exams in the COMAT series are:

  • Presented in a style and format comparable to the COMLEX-USA licensure series
  • Created to reflect osteopathic physician practice
  • Written by osteopathic and FBS discipline subject matter experts

III. COMAT Use Policy

The NBOME develops and provides the COMAT series to be administered by the COMs to assess the osteopathic medical knowledge of their medical students in the following areas:

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

Dimension 1 | Body Systems

  • Human Development, Reproduction, and Sexuality
  • Endocrine System and Metabolism
  • Nervous System and Mental Health
  • Musculoskeletal System
  • Genitourinary/Renal System
  • Gastrointestinal (GI) System and Nutritional Health
  • Cardiovascular and Hematologic Systems
  • Respiratory System
  • Integumentary System
  • Foundational Biomedical Principles

Dimension 2 | Disciplines

  • Biochemistry and Genetics
  • Foundational Anatomical Sciences
  • Microbiology and Immunology
  • Physiologic Basis of Health and Disease
  • Pharmacologic Principles and Concepts
  • Foundational Neurosciences

Body Systems

  • Human Development, Reproduction, and Sexuality
  • Musculoskeletal System
  • Genitourinary/Renal System
  • Gastrointestinal (GI) System and Nutritional Health
  • Cardiovascular and Hematologic Systems
  • Respiratory System
  • Integumentary System
  • Endocrine System and Metabolism


  • Biochemistry and Genetics
  • Foundational Anatomical Sciences
  • Microbiology and Immunology
  • Physiologic Basis of Health and Disease
  • Pharmacologic Principles and Concepts
  • Foundational Neurosciences
  • Osteopathic Principles & Practice (OPP)

COMs must maintain the security and integrity of the COMAT series.

IV. Examination Layout and Features

  • COMAT Clinical Subjects
    • 120 Questions
    • 2.5 Hours
    • 8 Subject Exams


    • 200 Questions, divided in 2 sections
    • 4 Hours* divided into two 2-hour sections
    • 16 Content Areas

    *Optional break after section 1 is completed.


    • 62 Questions
    • 1.5 Hours
    • 14 Content areas


    • 60 Questions
    • Option for Timed and Untimed Forms
    • Self-Paced
    • Real-time feedback and progress
    Key Features
    • Increase font size
    • Adjusted color scheme
    • Highlight
    • Strikeout
    • Mark item for review
    • Item level feedback
    • Embedded lab value for patient laboratory values and reference ranges
    • No calculator
    • No video or audio questions
  • V. Roles and Responsibilities

    COM Dean and Administrator

    Determine the utilization of COMAT examinations and work with the NBOME to execute a COMAT Master Agreement for examination administration and annual agreement renewal.

    COMAT Coordinator

    A COMAT Coordinator is designated by the dean to manage COMAT administrations for their COM students. The primary responsibilities of the COMAT coordinator are to:

    • Oversee administrative tasks for the COMAT administrations
    • Ensure that all COMAT administrations are delivered in a secure, proctored setting
    • Report and follow up with NBOME on adverse testing conditions that might impact the administration. Please refer to the COMAT Proctor Guide.
    • Manage COMAT invoices and payment

    COMAT Proctor

    COMAT examinations should be proctored by a COM-approved proctor. The primary responsibilities of the COMAT proctor include:

    • Secure a quiet location to administer the COMAT examination
    • Conduct the examination according to the specified procedures in the COMAT Proctor Guide
    • Run system checks and resolve any issues prior to COMAT administrations and ensure that the secure browser has been downloaded to all work stations if devices are provided for testing
    • Ensure test security and minimal disturbance
    • Monitor students throughout the examination
    • Report to COMAT administrator of adverse testing conditions that might impact the administration

    COMAT Students

    COMAT students are expected to:

    • Prepare any personal equipment prior to examination date
    • Conduct system check and download secure browser prior to examination date

    VI. Delivery Options

    In response to COM needs, the NBOME offers COM 3 delivery options:

    • In-Person Proctored at COM Approved Location(s) secure setting
    • Remote Proctored by COM proctor(s) in a secure setting
    • Self-Proctored at a secure setting chosen by student

    VII. Registration and Scheduling

    A COMAT Coordinator can schedule examination, choose the examination location, and assign a proctor via the NBOME secure portal up to the day of the examination administration. The registration includes selecting the student from the class list, choosing the specific examination, and assigning the date, location and proctor. For students who are approved by COM with accommodations, please refer to Section IX. Test Accommodations Requests.

    COMAT Coordinator can also reschedule or cancel the scheduled examination via the NBOME secure portal. COMs can make changes to a scheduled examination date at any time unless the examination is in progress. A missed examination can be scheduled for a new date at no cost to the COM.

    No COMAT examinations will be administered on Saturdays and Sundays, NBOME holidays and during examination blackout periods. Please check the NBOME website at COMAT Clinical Non-Testing Days and COMAT FBS Non-Testing Days for more information.

    VII. Retaking an Examination

    Students are allowed to retake COMAT examinations under the direction of their COM. COMs should allow students to retake the same COMAT examination subject only after receiving the prior examination result.

    IX. Test Accommodations Requests

    The COM is responsible for review and approval of all test accommodations requests for the COMAT administrations. The COM is responsible for all additional costs required to provide the approved accommodation. NBOME will make a good faith effort to provide such reasonable test accommodations as the COM determines are warranted for the students. For additional questions, please contact the NBOME client services at 866-479-6828 or clientservices@nbome.org.

    X. Examination Administration

    Arrival and Identification: For In-Person and Remote-proctored deliveries, proctors are responsible for verifying the identity of each student during the check-in process. A valid identification card is required to be provided by the student. The COM establishes the arrival and start time for an examination.

    Late Arrival: The COM will determine whether a student is allowed to sit for the examination upon late arrival to the examination session. No outside information or access while examination is in session: During the examination session, students are not permitted to access any information or data, including but not limited to any access to a cellular phone, electronic devices, text, notes or other materials, and may not communicate with anyone outside the testing area, in any manner.

    Interruption of Examination or Computer Malfunction for All Approved Locations: In the event of an examination interruption, the proctor will determine whether the examination can be resumed from the point the examination was stopped; the proctor will also determine if the examination interruption warrants the examination to be administered in its entirety.

    If the examination is interrupted for a period of time that will not permit the completion of the examination administration, or if the examination is canceled for emergency or safety purposes, the COM must inform NBOME immediately. NBOME will not score the examination in these cases. If the issue is not reported to the NBOME, the score will be released to the COM.

    Cancelation Due to Inclement Weather, Other Force Majeure: If a student is unable to test due to inclement weather, force majeure, or other event beyond the control of the COM, the examination can be rescheduled.

    Emergency Evacuation for All Approved Locations: Students will follow the emergency evacuation instructions of the testing site. For self-or remote proctored delivery, students must inform their COM as soon as they are able to do so.

    Test Day Issues: Students who encounter test day issues must report to their proctor and their COM immediately. The NBOME will work with the COM to review the issue to determine the appropriate resolution. If a student does not complete the examination for any reason, the school will still be responsible for payment of the examination.

    XI. Conduct

    The COM should follow its policy to prevent any possible irregularities in examination administration, student behavior, breach of test security, or confidentiality. Any proctor who suspects irregular conduct by a student during a COMAT administration should report the conduct to the COM and NBOME. The proctor should also report any irregularities in the proctor log.

    XII. Voided Examination Administration

    The NBOME can remove a score for an examination requested by the COM or under circumstances where NBOME determines the test administration was adversely impacted and/or the test administration or results were otherwise deemed by NBOME to be invalid. Students may not void their COMAT examination score for any reason.

    XIII. Fees and Invoice

    Examination Fees

    The examination fees for all COMAT examinations will follow the pricing structure set forth on the COMAT Master Agreement.

    Rescheduling and Cancelation Fee

    The rescheduling and cancelation fees for all COMAT examinations will follow the pricing structure set forth on the NBOME Master Agreement.


    All fees are invoiced after the examination administrations and are issued to COM on a monthly basis. The NBOME will not collect any fee directly from students.

    XIV. Scoring and Reporting

    The NBOME provides summary reports for single COMAT administrations, as well as cumulative reports for individual subjects within a COMAT testing cycle. Reports for single administrations may include summary statistics, performance profile, cumulative frequency distribution, score roster, and item key phrase report.

    COMAT Clinical

    Scores for examinations administered from Monday – Friday will be released on Thursday of the following week. This varies slightly when a new testing cycle begins or when there are non-testing days scheduled.


    Scores for COMAT FBS examinations administered from Monday – Friday will be released on the Wednesday of the following week. This varies slightly when a new testing cycle begins or when there are non-testing days scheduled.

    The reports are posted on the dean’s page. COMs can release individual score reports to student’s CRS account. The NBOME does not send the COMAT student score reports to students directly.

    Reported scores for most COMAT examinations are nationally normed standard scores, which reflect equating between different forms. Standard scores for COMAT Clinical subjects are set to have a mean of 100 and a standard deviation of 10, based on a representative norming sample. For COMAT FBS Comprehensive examinations, scores have a mean of 200 and an approximate standard deviation of 10, based on a national sample of examinees in their 2nd year in osteopathic medical school. Currently, normed standard scores are not available for COMAT FBS Targeted examinations, and percent correct score reports will be used.

    Standard score scales are reviewed annually, and may be reestablished at the discretion of the NBOME. Reported scores initially provided for new examination subjects are percent correct scores. After approximately one year of availability, percent correct scores are converted to standard scores, and all subsequent reported scores for the subject are standard scores.

    XV. Score Confirmation

    The NBOME conducts a thorough quality assurance process to ensure the accuracy of all candidate scores. Additionally, we will confirm an exam score for any COMAT exam if a school coordinator submits a written request within 30 days after scores are released.

    Individual students may not request score confirmations.

    Because score confirmation is limited solely to computer-recorded responses, the score is unlikely to change. The NBOME will ensure all sections of the exam were completed and that responses were graded against the proper form. The NBOME does not release information about the scoring of individual exam questions.

    The fee for score confirmation is $25, and the request must be accompanied by a check or credit card information. A score confirmation entails retrieving the original test responses, checking for testing or data abnormalities, rescoring using a process different from the operational scoring process, and comparing the rescored results with the originally reported scores. Results of a score confirmation will be sent to the school coordinator by NBOME Client Services within two weeks of the request.

    XVI. NBOME and ITS Administration

    The NBOME provides support for all COMAT administrations between the hours of 8 AM-5 PM (Central Time) Monday through Friday with the exception of NBOME holidays.

    NBOME Client Services can be reached at (866) 479-6828, and ITS Technical Support can be reached at (800) 514-8494 between the hours of 8 AM and 8 PM (Eastern Time).

    More information for...