fbpx
NBOME
COMLEX-USA BULLETIN of INFORMATION

COMLEX-USA Bulletin of Information 2021–2022

Effective 07/01/2021

Table of Contents

Inquiries

Introduction

Terms and Conditions

Description of Examinations

COMLEX-USA Eligibility

Requirements
A candidate must meet the requirements outlined below. Examinations must be taken in sequence and each Level passed before the candidate is eligible to take the next Level.

Prerequisites

COMLEX-USA Level 1

  • Completion of the first year of study at an accredited COM1
  • Attestation by the COM that the candidate is in good academic and professional standing2

COMLEX-USA Level 2-CE

  • Passing of COMLEX-USA Level 1
  • Completion of the second year of study at an accredited COM1
  • Attestation by the COM that the candidate is in good academic and professional standing2

COMLEX-USA Level 2-PE

  • Effective March 2020, the exam was indefinitely suspended


COMLEX-USA Level 3

  • Pass COMLEX-USA Level 2-CE
  • Pass Level 2-PE or meeting attestation requirements as outlined below:
    Class of 2020, 2021: Attestation by COM Dean that you have graduated and have demonstrated the fundamental osteopathic clinical skills necessary for graduation
    Class of 2022: Enhanced Attestation by COM Dean that you have graduated and have demonstrated the fundamental osteopathic clinical skills necessary for graduation
  • Graduation from an accredited COM1
  • Earned a DO degree
  • Attestation by a program director3,4 in an ACGME-accredited residency program; that the candidate is in good academic and professional standing2

1 An accredited COM is a college of osteopathic medicine (COM) accredited by the American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA).

2 “Good academic and professional standing” denotes that the candidate meets the academic and professional requirements of the college of osteopathic medicine or residency program and is eligible to continue as a student or resident in the program.

3 Individual who meets the requirements and qualifications as deemed by the ACGME as the director of a residency program and designated with authority and accountability for the operation of a residency/fellowship program.

4 Candidates not in a residency program, refer to Temporary Alternate Attestation pathway below.

VERIFICATION: All levels require the COM dean’s office to confirm eligibility requirements are met.

NOTE: Attestation by a residency program director that a candidate is in good academic and professional standing in an ACGME-accredited residency program is required for Level 3 eligibility for graduates after 2018. This attestation does not expire unless rescinded by the program director and is good for up to the six-attempt limit and four attempts in any 12- month period. An attestation can be provided by a program director up to six months after a candidate leaves or graduates from a program.

NBOME recommends but does not require that a candidate has completed six months in a residency program prior to taking the Level 3 examination. The exception to this is that candidates who have previously failed COMLEX-USA Level 2-PE examination and have not had an opportunity to retake the exam are required to complete six months of residency, and satisfy all other requirements as stated above.


Pathway Attestations for the Classes of 2020 and 2021
On March 11, 2021 the Special Commission on Osteopathic Medical Licensure Assessment announced three temporary eligibility pathways for the class of 2020 and 2021 for the COMLEX-USA Level 3. Below are the requirements for each of these pathways.

Pathway 1 (Traditional): for the Classes of 2020 and 2021 who have taken and passed COMLEX-USA Level 2-PE (as for prior DO graduates)

  • Pass both COMLEX-USA Level 2-CE and Level 2-PE
  • Graduation from an accredited college of osteopathic medicine (COM) with a DO degree as attested by the COM dean who will attest, “You are acknowledging that each student submitted is in good academic and professional standing, meets the requirements to graduate from your COM and that they have demonstrated the fundamental osteopathic clinical skills necessary for graduation.”
  • Attestation by the residency program director of an ACGME-accredited program that you are in good academic and professional standing
  • Six months of GME completion prior to taking COMLEX-USA Level 3 (Recommendation ONLY)


Pathway 2: for the Class of 2021, who have never taken COMLEX-USA Level 2-PE

  • Pass COMLEX-USA Level 2-CE
  • Graduation from an accredited college of osteopathic medicine (COM) with a DO degree as attested by the COM dean who will attest, “You are acknowledging that each student submitted is in good academic and professional standing, meets the requirements to graduate from your COM and that they have demonstrated the fundamental osteopathic clinical skills necessary for graduation.”
  • Attestation by the residency program director of an ACGME-accredited program that you are in good academic and professional standing
  • Six months of GME completion prior to taking COMLEX-USA Level 3 (Recommendation ONLY)

Pathway 3: for the classes of 2020 and 2021, who have unsuccessfully attempted (failed) COMLEX-USA Level 2-PE

  • Passing COMLEX-USA Level 2-CE
  • Graduation from an accredited college of osteopathic medicine (COM) with a DO degree as attested by the COM dean who will attest, “You are acknowledging that each student submitted is in good academic and professional standing, meets the requirements to graduate from your COM and that they have demonstrated the fundamental osteopathic clinical skills necessary for graduation.”
  • Attestation by the Residency Program Director of an ACGME-accredited program that you are in good academic and professional standing
  • Six months of GME completion prior to taking COMLEX-USA Level 3 (Required)

Pathway for Enhanced Attestation for the Class of 2022

In June 2021, the Special Commission on Osteopathic Medical Licensure Assessment announced the requirements for an enhanced attestation by the COM dean for a temporary eligibility pathway for the Class of 2022 for the COMLEX-USA Level 3. Below are the requirements for this pathway.
  • Passing COMLEX-USA Level 2-CE
  • Graduation from an accredited college of osteopathic medicine (COM) with a DO degree as attested by the COM dean who will provide an enhanced attestation that, “You are acknowledging that each student submitted is in good academic and professional standing, meets the requirements to graduate from your COM and that they have demonstrated the fundamental osteopathic clinical skills necessary for graduation.”
  • Attestation by the residency program director of an ACGME-accredited program that you are in good academic and professional standing
  • Six months of GME completion prior to taking COMLEX-USA Level 3 (Recommendation Only)


Temporary Alternate Pathway Attestation
For those candidates who are not in any residency program and therefore unable to attain a residency program director attestation, NBOME has created a temporary alternate pathway. The NBOME will accept a request from a dean of a college of osteopathic medicine for a temporary alternate pathway for COMLEX- USA Level 3 attestation for candidates who graduated in 2018 or later. This temporary alternate attestation will be reviewed during 2021 to determine if it will continue in 2022. The dean will attest to the candidate’s good academic and professional standing based on the conditions outlined in the petition guidelines. Read the petition guidelines and download the petition form.

Temporary Alternate Pathway Attestation (Dean’s Level 2-PE Verification)
For candidates who failed the COMLEX-USA Level 2-PE examination and did not have the opportunity to retake and pass, their deans will need to provide a Dean’s Verification attestation to confirm they have the fundamental osteopathic clinical skills necessary to graduate. With this verification attestation we would no longer require six months of GME training prior to taking the Level 3 examination. All other conditions noted above for the original Temporary Alternate Pathway Attestation will apply to this new attestation and the petition guidelines will include the additional criteria used by the dean to provide this Dean’s Level 2-PE Verification.

Grandfathered Attestation
For candidates who graduated in 2017 or earlier the NBOME has created a “grandfathered” attestation for Level 3 eligibility. Candidates must have been previously eligible to take the COMLEX-USA Level 3 examination, request to waive the Residency Program Director Attestation and did or did not participate in a residency program. This grandfathered eligibility attestation includes all requirements for other attestations such as multiple attempts up to our six attempt limit and a limit of four attempts in any twelve month period.

Additional Information

All candidates must:

  • Establish or maintain an online account with NBOME (see also Registration and Scheduling).
  • Agree to the Terms and Conditions described herein.
  • Provide proof of identity at the time of the examination (see also Examination Administration).
  • Understand and agree that no candidate may take any Level examination for practice or to improve their score for any purpose other than to pass a previously failed examination or an examination where the score has been voided.

Sequence of Examinations

COMLEX-USA is a three-level examination sequence that must be taken in order as follows. All eligibility requirements are outlined above.

Examination Sequence

In order to take A candidate
COMLEX-USA LEVEL 1 Must meet all eligibility requirements to begin the examination sequence
COMLEX-USA LEVEL 2-CE Must meet all eligibility requirements and have taken and passed COMLEX-USA Level 1
COMLEX-USA LEVEL 3 Must meet all eligibility requirements and have taken and passed
COMLEX-USA Level 1 and Level 2-CE

Retaking An Examination

If a Candidate’s Score Levels 1, 2-CE AND 3
IS PASSING Candidate is not permitted to retake examination to improve their score
IS FAILING Candidate may retake examination a maximum of four times in any 12-month period
IS NOT SCORED Candidate may retake examination a maximum of four times in any 12-month period

LIMITED NUMBER OF ATTEMPTS

Candidates taking COMLEX-USA examinations are limited to a total of six (6) attempts for each examination.

EXCEPTION TO SIX-ATTEMPT LIMIT

The only consideration for an exception to this policy for one additional attempt beyond the six-attempt limit is at the explicit request of a Medical Licensing Agency.

For NBOME to waive the limitation of a maximum of six attempts for any COMLEX-USA examination, candidates are required to:

  • Obtain a written petition for waiver from a Medical Licensing Agency;
  • Submit written documentation from the COM confirming the candidate remains in good academic and professional standing.
NOTICE of PLANNED CHANGE to POLICY:
Effective July 1, 2022, candidates taking COMLEX-USA examinations will be limited to a total of four (4) attempts for each examination (COMLEX-USA Level 1, Level 2-CE, and Level 3), including but not limited to all attempts prior to July 1, 2022. After June 30, 2022, no candidate will be allowed to take any examination more than four (4) times without obtaining approval from the NBOME.


CHANGE IN ELIGIBILITY STATUS

If a COM, residency program director or NBOME deems a candidate ineligible before administration of an examination

  • The candidate may not take the examination.
  • The candidate is required to promptly notify NBOME in writing via email of ineligibility to clientservices@nbome.org
  • If NBOME is notified that the candidate is ineligible for any reason and the examination was administered, the examination will not be scored. If the examination was administered and the examination was scored and released, the score will be voided.
  • If irregular conduct is found to have occurred, the NBOME transcript and other test administration records will be annotated with this information. See also “Irregular Conduct.”
  • COM must remove eligibility from the NBOME Portal.

To request a refund if the candidate becomes ineligible after the administration, the candidate must:

  • Provide a written explanation satisfactory to NBOME, within 30 days of the date notified ineligible to take the examination.
  • At NBOME’s discretion, all or a portion of exam fees paid may be refunded.
  • Fees outlined in “Candidate Rescheduled, Canceled, or Missed Scheduled Examinations” apply.
  • If not in compliance with the terms herein, all fees paid by or for the candidate will be forfeited.
  • Please contact NBOME Client Services (clientservices@nbome.org) should you have questions.

Registration and Scheduling

Registration Overview

Once a candidate is approved to take the examination by their COM, and they intend to take a COMLEX-USA examination, the candidate must set up an online account with NBOME and agree to the Terms and Conditions contained therein. With this account, a candidate can register, schedule, or cancel a COMLEX-USA examination by accessing the NBOME website (www.nbome.org) and logging in to the NBOME portal. Because dates and seats are limited, a candidate should schedule an examination at least 90 days in advance of the desired test session.

Testing dates for COMLEX-USA Level 1, Level 2-CE, and Level 3 are available for scheduling up to six months in advance. The examination calendar can be found on the NBOME website.

Examination fee information for each specific examination can be found under Registration & Scheduling on our website—examination fees for each COMLEX-USA examination: Level 1, Level 2-CE, Level 2-PE and Level 3.

Test Accommodation Requests

If a candidate is a person with disabilities as defined under the Americans with Disabilities Act (ADA), as amended, and has established an account with NBOME, is eligible for the examination and affirmatively has accepted the Terms and Conditions online, they may apply to the NBOME for reasonable accommodations under the ADA if needed for a COMLEX-USA examination to be offered in a place and manner accessible to the candidate.

Any candidate requesting an accommodation under the ADA must:

  • Download the appropriate form and instructions and carefully review the instructions, and complete the form.
  • Compile and provide credible and objective documentation to substantiate that the candidate is a “person with disability” as defined by the ADA, including the candidate’s physical or mental impairment(s), how the impairment(s) substantially limits the candidate’s ability to access the examination as is compared with most people in the general population, and why the requested accommodation(s) is necessary and reasonable for the examination to be accessible to the candidate.
  • Include with the completed application form a personal statement that elaborates or further explains the information requested on the application form.

  • Submit the completed form and all supporting documentation to the NBOME by email to testacc@nbome.org (preferred method) or by U.S.P.S. certified mail return receipt requested or other commercial carrier at 101 West Elm Street, Suite 230, Conshohocken, PA 19428.

A completed application with full supporting documentation is generally evaluated and a decision rendered by the NBOME within approximately seventy-five (75) days of its receipt by NBOME; however additional processing time may be required if additional documentation is needed.

If the candidate does not provide complete information and supporting documentation within thirty (30) days of receipt by the candidate of any notification that the application is incomplete, NBOME will close the candidate’s request and notify the candidate that the case has been closed. The candidate may subsequently submit a new application for test accommodations.

Scheduling

A candidate may not schedule an accommodated examination unless and until the candidate receives written approval of the accommodation from NBOME. Nonetheless, pending NBOME’s consideration of a request for accommodation(s), a candidate may schedule a standard (non-accommodated) examination. However, if an accommodation is later approved by the NBOME, and the candidate has not taken the examination, the candidate may need to reschedule depending on the nature of the approved accommodation(s). See “Candidate Rescheduled, Canceled, or Missed Scheduled Examinations.”

If an accommodation is approved by the NBOME for a candidate to take a COMLEX-USA examination, the candidate must contact Client Services to arrange for administration of that examination or other instructions regarding the accommodation.

If the candidate chooses to schedule and takes a standard (non-accommodated) examination while their request for accommodation and any accommodated examination is pending, the candidate’s application of an accommodation will be deemed to have been withdrawn and NBOME will score the standard (non-accommodated) examination and report the candidate’s score in the manner set forth herein.

Reconsideration

If an application for accommodation is not approved as requested, and the candidate thereafter obtains new information and/or documentation supporting their request and which addresses NBOME’s concerns, the candidate may request the NBOME to reconsider its decision. Any request for reconsideration must be in writing and submitted to the NBOME by email at testacc@nbome.org. Requests for reconsideration are subject to the same level of review as initial applications and are generally evaluated and a decision reported by the NBOME within approximately seventy-five (75) days of NBOME’s receipt of the request.

Candidate Rescheduled, Canceled or Missed Scheduled Examinations

The process and fees associated with candidates that reschedule, cancel, or miss scheduled examinations differ by the examination type and lead time.

For COMLEX-USA Level 1, Level 2-CE, and Level 3, candidates may reschedule as follows:

More than 30 days before the scheduled date

  • Reschedule or cancel online
  • No fee due
  • Receive a refund for the full amount for cancellations

6 to 30 days before the scheduled date

  • Reschedule or cancel online
  • $85 fee due to Prometric for COMLEX-USA Level 1, Level 2-CE
  • $170 fee due to Prometric for COMLEX-USA Level 3
  • Receive a refund for the remainder for cancellations

1 to 5 days before the scheduled date

  • Cancel online
  • Forfeit $250 of the registration fee for COMLEX-USA Level 1, Level 2-CE
  • Forfeit $350 of the registration fee for COMLEX-USA Level 3
  • Receive a refund for the remainder for cancellations

Within 24 hours of the scheduled date

  • Candidate is a “No Show”
  • Forfeit $400 of the registration fee for COMLEX-USA Level 1, Level 2-CE
  • Forfeit $500 of the registration fee for COMLEX-USA Level 3
  • Receive a refund for the remainder for cancellations

Request for Waiver of Rescheduling/Cancellation Fee

If the candidate reschedules, cancels, or is considered a “No Show” because of circumstances beyond their control, and submits a request to the NBOME in writing no later than 30 days following the scheduled/missed administration, the NBOME in its sole discretion may waive and/or refund all or a portion of the rescheduling/cancellation fee. Please contact NBOME Client Services (clientservices@nbome.org) should you have questions.

Examination Administration

Adverse Testing Conditions

During an examination administration, unanticipated circumstances may arise. Candidates must obey all test center professional staff instructions for the safety of all affected by an emergency.

Some events may be considered to be an Adverse Testing Condition (“Adverse Testing Condition” or “ATC”). An ATC is a situation that occurs during an examination administration that the NBOME determines, in its sole discretion, is outside the control of the candidate and interrupts the normal administration of the examination and substantially affects the candidate’s performance on the examination. Examples include delayed start of an examination, test interruption, equipment/technical malfunction, and/or test center environment.

If during an examination a candidate brings to the attention of the test center professional staff any testing condition that they believe has or will substantially and adversely affect their performance on the examination, and the condition is not resolved to the reasonable satisfaction of the candidate at the test site, the candidate may either:

CONTINUE THE EXAMINATION or WITHDRAW FROM THE EXAMINATION

In either case, the candidate must:

  1. Promptly report any interruption of the examination to the test center staff on the day of the examination.
  2. Directly provide to the NBOME, via email to clientservices@nbome.org, credible and verifiable written evidence of the incident within 10 calendar days following the date of the examination. Simply making a comment in the post examination survey regarding any possible ATC does not qualify as written notification.

The NBOME will initiate a review. The NBOME will place the scoring process “on hold” until the NBOME has completed its review of the matter.

After completing its review of an alleged ATC, the NBOME in its sole discretion may proceed with scoring or not scoring the examination and offer the candidate the opportunity to retake the examination in part or in its entirety as determined by the NBOME in its sole discretion.

If the candidate fails to so notify both the test center staff and the NBOME of any claimed ATC, the candidate thereby waives any claim or right to any recourse they have against the NBOME; Prometric; or their employees, agents, or representatives arising out or relating to that claimed ATC.

If an ATC at a test center is universally adverse to all or most candidates, as determined by the NBOME in its sole discretion, the NBOME may offer to all candidates so affected an option to reschedule the examination for a mutually agreeable future date without the candidate incurring any additional fee. For any rescheduling thereafter, the candidate will be responsible for the associated fees. If the NBOME is unable to reschedule the examination when this option is offered, then it is the responsibility of the candidate to make the new test appointment for a mutually agreeable future date.

Irregular Conduct

If the NBOME determines in its sole discretion that a candidate committed or contributed to any Irregular Conduct in connection with the application, registration or taking of an examination, the NBOME may in its sole discretion take one or more of the following actions:

  • Void the candidate’s examination and score or not score any examination.
  • Deem the candidate to have failed the examination and enter a “fail” score on the candidate’s examination record and NBOME transcript.
  • Annotate the candidate’s examination record and NBOME transcript for the examination as “Irregular Conduct.” For instances where the conduct is deemed less severe, NBOME has the discretion to annotate the candidate’s examination record, ERAS transcript, and NBOME transcript with “Other” to document this conduct.
  • Suspend, revoke, or refuse to provide any score report or NBOME transcript to a candidate or any third party.
  • Deny any application by the candidate to take any NBOME examination.
  • Report the incident to the candidate’s school or graduate medical education program and/or to any licensure board or state or national jurisdiction, agency or authority.
  • And/or take any other action the NBOME in its sole discretion deems appropriate.

The candidate shall fully cooperate with any NBOME investigation of any possible irregularities in examination administration, candidate behavior, breach of test security, or confidentiality. Failure to fully cooperate can result in sanctions, including examination failure, notation of irregular conduct, suspension of eligibility, or permanent loss of eligibility to take a future COMLEX-USA examination.

The term “Irregular Conduct” includes any behavior on the part of any candidate that violates the integrity or security of the examination, behavior that is disruptive to administration of the examination, or behavior deemed by the NBOME in its sole discretion to be inappropriate in connection with the application, registration, taking, administration, integrity, and security of any NBOME examination. Such behavior includes but is not limited to:

  • Copying, fraud, deceit, or other dishonest conduct.
  • Refusal to provide proper identification or permit photo documentation or other identification for verification at any time.
  • Disrupting another candidate or candidates.
  • At any time (i.e., before, during, or after any examination) verbally or physically harming or threatening to harm the test center professional staff, other examinees, test center employees, or NBOME personnel, representatives or agents, during telephone and in-person encounters regarding scheduling, scores, or score reporting.
  • Communication or attempts to communicate with others during the examination other than authorized test center professional staff.
  • Removal of or attempts to remove any test material, scrap paper, or white board from the assigned test area.
  • Damage to property.
  • Non-compliance with test center rules and regulations and security requirements, including operating test center equipment without reasonable care.
  • Providing or receiving unauthorized information about the content of an examination.
  • Communication or attempts to communicate about the content, format, or specific test items with another candidate or with any outside source or party (including use of cell phones, personal computers, internet access, test review companies, or any other means) at any time, either before, during, or after any examination.
  • Using or having available or access to any unauthorized device, text, notes, or other material that could assist the candidate in taking the examination.
  • Providing false admittance information or altering or misrepresenting information in applications, score reports, transcripts, or certificates.
  • Providing false or forged identification upon presentation for testing at a test center.
  • Violation of the NBOME’s non-disclosure or confidentiality policies or the candidate’s non-disclosure agreement at any time.
  • Any violation of the Terms and Conditions, policies, rules, procedures, or obligations of candidates set out in the Bulletin of Information (BOI) as published at the time of the violation.
  • Bringing personal property into the test area is considered by the NBOME to violate the security of the examination.
  • Leaving their assigned test area during the administration of any COMLEX-USA examination.
  • Other behavior as deemed by the NBOME to be unethical or unprofessional.

NOTE: Candidates are under both proctor and electronic surveillance during administration of the COMLEX-USA examinations at all test centers.

Any test center professional staff or other Prometric staff who suspects Irregular Conduct by a candidate during administration of the COMLEX-USA examinations will report that information to the NBOME. Also, candidates who directly observe Irregular Conduct must report such activity to the Prometric test center professional staff.

NBOME reviews all Irregular Conduct reports and may pursue any and all actions it deems appropriate for or in connection with any Irregular Conduct, including but not limited to any damages or losses incurred by NBOME, including its reasonable attorneys’ fees and costs, caused by the candidate’s Irregular Conduct, and injunctive or other equitable relief without bond or other security.

Copying, reproducing, verbally discussing, relaying, or recording test items or test content, in addition to violating security, may result in action by NBOME against the candidate for violation of copyright laws and/or other action by NBOME allowed by law.

A candidate who is notified that they have, or is believed to have been, engaged in Irregular Conduct, or is being investigated for alleged Irregular Conduct, will have 10 calendar days from the date of such notification to submit in writing, including email, and be received by the NBOME, a personal statement signed by the candidate of their position on the claimed or possible Irregular Conduct, and any and all information known or available to the candidate that they believe is relevant to the matter. After receipt of the candidate’s statement and any information, or the lapse of the 10-day response period, whichever is earlier, NBOME will determine whether the candidate has engaged in Irregular Conduct and, if so, what action NBOME will take. Notwithstanding the foregoing, the NBOME may in its sole discretion take any action it deems appropriate prior to the submittal of any statement by the candidate to protect NBOME and the integrity of its examinations.

Decisions regarding Irregular Conduct are determined solely at the discretion of NBOME and all such decisions of NBOME are final.

Due to the nature of the process involved in reports of Irregular Conduct of a candidate or investigation of such conduct or any complaint in connection with the administration of a COMLEX-USA examination, an investigation of any actual or suspected Irregular Conduct may delay the release of any score of a candidate. NBOME will not release a score, if any, while the matter is under investigation. If a score release is expected to be significantly delayed because of an investigation for reasons of alleged Irregular Conduct, NBOME will notify the candidate and give the reasons for the investigation.

Information relating to any Irregular Conduct or behavior of a candidate and any action taken by NBOME in response to a candidate’s Irregular Conduct or behavior may become part of the permanent record of the candidate maintained by NBOME and available to third parties. Every candidate authorizes NBOME to release any or all of the candidate’s personal statement or other information provided by the candidate and any action taken by NBOME relating to the candidate’s actual or alleged Irregular Conduct or behavior to the candidate’s medical school, residency program director, any licensing board, authority, or other person(s) or entity or entities deemed appropriate by NBOME or required by law, without prior notice to or the consent of the candidate.

Other Unprofessional Conduct

NBOME deems professionalism to be an important competency of an osteopathic physician, and a candidate must demonstrate professionalism at all times. Unprofessional conduct includes:

  • The use of foul, lewd, improper, or culturally insensitive statements or behavior toward test center employees, other examinees, NBOME personnel, representatives or agents, including during telephone and in-person encounters regarding scheduling, scores, or score reporting before, during, or after any examination.
  • Any conduct or behavior deemed by the NBOME to be inappropriate or unprofessional for an osteopathic physician.
  • Violation by the candidate of any of the Terms and Conditions as set out in NBOME’s Bulletin of Information (BOI) that was in effect when the violation occurred.

When any unprofessional conduct comes to the attention of NBOME, NBOME at its sole discretion may take any action it deems appropriate, including, but not limited to, any action for Irregular Conduct and/or any of the following:

  • Record the name of the candidate, nature of the behavior or conduct, and the time and conditions under which the behavior or conduct occurred.
  • Notate the candidate’s record to reflect the unprofessional conduct.
  • Record and store conversations or other documentation that are considered to be unprofessional.
  • Record the punitive action, if any, taken against a candidate, including, but not limited to, a period of suspension or permanent ineligibility to test.
  • Void and/or not score any examination taken by the candidate, deem the candidate to have failed the examination, report “fail” as the result of the examination, and annotate the candidate’s examination record for the examination with an “I” as Irregular Conduct.
  • For instances where the conduct is deemed less severe, NBOME has the discretion to annotate the candidate’s examination record with “Other” to document this conduct.
  • Notification to the office of the dean of the college of osteopathic medicine and/or the director for medical education of the graduate medical education program where the candidate is matriculated or enrolled.

As with other Irregular Conduct, information relating to a candidate’s unprofessional conduct may become part of the permanent record of the candidate maintained by NBOME. NBOME may in its sole discretion release any or all of the candidate’s information or action(s) taken by NBOME relating to the candidate’s Irregular Conduct or unprofessional conduct to the candidate’s medical school, residency program director, any licensing board, authority, or other person(s) or entity or entities deemed appropriate by NBOME or as required by law, without prior notice to or the consent of the candidate.

Security and Confidentiality

All examinations, examination materials, answer sheets, grading materials, and clinical materials used in the COMLEX-USA examinations or other examinations of NBOME are the sole and exclusive property of the NBOME. All examinations of NBOME are protected by the copyright laws of the United States. Candidates have no right, title, or interest in or access to any examination of the NBOME, or to NBOME’s means and methods for test development or its methodology of testing and scoring, or to any data or information relating to any examination of NBOME. All rights are reserved by NBOME. Only authorized test center professional staff or other authorized agents or employees of NBOME shall have custody or control of the examination and the examination materials.

NBOME is not affiliated with, does not sanction, and does not endorse any commercial enterprise that purportedly offers COMLEX-USA test preparation courses or materials. For self-assessment purposes, NBOME publishes and makes available to candidates its COMSAE examination series and tutorials.

Candidates may have access to the examination only while it is being administered and only under the supervision of authorized test center professional staff. Post-examination access to, discussion of, or review by candidates, or any person on behalf of the candidates, of the examination or examination material is strictly prohibited.

Any discussion or disclosure of any aspect of the test items or the clinical cases or standardized patients either during the examination or after the examination is strictly prohibited. Candidates shall not discuss, disclose, paraphrase, publish, or otherwise make known to anyone, including another professional student, any test item, or information relating to any NBOME examination or other confidential property belonging to NBOME. Any violation by a candidate of this confidentiality agreement will be considered Irregular Conduct and be dealt with as prescribed in “Irregular Conduct” and/or as otherwise determined by NBOME. NBOME shall also be entitled to recover from the candidate all its damages and losses, including reasonable attorneys’ fees and costs, caused by any Irregular Conduct of the candidate. Every candidate also agrees and acknowledges that NBOME may have no adequate remedy at law and in its sole discretion is entitled to injunctive and/or other relief to prevent or limit any disclosure of test items or other confidential property of NBOME, in addition to its damages or losses, including its reasonable attorneys’ fees and costs incurred by NBOME as a result of any action taken to defend or protect its confidential property. See also sections 2 and 5 of the Terms and Conditions.

Refusal to Administer Examination

NBOME may in its sole and absolute discretion refuse to administer or provide any of its examinations to any person for failure to meet the eligibility requirements or to adhere to the terms of this BOI, including but not limited to Irregular Conduct or Other Unprofessional Conduct. If NBOME determines not to provide its examination to any person who has registered or scheduled to take a NBOME examination and paid a registration or other fee to NBOME, the only recourse that person shall have against NBOME is a refund of the registration or other fee paid to NBOME by the candidate.

Examination Scores

Release of Certified Transcripts

Printable PDF

^