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Examination Scores

The number of test items answered correctly (the raw score) is converted to a 3-digit standard score for the purposes of making the NBOME’s pass/fail decisions and for reporting the results. Please note as of May 10, 2022, the NBOME transitioned from a three-digit numeric score for COMLEX-USA Level 1 to “pass” or “fail.”

The conversion for standard scores involves information about the performance of candidates that have taken these examinations previously:

Passing Scores
COMLEX-USA Level 1 400
COMLEX-USA Level 2-CE 400
COMLEX-USA Level 3 350

For information on converting a COMLEX-USA score to a percentile score using the COMLEX-USA Percentile Score Conversion Tool, refer to COMLEX-USA Percentile Scores on the NBOME website.


Levels 1, 2-CE and 3

The percentage of candidates that pass or fail a COMLEX-USA examination is not predetermined. The pass/fail standard is criterion-based. A candidate’s performance on any COMLEX-USA examination is based solely on the total examination, not on performance in individual content areas. As of May 10, 2022, the COMLEX- USA examination reports include “Pass” or “Fail” status and performance profiles summarizing relative strengths and weaknesses for areas designated on the blueprint for Level 1, while Levels 2-CE and 3 continue to report “Pass” or “Fail” status along with 3-digit score and performance profiles on the clinical disciplines and on the blueprint.

Items that may be included in the examination solely for research or pre-testing purposes will not contribute to candidate score or passing status on the COMLEX-USA examinations.

Setting the Minimum Pass/Fail Standard

Consistent with many other national high-stakes examinations for physician licensure worldwide, the NBOME follows industry standard best practices in determining minimum pass/fail standards for its COMLEX-USA examinations, for periodic review, and, if needed, for updating current standards. Typically every three to five years, the NBOME reviews the standards for minimum competency required to pass COMLEX-USA examinations. This process, referred to as “standard setting,” may result in a change in the “cut score” needed to pass a COMLEX-USA examination. The NBOME reserves the right to review the minimum passing standards for any NBOME examinations at any time, and minimum passing standards may be adjusted without notice before candidate report release. The standard setting review schedule is posted on the NBOME website. To learn more about the NBOME’s process for standard setting, refer to the Standard Setting section of the NBOME website for all Levels.

Primary Intended Use and Secondary Uses of COMLEX-USA Examination Scores

The primary intended use of COMLEX-USA is for initial licensure of osteopathic physicians for the practice of osteopathic medicine. Recognized and important secondary uses of the COMLEX-USA examination program include the following: advancement and promotion, including graduation, of students in osteopathic medical schools; direct evidence of student learning and outcomes research by osteopathic medical schools and of residents in graduate medical education programs; uses by residency program directors as part of eligibility criteria for entry into graduate medical education programs; and advancement, promotion, and assessment of medical knowledge competencies for program completion by residents in graduate medical education programs.

The NBOME advises against the use of any evaluation instrument for which there is insufficient validity evidence.

Score Reporting

Candidates will be notified by email when their score reports have been released. Candidates may access their score reports for any COMLEX-USA examination through the Portal on the NBOME website. The office of the dean at a candidate’s college of osteopathic medicine may access this information for their students using a secure school page on Portal.

Each candidate acknowledges and agrees that the NBOME will provide the candidate’s COMLEX-USA Levels 1 and 2 examination score reports to the candidate and office of the dean of the candidate’s school and the NBOME will provide the COMLEX-USA Level 3 examination score reports to the candidate and the office of the dean of the candidate’s school of graduation, the program director, director of medical education, or designated institutional official of the candidate’s graduate medical education program. Each candidate acknowledges and agrees that their examination records may be provided to additional third parties as provided in the Bulletin of Information (BOI) (including but not limited to as specified in the Privacy and Use of Candidate Data section herein) and in the NBOME Privacy Notice posted on the NBOME website.

No COMLEX-USA examination results will be reported by telephone, email, or fax.

For candidates tested before July 1, 2012, a reprint of the score report may be requested in writing (including email).

Score Reports are generally posted to the candidate’s account at “View Score Report” and the secure school page of the NBOME Portal. Specific score release target dates for COMLEX-USA scores, based on dates of test administration, can be found under Score Release Dates on the NBOME website.

Score report release may be subject to delays that are contingent upon candidate scheduling, standard setting, and other variables.

Examination Record Annotations

On occasion, scores may be released with the following annotations:

I – Irregular Conduct which occurred on the part of the candidate. Candidate conduct which may be considered irregular is described under “Irregular Conduct.” Authorized persons may obtain further information regarding this annotation by contacting the NBOME.

O – Other Condition(s) which occurred during the administration of an examination and resulted in the examination not being scored, or the examination was scored after being administered or taken by the candidate under different or unusual conditions. Authorized persons may obtain further information regarding this annotation by contacting the NBOME.

Posting Scores on NBOME Portal

In addition to the information below, please see the score release schedule on the NBOME website.

The score release dates for candidates taking COMLEX-USA Levels 1, 2-CE and 3 from the first and second testing windows are anticipated to be longer than usual to allow sufficient time to statistically validate candidate performance for the new testing cycle, which began on May 10, 2022 for Level 1, June 14, 2022 for Level 2-CE and January 19, 2022 for Level 3. Please see the COMLEX-USA score release web pages for specific score release information.

Score Confirmation

Before releasing examination results or posting score reports, the NBOME conducts a thorough quality assurance process to ensure accuracy of examination results.
Any candidate who wishes to have their examination results reviewed one extra time may request a score confirmation, for a fee of $75. It takes up to 10 business days for Level 1 and Level 2-CE and 15 business days for Level 3 to receive a letter from NBOME with the score verification result.
Confirmation for any COMLEX-USA examination can be provided by request, if submitted within 120 days of the examination. Requests are processed through your NBOME account, located within the ‘View Scores’ section. The option for submitting this request is listed at the bottom of the page. The NBOME does not release information about the scoring of individual examination questions.

COMLEX-USA computer-based examination score confirmation is limited solely to a review of the candidate’s recorded responses and is unlikely to change the candidate’s score. We verify that candidate responses were graded against the scoring key for the exam form that was assigned to the candidate.

Privacy and Use of Candidate Data

It is the policy of the NBOME that candidate examination results and other confidential data, including personally identifiable information, provided by the candidate or about the candidate, are protected from improper access, use, or disclosure and will not be released to any third party, except as provided or authorized in the Bulletin of Information (BOI), or at the request of the candidate, or as required by law; provided the NBOME may use a candidate’s de-identified examination results or other candidate data or information for research or other purposes related to the mission of the NBOME without notification to or the permission of the candidate unless and until the candidate specifically notifies the NBOME in writing that their examination results, data, and information may not be used by the NBOME for research or other purposes.

For more information please see NBOME’s Privacy Notice on our website.


Bulletin of Information 2022-2023