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Blueprint · COMLEX-USA Level 1

Required Knowledge and Content for COMLEX-USA Level 1

The COMLEX-USA examination series is designed to assess the osteopathic medical knowledge and fundamental clinical skills considered essential for osteopathic generalist physicians to practice osteopathic medicine. COMLEX-USA is constructed in the context of clinical problem-solving that involves “competency domains” and “clinical presentations.”

The assessment focuses on these two distinct dimensions, which integrate the following elements:

Osteopathic principles and practices are integrated throughout all areas of the examination to reflect the way they permeate osteopathic medicine. The tables below present the major categories of the two dimensions and the minimum portion of the total content they constitute in the Level 1 examination.

Dimension 1 of the COMLEX-USA blueprint consists of seven competency domains. These include foundational abilities, representing the required elements and outcomes that define knowledge, skills, experience, attitudes, values, behaviors, and the established professional standards an osteopathic physician should possess.

Dimension 1: Competency Domains Minimum % Level 1
1 Osteopathic Principles, Practice, and Manipulative Treatment 12%
2 Osteopathic Patient Care and Procedural Skills 6%
3 Application of Knowledge for Osteopathic Medical Practice 60%
3.1 Foundational Biomedical Sciences Knowledge Base 75%
4 Practice-Based Learning and Improvement in Osteopathic Medical Practice 4%
5 Interpersonal and Communication Skills in the Practice of Osteopathic Medicine 3%
6 Professionalism in the Practice of Osteopathic Medicine 3%
7 Systems-Based Practice in Osteopathic Medicine 2%

Dimension 2 consists of ten clinical presentations, which represent the manner in which a particular patient, group of patients, or community present for osteopathic medical care.

Dimension 2: Clinical Presentations Minimum % Level 1
1 Community Health and Patient Presentations Related to Wellness 12%
2 Human Development, Reproduction, and Sexuality 5%
3 Endocrine System and Metabolism 5%
4 Nervous System and Mental Health 10%
5 Musculoskeletal System 13%
6 Genitourinary/Renal System and Breasts 5%
7 Gastrointestinal System and Nutritional Health 10%
8 Circulatory and Hematologic Systems 10%
9 Respiratory System 10%
10 Integumentary System 5%
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