Blueprint · COMLEX-USA Level 2-CE

Required Knowledge and Content for COMLEX-USA Level 2-CE

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 two dimensions that integrate the following elements:

Osteopathic principles and practices, by design, are integrated throughout all areas of the examination to reflect the way they permeate osteopathic medicine. The tables below presents the major categories of the two dimensions, and the portion of the total content they constitute in the Level 2-CE examination.

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

Dimension 1: Competency Domains Minimum % Level 2-CE
1 Osteopathic Principles, Practice, and Manipulative Treatment 10%
2 Osteopathic Patient Care and Procedural Skills 30%
3 Application of Knowledge for Osteopathic Medical Practice 26%
3.1 Foundational Biomedical Sciences Knowledge Base     25%
3.2 Clinical Sciences Knowledge Base     60%
4 Practice-Based Learning and Improvement in Osteopathic Medical Practice 7%
5 Interpersonal and Communication Skills in the Practice of Osteopathic Medicine 5%
6 Professionalism in the Practice of Osteopathic Medicine 7%
7 Systems-Based Practice in Osteopathic Medicine 5%


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

Dimension 2: Clinical Presentations Minimum % Level 2-CE
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%

To see retired blueprint information for exams prior to May 2019, Click here.

Reference Materials

COMLEX-USA · Level-2-CE Score Release Dates


Fundamental Osteopathic Medical Competency Domains


Client Registration System Tutorial


Candidate Assistance Program: Rescheduling Fee Waivers

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