Examination Format

COMLEX-USA Computer-Based Examinations

The COMLEX-USA Level 2-CE contains 352 multiple choice questions.

The examination questions will continue to be related to diverse clinical and patient presentations and seven defined competency domains for osteopathic medical practice. The examination is divided into two 4-hour sections. During the examination day, three optional breaks can be taken: two 10-minute breaks and a 40-minute lunch break.

Test questions are single-best answer, multiple-choice format. Some test questions involve audio-visual components designed to assess an expanded physician competency subset.

The COMLEX-USA examinations are administered only in the English language in a standardized, time-measured environment to assess the candidate’s ability to interpret, process, and apply clinical knowledge and skills with fluency.

COMLEX-USA Computer-Based Examination Outline
144Morning Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed one section at a time. Individual sections are not timed.
Authorized 10-minute break
Authorized 40-minute lunch break
544Afternoon Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed one section at a time. Individual sections are not timed.
Authorized 10-minute break

Available Examination Features

Examination Review Screen
A review page is presented for each section. This provides candidates with information about the status of the items in the current section, which includes questions completed, questions marked for further review, and questions left incomplete (i.e., no answer is given).

Advancing through Examination Sections
Once a section is completed, the candidate cannot return to review or change any answers within that section.

Time Limitations
Although each session is 4 hours in total, the individual sections within a session are self-paced. A clock is provided to assist with time management. Warnings are given of the time remaining before the end of each 4-hour session.

Examination Visual References
Use of an “Exhibit” button may be required in order to see graphic materials related to a test question. These “Exhibits” consist of images, video or audio avatars. In some cases, two “Exhibits” may be used in order to answer a question.

Additional Tools
New functional features have been added, including a built-in standard calculator and lab values with reference ranges (where applicable) embedded directly into test questions and clinical cases. These features were made available during the COMLEX-USA 2017–18 new test cycles for each examination.

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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