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Blueprint · COMLEX-USA Level 2-PE

COMLEX-USA Content Outline · Competency Domains and Clinical Presentations

The COMLEX-USA examination series is designed to assess the osteopathic medical knowledge, knowledge fluency, and fundamental clinical skills considered essential for osteopathic generalist physicians to practice osteopathic medicine. The foundation of COMLEX-USA is based on the osteopathic philosophy of whole-person health care, underlying structure-function relationships and the interdependence of body systems, self-healing and self-regulatory mechanisms, and the osteopathic approach to patient care, including osteopathic manipulative medicine. COMLEX-USA is constructed in the context of clinical problem-solving that involves “Competency Domains” and “Clinical Presentations.”

Two Distinct Dimensions

The assessment focuses on two dimensions that continue to integrate:

Dimension 1 of the COMLEX-USA blueprint consists of seven Competency Domains, which represent 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.

Dimension 1: Competency Domains Minimum % Humanistic Minimum %
1 Osteopathic Principles, Practice, and Manipulative Treatment 0% 15%
2 Osteopathic Patient Care and Procedural Skills 0% 25%
3 Application of Knowledge for Osteopathic Medical Practice 0% 15%
 3.1 Foundational Biomedical Sciences Knowledge Base
4 Practice-Based Learning and Improvement in Osteopathic Medical Practice 0% 5%
5 Interpersonal and Communication Skills in the Practice of Osteopathic Medicine 60% 20%
6 Professionalism in the Practice of Osteopathic Medicine 30% 6%
7 Systems-Based Practice in Osteopathic Medicine 0% 5%


Dimension 2 consists of 10 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-PE
1 Community Health and Patient Presentations Related to Wellness 14%
2 Human Development, Reproduction, and Sexuality
3 Endocrine System and Metabolism
4 Nervous System and Mental Health 14%
5 Musculoskeletal System 14%
6 Genitourinary/Renal System and Breasts
7 Gastrointestinal System and Nutritional Health 14%
8 Circulatory and Hematologic Systems 14%
9 Respiratory System 14%
10 Integumentary System

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

Reference Materials

Fundamental Osteopathic Medical Competency Domains



Client Registration System Tutorial


Candidate Assistance Program: Rescheduling Fee Waivers


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