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Standard Setting

Standard Review Schedule
COMLEX-USA Level 2-PE Exam


Setting Pass/Fail Standards

For the NBOME’s COMLEX-USA Level 2-PE, passing the examination means the examinee has demonstrated the minimal level of competency required by the Osteopathic medical profession for safe and effective practice, at the supervised level of educational training. The COMLEX-USA Level 2-PE standard marks the point of decision for the pass or fail outcome based on required knowledge and application of clinical skills within the Humanistic and Biomedical/Biomechanical domains set by stakeholders across the Osteopathic medical profession.

Every three to five years, NBOME reviews the COMLEX-USA Level 2-PE standards, comprised of minimum competency requirements for the Humanistic and Biomedical/Biomechanical domains to assure they are within the bounds of undergraduate osteopathic medical educational training and practice. For each domain of the examination, an examinee-centered approach is utilized throughout the standard setting process. Please refer to resources below for best practices in standard setting for performance assessments. The standard setting process could result in an adjusted point for the pass/fail decision to realign with the requirements of minimal competency.

The NBOME thoroughly analyzes COMLEX-USA Level 2-PE operational procedures to account for the high-stakes pass decision when the pivotal accumulation of points throughout the examination exceeds the threshold of the standard. Periodic review of the COMLEX-USA Level 2-PE Humanistic and Biomedical/Biomechanical domain standards ensure that osteopathic medical knowledge and clinical skill reflect current medical education and practice required for licensure. The process is consistent with the NBOME’s mission of protecting the public by assessing competencies for osteopathic medicine and related health care professions.

Standard Setting References

Reference Materials

Fundamental Osteopathic Medical Competency Domains



Client Registration System Tutorial


Candidate Assistance Program: Rescheduling Fee Waivers


Locations & Travel

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