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Blueprint · COMLEX-USA Level 2-CE

This content is for candidates who took the COMLEX-USA Level 1 before June 2019. Click here to view the current documentation.

Required Knowledge & Content for COMLEX-USA Level 2-CE Examination

The COMLEX-USA examination series is designed to assess the osteopathic medical knowledge and 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 “Patient Presentations” and “Physician Tasks.”

The Patient Presentation (“Dimension 1”) of the COMLEX-USA examination blueprint identifies high-frequency and/or high-impact health and disease issues that osteopathic generalist physicians encounter in clinical practice.

The Physician Tasks (“Dimension 2”) specifies the major physician tasks and competency sets that osteopathic physicians generally use to solve clinical problems and assist in providing patient care.

The major categories of the two dimensions are presented in the table below.

Dimension 1: Patient Presentation
Population Health Concepts and Patients with Presentations Related to Health Promotion, Chronic Disease Management, and Human Development 8 – 16%
Patients with Presentations Related to Digestion and Metabolism 4 – 10%
Patients with Presentations Related to Cognition, Behavior, Sensory & Central Nervous Systems, Substance Abuse, and Visceral and Sensory Pain 28 – 38%
Patients with Presentations Related to the Musculoskeletal System, including Somatic Pain 6 – 12%
Patients with Presentations Related to the Genitourinary System and Human Sexuality 3 – 8%
Patients with Presentations Related to Circulation and the Respiratory System 8 – 16%
Patients with Presentations Related to Thermoregulation 2 – 6%
Patients with Presentations Related to Trauma, Masses, Edema, Discharge, and the Skin, Hair, and Nails 8 – 16%
Patients with Presentations Related to Pregnancy, the Peripartum, and the Neonatal Period 3 – 8%

Dimension 1 Categories

Dimension 2: Physician Tasks Level 1 Level 2 CE Level 3
Health Promotion & Disease Prevention 1 – 5% 15 – 20% 15 – 20%
History & Physical Examination 5 – 15% 30 – 40% 10 – 20%
Diagnostic Technologies 1 – 5% 10 – 20% 15 – 25%
Management 2 – 7% 10 – 20% 25 – 40%
Scientific Understanding of Health & Disease Mechanisms 70 – 85% 5 – 15% 5 – 10%
Health Care Delivery Issues 1 – 3% 5 – 10% 5 – 10%

Dimension 2 Categories

Osteopathic principles and practices, by design, are integrated throughout all areas of the examination to reflect the way they permeate osteopathic medicine.

Implementation of New Blueprint

Based on extensive research and expert consensus, a new two-dimensional blueprint for COMLEX-USA examinations has been developed and will be implemented beginning with COMLEX-USA Level 3 in 2018. COMLEX-USA Level 1, Level 2-Cognitive Evaluation (CE) and Level 2-Performance Evaluation (PE) will implement the new blueprint in 2019. For more information, see the COMLEX-USA Master Blueprint 2018-2019.

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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