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Concordance: COMLEX-USA and USMLE Score Ranges

February 15, 2022

“The NBOME Continues Research on Need for Holistic Review by RPDs, Offers New Tool for Licensure Score Comparison…”

RPD Toolbox

Mar 8, 2017

“Resources to help Residency Program Directors…”

COMLEX-USA for Residency Program Directors

Aug 20, 2021

“Evidence–based assessment designed specifically for osteopathic medical students and residents…”

NBOME to Modify Attempt Limits for COMLEX-USA Effective July 1, 2022

The NBOME Board of Directors approved changes to eligibility for COMLEX-USA to limit the maximum number of attempts to 4 total per exam, effective July 1, 2022. This change is intended to minimize misclassification, enhance test security/integrity, and reinforce NBOME’s mission to protect the public. Exceptions petitioned by a state medical or osteopathic medical licensing board will be evaluated on a case-by-case basis. Further information will be outlined in the COMLEX-USA Bulletin of Information, planned for release in July 2020.


Boulet JR, Gimpel JR, Sandella JM, Turner MD. Comments on “Reported completion of the USMLE Step 1 and match outcomes among senior osteopathic students in 2020”. Journal of Osteopathic Medicine. 2022. doi:10.1515/jom-2022-0080

Sandella JM, Boulet JR, Barnum S, Tsai T-H, Wang Y. To the Editor: Response to: Limitations and Alternative Approaches to a USMLE COMLEX-USA Concordance. Journal of Graduate Medical Education. 2022:14(3):355-356. doi:10.4300/JGME-D-22-00352.1

Sandella JM, Craig B, Tsai T-H, Fleury M, Clem A. Response to “COMSAE phase 1: value added”. Journal of Osteopathic Medicine. 2021:121(8):719-721. doi:10.1515/jom-2021-0160

Gimpel JR. Single Accreditation Does Not Mean Double Jeopardy for Osteopathic Medical Students. Academic Medicine. 2021:96(8):1078. doi:10.1097/ACM.0000000000004134

Langenau EE, Sandella JM, Gimpel JR. Fairness to Students Top Priority. Family Medicine. 2012:44(1):53-54. PMID:22241343

Gimpel JR. Response to “Relationship Between COMLEX and USMLE Scores Among Osteopathic Medical Students Who Take Both Examinations”. Teaching and Learning in Medicine. 2010:22(4):323-325. doi:10.1080/10401334.2010.513198

Gimpel JR. Re: “COMLEX-1 and USMLE-1 Are Not Interchangeable Examinations”. Academic Emergency Medicine. 2010:17(10):1146-1147. doi:10.1111/j.1553-2712.2010.00898.x

Gimpel JR. New COMLEX-USA-to-USMLE Conversion Formula Needed. Journal of Osteopathic Medicine. 2010:110(10):577-578. doi:10.7556/jaoa.2010.110.10.577

The NBOME provides reasonable and appropriate accommodations in accordance with the Americans with Disabilities Act for candidates taking the COMLEX-USA examinations who provide the required documentation substantiating that they are a person with a disability.

Instructions to Request Test Accommodations

Request Accommodation

Request Accommodation for Pregnancy or Lactation

Submit a request by completing the application form and sending it with the required supporting documentation to NBOME Test Accommodations.

A completed application with full supporting documentation is generally evaluated and a decision rendered by the NBOME within approximately seventy-five (75) days of its receipt by the NBOME; however, additional processing time may be required if additional documentation is needed.

You may choose to schedule a standard (non-accommodated) examination while your accommodation application is pending. However, if your application is approved by the NBOME and testing accommodations are granted, and you have not yet taken the examination, you will have to cancel your scheduled examination date so the approved accommodation(s) can be attached to your testing profile. If you have taken the examination without accommodations before being notified of a decision, the NBOME will report your score as if you had not requested an accommodation.

For more details refer to the Bulletin of Information.

Reference Materials

The National Board of Osteopathic Medical Examiners (NBOME), an independent, not-for-profit organization that provides competency assessments for osteopathic medical licensure and related health care professions, has partnered with Pearson VUE, the global leader in computer-based certification and licensure testing, to provide delivery of the COMLEX-USA examination series.

CORRE, COMVEX, several client exams will also be delivered by Pearson VUE

The National Board of Osteopathic Medical Examiners (NBOME), an independent, not-for-profit organization that provides competency assessments for osteopathic medical licensure and related health care professions, has partnered with Pearson VUE, the global leader in computer-based certification and licensure testing, to provide delivery of the COMLEX-USA examination series.

Beginning January 2023, all COMLEX-USA Level 3 examinations will be administered at Pearson VUE test centers, followed by Level 1 in May 2023 and Level 2-CE June 2023 (date tentative), respectively. The transition date for Level 2-CE will be confirmed by December 31, 2022.

Registration and scheduling for each exam are anticipated to open roughly six months prior to administration dates.

Pearson VUE will deliver the COMLEX-USA examination series across its network of nearly 300 Pearson Professional Centers and other affiliated test centers across the U.S., offering test takers a professional, highly secure, and consistent testing experience. For more on testing with Pearson VUE, visit PearsonVUE: Resources for Test-Takers.

Testing fees, score release dates, and exam preparation materials for COMLEX-USA are not expected to be affected by this transition.

In addition, COMVEX, CORRE, and several NBOME client examination administrations will also take place at Pearson VUE facilities beginning in 2023.

“We are excited to partner with Pearson VUE to enable us to continue providing best-in-class test-taking experiences and valid and reliable assessments for our candidates and clients,” said John R. Gimpel, DO, MEd, president and CEO of the NBOME. “We will work to ensure the transition is as smooth as possible for COMLEX-USA candidates, clients, and other stakeholders.”

The transition to Pearson VUE addresses an important objective of the current NBOME Strategic Plan: to provide innovative assessments on robust technology-enhanced platforms that meet industry demand for agile, practice-relevant point-of-care assessments.

‘’We are honored to now be delivering these important licensure exams for the NBOME,’’ commented Eric D’Astolfo, vice president, business development, Pearson VUE. ‘’The osteopathic profession demands the highest quality assessment services; we look forward to playing our part in advancing patient care through certifying the competencies of its medical students.’’

The NBOME recognizes that this transition will no doubt raise many questions for students preparing to take any Level of COMLEX-USA. Current information is available at our FAQs, and more specific information related to the logistics of the transition for candidates preparing for each Level is forthcoming.

The Coalition for Physician Accountability formed the Undergraduate Medical Education to Graduate Medical Education Transition Review Committee (UGRC)—of which the NBOME is a member—in 2020 to focus on improvements to the current state of transitioning from medical school into residency. Today, the Coalition released a report from the UGRC which laid out 34 recommendations for improvement in several areas such as the application process, career advising resources, competency assessments, processes related to interviewing, ranking and matching, and onboarding into residency.

“The UGRC focused considerable attention on student and other stakeholder wellness, reducing stressors and fostering inclusion for all residency applicants,” said NBOME President and CEO John R. Gimpel, DO, MEd, who served as a member of the UGRC and on the Coalition’s Management Committee. “The ultimate goal was enhancing the transition, reducing systemic biases and stressors in the system, and improving health care for the patients we all have the privilege to serve,” he added.

Numerous recommendations in the report focus on providing accurate, trustworthy advising resources, which currently add considerable misinformation and bias into the system. Important consensus recommendations included attention to the interview process and competencies for all learners. In addition, the URGC recommended that applicants be reviewed in a way that is holistic, mission-based and equitable. This includes a recommendation “to promote equitable treatment of applicants regardless of licensure examination requirements, comparable exams with different scales (COMLEX-USA and USMLE) should be reported within the electronic application system in a single field.”

This recommendation calls for the creation of a combined score field in the Electronic Residency Application Service that allows scores of the two licensing exams to be compared more easily, mitigating structural bias and reducing financial and other stressors for DO applicants.

While COMLEX-USA is accepted in all 50 states (and in many international jurisdictions), the report noted that many residency programs are unclear on the equivalency of the licensure examinations, and do not understand the COMLEX-USA scale. This results in some DO applicants feeling compelled to take the USMLE because they believe it will make them most competitive in certain residency programs.

For these students, that perception leads to increases in time, cost and stress levels. According to the UGRC’s report, “currently, over 4000 students [sit for both]—wasting time, enduring additional stress, and paying over $5 million out of pocket that is not needed.” The UGRC’s recommendation (#18) aims to reduce the perceived need to be tested twice.

According to the report, the UGRC’s first goal was to “envision an idealized future state for the transition from UME to GME.” This ideal state foresees the UME to GME transition as “equitable, coordinated, efficient, transparent, and cohesive,” and the key to its success as a “commitment to the broad inclusion of students, educators, schools, programs, and the public in the design, evaluation, and continuous improvement of the UME-GME transition.”

“Alongside the AOA and AACOM, we have advocated strongly for osteopathic medical education, assessment and the distinctive and valid pathway to osteopathic medical practice,” said Gimpel. “We believe these recommendations will help create better organizational alignment across the transition, address inequities and educate many stakeholders. We also believe they will enhance wellness and produce many additional positive outcomes for applicants from all backgrounds.”

Read the full report from the UGRC here.

The NBOME participated throughout the Coalition’s UGRC Planning Committee process, and joined 16 other Coalition members—along with several public members—in unanimous acceptance of the UGRC Report and its 34 recommendations. Those members include the Accreditation Council for Graduate Medical Education (ACGME), the American Medical Association (AMA), the American Osteopathic Association (AOA), the Educational Commission for Foreign Medical Graduates (ECFMG), the Association of American Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM), the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).