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Comprehensive Osteopathic Medical
Variable-Purpose Examination


The Comprehensive Osteopathic Medical Variable-Purpose Examination, COMVEX, is the current evaluative instrument offered to osteopathic physicians who need to demonstrate current osteopathic medical knowledge. As a measurement tool, the COMVEX provides the state medical licensing boards with a clear evaluation of a candidate's knowledge of current osteopathic medical practice.

The introduction of the COMVEX completes the cycle of osteopathic assessment that begins with the COMLEX-USA initial licensing sequence available to osteopathic medical students. COMVEX builds on the same assessment foundation by utilizing common outlines and subject areas. This examination assesses both the depth and breadth of osteopathic medical practice.

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Life-Long Learning

Obtaining and assessing medical knowledge is a process that continues throughout the length of medical practice as referenced in the accompanying illustration. The National Board of Osteopathic Medical Examiners provides examinations for each step of the licensing process with evaluation tools focused on the particular knowledge blocks that should be acquired as medical students progress from the narrow focus of the first two years of medical school to the broad-based clinical knowledge characteristic of practicing osteopathic physicians. The core area of medical knowledge shown in the accompanying illustration by the horizontal line stays constant throughout a physician's practice. However, the clinical knowledge base indicated by the widening cone continues to expand over time as the physician interacts with a broader patient base and encounters more clinical scenarios. The COMLEX-USA/COMVEX sequence assesses these patterns by utilizing a simple two dimensional grid system of categorization that mirrors the real-life practice patterns of osteopathic physicians.

The illustration below shows osteopathic physician education, training, and practice which offers an increasing scope of physician knowledge and skill (Dimension 2); while the medical knowledge, (Dimension 1), is the core of all physicians' practice. The COMLEX-USA and COMVEX partners with you to offer ever-expanding career opportunities. The first axis, Dimension 1, focuses on core medical knowledge areas and consists of different patient encounters -- the situations that cause patients to seek medical care. Although the subject areas of this axis remain constant over time, the test items become more advanced reflecting the candidate's increasing level of knowledge. Dimension 2 contains six areas of osteopathic knowledge that a clinician brings to the core knowledge base of Dimension 1. These areas include: history and physical, diagnostic technologies, case management, scientific understanding of mechanisms, health care delivery issues and health promotion/disease prevention. The scope of clinical practice shown by the life-long learning model demonstrates the increasing sophistication in clinical knowledge and experience physicians use in making health care decisions.

The COMVEX, as a further assessment point for many physicians, is comprehensive in evaluating the broad scope of unsupervised clinical practice. Therefore, Dimension 2 concentrates on areas of patient evaluation and case management. The majority of the examination focuses on applying physician knowledge in the areas of history and physical, diagnostic technologies and case management. The relative percentages of Dimension 2 subject areas indicated in the graph below.

Dimension 2
Health Promotion / Disease Prevention 3 - 6 %
History and Physical 22 - 26%
Diagnostic Technologies 13 - 17%
Management 35 - 43%
Scientific Understanding of Health and Disease Mechanisms 3 - 6%
Health Care Delivery 8 -12%

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Who takes COMVEX?

COMVEX is an appropriate examination in the following circumstances:

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COMVEX is available through the NBOME after an applicant has obtained approval through his/her individual state licensing board. The examination is created by test development and review committees composed of a variety of osteopathic physicians from a range of medical disciplines. Further details concerning administration and scoring are found in the COMVEX Bulletin of Information and application (see links at the top of this page). You may also contact the NBOME' Client Services Department at clientservices@nbome.org or (866) 479-6828 for additional information. Hours are 7:00am - 7:00pm (Eastern Time) Monday - Friday.

Public policy as reflected by practice acts, the U.S. court system and licensing boards across the country has consistently maintained a clear distinction between allopathic and osteopathic medical licensure. The policy maintains that there are differences in the education and the practice patterns of each physician group. Currently and historically, allopathic and osteopathic medical students have followed parallel but distinctly separate pathways for initial medical licensure. The introduction of COMVEX maintains the integrity of these separate pathways throughout the reevaluation process by supplying state licensing boards with high quality evaluation for the osteopathic physician seeking reexamination.

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