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NBOME
COMLEX-USA BULLETIN of INFORMATION

Description of Examinations

About COMLEX-USA

The COMLEX-USA examination series is designed to assess the osteopathic medical knowledge, knowledge fluency, 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 full scope of the osteopathic approach to patient care, including osteopathic manipulative medicine.

The COMLEX-USA program is an examination sequence with three levels. This progressive nature of the COMLEX-USA examinations ensures the consistency and continuity of the measurement objectives of the osteopathic medical licensing examinations. A description of the examination blueprint is below, and descriptions of each examination component of the series, including what constitutes a passing score, follows.COMLEX-USA examinations are administered only in the English language.

Each COMLEX-USA examination is administered in a standardized, time-measured environment. The ability to recall, interpret, process, and apply clinical knowledge and skills without hesitation and in a fluid manner (“knowledge fluency”) is fundamental to a generalist osteopathic physician’s competence to practice osteopathic medicine and therefore is one of the fundamental competencies the COMLEX-USA examinations assess.

The blueprint contains two dimensions that outline the patient presentations (clinical presentations) and the physician tasks (competency domains). While all examination Levels have a two-dimensional blueprint structure, the depth and emphasis of each Level parallels the educational experiences and the clinical responsibilities of the candidate.

For more information on all COMLEX-USA examinations, the examination blueprint, including registration, practice materials, and updates, visit the NBOME website.

COMLEX-USA Overview and Blueprint

LEVEL 1 ·
Assessment of Foundational Biomedical Sciences and Osteopathic Principles and Practice

DESCRIPTION

A one-day computer-based assessment that integrates the foundational biomedical sciences and osteopathic principles with clinical knowledge and other physician competencies relevant to addressing clinical presentations and promoting health in supervised clinical practice settings.

Foundational Biomedical Sciences

  • Anatomy
  • Behavioral Science
  • Biochemistry
  • Genetics
  • Health Promotion and Disease Prevention
  • Immunology
  • Microbiology
  • Osteopathic Principles and Practice
  • Pathology
  • Pharmacology
  • Physiology

FORMAT

  • Two computer-based test sessions taken on one day (8 hours exam time).
  • Administered in a secure, time-measured environment.
  • Contains 400 questions related to diverse clinical and patient presentations and seven defined competency domains for osteopathic medical practice.
  • Test questions are single-best answer, multiple-choice format. Also includes test questions involving audio-visual components designed to assess an expanded physician competency subset.
  • Examples of test question types in Level 1 are found in the practice exam.
  • Breaks are permitted only as set forth under Examination Administration.

 

Subsection Questions
1 50 Morning Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed
one subsection at a time. Individual subsections are not timed.
2 50
Authorized 10-minute break
3 50
4 50
Authorized 40-minute lunch break
5 50 Afternoon Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed
one subsection at a time. Individual subsections are not timed.
6 50
Authorized 10-minute break
7 50
8 50

PASSING

Passing Level 1 indicates that the candidate has demonstrated competence in the foundational biomedical sciences and osteopathic principles and related physician competency domains for osteopathic medical care of patients as required to enter supervised patient care settings and to continue lifelong learning.

LEVEL 2-CE ·
Assessment of Osteopathic Patient Care and Related Competency Domains

DESCRIPTION
A one-day computer-based assessment that integrates application of knowledge in clinical and foundational biomedical sciences and osteopathic principles with other physician competencies related to the clinical care of patients and promoting health in supervised clinical settings. These competency domains include application of osteopathic medical knowledge, osteopathic patient care and osteopathic principles and practice, communication, systems-based practice, practice-based learning and improvement, professionalism and ethics.

Clinical Sciences Disciplines

  • Emergency Medicine
  • Family Medicine
  • Health Promotion and Disease Prevention
  • Internal Medicine
  • Neurology
  • Obstetrics/Gynecology
  • Osteopathic Principles and Practice
  • Pediatrics
  • Psychiatry
  • Surgery

FORMAT

  • Two computer-based test sessions taken on one day (8 hours exam time).
  • Administered in a secure, time-measured environment.
  • Contains 400 questions related to diverse clinical and patient presentations and seven competency domains for osteopathic medical practice.
  • Test questions are single-best answer, multiple-choice format. Also includes test questions involving audio-visual components designed to assess an expanded physician competency subset.
  • Examples of test question types in Level 2-CE are found in the practice exam.
  • Breaks are permitted only as set forth under Examination Administration.

Subsection Questions
1 50 Morning Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed
one subsection at a time. Individual subsections are not timed.
2 50
Authorized 10-minute break
3 50
4 50
Authorized 40-minute lunch break
5 50 Afternoon Session: 4 Hours Total Testing Time
Questions can be answered, reviewed, and changed
one subsection at a time. Individual subsections are not timed.
6 50
Authorized 10-minute break
7 50
8 50

PASSING

Passing Level 2-CE indicates that the candidate has demonstrated competence in the clinical sciences and osteopathic principles and related physician competency domains for osteopathic medical care of patients as required to enter into supervised graduate medical education settings and to continue lifelong learning.

LEVEL 2-PE ·
Assessment of Fundamental Clinical Skills for Osteopathic Medical Practice

DESCRIPTION
The Level 2-Performance Evaluation (PE) is an assessment of fundamental clinical skills evaluated through 12 encounters with standardized patients. Candidates assess problem-centered and wellness-centered patient presentations. Each candidate must personally perform the clinical skills with standardized patients as appropriate in a timely, efficient, safe, and effective manner.

The examination augments the Level 2-Cognitive Evaluation (CE) through an assessment of seven fundamental clinical skills for osteopathic medical practice within two scored examination domains: the Humanistic Domain and the Biomedical/Biomechanical Domain.

Fundamental Clinical Skills Assessed

Humanistic Domain

  • Physician-Patient Communication
  • Interpersonal skills
  • Professionalism

Biomedical/Biomechanical Domain

  • Medical History-Taking and Physical Examination Skills
  • Osteopathic Principles and Osteopathic Manipulative Treatment (OMT)
  • Documentation Skills (including synthesis of clinical findings, integrated differential diagnosis, and formulation of a diagnostic and treatment plan)

FORMAT

  • 12 standardized patient based-cases.
  • 14-minute duration for each patient encounter plus nine minutes to document findings in an e-SOAP note (Subjective Objective Assessment Plan format).
  • Administered at NBOME National Centers for Clinical Skills Testing in Philadelphia and Chicago.

PASSING

Passing Level 2-PE indicates that the candidate has demonstrated competence in the fundamental clinical skills and related physician competency domains for osteopathic medical care of patients as required to enter into supervised graduate medical education settings and to continue lifelong learning.

LEVEL 3 ·
Assessment of Competencies for Osteopathic Medical Practice

DESCRIPTION

A two-day computer-based examination assessing competence in the foundational competency domains required for generalist physicians to deliver safe and effective osteopathic medical care and promote health in unsupervised clinical settings.

Competency domains assessed include application of osteopathic medical knowledge, osteopathic patient care and osteopathic principles and practice, communication, professionalism and ethics.

Competency assessment occurs in the context of clinical and patient presentations and systems-based practice as required for entry in the unsupervised practice of osteopathic medicine as an independently practicing osteopathic generalist physician and for readiness for lifelong learning and practice-based learning and improvement.

FORMAT

  • Four computer-based test sessions of 3.5 hours each taken over two days (two sessions per day).
  • Administered on consecutive days (or within a 14-day window) in a secure, time-measured environment.
  • Contains 420 questions in the multiple-choice question format (MCQ) and test questions related to approximately 26 clinical decision-making (CDM) cases. These are related to diverse and representative clinical presentations and seven competency domains for osteopathic medical practice.
  • Test questions are predominantly in the single-best answer and multiple-choice formats.
  • CDM question formats include extended multiple-choice (selection of more than one answer from an extensive list that may contain more than one correct answer) and constructed response (short-answer) test questions.
  • Also includes audio-visual components designed to assess an expanded physician competency subset.
  • Examples of test question types in Level 3 are found in the practice exam.
  • Breaks are permitted only as set forth under Examination Administration.

Subsection Questions
1 70 MCQs Morning Session: 3.5 Hours Total Testing Time
Questions can be answered, reviewed and changed one subsection at a time. Individual subsections are not timed.
Authorized 10-minute break
2 70 MCQs
Authorized 40-minute lunch break
3 70 MCQs Afternoon Session: 3.5 Hours Total Testing Time
Questions can be answered, reviewed and changed one subsection at a time. Individual subsections are not timed.
Authorized 10-minute break
4 70 MCQs
Subsection Questions
5 13 CDM Cases Morning Session: 3.5 Hours Total Testing Time
Questions can be answered, reviewed and changed one subsection at a time. Individual subsections are not timed.
Authorized 10-minute break
6 13 CDM Cases
Authorized 40-minute lunch break
7 70 MCQs Afternoon Session: 3.5 Hours Total Testing Time
Questions can be answered, reviewed and changed one subsection at a time. Individual subsections are not timed.
Authorized 10-minute break
8 70 MCQs

PASSING

Passing Level 3 indicates that the candidate has demonstrated competence in the foundational competency domains required for generalist physicians to deliver safe and effective osteopathic medical care of patients as required for entry into the unsupervised practice of osteopathic medicine and to continue lifelong learning and practice-based learning and improvement.

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