Examination Format

COMLEX-USA Computer-Based Examinations

The COMLEX-USA examinations are administered only in the English language in a standardized, time-measured environment to assess the candidate’s ability to interpret, process, and apply clinical knowledge and skills with fluency.

This is fundamental to a generalist osteopathic physician’s competence to practice osteopathic medicine. Passing Level 1 of COMLEX-USA is a requirement for medical school graduation and to begin a postgraduate medical education or residency training program.

The COMLEX-USA Level 1 examination consists of 400 multiple choice questions. During the day, two optional breaks can be taken: two 10-minute breaks and a 40-minute lunch break.

COMLEX-USA Computer-Based Examination Outline
SectionQuestionsMorning Session: 4 Hours Total
150Questions can be answered, reviewed, and changed one section at a time. Individual sections are not timed.
10 minute break
SectionQuestionsAfternoon Session: 4 Hours Total
550Questions can be answered, reviewed, and changed one section at a time. Individual sections are not timed.
10 minute break

Available Examination Features

Examination Review Screen
A review page is presented for each section. This provides candidates with information about the status of the items in the current section, which includes questions completed, questions marked for further review, and questions left incomplete (i.e., no answer is given).

Advancing through Examination Sections
Once a section is completed, the candidate cannot return to review or change any answers within that section.

Time Limitations
Although each session is four hours in total, individual sections are untimed. A clock is provided to assist with time management. Warnings are given of the time remaining before the end of each four-hour session.

Examination Visual References
Use of an “Exhibit” button may be required in order to see graphic materials related to a test question. These “Exhibits” consist of images, video or audio avatars. In some cases, two “Exhibits” may be used in order to answer a question.

Additional Tools
New functional features have been added, including a built-in standard calculator and lab values with reference ranges (where applicable) embedded directly into test questions and clinical cases. These features were made available during the COMLEX-USA 2017–18 new test cycles for each examination.

Reference Materials

Fundamental Osteopathic Medical Competency Domains


COMLEX-USA for Residency Program Directors

Upcoming Changes

COMLEX-USA Master Blueprint Effective 2018


Client Registration System Tutorial

Practice Exams

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