Blueprint · COMLEX-USA Level 3

Required Knowledge & Content for COMLEX-USA Level 3 Examination

The COMLEX-USA examination series is designed to assess the osteopathic medical knowledge and fundamental 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 “Competency Domains” and “Clinical Presentations.”

Two Distinct Dimensions

The assessment focuses on two dimensions that continue to integrate:


Dimension 1 of the COMLEX-USA blueprint consists of seven Competency Domains, which represent the related sets of foundational abilities representing the required elements and outcomes that define the knowledge, skills, experience, attitudes, values, behaviors, and established professional standards.

Dimension 1: Competency Domains Minimum % Level 3
1 Osteopathic Principles, Practice, and Manipulative Treatment 10%
2 Osteopathic Patient Care and Procedural Skills 40%
3 Application of Knowledge for Osteopathic Medical Practice 17%
3.1 Foundational Biomedical Sciences Knowledge Base 10%
4 Practice-Based Learning and Improvement in Osteopathic Medical Practice 8%
5 Interpersonal and Communication Skills in the Practice of Osteopathic Medicine 3%
6 Professionalism in the Practice of Osteopathic Medicine 6%
7 Systems-Based Practice in Osteopathic Medicine 6%


Dimension 2 consists of 10 Clinical Presentations, which represent the manner in which a particular patient, group of patients, or a community presents for osteopathic medical care.

Dimension 2: Clinical Presentations Minimum % Level 3
1 Community Health and Patient Presentations Related to Wellness 12%
2 Human Development, Reproduction, and Sexuality 5%
3 Endocrine System and Metabolism 5%
4 Nervous System and Mental Health 10%
5 Musculoskeletal System 13%
6 Genitourinary/Renal System and Breasts 5%
7 Gastrointestinal System and Nutritional Health 10%
8 Circulatory and Hematologic Systems 10%
9 Respiratory System 10%
10 Integumentary System 5%

Reference Materials

Fundamental Osteopathic Medical Competency Domains

Upcoming Changes

COMLEX-USA Master Blueprint Effective 2018


Client Registration System Tutorial

Practice Exams

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