Home Academics COMSAE and COMLEX Medical Boards COMLEX-USA Level 1


COMLEX stands for the Comprehensive Osteopathic Medical Licensure Examination. According to the National Board of Osteopathic Medical Examiners (NBOME), “The COMLEX-USA Level 1 is a problem- and symptom-based assessment, administered in a time-measured environment that integrates the foundational and basic biomedical sciences and other areas of medical knowledge relevant to solving clinical problems and promoting and maintaining health in providing osteopathic medical care to patients.” It should be noted that COMLEX Level 1 is specifically geared toward knowledge and clinical problem-solving skills that would be acquired during the first two years of medical school.

For a thorough description of the exam, refer to the NBOME COMLEX-USA Level 1.

Exam Facts

The COMLEX-USA Level 1 is given over a single eight-hour day divided into a four-hour morning session and a four-hour afternoon session separated by an optional 40-minute lunch period. The lunch break does not count against your time, but any unused time will not be added to your total exam time.

Each four-hour session is composed of four one-hour blocks of 50 questions (400 questions over the course of the day). The testing center provides one 10-minute mid-morning break and one 10-minute mid-afternoon break. These breaks are optional and do count against your total time.

Students are often tempted to skip the breaks or lunch period and push through the exam non-stop, beginning to end, but this is not recommended.

Students can advance through the 50-question blocks at their own pace; however, there is no ability to return to a previous block of questions after advancing to the next.

It is highly recommended that students familiarize themselves with the testing format by exploring the resources provided on the NBOME website.

NBOME Resources

Exam Scoring

For the COMLEX-USA computer-based cognitive examinations, the number of items answered correctly (the raw score) is converted to a standard score for the purposes of reporting results and providing a pass-fail designation.

Each test question contributes equally to the candidate’s score. A passing score for all COMLEX-USA Levels is based solely on the candidate’s performance on the total examination, not on a candidate’s performance in individual content areas.

  • Standard deviation (approximately), 85
  • Mean score, first-time candidates (approximately), 520
  • The minimum passing score, 400

According to the NBOME, exam score reports become available in the student’s account at “View Score Report” approximately 4 to 6 weeks after the exam date.

For more information on Score Interpretation, visit the NBOME Scoring Principles.

Preparation Materials

Our Board Prep Resources PDF, provided by the LUCOM Academic Support & Success Center (ASSC), contains an extensive list of board preparation resources, a suggested OMS-II preparation schedule, and other resources to help you in your preparation. For information regarding reimbursement for preparation materials, please contact the LUCOM Office of Medical Education at LUCOMMedEd@liberty.edu.