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The Comprehensive Osteopathic Medical Licensure Examination (COMLEX)-USA Level 2 Cognitive Evaluation (CE) is a one-day computer-based assessment that integrates application of knowledge in clinical science 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. Competency domains assessed 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.

Test Blueprint

Adequate preparation should begin with an understanding of what you will be tested on. As with Level 1, students should become familiar with the Level 2 test blueprint.

When Should You Take COMLEX Level 2-CE?

LUCOM does not mandate a date by which students must take COMLEX Level 2-CE; however, passing Level 2-CE and PE is a graduation requirement. Most students take the exams at some point during their OMS-III year, most in May or June following their last rotation. Students are required to take and pass the CE of Level 2 prior to the start of audition rotations in July for OMS-IV.

For more information about LUCOM’s policies regarding COMLEX Level 2-CE, please refer to the Student Handbook.

How Should You Prepare for Level 2-CE?

Preparation for Level 2-CE begins with your first rotation, just as preparation for Level 1 began with the first course of the first semester. Be as engaged as possible in all rotations, regardless of your level of interest in that specialty. Try to learn as much as possible from patient encounters and from the attending physicians, residents, and other medical students with whom you interact. Try to read a little every day about the cases you’ve seen. Study in earnest for your COMAT exams.

As with Level 1, it is useful to gauge your baseline performance, either by taking a version of COMSAE Phase 2 or by creating a practice test using your Qbank of choice. It is also important to be familiar with the test blueprint, create a study schedule, identify key resources, do practice questions, and assess your progress with practice tests.

Level 2-PE

The COMLEX-USA Level 2-Performance Evaluation (Level 2-PE) is a patient-presentation-based assessment of fundamental clinical skills evaluated through 12 encounters with standardized patients. Each candidate must personally perform the clinical skills with standardized patients as appropriate in a timely, efficient, safe and effective manner.

This examination augments the Level 2-Cognitive Evaluation (Level 2-CE) to fulfill the public and licensing authority mandate for enhanced patient safety. Level 2-PE assesses six fundamental clinical skills for osteopathic medical practice within two scored examination domains: the Humanistic Domain and the Biomedical/Biomechanical Domain.

The COMLEX Level 2-Performance Exam (PE) must be taken on or before December 31 of the OMS-IV year at LUCOM. If on an alternative degree completion plan, the timing of the COMLEX Level 2-PE examination will be assigned by the Office of Clinical Education for the student but should occur no later than five months before expected graduation.

For more information about LUCOM’s policies regarding COMLEX Level 2-CE, please refer to the Student Handbook.

During this clinical skills exam, students encounter 12 standardized patients (SP) over the course of a seven-hour day. Examinees have 14 minutes for each patient encounter and nine minutes to complete an electronic SOAP Note. The skills evaluated fall under two domains:

  • Biomedical/Biomechanical Domain
    Osteopathic Principles and/or Osteopathic Manipulative Treatment
    History-taking and Physical Examination Skills
    Integrated Differential Diagnosis and Clinical Problem-Solving
    Documentation and Synthesis of Clinical Findings (SOAP note format)
  • Humanistic Domain
    Physician-Patient Communication
    Interpersonal Skills

Test Blueprint

Adequate preparation should begin with an understanding of what you will be tested on. Students should become familiar with the Level 2-PE test blueprint.

How is the COMLEX Level 2-PE Graded?

Students must pass BOTH the Biomedical/Biomechanical and the Humanistic Domains to pass the Level 2-PE. As outlined on the NBOME website, candidates’ history-taking and physical examination skills are documented by the SP portraying the patient immediately following the encounter, as are doctor-patient communication, interpersonal skills, and professionalism. Completed e-SOAP Notes and OMT skills (via a secured electronic recording process) are rated by NBOME trained and approved osteopathic physician examiners.

Pass or fail results are reported as the overall examination outcome reflecting the osteopathic medical profession standard for undergraduate students preparing for graduation and also for each of the two examination domains.