NBOME
COMLEX Level 1
Comprehensive Osteopathic Medical Licensing Examination of the United States, Level 1
The first of three licensure exams every osteopathic (DO) medical student must pass, testing foundational biomedical sciences and osteopathic principles. Pass/fail since 2022 and required to progress toward DO licensure.
What's on the exam
COMLEX-USA Master Blueprint, Level 1 (Dimension 2: Clinical Presentations)
Community Health and Patient Presentations Related to Wellness
~6%Preventive medicine · Epidemiology and biostatistics · Health promotion · Population health · Medical ethics
Human Development, Reproduction, and Sexuality
~7%Embryology · Reproductive physiology · Pregnancy and fetal development · Genetics and inheritance · Lifespan development
Endocrine System and Metabolism
~8%Hormone signaling · Glucose regulation and diabetes · Thyroid and adrenal disorders · Metabolic pathways · Nutrition and vitamins
Nervous System and Mental Health
~13%Neuroanatomy · Neurophysiology · Neuropharmacology · Behavioral science · Psychiatric pathophysiology
Musculoskeletal System
~14%Anatomy of the spine and extremities · Osteopathic structural diagnosis · OMT principles and techniques · Somatic dysfunction · Rheumatologic pathology
Genitourinary/Renal System and Breasts
~7%Renal physiology · Acid–base balance · Nephron pathology · Genitourinary anatomy · Breast pathology
Gastrointestinal System and Nutritional Health
~11%GI anatomy and histology · Digestive physiology · Hepatobiliary function · GI microbiology · Nutritional deficiencies
Circulatory and Hematologic Systems
~13%Cardiac physiology · Cardiovascular pathology · Hemostasis and coagulation · Hematologic malignancies · Cardiovascular pharmacology
Respiratory System
~12%Pulmonary physiology · Gas exchange and transport · Respiratory pathology · Pulmonary infections · Acid–base compensation
Integumentary System
~9%Skin anatomy and histology · Dermatologic pathology · Skin infections · Immunologic skin disorders · Wound healing
Frequently asked questions
How much does the COMLEX Level 1 cost?
Fees vary. Approximately $760; confirm the current NBOME fee schedule.
How long is the COMLEX Level 1 and how many questions does it have?
352 items — About 8 hours of testing plus breaks (one day).
What do you need to pass the COMLEX Level 1?
Pass/fail against the NBOME standard (numeric scores discontinued in 2022).
Can you retake the COMLEX Level 1?
Retake permitted only after a failing attempt; attempt limits and waiting periods set by NBOME.
What is the best way to study for the COMLEX Level 1?
Study the official blueprint, not random material: the exam is weighted by domain (Community Health and Patient Presentations Related to Wellness ~6%, Human Development, Reproduction, and Sexuality ~7%, Endocrine System and Metabolism ~8%, Nervous System and Mental Health ~13%, Musculoskeletal System ~14%, Genitourinary/Renal System and Breasts ~7%, Gastrointestinal System and Nutritional Health ~11%, Circulatory and Hematologic Systems ~13%, Respiratory System ~12%, Integumentary System ~9%). Spaced-repetition flashcards built domain-by-domain against that blueprint are the most time-efficient way to cover everything the exam tests.
Program in development
We're building a blueprint-complete program for this exam. Meanwhile, explore live programs across 7 exam.
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