COMLEX-USA

COMLEX-USA or Comprehensive Osteopathic Medical Licensing Examination is a series of three osteopathic medical licensing examinations administered by the National Board of Osteopathic Medical Examiners (NBOME) similar to the United States Medical Licensing Examination (USMLE). COMLEX-USA is the most common pathway by which osteopathic physicians (D.O.'s) apply for licensure, and is accepted in all 50 states. The 3-digit standard scores of COMLEX-USA Level 1, Level 2-CE, and Level 3 have a mean of 500.

Level One
Step one is taken after the second year of medical school. It is administered in one day and consists of two, four-hour exam sessions separated by a 40-minute break. Each four-hour session also includes a ten-minute break. Candidates are expected to know the basic mechanisms of health and disease process. Specifically, level one covers basic medical sciences, including:
 * anatomy
 * behavioral science
 * biochemistry
 * microbiology
 * osteopathic principles
 * pathology
 * pharmacology
 * physiology

Level Two
Level two, taken during the fourth year of medical school, consists of two parts: Level 2-CE and Level 2-PE. Level 2-CE requires candidates to demonstrate knowledge of clinical concepts and medical decision-making. It is problem-based and symptoms-based, integrating the clinical disciplines of:
 * emergency medicine
 * family medicine
 * internal medicine
 * obstetrics/gynecology
 * osteopathic principles
 * pediatrics
 * psychiatry
 * surgery

Level 2-PE was introduced in 2005. It is a one-day, seven-hour exam and utilizes standardized patients (actors trained to present clinical symptoms) to test clinical skills. Specifically, candidates must demonstrate proficiency in:
 * history taking and physical examination skills
 * integrated differential diagnosis and clinical problem solving
 * written communication and synthesis of clinical findings (SOAP note format)
 * osteopathic principles and/or osteopathic manipulative treatment

Level Three
The final exam, level three, is typically taken after starting residency and, like step two, covers the clinical disciplines of medicine, including:
 * emergency medicine
 * family medicine
 * internal medicine
 * obstetrics/gynecology
 * osteopathic principles
 * pediatrics
 * psychiatry
 * surgery