COMLEX (DO Medical Licensing) Requirements & Prerequisites
Everything you need to know before registering for the COMLEX (DO Medical Licensing), eligibility, cost, format, and what to expect on exam day.
Cost
$680
Provider
NBOME
Validity
7 years
Available
USA
Education
Check official exam requirements
Experience
3-5+ years of professional experience typically required
Specific Requirements
- For Level 1: completion of the first year of study at a college of osteopathic medicine accredited by the AOA Commission on Osteopathic College Accreditation, plus a good academic and professional standing attestation from the COM dean.
- For Level 2-CE: a passing result on Level 1, completion of the second year of study at an accredited COM, and a good academic and professional standing attestation from the COM dean.
- For Level 3: passing results on Levels 1 and 2-CE, graduation from an accredited COM, a good academic and professional standing attestation from a residency program director, and a clinical skills attestation from the COM dean or a passing Level 2-PE result. NBOME recommends completing six months of graduate medical education first.
- The levels must be taken in numerical order and each level passed before you become eligible for the next.
- You must establish and maintain an online NBOME account, agree to the Terms and Conditions, and provide proof of identity at the examination.
- Candidates dismissed from or withdrawing from a COM or residency program are ineligible, and you must inform NBOME promptly of any change to your status.
Number of Questions
Level 1 and Level 2-CE: 320 single-best-answer multiple choice questions in eight sections of 40, reduced from 352 for cycles beginning spring 2026. Level 3: 420 multiple choice questions plus 26 clinical decision-making cases, changing to 240 questions plus 16 CDM cases from 13 January 2027.
Duration
Level 1 and Level 2-CE: two timed sessions of four hours each, eight hours of testing, with the full day at the centre running about nine hours including the tutorial and breaks. Level 3: currently four sessions of 3.5 hours across two days within a 14-day window, becoming four two-hour sessions in one day from 13 January 2027.
Question Format
Single best answer multiple choice questions, Questions carrying audiovisual exhibits including images, videos and audio clips, opened with an Exhibit button, Clinical decision-making cases on Level 3, each presenting a scenario followed by two to four questions, Level 3 CDM responses in extended multiple choice format, where more than one correct answer may be required, or short answer format
Passing Requirement
Level 1 is reported as pass or fail with no numeric score. Level 2-CE has a passing standard of 400 and Level 3 a passing standard of 350, both on the three-digit standard score scale.
How It Is Delivered
Computer based at Pearson VUE test centres, with digital photo and palm vein biometric check-in and video monitoring throughout the session
Languages Offered
English
Visit the official NBOME certification page
Create an account and select your exam
Choose a test center or online proctoring option
Pay the exam fee and schedule your date
- Two forms of valid ID (one government-issued with photo)
- Appointment confirmation email
- For online proctoring: webcam, microphone, clean desk, stable internet
What are the prerequisites for the COMLEX (DO Medical Licensing)?
For Level 1: completion of the first year of study at a college of osteopathic medicine accredited by the AOA Commission on Osteopathic College Accreditation, plus a good academic and professional standing attestation from the COM dean.. For Level 2-CE: a passing result on Level 1, completion of the second year of study at an accredited COM, and a good academic and professional standing attestation from the COM dean.. For Level 3: passing results on Levels 1 and 2-CE, graduation from an accredited COM, a good academic and professional standing attestation from a residency program director, and a clinical skills attestation from the COM dean or a passing Level 2-PE result. NBOME recommends completing six months of graduate medical education first.. The levels must be taken in numerical order and each level passed before you become eligible for the next.. You must establish and maintain an online NBOME account, agree to the Terms and Conditions, and provide proof of identity at the examination.. Candidates dismissed from or withdrawing from a COM or residency program are ineligible, and you must inform NBOME promptly of any change to your status..
How much does the COMLEX (DO Medical Licensing) cost?
The COMLEX (DO Medical Licensing) exam costs $680. This includes the exam fee only, study materials are additional.
How do I register for the COMLEX (DO Medical Licensing)?
Visit the official NBOME certification page → Create an account and select your exam → Choose a test center or online proctoring option → Pay the exam fee and schedule your date
What should I bring to the COMLEX (DO Medical Licensing)?
Two forms of valid ID (one government-issued with photo). Appointment confirmation email. For online proctoring: webcam, microphone, clean desk, stable internet.
Ready to prepare for COMLEX (DO Medical Licensing)?
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