IMPORTANT UPDATES: COMLEX-USA Examination Program

February 1, 2020

COMLEX-USA Item Reduction



The NBOME Board of Directors approved plans to shorten COMLEX-USA Level 2-CE from 400 to 352 test items, beginning June 2020. This will only affect pre-test content, so exam validity/content coverage or reliability will not be impacted. This change should also reduce some of the stress associated with the time-pressured environment. Available test time will remain at 8 hours. Similar changes have been approved for COMLEX-USA Level 1 beginning May 2021.

Pretest questions are embedded into COMLEX-USA exams but do not count towards candidate’s scores. They provide useful information on the quality and relative difficulty of the questions to ensure fairness for candidates. They help obtain item statistics (for quality control as well as equating purposes), and to further test novel item formats. The number of total items per block will decrease from 50 to 44 items.

Further Review of COMLEX-USA Exam Scoring and Score-Reporting

NBOME has continued to study the uses of COMLEX-USA scores and score-reporting as it relates to the primary and intended purposes of the examinations (i.e., licensure), as well as secondary uses (most cited one is in residency program applications.) Our Board of Directors has approved the continued use of pass-fail only for the COMLEX-USA Level 2-PE clinical skills exam, and recommended further study related to the use of pass-fail as well as numerical scoring for COMLEX-USA Level 1, Level 2-CE and Level 3. Further updates will be provided as early as July 2020.

Modification to COMLEX-USA Level 1 and Level 2-PE Test Cycles in 2020

In response to feedback from candidates and deans, NBOME has modified the 2020-2021 test cycle for COMLEX-USA Level 1. It now commences 3 weeks earlier than prior years, running May 5, 2020 through April 2021.

We have also adjusted the COMLEX-USA Level 2-PE test cycle in response to increased demand during the spring months. The 2020 test cycle will now end in early November 2020, with a new complete test cycle beginning November 30, 2020. This change should provide additional testing opportunities in times of higher demand, thus helping candidates and schools to better facilitate the residency program application process.

Prometric Test Center and COMLEX-USA Enhancements for New Test Cycles in 2020

To assure an optimal computer-based testing experience at Prometric Test Centers, modifications continue to be made for COMLEX-USA examinations. Effective with the new May 2020 test cycle for COMLEX-USA Level 1, and the new June 2020 test cycle for Level 2-CE, the Prometric test driver used for all COMLEX-USA examinations has been updated to that already being used in COMLEX-USA Level 3. We endeavor to provide an optimal testing experience for all COMLEX-USA candidates and feel confident that these changes will further enhance the COMLEX-USA program.

NBOME to Modify Attempt Limits for COMLEX-USA Effective July 1, 2022

The NBOME Board of Directors approved changes to eligibility for COMLEX-USA to limit the maximum number of attempts to 4 total per exam, effective July 1, 2022. This change is intended to minimize misclassification, enhance test security/integrity, and reinforce NBOME’s mission to protect the public. Exceptions petitioned by a state medical or osteopathic medical licensing board will be evaluated on a case-by-case basis. Further information will be outlined in the COMLEX-USA Bulletin of Information, planned for release in July 2020.

For more information, please contact NBOME Client Services at clientservices@nbome.org or 866.479.6828