Pass COMLEX Level 1, 2-CE & 3 —Built for DO Students
COMLEX-USA is your pathway to osteopathic licensure — and, since Level 1 went pass/fail, your Level 2-CE score has become the number residency programs actually look at. Expert 1-on-1 coaching, osteopathic-specific strategy, and a personalized study plan for every level of the series.
20+ Years of proven results
4.9★ Average Google rating
500+ Students coached

Pass / Fail
Level 1 · Criterion score of 400+ required, no numeric score reported

~525–540
Level 2-CE national mean score · Minimum passing score is 400

~520
Level 3 national mean score · Minimum passing score is 350

8 hrs
Level 1 & 2-CE testing time · Level 3 spans two exam days
The High-Stakes Reality
Your COMLEX Scores Shape Your Path to Residency
COMLEX-USA is the primary licensing pathway for osteopathic (DO) medical students and is accepted for licensure in all 50 states. With Level 1 now pass/fail and Level 3 moving to a condensed one-day format in 2027, understanding exactly what each exam demands — and building a plan around it — is essential to staying on track for residency.
🦴
Osteopathic Content Is Tested Throughout
Unlike the USMLE, COMLEX weaves osteopathic principles and manipulative medicine (OMM) into every level. Students who treat OMM as an afterthought consistently underperform — it's high-yield, testable material at every stage of the series.
📈
Level 2-CE Now Carries the Weight
With Level 1's numeric score gone, Level 2-CE has become the primary quantitative benchmark residency programs use to compare DO applicants. The national mean sits at roughly 525–540 — scoring well above that is what makes you competitive.
🔁
Format Changes Are Underway
NBOME is reducing Level 1 and Level 2-CE from 352 to 320 questions in 2026, and collapsing Level 3 to a single exam day beginning January 2027. The content blueprint is unchanged — but your pacing and block strategy need to match the current format.
Know Your Exam
COMLEX-USA Fast Facts
320 Qs
Level 1 & 2-CE question count starting 2026 · Down from 352, same ~8-hour testing day
400+
Minimum passing standard score for Level 1 and Level 2-CE (Level 1 reports Pass/Fail only)
350+
Minimum passing standard score for Level 3 · National mean is approximately 520
446 items
Level 3: up to 420 MCQs plus 26 Clinical Decision-Making cases across two exam days
The Full Series
COMLEX Level 1, Level 2-CE & Level 3 — What Each Exam Demands
Three exams, three different goals — from a pass/fail foundation check to the clinical decision-making exam you'll take mid-residency. Here's what's different about each one, and where MedSmarter
tutors focus their coaching.
Level 1 · OMS-II
Pass / Fail
The Foundational Science Gate
Tests basic biomedical sciences plus osteopathic principles across organ systems. Pass/fail since May 2022 — the goal is a confident first-attempt pass, not a chase for points.
Format
320 Qs · ~8 hrs
Passing
Score 400+
Typically taken
End of OMS-II
Level 2-CE · OMS-III/IV
Mean ~525–540
The Score Programs Actually See
Tests clinical decision-making across core disciplines. This is now the primary numeric metric on your residency application —
a strong score here matters more than
ever.
Format
320 Qs · ~8 hrs
Passing
Score 400+
Typically taken
Late OMS-III / early OMS-IV
Level 3 · Residency
Mean ~520
The Final Licensing Exam
Taken during residency, this exam tests independent clinical management through MCQs and Clinical Decision-Making cases. Moving to a one-day format beginning January 2027.
Format
420 MCQ + 26 CDM
Passing
Score 400+
Typically taken
During residency
What's Tested
Content Coverage Across the COMLEX Series
L1
Level 1 — Basic Biomedical & Osteopathic Sciences
Anatomy, physiology, biochemistry, microbiology, pathology, pharmacology, and behavioral science — integrated with osteopathic principles and manipulative medicine (OMM) across every organ system. Delivered as single-best-answer questions with occasional audiovisual exhibits.
320 Questions · 8 One-Hour Blocks · Pass/Fail
L2
Level 2-CE — Clinical Decision-Making
Problem- and symptom-based questions integrating internal medicine, surgery, OB/GYN, pediatrics, psychiatry, and osteopathic clinical application. Emphasizes diagnosis, management, and next-best-step reasoning over isolated recall.
320 Questions · 8 One-Hour Blocks · Scored + Pass/Fail
L3
Level 3 — Independent Clinical Practice
Multiple-choice questions plus Clinical Decision-Making (CDM) cases that simulate managing a patient over time — ordering tests, interpreting results, and adjusting treatment. Tests the judgment expected of a supervised resident physician.
Up to 420 MCQs + 26 CDM Cases · Two Exam Days
OMM
Osteopathic Principles — Tested at Every Level
OMM and osteopathic philosophy aren't a side topic on COMLEX — they're woven into vignettes across all three levels. This is the single biggest content gap for students transitioning from USMLE-style resources, and where dedicated OMM review pays off most.
Integrated Across Levels 1, 2-CE & 3
📅
When to Take Each Level
Level 1 is typically taken at the end of OMS-II, after core systems coursework. Level 2-CE is usually taken in late OMS-III or early OMS-IV, once most core clerkships are complete — ideally before ERAS applications open in September. Level 3 is taken during residency, once your program clears you to sit.
⏱️
Format Changes for 2026–2027
Level 1 (May 2026) and Level 2-CE (June 2026) both drop from 352 to 320 questions, delivered in eight 1-hour blocks of 40 with total seated time holding at about 8 hours. Level 3 moves from a two-day to a one-day exam beginning January 2027. The content blueprint itself is unchanged.
🔁
Eligibility & Registration
Your college of osteopathic medicine must mark you eligible in the NBOME system before you can register. Requirements vary by school but typically include passing prerequisite coursework and, for some programs, a minimum COMSAE benchmark score before clearance to test.
📋
How Long Should I Prepare?
Most students dedicate 6–8 weeks of focused study for Level 1 on top of a solid pre-clinical foundation, and a similar window for Level 2-CE during clinical rotations. A MedSmarter tutor helps you build a realistic schedule that fits around coursework, clerkships, or residency duties.
What Every COMLEX Candidate Should Know
Smart COMLEX Strategy Starts With Knowing What's Different
COMLEX isn't just "the USMLE with extra osteopathic questions." Its structure, scoring, and content emphasis are genuinely different — and a generic prep plan built for the USMLE will leave real gaps. Here are the high-leverage facts our tutors build into every COMLEX prep plan from day one.
CRITICAL
Level 1 Is Pass/Fail — But Don't Coast
Since May 2022, Level 1 reports only Pass or Fail, with a criterion-based passing standard score of 400. There's no partial credit for "close." Because Level 1 no longer signals strength to residency programs, the goal shifts to a confident, comfortable pass and a durable knowledge base for Level 2-CE.
TIP
Don't Skip OMM to Save Time
Osteopathic manipulative medicine appears throughout every level of COMLEX, yet it's the topic most students under-review because it isn't tested on the USMLE. Building OMM into your study plan from week one — not cramming it at the end — consistently improves section performance.
KEY FACT
Level 2-CE Is Your Residency Number
With Level 1's numeric score gone, program directors lean on your Level 2-CE score to compare DO applicants quantitatively. The national mean is roughly 525–540 — testing above that range meaningfully strengthens your application relative to peers.
STRATEGY
Practice in the New Block Format
Starting in 2026, Level 1 and Level 2-CE shift to eight 40-question blocks instead of the older 44-question format. Many question banks still default to the old block size — matching your practice blocks to the real exam format is a simple, high-impact fix.
Tutoring Packages
Flexible Plans for Level 1, Level 2-CE & Level 3
Whether you're working toward a confident Level 1 pass, chasing a top Level 2-CE score, or preparing for Level 3 mid-residency, there's a package matched to your timeline. All sessions are live, 1-on-1, and scheduled around your life.
2 Hours
$279/session
Trial Session — limited 1 per student
2-hour initial tutoring session
Diagnostic knowledge assessment
1-month platform subscription
Custom study plan preview
10 Hours
$199/hr
Starts at $1,990
10 hours of 1:1 tutoring
3-month platform subscription
Personalized study plan
NBME progress tracking
Unlimited platform Q&A
Monthly payments available
Most Popular
20 Hours
$189/hr
Starts at $3,780
20 hours of 1:1 tutoring
6-month platform subscription
Dedicated tutor + backup tutor
Full study plan & weekly check-ins
Biweekly NBME review sessions
Priority scheduling
Monthly payments available
40 Hours
$179/hr
Starts at $7,160
40 hours of 1:1 tutoring
12-month platform subscription
Comprehensive exam overhaul
Multiple exam coverage allowed
Monthly progress reports
Residency interview coaching add-on
Monthly payments available
Not sure which package fits? Book a free 15-min call and we'll recommend the right one for you.
Every Package Includes
Built to Pass — At Every Level of COMLEX
Everything you need to move from your current baseline to a confident result — in one
integrated, expert-led tutoring system.
👤
Dedicated 1:1 Expert Tutoring
Live, private sessions with a vetted COMLEX tutor — every session focused entirely on your weakest systems and reasoning gaps.
🦴
Dedicated OMM Coaching
Focused osteopathic manipulative medicine review — the content area most students under-prepare and most tutors overlook.
🧘
Exam-Related Anxiety & Stress Management
Mental conditioning techniques to perform under pressure — because knowledge alone doesn't guarantee performance on an 8-hour exam day.
🗺️
One-on-One Study Plan
Your tutor builds a custom weekly roadmap around your target exam date, current baseline, and system-level weaknesses.
📈
Continuous Progress Tracking
Monitor system-level and overall improvement in real time. Your tutor adjusts your plan based on data, not assumptions.
👥
MedLOGs Group Study (Optional)
Live online group sessions to reinforce core concepts, review clinical case presentations, and stay accountable with fellow DO students.
📄
MedSmarter High-Yield PDF Notes
Concise, exam-focused notes covering core disciplines and osteopathic principles — built for efficient review.
🎯
Test-Taking Strategies
Question-elimination frameworks, block pacing for the new 40-question format, and stamina training for exam day.
🖥️
Access to Productivity Platform
Your study planner, session notes, schedule, and high-yield resources — all in one place, accessible 24/7 on any device.
Getting Started
From Sign-Up to Exam Day in 4 Steps
Simple onboarding. You'll be working with your tutor within days of enrolling — with
a clear plan already built around your COMLEX level and timeline.
Free Consultation
A Senior Advisor reviews your COMLEX level, exam date, current preparation, and specific challenges to recommend the right package and study approach.
Tell Us About You
Complete a quick questionnaire covering your coursework or clerkship progress, strongest and weakest systems, and preferred learning style.
Meet Your Tutor
We match you with an expert COMLEX tutor whose specialties — including OMM — align with your profile, within 2–3 business days.
Follow Your Plan
Launch into personalized sessions, track your progress by system, and walk into exam day with a pass-ready strategy and the confidence to use it.
Who We Serve
COMLEX Tutoring for Every Stage of the DO Journey
From your first Level 1 attempt to Level 3 mid-residency, MedSmarter has an approach built specifically for
where you are in the series.
🎓
Level 1 Candidates
Typically OMS-II students preparing for their first licensing exam. Our tutors build structured plans that integrate systems review, OMM, and practice questions to secure a confident, first-attempt pass.
OMS-II
First Attempt
Pass/Fail Focus
📊
Level 2-CE Score Chasers
Since Level 2-CE now carries the primary quantitative weight for residency applications, our tutors help OMS-III/IV students push beyond the national mean with targeted clinical-reasoning coaching.
OMS-III/IV
Score Improvement
Residency-Ready
🩺
Level 3 Residents
Balancing residency duties with exam prep is its own challenge. A dedicated tutor helps busy residents prepare efficiently for Level 3's Clinical Decision-Making cases without derailing clinical responsibilities.
Residency
Efficient Prep
CDM Cases
Not Sure Where You Stand?
Take our free COMLEX practice quiz and see which systems need the most attention — in under 10 minutes, no sign-up needed.

Frank Navarrete
M.D. INSTRUCTOR
Expert Educators
Tutors Who Understand Osteopathic Medicine — Not Just Board Prep
Every MedSmarter COMLEX tutor is a vetted educator trained in our proprietary diagnostic methodology. They don't follow a generic USMLE-adapted syllabus — they identify exactly which systems, question types, and osteopathic concepts are limiting your progress, then build a precise plan to fix them across Level 1, 2-CE, or 3.
Deep expertise across all three COMLEX levels — including dedicated OMM specialists
Rigorously screened for subject mastery and demonstrated pass/score improvement results
Trained in MedSmarter's gap-diagnosis methodology for high-impact, efficient prep
Experienced working with students from OMS-II through residency
Skilled in COMSAE practice exam analysis and system-level performance coaching
Confident managing exam anxiety and building endurance for long testing days
Real Results
DO Students Who Passed Are Talking
From first-time Level 1 candidates to residents preparing for Level 3, our tutors have helped hundreds of osteopathic students reach the result they needed.
INDEPENDENT REVIEWS & TESTIMONIALS FROM STUDENTS
We pride ourselves on building lasting relationships by being transparent and following the Golden Rule. Read what some of our previous students are saying about their experiences with MedSmarter’s instructors and programs.
What’s the Golden Rule… “Do unto others as you would have them do unto you” … with honesty, integrity, hard work, and dedication. These are the core values that help shape aspiring doctors with medical skills and a good bedside manner. We aim to instill those same values in all of our students.
Common Questions
COMLEX Tutoring — Your Questions Answered
Everything you need to know before you start your COMLEX prep — with current scoring, format, and strategy guidance.
Is COMLEX Level 1 pass/fail?
Yes. Since May 10, 2022, COMLEX-USA Level 1 is scored strictly as Pass or Fail — no three-digit numeric score is reported. Passing requires a criterion-based standard score of 400 or higher. You'll also receive a Formative Performance Profile comparing your strengths and weaknesses to other first-time test-takers, but only your Pass/Fail result appears on your residency application.
What is a good COMLEX Level 2-CE score?
The minimum passing score is 400, but the national mean for Level 2-CE is approximately 525–540. Since Level 1 no longer reports a numeric score, Level 2-CE has become the primary quantitative metric residency programs use to evaluate DO applicants — making a strong score here especially important for your application.
When should I take each COMLEX level?
Level 1 is typically taken at the end of OMS-II. Level 2-CE is usually taken in late OMS-III or early OMS-IV — ideally before ERAS applications open in September, so your score is available to programs. Level 3 is taken during residency, once your program confirms you're eligible to sit.
How long should I study for COMLEX Level 1?
Most students dedicate about 6–8 weeks of focused study on top of a solid pre-clinical foundation built throughout OMS-I and OMS-II. Your ideal length depends on how strong that foundation is and your performance on practice questions and COMSAE assessments. A MedSmarter tutor can recommend a specific timeline based on your baseline.
How many questions are on COMLEX Level 1 and Level 2-CE?
Starting May 2026 for Level 1 and June 2026 for Level 2-CE, both exams move from 352 to 320 questions, delivered in eight 1-hour blocks of 40 questions each, with total seated testing time remaining approximately 8 hours. The content blueprint itself is unchanged — only the question count and block structure shift.
What is on COMLEX Level 3?
COMLEX Level 3 is currently a two-day exam (moving to a single day beginning January 2027) with up to 420 multiple-choice questions plus 26 Clinical Decision-Making cases, each with two to four extended questions. It tests clinical management and independent decision-making across core disciplines and carries a minimum passing score of 350.
DO students need to take the USMLE too?
Not necessarily. COMLEX-USA is accepted for DO licensure in all 50 states, and ACGME residency programs can accept either COMLEX or USMLE scores. Some DO students choose to also take the USMLE to broaden their residency options or simplify comparison with MD applicants — this decision should be based on your target specialty and programs.
Can I finance my COMLEX tutoring?
Yes. MedSmarter offers 0% APR financing through Affirm on all tutoring packages, allowing you to start immediately and pay over time with no interest. Select Affirm at checkout when enrolling in a 10-, 20-, or 40-hour package. Learn more at medsmarter.com/affirm-educational-page/.
Ready to Pass COMLEX Level 1, 2-CE & 3
and Move Forward with Confidence?
Book a free 15-20 minute consultation with a MedSmarter Senior Advisor. We'll review your COMLEX level, exam date, current preparation, and specific challenges — and match you with the right tutor at no cost.
No commitment required · Enrollments open year-round · 0% APR financing via Affirm
