COMLEX-USA · Level 1

Assessment of Foundational Biomedical Sciences and Osteopathic Principles and Practice

Examination Description

COMLEX-USA Level 1 is a problem- and symptom-based assessment, administered in a time-measured environment that integrates the foundational biomedical sciences and other areas of medical knowledge relevant to solving clinical problems and promoting and maintaining health in providing osteopathic medical care to patients.

Competency domains assessed include application of osteopathic medical knowledge, osteopathic patient care and osteopathic principles and practice, communication, professionalism and ethics. Competency assessment occurs in the context of clinical and patient presentations and systems-based practice as required for entry into the supervised practice of osteopathic medicine as an independently practicing osteopathic generalist physician and for readiness for lifelong learning and practice-based learning and improvement.


Foundational Biomedical Sciences

  • Anatomy
  • Behavioral Science
  • Biochemistry
  • Genetics
  • Preventive Medicine and Health Promotion
  • Immunology
  • Microbiology
  • Osteopathic Principles and Practice
  • Pathology
  • Pharmacology
  • Physiology

The examination consists of two computer-based test sessions of four hours each taken on one day in a secure, time-measured environment. It contains 400 test questions related to diverse clinical and patient presentations and seven defined competency domains for osteopathic medical practice. Test questions are single best answer multiple choice format with some novel test questions involving audio-visual components designed to assess an expanded physician competency subset.

Examples of test item types expected to be encountered in Level 1 can be found under Practice Exams.


What Passing Level 1 Means

Passing COMLEX-USA Level 1 indicates that the candidate has demonstrated competence in the foundational biomedical sciences and osteopathic principles and related physician competency domains for osteopathic medical care of patients as required to enter supervised patient care settings and to continue lifelong learning.

Reference Materials


Client Registration System Tutorial


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