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The COMLEX and NBOME FAQ

Questions:

  1. What is the NBOME?
  2. What is the COMLEX?
  3. What is the USMLE?
  4. When do medical students and interns take the COMLEX?
  5. Why do I need to take the COMLEX?
  6. Why do residency programs use board scores as selection criteria?
  7. Can I take the USMLE?
  8. Do I need to take the USMLE too?
  9. Why do some D.O. students take the USMLE?
  10. Do some residency programs not accept the COMLEX?
  11. Is the COMLEX easier than the USMLE?
  12. Has the COMLEX undergone independent verification?
  13. Who writes the COMLEX? How is it created?

What is the NBOME?

The NBOME is the National Board of Osteopathic Medical Examiners. It’s a nonprofit corporation dedicated to serving the public and state licensing agencies by administering examinations testing the medical knowledge of osteopathic medical students and interns. The NBOME was established in July 1934. Its website is at http://www.nbome.org.

What is the COMLEX?

In order to more accurately measure the knowledge required by today’s physicians, the NBOME initiated the three-level Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) to replace the former three-part NBOME examination series. The COMLEX is a three part exam. Each exam is administered over a two day period, and employs an osteopathic primary care approach to patient care fully integrated throughout the examination.

What is the USMLE?

The USMLE is the United States Medical Licensing Exam — it is taken by allopathic medical students and interns. It is administered by a Committee Consisting of representatives of the Educational Commission for Foreign Medical Graduates (ECFMGSM), the Federation of State Medical Boards (FSMB), the National Board of Medical Examiners (NBME), and the public. The Composite Committee establishes policies and procedures for the USMLE program. View our USMLE FAQ here.

When do medical students and interns take the COMLEX?

The first COMLEX is usually taken at the completion of the second-year of medical school. The next COMLEX is taken during the fourth year of medical school. The final exam is taken during the internship (first residency year).

Why do I need to take the COMLEX?

All states require you to have passed a licensing exam before they will issue you a license to practice. Most osteopathic medical schools require COMLEX as part of the process towards graduation. It is also used by residency programs to make selections of who they will interview and accept for their program. Usually this decision is made only with the scores from the first COMLEX.

Why do residency programs use the COMLEX score as a selection criteria? Is that fair?Fair or not, grades and COMLEX scores are key factors in granting interviews. The most important COMLEX score is the first one. When you’re applying for residency or internship, you will not have the results of your second COMLEX test.

Can I take the USMLE?

Yes, you can. You have to take either COMLEX or USMLE to get licensed, but since osteopathic medical schools require COMLEX there is no need to take both.

Do I need to take the USMLE too?

No.

Why do some D.O. students take the USMLE?

Some students feel that they need to take the USMLE in order to get accepted into an ACGME* (allopathic) residency. There is a perception that ACGME residency programs discriminate against students that take only the COMLEX. Of course this is a misguided idea; if a residency program discriminates based on which test you take, don’t you think they might also discriminate against which degree you have, or which medical school you attended?

*The ACGME is the Accreditation Council for Graduate Medical Education. It is responsible for the accreditation of post-MD medical training programs within the United States. Their website is at http://www.acgme.org.

Do some residency programs not accept the COMLEX?

A few ACGME (allopathic) residency programs don’t want to use the COMLEX because its scoring system is different than that of the USMLE. However, when looking at raw scores and national averages, it is easy to compare scores because the exams are very similar in their testing of knowledge.

Is the COMLEX easier than the USMLE?

Sorry! They’re both tough exams. You will likely get similar percentages on both.

Has the COMLEX undergone independent verification?

No test is “branded” Valid or Not Valid, there is just accumulated evidence towards validity.

The University of Chicago MESA psychometric lab published a 17 page study July 8, 1999. One of their many conclusions about the COMLEX USA is that they find it to be “equal to any and better than most” of the examinations they have studied.

Who writes the COMLEX? How is it created?

The COMLEX is written by hundreds of volunteer basic science faculty, academic physician faculty, and practicing D.O.s. They spend hours each year writing questions for the exam process. Literally thousands of questions are reviewed by another team of volunteer scientists, clinical faculty, and practicing physicians to ensure they are testing key information and that the questions are appropriate for the exam level for which they are being used.

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