About the COMLEX 3 Examination

The Comlex-USA Level 3 examination is similar to the other two Comlex examinations in that it is entirely a computer-based examination. Unlike the other tests, however, the Comlex-USA Level 3 exam is a two-day examination, while the others are just one-day examinations. The goal of the level 3 exam is to assess your competence in the different competency domains necessary for the osteopathic generalist to deliver safe and effective care in an unsupervised clinical setting.

You will need to keep in mind those things you have learned about osteopathic medical knowledge and its applications, patient care, communication, osteopathic principles and practice, ethical practices, and professionalism. The questions on the examination generally involve patient presentations and will test your knowledge with regard to the complete management of the well patient and those with medical and osteopathic concerns.

The Level 3 examination involves four separate computer-based question and answer sessions, each lasting 3.5 hours, taken within a 14-day window. The entire examination involves completing 420 multiple choice questions for which there will be one correct answer. Any given question will involve a test of your knowledge in ten clinical areas or one of seven competency domains in the field of osteopathy.

In addition, there are 26 clinical decision-making cases that each involve two to four questions per case. These are more complex and more difficult to study for because, not only could any given case involve any area of osteopathic medicine, but there will be an extended multiple choice format for which there will be more than one correct answer or a short answer response required. There may be audiovisual components to the clinical decision-making case questions.

While the multiple choice questions are fairly straightforward, the CDM or clinical decision-making cases, given in two separate sessions, are more difficult but better represent the kinds of decisions you will have to make as an osteopathic physician. The CDM cases will ask you about things like data acquisition or patient history,

examination findings, and the ordering of tests, generating a diagnosis, and patient management, which could involve some type of OMT, the prescribing of medication, patient counseling, and follow-up care.

In each of the eight separate sections of the two-day exam, you must complete the section within the 3.5-hour timeframe. You can change your answers at any time during each section but, once you have completed the section, that part of the exam is closed and you will not be able to return to the section or change any answers you have already given.

All Comlex-USA examinations have questions that have equal weight in determining the raw score, which is the number of questions correctly answered. You will not know this number but will be given a pass-fail designation as well as a standard score that has been converted so that the mean test score will be between 500 and 550. A percentile rank is not given; however, you can go to the National Board of Osteopathic Medical Examiners website to convert your standard score into a percentile rank if you desire. In addition, each osteopathic college is provided with information comparing its students’ scores in relation to the national average.