It’s already time for your first COMLEX exam! This is a big milestone in your med school journey, and we’re sure you have tons of questions.
Based on our conversations with DO students over the years, we've pulled together everything you need to know — from how to reserve your exam date to how to decide if you’re really ready. Let’s walk through it step by step:
Reserving your COMLEX test date
Getting ready for COMLEX
After the exam
Let’s start with the housekeeping topics: how to reserve your COMLEX date. Setting the date seems like a small detail — but it’s the first step you need to take!
Registering for COMLEX can be done online. Just set up an account with NBOME and log in to the portal to choose your exam date. The NBOME recommends you book your exam at least four months in advance, as spaces are limited and popular test centers fill up quickly.
Most COMLEX centers offer a variety of different test dates to fit your schedule. Find a test center near you and select a date that fits your schedule. The NBOME advises students to reserve their spots at least four months in advance. This way, you can find a center and date that are convenient for you.
And a tip from us at AMBOSS: we’ve found it’s wise to avoid dates near stressful or busy events in your personal life (travel, moving, family responsibilities, commitments outside of school, etc.). That way, you free up your full mental capacity to prepare for your exam.
As of 2026, COMLEX Level 1 is $745. If you know in advance that you need to reschedule your exam, do it as early as you can. The closer to the exam date you cancel, the higher the cancellation fee. If you cancel 30+ days before, the fee is $85. If you cancel 6-30 days before, it’s $85, and if you change your mind within 5 days of the exam date, it’s $250. No-shows are charged an even higher fee.
If you have successfully completed your first year of study at an accredited school of Osteopathic Medicine, you should be eligible to take COMLEX Level 1. Some schools recommend you take it at a specific time.
This is a nuanced question, and it’s important to consider your individual situation. We asked Dr. Jonny Hatch, DO, a dermatology resident who mentors med students looking to match their dream specialty.
“Everyone agrees that for competitive specialties, most DOs should take BOTH Step 2 and Level 2, but the answer isn’t quite so clear-cut for Step 1 and Level 1. From my experience, most institutions just want DOs to take Level 1. They do not care whether they take Step 1 or not. The issue is that several programs on Residency Explorer will list USMLE Step 1 as being required. Typically, I advise students to reach out to these programs and verify their requirements. Sometimes, their requirements are not updated on Residency Explorer, so with an inquiry like this, they may gladly accept an application for someone if they only have Level 1. That being said, if you want to maximize every chance of success and have the means to pay for both exams, I would advise going ahead and taking both Step and COMLEX just to ease your own fears and anxieties, and to check every box.”
Divya Seth, a DO (Touro College of Osteopathic Medicine - Harlem, Class of 2022) and Medical Editor at AMBOSS, agrees that thinking about your long-term options is important:
“If you are interested in specific programs where you know directors are familiar with COMLEX exams, Step 1 may be less relevant, especially now that it’s pass/fail. However, some directors aren’t as familiar with COMLEX, which becomes more relevant for scored exams, like Level 2 and Level 3. Having both USMLE and COMLEX could keep more options open and help make your application more universally understood.”
Finding a way to ‘multitask’ and cover concepts that appear on both can save you a lot of time here. As for which exam to take first, we asked Dr. Jonny Hatch, a qualified DO and dermatology resident. He advises: “If you choose to take both, I typically recommend taking Step first, then spending 2–5 days studying the COMLEX-specific material and taking Level 1 about 5–7 days later.”
Divya Seth, a DO and Medical Editor at AMBOSS who took both USMLEs and COMLEX, also recommends taking Step 1 before Level 1. “If you leave a lot of time between Step 1 and Level 1, you might forget stuff you covered earlier in your dedicated study period, and need to learn it all over again. So I would recommend taking COMLEX around one week after USMLE.”
There isn’t definitive data comparing COMLEX difficulty to other exams, but we do know that approximately 90–92% of COMLEX takers pass on their first attempt. The cutoff is the 8th percentile.
We have found that students who get good results in any exam are the ones who use their study time efficiently and focus on the areas where they have the most to gain: high-yield topics and their weak areas. AMBOSS has resources to help you do that. Without a structured plan, it’s easy to miss heavily tested concepts or spend too much time on low-yield material.
To provide that structure, AMBOSS offers dedicated study plans such as High-Yield Osteopathic Manipulative Medicine and 200 concepts that appear on every COMLEX Level 1 exam. These plans are designed to help you focus on the content most likely to influence your score, while giving a clear, organized path for progress.
The NBOME's official guidelines explain that COMLEX Level 1 tests “foundational biomedical sciences (anatomy, physiology, pathology, microbiology, biochemistry, pharmacology) to clinical scenarios.” You can also expect questions about Osteopathic Principles and Practice (OPP/OMT), ethics, and medical communication. You can check out the COMLEX blueprint/content outline here!
Now that you know what you need to study, how can you do it more efficiently?
AMBOSS has several COMLEX-specific resources you should make sure to cover:
If you’re planning to take both Step and Level, you can expect to see a lot of concepts twice. It’s well worth using COMLEX-specific resources to ensure you’re familiar not only with the key concepts, but also with the way COMLEX tests them.
Not seeing COMLEX Qs in AMBOSS? Make sure your study objective is set to COMLEX, and you’ll see everything that fits your current stage.
We know you’ll work hard — so give this your best shot and try not to let nerves get the best of you. Over the years, the AMBOSS team has worked with DO students and practitioners from all over the country. From hearing about people’s experiences of getting disappointing results in COMLEX, we’ve identified a few common themes:
Reason #1: Didn’t have enough time in the exam: Some students feel rushed, either not managing to answer every question, or answering them so hurriedly that they make mistakes they wouldn’t have made in a lower-pressure environment.
Solution: Try to do a dry run and simulate the exam environment and timing at home. The COMLEX Level 1 Self-Assessment is a great way to do that. You’ll answer 160 Qs in a timed, exam-like environment, but don’t worry about getting a perfect score: think of this purely as a learning exercise. You have more control over breaks in COMLEX than USMLE — which helps you learn your flow, and identify when you should take breaks. At the end, you’ll get a breakdown of your strong and weak areas, and resources to help fill in your knowledge gaps ahead of test day.
If picking out the important details in the question is something you struggle with, watch this video about how to quickly pick out the pertinent info in USMLE questions — it’s pretty relevant for COMLEX, too. Practice these techniques, and over time, answering Qs will quickly become second nature.
Reason #2: Could have used their study time better. Sadly, the number of hours spent studying does not necessarily correlate with high test scores. Some students spent too long on low-yield topics that weren’t tested.
Solution: Focus on the areas where you have the most to gain: high-yield topics, in particular the ones you’re weak on. AMBOSS’s study plans for High-Yield Osteopathic Manipulative Medicine and 200 concepts that appear on every COMLEX Level 1 exam are a great start!
Reason #3: Letting nerves get the best of you. Losing confidence in the exam hall, or worrying so much that you get a horrible night’s sleep the night before and feel ‘off’, are things that have happened to even the best students.
Solution:
Whether you’re in the early stages of prep or facing COMLEX next week, there’s always a lot you can do.
AMBOSS has a study plan that covers all the High-Yield Osteopathic Manipulative Medicine topics in one place. Our tip: articles like General Osteopathic Principles and Chapman reflex points are especially important, so make sure to bookmark those! As well as that, you should check out the 200 concepts that appear on every COMLEX Level 1 exam.
One AMBOSS membership gives you access to all our content: that means boards, COMLEX, rotations, and in-house exams are all covered. Here are the COMLEX-specific resources you should pay attention to if you’re prepping for Level 1 rn:
Feeling some nerves before a big exam is totally normal. Divya Seth, DO, and Medical Editor at AMBOSS, who took both USMLEs and COMLEX, advises: “Even though it can be tempting to push your Level date back, don’t do it! You covered a lot during dedicated, and many of the same concepts will be on the Level 1 exam. If you leave a lot of time between Step 1 and Level 1, you might forget stuff you covered earlier in your dedicated study period, and need to learn it all over again. So I would recommend planning to take COMLEX around one week after USMLE, and sticking to that.”
Luckily, AMBOSS has some tools to help take the guesswork out of that decision:
Check out the NBOME’s testing windows and release dates. Scores should be out by 5:00 pm Central time. Best of luck!
Firstly, congratulations! Passing your first NBOME exam is a huge achievement. Take some time to acknowledge all your hard work and treat yourself to something nice as a reward. Once you’re ready to gear up for COMLEX Level 2, rest assured that all your performance data about your strong and weak areas is still in AMBOSS. You can pick up where you left off.
AMBOSS has 3,400+ Qs for COMLEX Level 2 and COMAT. The most frequently used resource is probably 200 concepts that appear on every COMLEX Level 2 exam, which is a great way to start ticking things off your study to-do list, whether you’re just jumping in or in the late stages of prep.
We’re sorry to hear things didn’t go your way — it happens, even to very good students. Take some time to decompress. Once you feel ready to start preparing again, try to see your first try as a learning experience. Ask yourself these questions:
After that, you’ll want to study as efficiently as possible so you’re 110% ready for the retake. If you need a general overview of COMLEX topics, focus your attention on our study plans: 200 concepts that appear on every COMLEX Level 1 exam and High-Yield Osteopathic Manipulative Medicine.
We also recommend you take the COMLEX Level 1 Self-Assessment. It’ll give you a breakdown of your strong and weak topics, and recommend resources to bring you up to speed.
Don’t let a bad experience hold you back: you will learn a lot from this and be ready to ace that exam the second time around!
We hope this article has answered your questions about Level and helped you figure out how you can get on track to pass with flying colors.
We’d be honored to support you, no matter what stage of prep you’re at. If you’re new to AMBOSS, you can get a 5-day free trial to explore how the platform.
And as a bonus, one AMBOSS membership gives you access to everything: COMLEX, Step, Shelf, COMAT, rotations, and everything else. That means smarter, more time-efficient prep – no more jumping back and forth!