Attaining a Doctor of Osteopathic Medicine (DO) and licensure for practicing requires the completion of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA). These exams prove that individuals have the knowledge and skills to work as osteopathic generalist physicians.

In this article, we’ll be going over a few tips on how to calculate and convert a COMLEX score into a percentile rank, as well as attempt to explain how the exam is scored.

For more on what COMLEX is and what it evaluates, we’ve also provided short explainers at the end (so feel free to skip to that section first).

**Contents**show

## COMLEX Scores

The National Board of Osteopathic Medical Examiners (NBOME) is responsible for administering the COMLEX-USA exams and scoring them. Scores are obtained by assessing the number of questions answered correctly. This data is then converted into a three-digit standard score. **As of May 2022, the scoring report for COMLEX Level 1 has changed from three-digit to a “Pass” or “Fail” status**.

The exam evaluates a candidate’s performance as a whole and not in individual areas. It assesses the quality of the answer as well as psychometric properties. **All questions contribute equally to the final score**.

Passing the COMLEX exams requires a **minimum score of 400 for Level 1 and 2 exams** and **350 for Level 3 exams**. These values don’t represent the number or percentage of questions answered correctly.

COMLEX Level 1 and 2 (CE) examination scores are usually reported four to six weeks after the day the test was administered. Level 3 examination students can expect their results eight to ten weeks after they’ve taken the test.

## COMLEX Score Percentiles

NBOME only provides students their three-digit scores, **it doesn’t report percentile rankings**. However, if students still want to know how they fared in comparison with their peers, there are still some ways to infer their COMLEX score percentiles.

### What Is a COMLEX Score Percentile?

**A COMLEX score percentile is a comparison score that allows students to assess how they did on the exam in comparison to the rest of the students in the same cohort**. For example, if a student ranked in the 90^{th} percentile it means that their score was higher than 90% of all other scores.

### How to calculate COMLEX Score Percentiles

There are three methods to calculate the COMLEX Score Percentiles. Students can use the NBOME Score Converter, do some quick calculations of their own, or compare current statistics.

#### 1. NBOME Score Converter

NBOME created a helpful tool that allows students to convert their three-digit score into a percentile depending on the level of the exam and the date when it was taken.

To use the NBOME Score Converter students simply must input the date of the examination, their score, and the test level. The tool then converts it and calculates the percentile score based on other first-time students taking that same exact exam, in the same cycle.

#### 2. Quick Calculations

Students can also assess their score percentile by using a calculator and some simple math. By calculating their mean exam score and applying the standard deviation value, students can then take the result and check with their NBOME report card to predict their results.

NBOME claims that the approximate standard deviation for Level 1 exams is 85. Using this value, students can roughly estimate the entire spread of their score percentile results.

#### 3. Statistic Comparisons

For students who can’t be bothered with calculations, there’s another simple solution. They can try finding the latest statistics available regarding the correlation between scores and percentiles to predict their results.

This table depicts data for COMLEX Level 1 test-takers in the 2018/2019 test cycle and associates it with approximate score percentile estimates. Students can use information like this to predict their score percentiles for whatever year they attempt the exam.

These values are subject to change every year, as NBOME sees fit. The safest way to use this method for score percentile estimation is to try finding the most current and reliable information online.

## What’s the COMLEX Exam?

The COMLEX is a series of three exams that students in osteopathic schools need to pass to obtain licensure for osteopathic medicine practice. It is also a requirement for graduating as a Doctor of Osteopathic Medicine (D.O.).

Residency program directors also use these scores to assess students’ capabilities and eligibility to enter some of the most competitive residency programs.

### What Does the COMLEX Exam Evaluate?

The COMLEX exams evaluate specific competencies, skills, and knowledge in the osteopathic field. They assess if the student’s general knowledge is sufficient and fluent enough for real practice.

Students can refer to the COMLEX-USA Master Blueprint to obtain more information on the exam’s design and the different types of content covered.

There are three levels of COMLEX exams:

**COMLEX Level 1:**Second-year students test their knowledge in a wide variety of subjects, including anatomy, microbiology, osteopathic principles, and pharmacology**COMLEX Level 2 – Cognitive Evaluation (CE):**Students who’ve completed a year of clinical rotations take this test to see if they can think like a clinician. It tests clinical knowledge, diagnosing abilities, and management**COMLEX Level 2 – Performance Evaluation (PE):**This is a hands-on exam where students must simulate assessing a patient’s history, performing a physical exam, documenting their findings, and preparing a diagnosis**COMLEX Level 3:**The final exam is destined for residents. It assesses their ability to fundamentally understand everything that goes into being a generalist clinician. It evaluates patient safety, independent practice, and clinical presentations

COMLEX Level 1, 2 (CE), and 3 are computer-based examinations. Level 1 and Level 2 (CE) tests contain 352 questions and are divided into two sessions of four hours. COMLEX Level 3 test is a two-day examination.

Level 3 exams consist of four test sessions of three and a half hours each. Students have to take two sessions per day within a 14-day window. They contain 420 multiple-choice questions and 26 clinical decision-making cases, each of them with two to four questions.

Students have to take all the tests in their sequential order and pass every level before being eligible to take the next one. They are only allowed to choose the order they prefer when taking the Level 2 CE and PE exams.

## Sources

- https://www.medschoolcoach.com/what-are-the-comlex-exams/
- https://www.nbome.org/assessments/comlex-usa/
- https://www.nbome.org/scores-transcripts/percentile-scores/
- https://www.nbome.org/assessments/comlex-usa/comlex-usa-level-1/scores-transcripts/scoring-principles/
- https://www.nbome.org/assessments/comlex-usa/comlex-usa-faqs/
- https://www.nbome.org/scores-transcripts/scoring-principles/
- https://bemoacademicconsulting.com/blog/comlex-level-1
- https://blog.blueprintprep.com/medical/apples-oranges-comparing-usmle-and-comlex-scores/
- https://www.varsitytutors.com/hotmath/hotmath_help/topics/percentile