COMLEX-USA Level 3 Osteopathic Medical Practice

Most candidates take the exam during their first year of residency (PGY-1). This timing allows you to apply your growing clinical experience directly to the exam's focus on management and decision-making. It is advisable to schedule it after you have acclimated to your residency workload but before the demands of later training years increase. Check your specific state licensing board requirements for any deadlines.

The exam is a two-day assessment. Day 1 consists of multiple-choice questions (MCQs) focusing on applying foundational science and clinical knowledge. Day 2 includes more MCQs and the Computer-based Case Simulation (CCS). The CCS presents interactive patient management scenarios where you must diagnose and treat virtual patients in real-time, ordering tests, prescribing treatments (including OMT), and managing follow-up over simulated minutes, hours, or days.

Dedicate significant time to practicing with official NBOME CCS practice software and cases. Focus on developing a systematic workflow: initial assessment, urgent interventions, diagnostic workup, and treatment plan. Practice managing time within the simulation and writing concise, clinically relevant patient notes. The key is familiarity with the interface and honing your ability to prioritize actions in a sequential, patient-safe manner.

Yes. Osteopathic Principles and Practice are integrated throughout the exam. You will be expected to identify when OMT is an appropriate component of a patient's management plan, understand contraindications, and know the expected outcomes of treatment. Questions may ask about somatic dysfunction diagnosis, specific OMT techniques, and the integration of OMT with other therapeutic modalities.

The passing standard is set by the NBOME and is represented as a minimum converted score, typically around 350. If you do not pass, you will receive a performance report identifying areas of weakness. You are permitted to retake the exam, but you must wait a mandatory period and adhere to NBOME's retake policies and limits. It is crucial to analyze your performance and address knowledge gaps before reattempting.