COMLEX Level 1 Adopts Pass Fail Scoring

May 27, 2022


NBOME announces COMLEX Level 1 adopts pass fail scoring starting May 10th.

“There is something sacred about the relationship between physician and patient. The basis of the relationship lies in the implicit trust placed in the physician by the patient. That trust stems from the belief that the physician is competent to practice medicine, and thus the public has come to inherently rely on jurisdictional regulatory agencies, licensing examinations, certifying boards, and hospitals to assure them that the physician is competent.”

Frederick C. Meoli*, DO, FACO

Recently, the National Board of Osteopathic Medical Examiners (NBOME) announced that reporting for COMLEX-USA Level 1 would transition from a three-digit numeric score to a Pass or Fail outcome commencing on or after May 10th, 2022. Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Levels 1, 2 and 3 are high stakes board exams for osteopathic medical students who are preparing to practice as physicians in any variety of medical specialties. The move aligns the pass-fail method of scoring for the exam with the start of the 2022-2023 testing cycle for osteopathic students.

*Dr. Frederick C. Meoli is the former President & CEO of the National Board of Osteopathic Medical Examiners.

NBOME’s Parallel Decision

NBOME’s decision that COMLEX Level 1 adopts pass fail scoring comes in the wake of a similar change by the United States Medical Licensing Examination for the USMLE Step 1 that started in January of 2022.

In an earlier blog titled Unintended Consequences of USMLE Pass Fail Scoring, the founder of the Physician Achievement Concept Course and director of WOLFPACC Dr. Hans Wolf said, “Since the numeric score is no longer reported, many medical students are looking at this as a big plus. But this could have unintended consequences for some students as the level of difficulty of the exam has not changed.”

“The change in scoring to pass fail for both exams will continue in parallel for COMLEX and USMLE,” remarked Dr. Wolf. “This way both osteopathic and allopathic students should experience the same advantages and disadvantages when taking their Level One exams.” WOLFPACC recommends that all students take the initiative early on and properly prepare for the COMLEX-USA Level 1 exam. You will be better prepared for your exam and to practice medicine as a confident doctor.

Medical Licensing can be Confusing…

Medical licensing in the United States can be confusing for students and the general population. Even though the path to practicing medicine in our country for all doctors is rather straight forward, there are differences. Allopathic medical students will complete their board exams by passing all levels of the United States Medical Licensing Examination (USMLE) as well as completing his or her residency. For students in osteopathic programs, licensing options differ slightly as they prepare for selection to through a Residency Match Program.

COMLEX-USA is recognized by the federation of State Medical Boards and is accepted for physician licensure in all 50 states as well as other international jurisdictions. The primary purpose of the exam is for accreditation of an osteopathic physician (DO) seeking to practice medicine and surgery in the United States. Currently, international medical school graduates are only eligible to apply for the allopathic National Residency Match Program (NRMP), so IMGs should only consider the USMLE and not the COMLEX.

Why take both exams?

Historically, osteopathic medical students seeking residency for more competitive specialties have taken both the COMLEX and USMLE. Under a split residency accrediting system, many students in osteopathic programs have taken the COMLEX Level 1 and USMLE Step 1 within weeks of each other. However, during the recent pandemic, physician licensure programs had to adjust to a “New Normal”. For example, after decades of serving as an established requirement, the NBOME announced the demise of the USMLE Step 2 CS (clinical skills) exam.

Since there will be more allopathic students applying using USMLE scores rather than COMLEX scores, osteopathic students pursuing certain specialties may feel somewhat compelled to take the USMLE. Passing both might improve their chance of acceptance to some residencies. In turn, MD students and DO students believe the three-digit scores received on the USMLE Step 2 CK (clinical knowledge) exam may become a more important measure for residency match. After all, it is difficult to imagine the selection process without some consideration of more traditional numeric grades.

New Accreditation Process for Residency Match

There is no doubt the USMLE and the COMLEX are challenging medical exams that have always had major implications for a medical student’s career. Moreover, after the merger between the American Osteopathic Association and the American Council for Graduate Medical Education to form one accrediting source for residencies, more doors are open for DO students to apply to a majority of accredited programs. However, whereas osteopathic students do not have to pass any USMLE exam to apply, some will still choose to take both when pursuing a highly competitive specialty like neuro-surgery.

“When it comes to DO students taking the USMLE exams, it really depends on what they want to do as physician,” advised Dr. Wolf. “Our Physicians Achievement Concept Course was developed to help any doctor better apply the information learned in medical school whether they are studying to be a DO, MD, or IMG.” Studying for either or both medical licensure exams depends upon the student’s foundational knowledge from their medical school curriculum. “At WOLFPACC, our USMLE and COMLEX-USA training programs are not only designed to help students pass either exam but to help them become a better doctor.”

The effect on acceptance to residency match programs is still difficult to predict. At WOLFPACC, we can help you understand the differences in how the USMLE and COMLEX exam questions are written and scored as well as differences in the diagnosis and management of patient care. We offer 4-week, 6-week and 8-week test preparation review courses, submit this website’s convenient registration form or call (904) 209-3140 for immediate assistance.