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4 Do’s When Studying for COMLEX Level 1

Don't cross the streams!

Many Osteopathic students approach their COMLEX Level I exams with trepidation. They have heard horror stories about ambiguous questions, blurry x-rays, exam unpredictability, and even grammatical errors, which make it difficult to determine the correct answers on test questions.

While all of these things, and more, can and do show up on the exam, there is still a proper method of preparation that will give you the best chances of being successful on the COMLEX Level I exam. Below, we have compiled a list of 4 “Do’s” to consider when preparing for the COMLEX Level I exam.

#1: Do Use the Same Resources You Would Use for USMLE Step 1

Many times when students come to us, they are under the impression that they need to use a totally different approach to study for COMLEX Level I than what they would use to study for USMLE Step 1. While it’s true that the question style differs greatly, most of the content on the exam is actually quite similar. With the exceptions of OMM (addressed below) and biochemistry, the remainder of the scope of the exam is nearly identical. Since there aren’t really any books that are geared towards helping DO students with COMLEX Level I, we recommend that students use essentially the same study resources that we recommend for USMLE Step 1. This even includes USMLE World, as it is a much better learning tool than any of the currently available Qbanks made specifically for the COMLEX. A side benefit for DO students planning to take both the USMLE and COMLEX is that the preparation will be the same for both exams with a few modifications.

#2: Do Use a COMLEX-Specific Qbank

When I help students prepare for the COMLEX, I always recommend that they use a COMLEX-specific Qbank (COMBANK or COMQUEST) in addition to USMLE World. The reason for this is the Law of Specificity. Athletes know that if they want to get better at a specific skill, they must practice that skill in order to excel at it. For example: All doping issues aside, even though Lance Armstrong was the world’s best cyclist, when he competed in a marathon, he wasn’t even near the top. This is because, for years, he practiced cycling and not running. The lesson is simple. If you want to perform very well on the COMLEX, you must practice doing questions that are written the way the COMLEX will be written. 

I learned this lesson, myself, the hard way. For COMLEX Levels I and II, the only Qbank I used was USMLE World. Although I did quite well on both exams, I improved my score for Level III by using COMBANK, and scored the highest possible score on th

#3: Do Take the Time to Study OMM

Probably the biggest difference between USMLE Step 1 and COMLEX Level I is the inclusion of OMM as one of the subjects tested on the COMLEX. It is easy to neglect this subject, especially for students who are taking both exams. I always stress to students how important it is to study OMM before taking the COMLEX. There are two main reasons for this.

The first is that OMM is not an insignificant portion of the exam. It often makes up about 10% of the exam which can easily be the difference between passing and failing, or a mediocre score and a solid score.

The second reason is that the return you can get from OMM for the amount of time put in is very high. Many of the OMM questions on the exam are actually quite easy as long as you have put in the time to cover the material during exam preparation. This is not always true with other subjects like physiology and pathology. For the relatively few hours it takes to learn the material for the OMM portion of the exam, the payoff is quite high.

#4: Do Use the COMSAEs

We have discussed previously the importance of assessment in the exam preparation process (link to NBME post). The COMLEX Level I has its own assessment test called COMSAE Phase I. There are three forms currently available: A, B, and C. The test is composed of 200 questions (a half-length exam) and gives 3-digit scores that are analogous to the COMLEX score. It also gives a breakdown of how students did on specific subjects.

Although the COMSAEs are not as accurate an assessment tool as the NBMEs, I still highly recommend that students use them during their preparation for COMLEX Level I. The reason is very simple. They are the best assessment tool we have to estimate readiness to take the COMLEX Level I exam. The COMSAEs are made by the NBOME, which is the same organization that creates the COMLEX Level I, and the assessments are composed of COMLEXstyle questions. Because the COMSAEs are not as accurate as the NBME assessment exams, I recommend that students have a nice buffer before they actually sit for COMLEX Level I. For example: The passing score on COMLEX Level I is a 400, so ideally students should score a 500 on the COMSAE before they sit for the exam, but a 450 is an absolute must. 

If you put these 4 Do’s to work, you will take massive strides toward crushing your COMLEX. (And if that doesn’t work, you know who to call.)

Plan your study schedule COMLEX level 2 & level 1 ahead of time, so you can be well-prepared on your test day!