DO Corner: Structure of COMLEX Level 1

By Sean Martin

One of the major rumors I’ve heard around campus lately surrounds the structure and scoring of COMLEX. Depending on the school you attend, you may have noticed that some students have a real grasp of what is going on and others seem to be a little confused. I am writing this post to set the record straight and to give you nothing but the facts, with maybe a couple of tips thrown in.

COMLEX Level 1 is a 400-question test with a total of eight hours of allowed testing time. When you scheduled your exam, you may have noticed that you scheduled a nine-hour block but your schedule includes time to fill out a survey, do the tutorial, and take a lunch break.

The 400 questions of the exam are divided into two, 200-question sessions – one session in the morning followed by a lunch break, and another session in the afternoon followed by a night of fun and freedom until your first clinical rotation.

Each 200-question session of the exam is divided into four, 50-question blocks, which you are allotted a total of four hours to complete. While the time allowance averages out to one hour per 50 questions, you are free to finish a section as fast as you wish, or you may borrow time from one block to finish a set your find more difficult and time consuming.

Unlike the USMLE, during which a student may take a break after any section, COMLEX permits breaks only after the second and sixth sections. These breaks may be anywhere from zero minutes to a max of ten minutes. WARNING: your breaks come out of the total four hour block of time you are given for a session! Many students do not realize this until test day and are then surprised when they come back from the bathroom to see time missing. While I warn you of this, I would also advise you to take every break. Even if you just walk out of the testing room and get a drink of water for three minutes, take the break. As much as this test is about knowledge, there is certainly an endurance factor involved.

As far as scoring goes, many students tend not to understand the system. When you get your report roughly one month after you take your test, you will see both a two- and a three-digit score. Neither of these scores is a percentile; they are both just measures of passing. A pass on COMLEX Level 1 is 400 points, or a two-digit score of 70. The mean score is set yearly at 500. The AOA website provides match data for each specialty, and gives an overview of average COMLEX scores in specialties, which may help you set your scoring goals.

While this post may be trivial to some, hopefully it will put a few rumors to rest. Part of being prepared for the test means being aware of what you have gotten yourself into. As always, review your OMM, and look for an upcoming post regarding differences in the computer layout and some last minute COMLEX tips.

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