Part of the expanding PassProfessor catalog: PassProfessor is building COMLEX-USA Level 1 practice as its own program — 2,002 original practice questions written to the two-dimensional blueprint the National Board of Osteopathic Medical Examiners (NBOME) publishes for Level 1, with an explanation for every question. Join the notify list and we will email you when enrollment opens.
This program is part of the expanding PassProfessor catalog — join the notify list and we’ll email you when enrollment opens.
COMLEX-USA Level 1 is the first examination in the Comprehensive Osteopathic Medical Licensing Examination of the United States, the licensure examination sequence for osteopathic physicians, administered by the National Board of Osteopathic Medical Examiners (NBOME). It is a one-day, eight-hour, computer-based assessment of the foundational biomedical sciences and osteopathic principles and practice, delivered as 320 single-best-answer questions across eight sections of 40 — four sections in each of two four-hour sessions. Level 1 has been reported as pass/fail since May 2022. Its blueprint is two-dimensional: every question sits inside both a competency domain and a clinical presentation, and osteopathic principles, practice, and manipulative treatment are woven through the exam rather than appended to it. PassProfessor’s COMLEX Level 1 program holds 2,002 original practice questions built to that blueprint. The full breakdown of the real exam is in the COMLEX Level 1 exam guide.
What the program covers
A COMLEX bank — written for the osteopathic exam, not adapted from a USMLE bank. Level 1 tests the foundational biomedical sciences the way osteopathic practice uses them, with osteopathic principles and practice (OPP) and osteopathic manipulative treatment (OMT) integrated into the same vignettes as the pathology, pharmacology, and physiology. A bank built for a different examination cannot cover that ground by relabeling: the questions here are written from scratch against NBOME’s published Level 1 blueprint, including its osteopathic content, its clinical-presentation organization, and its single-best-answer format.
2,002 original practice questions, each with an explanation. The bank is built and verified: 2,002 questions, and an explanation for every question — not a bare answer key. Explanations teach the reasoning the question tests: the mechanism or finding that makes the keyed answer right, and what separates it from the closest alternatives. Every question is written for PassProfessor; none is an actual NBOME item, a recalled item, or another provider’s material.
Practice organized on both blueprint dimensions. NBOME constructs Level 1 on two dimensions at once. Dimension 1, Competency Domains, asks what you can do — led by Application of Knowledge for Osteopathic Medical Practice at a 60% published minimum, with Osteopathic Principles, Practice, and Manipulative Treatment at a 12% minimum. Dimension 2, Clinical Presentations, asks why the patient came in — ten presentation categories led by the musculoskeletal system at a 13% published minimum and community health and wellness presentations at 12%. This program drills and reports on both dimensions, so a weak presentation category or a thin competency domain shows up in your results while there is still time to fix it.
Timed practice in the real session shape. Level 1 runs two separately timed four-hour sessions, four 40-question sections in each, with 60 minutes of pooled break time you allocate at the scheduled breaks. Time unused in Session A does not carry into Session B — a pacing rule with real consequences for how you rehearse. The program’s timed practice mirrors that shape: 40-question sections, four-hour session blocks, and full-day simulations, so the rhythm you train is the rhythm of the real day.
A study loop tied to the published blueprint. Practice results break down by competency domain and by clinical presentation, moving you from a diagnostic set, to focused drills on the domains and presentations that cost you, to full timed sessions. For a pass/fail examination, that breakdown is the point: the official result tells you only pass or fail, so the diagnostic work of finding your weak ground has to happen in practice, before the day that counts.
The real exam at a glance
Current as of November 2026, per NBOME’s official examination description at nbome.org. Full detail — eligibility, registration, retakes, and test day — is in our COMLEX Level 1 exam guide.
| COMLEX-USA Level 1 fact | Current published detail |
|---|---|
| What it assesses | Foundational biomedical sciences and osteopathic principles and practice, integrated with clinical knowledge and physician competencies for supervised patient care settings |
| Format | One day; two separately timed sessions (A and B) of four hours each; four sections per session; 40 questions per section |
| Items | 320 single-best-answer multiple-choice questions (reduced from 352 beginning with the May 2026 test cycle) |
| Testing time | Eight hours, with 60 minutes of pooled break time usable at the scheduled breaks; time does not carry between sessions |
| Score reporting | Pass/fail only (since May 2022); candidates also receive a Formative Performance Profile |
| Examination fee (per NBOME) | $745 |
| Where it is taken | Pearson VUE test centers |
- There is no numeric score to aim at. Level 1 reports pass or fail. NBOME does not report a three-digit score for Level 1, and this page states no numeric passing score for it — because candidates never see one. The honest preparation target is margin: timed practice performance comfortably clear of the standard, across every blueprint area, not a converted percentage.
- 320 is the current item count. Administrations before the May 2026 cycle carried 352 questions in sections of 44. If a study resource still describes 352 questions or 44-question sections as the live format, it is describing a retired one.
- The fee above is NBOME’s examination fee, not a PassProfessor price. No price has been announced for this PassProfessor program; the notify-list email will carry it when enrollment opens.
How the practice maps to the real exam
NBOME publishes the Level 1 blueprint as minimum percentages across two dimensions. Minimums are floors, not exact shares — NBOME presents them so candidates can see the guaranteed weight of each area.
Dimension 1 — Competency Domains (published minimums)
| Competency domain | Published minimum |
|---|---|
| Application of Knowledge for Osteopathic Medical Practice | 60% |
| Osteopathic Principles, Practice, and Manipulative Treatment | 12% |
| Osteopathic Patient Care and Procedural Skills | 6% |
Within Application of Knowledge, NBOME’s blueprint identifies the Foundational Biomedical Sciences Knowledge Base at 75% — the anatomy, behavioral science, biochemistry, microbiology, pathology, pharmacology, physiology, and public health disciplines on which the clinical application rests. The remaining competency domains — health promotion and disease prevention, communication and interpersonal skills, professionalism and legal/ethical practice, and practice-based learning — complete the seven-domain dimension and are drilled in the program without a stated percentage where NBOME’s summary table does not publish one for them in this view.
Dimension 2 — Clinical Presentations (published minimums)
| Clinical presentation category | Published minimum |
|---|---|
| Musculoskeletal System | 13% |
| Community Health and Patient Presentations Related to Wellness | 12% |
| Nervous System and Mental Health | 10% |
| Gastrointestinal System and Nutritional Health | 10% |
| Circulatory and Hematologic Systems | 10% |
| Respiratory System | 10% |
| Human Development, Reproduction, and Sexuality | 5% |
| Endocrine System and Metabolism | 5% |
| Genitourinary / Renal System and Breasts | 5% |
| Integumentary System | 5% |
Read the two dimensions together: a musculoskeletal presentation tested through osteopathic principles is a different question from the same presentation tested through pharmacology, and Level 1 contains both kinds. Drilling by presentation alone, or by domain alone, covers half the blueprint.
How to use it
- Join the notify list today. While enrollment is being prepared, start with NBOME’s own materials: read the COMLEX-USA Bulletin of Information and NBOME’s published practice resources, including the COMSAE Phase 1 practice assessment, which is built on the same Level 1 specifications.
- Confirm your school’s attestation timeline. Level 1 eligibility runs through your college of osteopathic medicine — plan your test date around your school’s process, not just your study calendar.
- When enrollment opens, start with a timed diagnostic set. Your breakdown by competency domain and clinical presentation is the study plan: it shows where the next weeks of drilling belong.
- Drill the osteopathic content as its own discipline. OPP and OMT carry a 12% published minimum on Dimension 1 and surface inside presentations across Dimension 2. Candidates who treat them as a final-week add-on leave a guaranteed slice of the exam underprepared.
- Finish with full-day timed simulations in the real shape — two four-hour sessions, 40-question sections, pooled breaks managed the way the real day manages them — and schedule the real exam through NBOME and Pearson VUE when your timed practice sits comfortably clear of the standard across both dimensions.
Frequently asked questions
What is COMLEX-USA Level 1? Level 1 is the first examination in the COMLEX-USA licensure sequence for osteopathic physicians, administered by NBOME. Per NBOME, it is a one-day, computer-based assessment that integrates the foundational biomedical sciences and osteopathic principles with clinical knowledge and other physician competencies relevant to clinical presentations and promoting health in supervised patient care settings.
How many questions are on COMLEX Level 1? 320 single-best-answer multiple-choice questions, per NBOME — eight sections of 40 questions, four sections in each of two four-hour sessions, in one eight-hour day with 60 minutes of pooled break time. Administrations before the May 2026 test cycle carried 352 questions; 320 is the current count.
Is COMLEX Level 1 pass/fail? Yes. Since May 2022, Level 1 results are reported as pass/fail only — NBOME does not report a numeric score for Level 1. Candidates also receive a Formative Performance Profile showing performance across blueprint areas relative to other first-time test takers. This page states no numeric passing score for Level 1 because candidates are not given one.
How is COMLEX Level 1 different from USMLE Step 1? They are different examinations from different bodies for different licensure pathways. COMLEX-USA is NBOME’s sequence for osteopathic physicians (DOs), built on a two-dimensional blueprint that integrates osteopathic principles, practice, and manipulative treatment throughout. USMLE is the FSMB/NBME sequence. Some DO students take both; the exams are not interchangeable, their blueprints differ, and this program is built specifically to NBOME’s Level 1 blueprint. PassProfessor’s USMLE programs are separate programs in this catalog, with their own banks.
Who is eligible to take COMLEX Level 1? Level 1 is taken by students and graduates of colleges of osteopathic medicine accredited by the Commission on Osteopathic College Accreditation (COCA), with eligibility attested through the candidate’s school under NBOME’s Bulletin of Information rules. If you are a DO student, your school’s attestation process and timeline govern when you may test — confirm them early.
How much does the real COMLEX Level 1 cost? NBOME’s examination fee for Level 1 is $745, current as of November 2026. That is the real exam’s fee, paid to NBOME — not a PassProfessor price. No PassProfessor price for this program has been announced.
How many practice questions does the PassProfessor COMLEX Level 1 program include? 2,002 original practice questions, each with an explanation. The bank is built and verified; enrollment opens through the notify list on this page.
Are these the actual COMLEX questions? No. PassProfessor practice questions are written independently, from scratch, to the blueprint NBOME publishes for Level 1. We never use actual NBOME items, recalled items, or another provider’s material.
When will the PassProfessor COMLEX Level 1 program be available? The question bank is built — 2,002 questions with an explanation for every question — and the program is in final preparation. Join the notify list on this page and we will email you when enrollment opens. No enrollment is being taken yet, and we are not publishing a launch date we cannot keep.
Disclaimer
PassProfessor is an independent exam-preparation provider and is not affiliated with, sponsored by, or endorsed by the National Board of Osteopathic Medical Examiners (NBOME). COMLEX-USA® is a registered trademark of NBOME. This program is exam preparation only and provides no medical degree, certification, or license; licensure for osteopathic physicians is granted solely by state licensing boards to candidates who meet their requirements, including passing the COMLEX-USA levels. Exam details on this page are general information current as of November 2026 — NBOME’s official publications govern if anything here differs from them.