COMLEX-USA LEVEL 1 - BLUEPRINT REVIEW
YEAR 2 | PAGE 57A - TWO-DIMENSION BLUEPRINT + CURRENT EXAM FORMAT
A. CURRENT BLUEPRINT VERSION + DIMENSION 1 COMPETENCY DOMAINS
| Competency domain | Level 1 minimum |
|---|---|
| 1. Osteopathic Principles, Practice, and Manipulative Treatment 2. Osteopathic Patient Care and Procedural Skills | 12% 6% |
| 3. Application of Knowledge for Osteopathic Medical Practice 4. Practice-Based Learning and Improvement in Osteopathic Medical Practice | 60% 4% |
| 5. Interpersonal and Communication Skills in the Practice of Osteopathic Medicine 6. Professionalism in the Practice of Osteopathic Medicine | 3% 3% |
| 7. Systems-Based Practice in Osteopathic Medicine | 2% |
A. CURRENT BLUEPRINT VERSION + DIMENSION 1 COMPETENCY DOMAINS
- B. CURRENT LEVEL 1 FORMAT
- For Level 1 testing on or before April 8, 2028, NBOME directs candidates to the blueprint revised February 2025. Blueprint 2.0 applies to Level 1 testing in May 2028 or later.
A. CURRENT BLUEPRINT VERSION + DIMENSION 1 COMPETENCY DOMAINS
| Exam element | Current format / implication |
|---|---|
| Questions Structure | 320 single-best-answer multiple-choice questions, including possible audiovisual elements. Two separately timed 4-hour sessions; each session contains four sections. |
| Section size Breaks | 8 sections x 40 questions. Once you advance to a new section, the prior section is no longer accessible. 60 minutes pooled break time for scheduled breaks; unused testing time does not transfer between Sessions A and B. |
A. CURRENT BLUEPRINT VERSION + DIMENSION 1 COMPETENCY DOMAINS — 1. Do not treat COMLEX as “Step 1 knowledge + late OMM cram” DEEP EXPLANATION The blueprint explicitly reserves a minimum for OPP/OMT and also tests patient care, communication, professionalism and systems-based practice. These competencies need longitudinal retrieval and
COMLEX-style application, not a late add-on.
A. CURRENT BLUEPRINT VERSION + DIMENSION 1 COMPETENCY DOMAINS — WHY STUDENTS MISS IT The large biomedical overlap makes it tempting to postpone osteopathic-specific preparation until after Step 1-style content review. EASIEST CLUE If OPP/OMT, communication and systems scenarios are absent from your weekly plan, the blueprint is not being represented. 2. Blueprint percentages are minimum specifications, not a day-by-day study calendar DEEP EXPLANATION NBOME uses the blueprint to construct the exam; your study allocation must combine blueprint coverage with school requirements, personal performance data and recurring errors. WHY STUDENTS MISS IT A percentage looks like an easy scheduling formula, so learners may translate 12% into exactly 12% of study time. EASIEST CLUE Use the blueprint to guarantee coverage; use performance data to decide extra remediation time. 3. Non-knowledge competency domains are testable, not decorative DEEP EXPLANATION Patient care, practice-based learning, communication, professionalism and systems-based practice can appear inside clinical vignettes and require sequencing, judgment and osteopathic framing. WHY STUDENTS MISS IT They may feel less “content-heavy” than pathology or pharmacology, so learners defer them. EASIEST CLUE When two answers are medically plausible, ask which best reflects safe, patient-centered osteopathic practice and the task being tested.
2026/27 COMLEX Level 1 blueprint expanded edition - verify current NBOME and school guidance before testing