| USMLE Step 1 | Foundational science applied to disease mechanisms. | Pass/fail. Since May 14, 2026: 14 x 30-minute blocks; up to 280 items; 8-hour session. | Open → |
| COMLEX-USA Level 1 | Foundational biomedical science + osteopathic principles/practice. | Pass/fail. 2026 format: 320 single-best-answer items across two 4-hour sessions. | Open → |
| NBME Subject Exams | Clinical science at the end of clerkships. | Common subjects include Medicine, Surgery, Pediatrics, OB/GYN, Psychiatry, Family Medicine, Neurology and Emergency Medicine. | Open → |
| COMAT Clinical | Osteopathically distinctive end-of-rotation subject exams. | 120 items, 2.5 hours; includes OPP/OMM. Subjects include EM, FM, IM, OB/GYN, OPP, Peds, Psychiatry, Surgery. | Open → |
| USMLE Step 2 CK | Clinical knowledge for supervised patient care. | Since May 7, 2026: 16 x 30-minute blocks; up to session. Passing standard 218 (since July 1, 20 | |
| COMLEX-USA Level 2-CE | Clinical + foundational science + osteopathic competencies. | 2026 format: 320 single-best-answer items in one 8-hour testing day; numeric passing score 400. | Open → |
| USMLE Step 3 | Independent general medical care. | Two-day exam with MCQ + CCS cases; final USMLE licensure exam. | Open → |
| COMLEX-USA Level 3 | Unsupervised osteopathic practice. | NBOME changes Level 3 to a one-day exam effective Jan 13, 2027: 240 MCQs + 16 CDM cases; passing score 350. | Open → |