You know what, the COMLEX Level-1 really sucks sometimes. I think this is something we can all agree on; from prepping for it to taking it… it just kind of really sucks.

The reality of it  is though that the COMLEX is a necessary evil if you want to make it out of the other side of medical school and practice medicine. While these tests aren’t perfect, they do what they can to evaluate a medical student and their knowledge…. No, I am not advocating for the COMLEX, I am just stating the facts.

So, with how much these exams can ruin people’s lives for no good reason, I wanted to give you my story and how I was able to achieve my 704 on the COMLEX-USA Level-1, with hopes that it can help you as you head towards your own exam.

Now, there are a ton of people that scored way better than me on this exam, but at the end of the day… I am extremely happy with my score and I really want to help you get a score you can be happy with too.

Take the information I am about to give you and adapt it to whatever you need to do the best you can possibly do on the COMLEX Level 1.

What is the COMLEX?

The COMLEX Level 1 is a test that is designed to evaluate you on your knowledge in the areas taught in the first two years of medical school, these are:

  • Basic Sciences
  • Osteopathic medical practice
  • Foundational Biomedical Sciences
  • Common Patient Presentations
  • Organ systems and their anatomy, physiology, and pathology

And many other areas of medical knowledge that you will learn in the first two years of medical school. You may encounter question stems that include clinical problems, but this is more typical for Level 2 CE vs COMLEX Level 1.

The exam takes place in a testing center in two separate four-hour sessions, with break time every two hours.

After the exam it takes a month or so to get your numerical score.

A passing score on COMLEX Level 1 is a 400, which is right below 50% of questions correct on a curved scale.

Onto the stuff you came here for

From this point there are three components to exam prep:

  • Practice questions
  • Study Material
  • Practice Tests

Lets break these down in more detail.

Practice Questions

The most important part of my COMLEX prep was getting ready for this beast alongside classes. I suggest really trying to make the COMLEX a priority in your life, even during courses.

So, getting ready for the COMLEX during courses means that you need to be efficient, and the most efficient way to prepare for this test is to do questions.

You should be doing questions early and you should be doing them often.

Let me ask you something. If you want to be a great basketball player what is the best way to get there? You practice basketball right, you pick up the ball and you shoot, dribble, pass, and whatever else they do. You don’t devote all your time to just studying the plays to run or the rules of the game… you get out there and play!

Same holds true for board exams… The test is not seeing how great you watch Pathoma or Boards & Beyond… it is a series of questions to test your knowledge. Now you might be saying, “Sean this analogy is dumb… because I need to know things before I answer questions.” And I would say that you are kind of right.

Answering questions in a low stakes situations such as a question bank allows you to fail in the privacy of your own home or wherever you do your studying. This failing allows you to take the time needed to really learn from the questions and soak them in.

When you learn from a practice question, not only are you learning what the topic is but you are learning the common ways that topic is presented in a question.

No, this does not mean that you need to ignore reading content or watching videos… but what I am saying is that if you incorporate questions into your daily prep early on like I did then you will be much better off than those that don’t start doing questions later board prep time.

Really, the central piece of my study plan was to start doing questions, early and frequently. I did somewhere between 15-25 questions per day starting in May of my first year.

You can check out my actual schedule (day-t- day basis) by downloading my 5 Tips to CRUSH the COMLEX Level-1 below.

You should do the questions on tutor mode, and random selection. Some people prefer to do them in subjects as opposed to random.

This is counterproductive, because if you do a block of 20 questions on cardiology then you know all 20 are about cardiology before you even begin. So, you are more inclined to pick an answer related to cardiology as opposed to really having to solve the problem.

I know people that did it in sections and did great too. So I don’t know if that is a deal breaker, but I chose random because my test was going to be random… and also random creates a sort of spaced repetition type thing.

What Materials to Study

I loved using Boards & Beyond throughout second year. I wish I would have purchased that material on my first day of med school. I used this almost every day during second year and I followed alongside my courses with it. So for a first year, if you are in Biochem and you just got a lecture on the Krebs Cycle from your school… then the smart thing to do would be to go pick up the biochem book from Boards & Beyond and also watch the corresponding Boards & Beyond biochem video on the Krebs Cycle.

Use Boards & Beyond alongside every course in this way and you will know the material so good test day won’t be fair for other testers.

Then use Pathoma in this manner in second year.

So a summary so far:
  • Do questions early and often. Do this to learn, don’t stress about percent correct… just learn from the from the questions.
  • Incorporate Boards & Beyond and Pathoma into your course work early on.

The last piece of this story is: practice testing.

I took a baseline practice test in January of second year. A full 6 months before my exam… this gave me a starting point to work from in my board prep.

My next practice exam was in March, and then I took a few more throughout April and May… typically every 2-3 weeks in April, and then every week in May.

They were a mix of USMLE and COMLEX practice tests. I took a total of 8 USMLE practice tests and 5 COMLEX practice exams for Level-1/Step-1.

I took my USMLE Step-1 the last week of May and my COMLEX Level-1 the first week of June.

The important thing here is that you simulate the exam environment when you take these tests. Meaning, put your ear plugs in, don’t search the answer on google during the exam, and put your books and phone away. TREAT IT LIKE YOUR TAKING YOUR REAL COMLEX EXAM!

If you take your practice tests serious then the numeric score you get on those can be comparable to the one you will get on your actual board exams.

Here is a quick summary of my overall game plan for COMLEX Level 1:
  • Do questions early and often.
  • Consume board prep content alongside classes (Boards & Beyond and Pathoma)
  • Do frequent practice tests increasing in frequency as test day approaches.

This is really the overall outline of my apporach to COMLEX LEVEL-1… nothing too fancy… just add in a ton of hard work and dedication and you can knock this test out of the park with this general outline.

Also, to learn more about the COMLEX Level 1 in general, watch this video from the NBOME:


I go into more depth in my 5 tips to Crush the COMLEX Level-1. You can download it and give it a read. It really hits more details of what I have explained here and more topics for the COMLEX.  So if you want more information then go ahead and download it.

Other FAQ’s Related to the COMLEX

What is a good COMLEX Level 1 Score?

Soon, the COMLEX Level 1 will be a P/F exam. Until it becomes a P/F exam, a “good” score depends on your goals. The median is typically around a 500-550.

People usually are impressed if you can score around 700 or higher, but really anything above 600 would be a good score in my opinion.

Is COMLEX Easier than the USMLE?

COMLEX is not as high order as the USMLE. It isn’t easier, but it can be more convoluted in some instances. I would describe the COMLEX test questions as more “you know it or you don’t” and the USMLE as “you can derive an answer choice through logical thinking”.

The COMLEX is easier than the USMLE in some respects, but I wouldn’t call it easier in all aspects.

What’s the difference between the USMLE and the COMLEX?

They are very similar exams. The main difference between the USMLE and the COMLEX is the material. COMLEX contains OMM and osteopathic principles, which adds to the topics you need to know for the exam.

Check out this OMM prep course.

Should you take the COMLEX or the USMLE first?

Doesn’t matter if you take the COMLEX or the USMLE first. Take them within a week of each other.

A lot of students like to take the USMLE first, then study OMM for a week or so and go take the COMLEX.

Do Osteopathic Medical Students take Step 1?

Osteopathic Physicians are not required to take USMLE Step 1, we are however required to take the COMLEX Level 1. We have the option to take the Step 1 if we want to, but with it moving to a P/F exam, this might not make sense in the future.

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