Curious when to start prepping for COMLEX level-1? Truth is from day is perfect, but lets dive into the details about how you can succeed on this and the many other exams in medical school.

If it were realistic to say from day 1 of medical school you should be studying for the COMLEX Level 1, I probably would. But day 1 of medical school I think you just need to focus on where the bathroom is and if you have a quiet place to study.

Many osteopathic medical students worst about creating a study plan, study schedule, and there used to be a focus on getting a high score, but with the P/F change, this is much less worrisome.

The tough thing is that prior to really spending too much time on serious prep for the comlex exams, you need to build a foundation of the basic sciences.

So, there is a way to study for boards, from day 1 really, but without the foundation doing a bunch of practice exams and similar things is pretty much useless.

This article will go over the ideal situation, the reality, and everything inbetween when it comes to the many different ways to study for COMELX Level 1 and when you should start that studying to make sure you get a passing score.

In all seriousness though, the earlier you start getting ready for the COMLEX the better.

I remember when I was starting first year, I had no clue what a COMLEX even was. It wasn’t until I spoke with some students in the class ahead of me and then started to do some research on my own.

After spending some time learning what the test was, then I started to decide when I would study for the beast. I came up with the plan that I would start studying in April/May of first year for it.

When I say that I started studying for it during this time, it was by no means a full fledged in-depth study for COMLEX.

I started doing practice questions and using First Aid and other books like the boards and beyond  series alongside my course work.

So moral of the story is that you need to start studying as early as you can for this test.

Now that I threw that tall order on you, we will talk a little about the nuts and bolts of why it is important to start earlier.

So When should you start studying for COMLEX Level 1?

Studying for COMLEX Level 1 from Day 1

It is important to start earlier because just like anything else in life the earlier you start practicing typically the better you will be.

It really comes down to simple math here, if you study for 13 hours a day, and I study for 8 hours a day, then right away you get 5 more hours of study time in then I do a day.

Now, if we take that and multiple it by 6 days a week, that is 30 extra hours a week.

It is pretty easy to see that you can accomplish a lot with 30 extra hours of studying a week. So while the rest of your class is sleeping in and spending their time complaining about anything and everything (because we medical students like to do that), you would be getting ready with all your extra time to absolutely OWN the COMLEX and the usmle step exams.

When to Start prepping for the COMLEX Level 1

How to start board studying earlier:

The best way to do this is by starting to do some practice questions. Don’t use UWorld at this point though, this should be saved until mid second yead, start using another question bank.

A few good options to use during this time would be COMQUEST (Get 15% off by using the code CPM15 at checkout), AMBOSS, Kaplan, or USMLE Rx.

You can start to do 15-20 questions a day on tutor mode. Let’s say you start at the end of first year like I did, you should not be doing any pathology questions at that time because you haven’t learned any yet, because most schools wait until second year to start teaching pathology.

So what you need to do is physiology, pharmacology or whatever subjects you have gone over in classes in those first few years.

Set your questions to tutor random but make sure when you are creating your test to only select subjects you have covered.

Doing 15-20 of these a day will help condition you to board style questions and will help all those concepts you learned in first year to stick. A good time in my opinion to start dabbling in board questions would be the summer between first and second year. It is a very low stress time and it would allow you to still keep your mind on medicine over the summer and put your eyes on the prize of a good board score.

What is the best way to prepare for level 1 COMLEX?

Focus on studying the right materials at the right time. Check out the individual sections below to help with this.

Studying OMM

Osteopathic students also need to worry about studying OMM. Just like all other topics, studying this early and often is best.

An approach that many students use when it comes to being more efficient with OMM is to just spend a few weeks during dedicated study time to focus on OMM.

Using Board studying resources alongside courses

As I mentioned above, it is also important to use some board resources throughout the year.

This is for two reasons:

The first being that it will increase your familiarity with the resource BEFORE dedicated board prep. This means that during a time that should ultimately be a review period and a time to polish up on your weaknesses you don’t have to spend time becoming accustomed to where things are in a given book or resource… by using it through out your course work, you already know and are familiar with it.

The second reason is that by using something like First Aid alongside your courses, you will be able to see what the most important topics for boards are, then be able to really solidify those certain topics before dedicated board prep time even comes. 

By being able to see what are the most important topics that will be on boards during your courses that seem to go on and on will help you stay focused and motivated. This will also let you see what fluff the instructors have added to their presentations that may only be needed for that block exam. See the benefit yet?

I honestly believe that by doing these few things alongside your courses you can set the foundation to absolutely OWN your COMLEX and USMLE if you are taking it.

Is there a curve on COMLEX?

All exams put out by the NBOME and specifically all levels of the comprehensive osteopathic medical licensing examination (COMLEX) are essentially grade on a “curve” with there being a mean and then standard deviations are taken from that.

This is nice and helpful for students, because then it doesn’t report simply a raw score, you are given a score that in a way compares your performance to all the others that took that same exam in that year.

So if you spend more time with prep courses and other resources getting ready for your board exams then you will likely get more questions right and if you end up getting the correct answer on a really tough question where a lot of other do students don’t then this is super beneficial for you!

Just remember that all COMLEX and COMAT exams are graded on a curve essentially and your numeric scores are based off of a mean with standard deviations applied.

Should osteopathic students take USMLE Step 1?

Step 1 used to be such an important factor in the overall path for many successful doctors. No with it being P/F it isn’t as important for osteopathic students.

It can still be important though if you want to take USMLE Step 2 CK, because you simply have to have it in order to take it.

The NBOME or the national board of osteopathic medical examiners has spent a decent amount of time making sure the comlex-usa level 1 and above exams are accepted at residency programs throughout the country.

Then the primary rule is that if you are going into a competitive specialty that requires higher scores on the step 2 CK or level 2 PE then you should take the USMLE.

If you are certain you want to do a less competitive field, then only take the COMELX and go on to enjoy the first two years and clinical rotations a little bit more.

How far apart should you take USMLE and COMLEX?

The nice thing about prepping for both of these exams is the primary resources are very similar.

If you focus on prepping for the core things and then take a week to prep for osteopathic principles and practice then you will be good to go.

Typically, the optimal time is to take the USMLE and the COMLEX about 1 week apart. This gives you enough time to rest for a bit then get at it and prep for all the OMM related stuff.

The trick is to make sure that week in between exams is not the first time that you go through the content, it really should be a quick run through of all the material and then a few practice questions to back it up. This is why CPM OMM is structured this way. It is literally built to be a quick run through in that week between exams, and a high yield resource that is geared towards test questions and making sure you get more of them right while spending less time studying overall.

Is Uworld good for COMLEX?

UWorld is great for the comlex level 1 and comlex level 2-ce. It is a fantastic way to make sure you build your foundational knowledge in all things medicine and is a fantastic way to spend your comlex prep when it matters most.

If you focused hard on UWorld and then added in COMQUEST (15% off with code “CPM15”), then add in CPM OMM on top of it. This would make for an incredible score, knowledge base, and would be a great way to manage your limited time.

Taking Breaks during Prep

One last thing, make sure you take at the least a 10 minute break every hour you are studying, otherwise you will just simply burn yourself out!

Take time to rest, eat, and exercise during this stressful time.


If you want to absolutely crush these exams and score in the highest percentile, then starting as early as possible is key.

From day 1 of medical school, one could make the argument that you could use board review resources alongside your courses in order to be ready for your exams.

This is what I did, and it allowed me to score in the 97th percentile on almost all my board exams.

I hope this has been helpful

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