Exam Domains
1 Osteopathic Principles, Practice, and Manipulative Treatment
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2 Osteopathic Patient Care and Procedural Skills
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3 Application of Knowledge for Osteopathic Medical Practice
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4 Practice-Based Learning and Improvement in Osteopathic Medical Practice
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5 Interpersonal and Communication Skills in the Practice of Osteopathic Medicine
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6 Professionalism in the Practice of Osteopathic Medicine
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7 Systems-Based Practice in Osteopathic Medicine
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8 Community Health and Patient Presentations Related to Wellness
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9 Human Development, Reproduction, and Sexuality
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10 Endocrine System and Metabolism
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11 Nervous System and Mental Health
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12 Musculoskeletal System
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13 Genitourinary/Renal System and Breasts
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14 Gastrointestinal System and Nutritional Health
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15 Circulatory and Hematologic Systems
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16 Respiratory System
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17 Integumentary System
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Exam Details
Question TypesMultiple Choice, Single Best Answer, OSCE (Level 2-PE, suspended)
FormatLinear computer-based (Levels 1, 2-CE, 3 at Prometric); OSCE (Level 2-PE, suspended)
Online ProctoringNot available
ID RequirementsGovernment-issued photo ID required. Name on ID must match NBOME registration exactly.
RenewalNot required -- COMLEX-USA scores do not expire. DO licensure itself is subject to state board continuing medical education (CME) requirements, which vary by state.
PrerequisitesCOMLEX-USA Level 1 passage (or concurrent eligibility per school policy); 3rd or 4th year of osteopathic medical school (recommended)
Retake Policy60-day waiting period between failed attempts. Maximum 4 attempts per COMLEX-USA level. Candidates who exhaust attempts must petition NBOME for additional eligibility.