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 and Level 2-CE passage; taken during or after residency training (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.