Secure Your Medical License With Expert COMLEX Level 3 Tutoring

COMLEX-USA Level 3 evaluates your ability to apply comprehensive osteopathic medical knowledge and provide safe, effective care in unsupervised clinical settings. It emphasizes clinical decision-making and patient management — including health promotion, disease prevention, and treatment — across the lifespan and care settings.

Content reflects the breadth expected of a generalist and places particular emphasis on Osteopathic Principles and Practice (OPP), though the official blueprint is organized by competency domains and clinical presentations rather than by specialty lists. Our COMLEX tutoring helps you master both the broad clinical knowledge base and the osteopathic philosophy that distinguishes this exam.

COMLEX-USA Level 3 is delivered over two testing days within a 14-day window, comprising four 3.5-hour sessions (two per day). The exam contains 420 questions in the multiple-choice question (MCQ) format and 26 clinical decision-making (CDM) cases that include two to four questions each.

Day 1: 4 MCQ sections × 70 = 280 MCQs.

Day 2: 2 CDM sections (13 cases each; ~70–80 scored questions total) + 2 MCQ sections × 70 = 140 MCQs.

Each day lasts about 9 hours including a brief tutorial and 60 minutes of pooled break time.

In MCQ sections you can mark/review within the section; once you advance, earlier sections lock. In CDM, you cannot mark or review questions and once you confirm the end of a part/case you can’t change prior answers. During CDM you can access an Approved Laboratory Test Panels list.

COMLEX-USA Level 3 reports a three-digit standard score with a minimum passing score of 350. Your total score combines all scored MCQs and CDM key-feature questions across both days; each scored item contributes equally, and NBOME converts the raw total to a standard score that accounts for exam-form difficulty.

Score reports are typically released 8–10 weeks after the end of your testing window and include a Formative Performance Profile to highlight relative strengths and weaknesses by Blueprint areas. For context on where a score sits relative to peers, use NBOME’s Percentile Score Converter.

Both exams assess readiness for unsupervised practice. COMLEX-USA Level 3 uniquely integrates Osteopathic Principles & Practice (OPP), including decisions around OMT, throughout its blueprint. Its CDM component uses key-feature, short-answer/extended-MCQ items.

USMLE Step 3 includes Computer-based Case Simulations (CCS)—interactive cases where you manage a virtual patient over simulated time (typically 13–14 cases on Day 2). Content breadth is generalist across care settings for both, with significant ambulatory and prevention content; the key difference is format and the explicit OPP/OMT presence on COMLEX, not a fundamentally different primary-care tilt.

Optimal preparation time for COMLEX Level 3 varies based on your clinical experience, study habits, and baseline knowledge. Most residents benefit from 2–6 months of dedicated preparation, though this timeline must accommodate your clinical responsibilities.

Strong clinical exposure during residency provides an excellent foundation, but focused review of osteopathic principles and structured exam preparation remain essential. Your COMLEX tutor will assess your starting point and create a realistic timeline that balances thorough preparation with your residency schedule.

The ideal number of COMLEX tutoring hours depends on your individual circumstances, including baseline performance, target score, and available study time. Students seeking modest score improvements often benefit from 10–20 hours of targeted tutoring, while those requiring comprehensive support may need 40+ hours spread across their preparation period.

High-risk students or those recovering from previous exam failures typically require more intensive support. Our initial assessment helps determine your specific needs, and we offer flexible packages to accommodate various preparation requirements.

A "good" COMLEX Level 3 score depends on your career goals and program requirements. While 350 represents the minimum passing score, competitive fellowship programs often expect scores well above this threshold.

Most residency programs consider scores above 500 as solid performance, with scores exceeding 550 demonstrating strong clinical knowledge. Highly competitive specialties and fellowship programs may look for scores above 600. Your COMLEX tutor can help you establish a realistic target score based on your specific career objectives and guide your preparation accordingly.

Failing COMLEX Level 3 creates significant challenges but doesn't end your medical career. Immediate consequences include potential delays in medical licensure, as many states require passing COMLEX Level 3 for full licensure. Your residency program must be notified, and some programs have specific remediation requirements.

You'll need to wait at least 90 days before retaking the exam. Our specialized COMLEX Level 3 tutoring for retakers addresses both knowledge gaps and test-taking issues that contributed to the initial failure, significantly improving your chances of success on subsequent attempts.