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Best COMLEX Level 1 Prep Study Resources

Student using laptop while studying for COMLEX level 1.


This blog was originally published on January 2nd, 2020, and was updated by Dr. Janet Tam on September 12th, 2023



Best COMLEX Level 1 Prep Study Resources


Studying for the COMLEX Level 1 exam can be an intimidating task. Especially since it is most likely your first time taking a medical board licensing exam. At first, it may seem like there are too many resources to choose from and too much content to learn. Choosing effective resources and starting early sets you up for success. As a general rule of thumb, mastering the basic science foundational knowledge will require utilizing many of the high-yield resources identified for the Step 1 exam. Specifically, UFAPS (UWorld, First Aid for Step 1, Pathoma, and Sketchy). Over the years, many valuable resources specific to the COMLEX exam series have also been introduced. In this blog post, we will highlight the best COMLEX Level 1 prep resources you should use to prepare for the Level 1 exam. Keep on reading to learn more.



What is COMLEX Level 1?


COMLEX Level 1 is a 1-day exam that consists of 352 questions. It is a required exam for all osteopathic medical students to get licensed. Historically, the 3-digit Level 1 score was an important factor for residency program directors to decide which candidates they wanted to interview. Following the USMLE Step 1 change to pass/fail scoring, the COMLEX Level 1 exam was also changed to pass/fail in May 2022. This change may take some pressure off of preparing for this exam, but it is still important to take it seriously, as a failure can be a red flag in your residency applications.


The content tested on the Level 1 exam is largely similar to the USMLE Step 1 exam, except for the added component of osteopathic principles, practice, and manipulative treatment. The musculoskeletal system, representing 13%, dominates among the various body systems tested on the exam. Therefore, using the correct study resources is important and students should aim to master this portion of the exam. For a more detailed breakdown of the exam content, refer to the COMLEX-USA Master Blueprint here.


Let’s break down the types of study resources that you’ll need in order to pass the Level 1 exam.



1) Basic Science Review


As mentioned earlier, UFAPS (UWorld, First Aid for Step 1, Pathoma, and Sketchy) are the most high-yield resources for building basic science foundations whether you are taking Step 1 or Level 1. In addition, we wanted to add a couple of other resources that may be helpful to you. As an osteopathic medical student, you may consider using COMBANK or COMQUEST question banks instead of the UWorld question bank. The reason for this is that the formatting and style of COMBANK and COMQUEST questions will most closely resemble what you will encounter on test day.


While UWorld is excellent, it may not be ideal if you’re short on time. You wouldn’t want to feel too overwhelmed by the abundance of resources and feel like you need to get through them all completely. However, if you are starting your studies early, it may not be a bad idea to add UWorld to your list. Whichever question bank you choose as your primary learning resource, you should get through the whole question bank at least once, ideally twice. Similar to the Sketchy videos, Pixorize is another video resource that can greatly enhance your studies. Pixorize illustrations tend to be shorter and more concise, which many students like, especially for biochemistry.



2) Osteopathic Review


In addition to covering basic science content, students preparing for the COMLEX Level 1 exam should also thoroughly review the osteopathic-specific content that appears on this exam. The best COMLEX Level 1 prep resource to review prior to exam day is the OMT Review by Robert E. Savarese (also known as “the green book”). It has the most-yield OMT concepts, with questions at the end of every chapter to test your knowledge. This book is relatively short and easy to read. Ideally, you should start using this book early on in your exam preparation and annotate as you complete OMT practice questions. Some of the most high-yield concepts are viscerosomatics, Chapman points (anterior), and counterstrain points. If you can master OMT, it will help boost your score significantly on the COMLEX Level 1 exam.


The most important resource for solidifying your osteopathic medical knowledge is to use a question bank – COMBANK or COMQUEST. These are specifically written and designed for osteopathic students taking the COMLEX series, so they will be the most representative of the questions you can expect to encounter on test day. The best way to use a question bank is to first do the questions, then go back to cross-reference and annotate your other resources to further build your understanding.



3) Practice Exams




In order to properly assess your readiness to sit for the exam, it is important that you are regularly completing practice exams. For osteopathic medical students, there is one practice COMSAE exam that you can purchase on the NBOME website. Your medical school may be able to purchase other COMSAE forms in order to get more practice for their students. Upon completion of the COMSAE exam, you will get a general breakdown of your performance and a prediction score of where you stand. However, the downside to the COMSAE exam is that it doesn’t provide the answer explanations and you cannot review those questions.




In 2021, NBOME released a new assessment tool called “WelCOM”, which consists of 75 questions that reflect the style and subject matter of the COMLEX exams. For COMLEX Level 1, there are 4 forms that you can purchase for $60 each. You have 90 days from the date of access to use this resource however you like. Unlike the COMSAE exams, WelCOM forms provide answer rationales along with corresponding reference/resource material as you work through the questions. This can give you a unique insight into what the test writers are thinking and what resources they are pulling their information from.




Many students also choose to take the NBME practice exams, designed specifically for the USMLE Step series. Historically, these practice exams have proven to be reliable indicators of whether a student is within the passing range for the COMLEX Level 1 exam. By comparing your NBME practice exam score, you can make a reasonable prediction about your potential COMLEX score. Additionally, these resources are invaluable for their provision of answer explanations, which serve to strengthen your understanding.


At this point, I hope that it is obvious that practice questions (question banks and practice assessment exams) are essential in the preparation for the COMLEX Level 1 exam!



Summary of the Best COMLEX Level 1 Prep Resources


  1. COMBANK or COMQUEST +/- UWorld
  2. First Aid for Step 1
  3. Pathoma
  4. Sketchy +/- Pixorize
  5. COMSAE, WelCOM, and NBME practice exams
  6. OMT Review by Savarese


Happy studying! Our best advice is to start studying early and develop good study habits. If you are interested in additional help studying for your COMLEX exams, consider enlisting the help of an Elite Medical Prep tutor! Schedule your complimentary consultation today to learn more about how we can help you succeed!

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About the Author

Karolina Woroniecka, MD/PhD

As a former Howard Hughes Medical Institute Student Fellow, Karolina Woroniecka graduated Phi Beta Kappa from Brown University with a B.S. in Biology and Hispanic…

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