How to Study for COMLEX Level 2-CE

What is COMLEX Level 2-CE?

COMLEX Level 2-CE (Cognitive Evaluation) is a day-long computerized exam that measures clinical problem-solving ability. Its companion, the COMLEX Level 2-PE (Performance Evaluation), is meant to augment the Level 2-CE to fulfill the public and licensing authority mandate for enhanced patient safety and entails the evaluation of fundamental clinical skills through 12 encounters with standardized patients. Overall, the COMLEX Level 2 exams integrate application of knowledge in clinical science and foundational biomedical sciences and osteopathic principles with other physician competencies related to the clinical care of patients and promoting health in supervised clinical settings.

Preparing for both the COMLEX Level 2-CE and -PE

Preparation for both the COMLEX Level 2-CE and -PE starts when you begin clinical patient care experiences during your 3rd year of medical school. The 10 clinical science disciplines tested on COMLEX Level 2-CE include Emergency Medicine, Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, Surgery, Health Promotion and Disease Prevention, and Osteopathic Principles and Practice. Rotating through each of these clinical areas will strengthen your knowledge of patient care within these domains and give you real-life perspective on how to care for patients in a variety of settings. 

Most students will supplement their time on the wards or in the clinics with content review to prepare for their rotation-specific shelf or COMAT exams. Online MedEd has proven itself to be by far and away the best resource for lecture-based review of clinical content. The video lectures are easy to understand and enjoyable to watch, and the comprehensive curriculum ensures that all your bases are covered. Furthermore, Online MedEd does include video lectures covering osteopathic medicine and treatment (OMM and OMT), which are also covered on COMAT exams and COMLEX Level 2-CE. In addition to Online MedEd, students will often go through practice questions in Uworld, COMBANK, or COMQUEST to prepare for the COMAT exams. Students who go through at least 1 question bank in its entirety prior to starting their period of dedicated study tend to get a good score on COMLEX Level 2-CE.

COMLEX Level 2 – Exam Structure 

Once the dedicated period of study begins for COMLEX LEVEL 2, often shortly after finishing the core clinical clerkships, the best way to prepare is through practice questions to build your endurance! The exam is notoriously long – it contains 400 test questions (vs 318 on USMLE Step 2) and is administered in two four-hour long test sessions. Building your stamina and ability to get through so many questions is key. Keep in mind that if you solely use Uworld to practice getting through questions on time, you may find yourself struggling on test day, since the timing of the USMLE and COMLEX is different. Some students address this issue by incorporating other qbanks such as COMBANK or COMQUEST, or by simply ending the timer on Uworld blocks early. Many students have dedicated periods of study as short as a week following the completion of their clinical rotations. If you are in this situation, getting through as many questions per day as possible can help mentally and physically prepare you for a long, grueling day. 

If you are fortunate to have a longer dedicated study period, you will be able to incorporate some content review. Focus on clinical areas in which you scored poorly on the COMAT or shelf exam. The COMLEX Level 2 is usually a relatively even mix of the content covered in the COMAT exams, and questions are related to diverse clinical and patient presentations. Brushing up on your weak areas, then, can boost your score significantly. In addition, the exam often presents clinical cases framed within seven pre-defined competency domains which are important to become familiar with. The seven defined competency domains for osteopathic medical practice as tested on the COMLEX Level 2-CE are defined as application of osteopathic medical knowledge, osteopathic patient care and osteopathic principles and practice, communication, systems-based practice, practice-based learning and improvement, professionalism and ethics. Keep in mind that these domains are more thoroughly covered in COMBANK or COMQUEST question banks than in Uworld, and brushing up on professionalism and ethics is important. While many students may blow off these competency questions as “easy,” often these can trip you up. There are a few key principles to know well that can give you some easy points on exam day if you spend a few hours reviewing these competencies.

Lastly, any thorough preparation for COMLEX Level 2-CE should include taking the COMSAE practice exam(s). The COMSAE is often offered by medical schools to students just prior to taking COMLEX Level 2, and there are some forms that are available for purchase as well. Keep in mind, though, that due to recent changes in the COMLEX Level 2 blueprint, that the scoring of the new blueprint COMSAE practice exams is very variable and may not accurately predict your score on COMLEX Level 2-CE.