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United States · Licensing exam

COMLEX vs USMLE

In COMLEX vs USMLE, the key difference is who each exam is for. COMLEX-USA is the osteopathic licensing exam from NBOME, and passing it is required to earn a DO degree from a U.S. osteopathic school. The USMLE, from FSMB and NBME, is open to DO students as well: students at COCA-accredited schools can take Step 1 and Step 2 CK.

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Updated October 2026 · Written from official sources, listed at the bottom of this page

COMLEX vs USMLE side by side

NBOME says Level 1 is usually taken in the second year of medical school and Level 2-CE in the third or fourth, and it recommends waiting six months after starting residency for Level 3.

COMLEX-USAUSMLE
Run byNBOMEFSMB and NBME
ForOsteopathic (DO) licensureMedical licensure in the U.S., for MD, DO and international graduates
PartsLevel 1, Level 2-CE, Level 3Step 1, Step 2 CK, Step 3
OrderIn order, each passed before the nextStep 1 and Step 2 CK in either order, then Step 3
Last partLevel 3 during residencyStep 3, usually in the first or second year of training

Is there a COMLEX to USMLE score conversion?

No official one. Neither NBOME nor USMLE publishes a conversion between the two scales. USMLE doesn’t even compare its own Steps: it says a Step 2 CK score and a Step 3 score aren’t comparable.

How DO students do on the USMLE

In USMLE’s 2025 data, 89% of first-time takers from U.S. DO schools passed Step 1, and 96% passed Step 2 CK in 2024-25. DO pass rates sit next to MD and international rates on our pass rates page.

USMLE pass rates →USMLE Step 1 →

Already licensed through COMLEX?

If a U.S. medical licensing authority has already licensed you based on other exams, including COMLEX-USA, you may not be eligible for the USMLE. Ask the organization that would register you before you apply.

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Everything else, in one place

OverviewThe USMLE examScoringHow USMLE scores workApply and scheduleHow to apply for and schedule the USMLECostHow much does the USMLE cost?What to bringWhat to bring to the USMLE, and your USMLE ID numberStep 1USMLE Step 1Step 2 CKUSMLE Step 2 CKStep 3USMLE Step 3Pass ratesUSMLE pass ratesTest centersUSMLE test centersAccommodationsUSMLE test accommodationsResultsWhen do USMLE results come out?TranscriptsUSMLE transcriptsBiostatisticsBiostatistics on the USMLELab valuesThe USMLE lab values PDF and reference tableSelf-assessments and Free 120USMLE self-assessments and free official practiceInternational graduatesThe USMLE for international medical graduates: FSMB and ECFMGIf you failFailed USMLE Step 1, Step 2 CK or Step 3? How retakes workContent outlineThe USMLE content outlinePractice testFree sample USMLE questionsWhere to learnUSMLE prep: where to studyStudy plannerYour USMLE study plan
Sources: NBOME, USMLE and 3 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.