This policy has been revised effective 1/21/2026.
All College of Osteopathic Medicine students must pass Comprehensive Osteopathic Medical Licensing Examination (COMLEX) -USA Level 1, and COMLEX- USA Level 2 Cognitive Evaluation (CE) from the National Board of Osteopathic Medical Examiners (NBOME) to progress successfully in the program and qualify for graduation. Additionally, all students must receive a passing COMLEX Level 2 score by January 30 of their OMS IV year, in order to be certified by CHSU-COM as eligible for the National Resident Matching Program (NRMP).
All students are required to take the COMLEX-USA examinations during the specific timeframes listed in the table below and the exams must be taken at a NBOME-approved testing center. The Associate Dean for Academic Affairs and Assessment has discretionary authority to grant students exemptions to these time-frame requirements in extraordinary circumstances. The agreed-upon extensions may not be rescheduled without approval from the Office of Academic Affairs.
Students are responsible for all costs associated with preparing for and taking all levels of the COMLEX-USA exams, including but not limited to extracurricular study programs, exam fees, travel costs, and the costs associated with multiple attempts at each exam if needed. These amounts are not included in the regular tuition.
Students who violate this policy will be required to appear at an SPC meeting and may be subject to disciplinary action as per SPC policy and process.
| Earliest Eligibility | Exam Deadline | Repeated Attempts | |
|---|---|---|---|
| COMLEX-USA LEVEL 1 | Following successful completion of OMS- II year curriculum including CSI Course COMLEX is typically taken June to July) | Prior to start of clerkships in OMS-III year (July) | Within 8 weeks of score release* |
| COMLEX-USA LEVEL 2 CE | May to July of OMS- III year, following successful completion of all required clerkships, COMATs and CCM Course. | Within 60 days of completing OMS-III year clerkships (and prior to September 30 of OMS-IV year) | Within 8 weeks of score release* |
* Any further delay will result in a delayed completion of the OMS-III and OMS-IV curricular years with an impact on graduation and residency placement.
COMLEX-USA LEVEL 1
Students must take COMLEX-USA Level 1 prior to the start of OMS-III year clinical clerkships, generally between May and July of the OMS-II year.
A student is eligible to take COMLEX-USA Level 1 if they have:
- Passed all OMS-I and OMS-II year courses and completed all required academic elements.
- Received certification for the exam from the CHSU Registrar’s Office.
The Associate Dean of Academic Affairs and Assessment, in collaboration with the Dean, has discretionary authority to determine if students are sufficiently prepared to take the COMLEX exam. In certain circumstances, such as in cases of inadequate academic performance, the Associate Dean of Academic Affairs and Assessment may recommend or require that the student delay taking the COMLEX-USA Level 1 until the student is adequately prepared to take the exam.
Students who are delayed due to not being ready to take any COMLEX exam may want to confer with the CHSU Financial Aid office to see how their eligibility for financial aid is affected.
COMLEX-USA Level 1 Failures
Failure of COMLEX-USA Level 1 may significantly impact a student’s clinical rotation schedule, progression through the curriculum, ability to match into residency, graduation, and eligibility to start residency on time. A student who fails any attempt of COMLEX-USA Level 1 is required to meet with the full Student Progress Committee (SPC). See the COM Student Progress Committee policy.
The full SPC meets with the student to discuss the COMLEX performance and vote on a recommendation, which will be sent to the Associate Dean for Academic Affairs and Assessment. The Office of Academic Affairs then works with the student and the Offices of the Student Affairs and Clinical Affairs to follow the SPC recommendations and create an individualized study plan for remediation, which may include, but not be limited to, a pause of clinical rotations, directed studies, and/or a formal board preparation course.
Students who fail COMLEX-USA Level 1 will be placed on academic probation as required by the COM Academic Standing and Progress policy.
Students requesting a Leave of Absence will be required to follow the LOA policy.
Students who are delayed due to not passing COMLEX may want to confer with the CHSU Financial Aid office to see how their eligibility for financial aid is affected.
Unless instructed otherwise by the Associate Dean for Academic Affairs and Assessment, students who did not achieve a passing score must re-take COMLEX-USA Level 1 within eight (8) weeks of receiving notification of failure.
Delays in which students miss more than two clerkships due to failing COMLEX Level I and retaking the exam will likely impact the ability of a student to stay on track to graduate on schedule with their current cohort/academic class. Students may be required to take a Leave of Absence (LOA) and return to the COM with the following cohort/academic class of students after passing COMLEX Level I.
A student who fails the COMLEX-USA Level 1 three (3) times is subject to dismissal from CHSU-COM due to insufficient academic progress.
COMLEX-USA LEVEL 2 CE
Students are required to take COMLEX-USA Level 2 CE sixty (60) days following successful completion of all OMS-III year curricular and clerkship requirements.
A student is eligible to take COMLEX-USA Level 2 CE if they have:
- Successfully completed all OMS-III year curricular and clerkship requirements, including the required Osteopathic Principles and Practice (OPP) elements. The requirements for each course are listed in the course syllabus and may include, but are not limited to, completion of all patient logs, cases, quizzes, and passing all post-rotation NBOME COMAT examinations, including the OPP NBOME COMAT examination.
- Students are given a 24-hour excused absence from clerkships to take COMLEX-USA Level 2CE if a request is submitted to the Clinical Education Department at least ten (10) business days in advance of the examination.
COMLEX-USA Level 2 CE Failures
Failure of COMLEX-USA Level 2 CE may significantly impact the timely completion of a student’s clinical rotation schedule, progression through the curriculum, ability to match into residency, graduation, and eligibility to start residency. A student who fails any attempt of COMLEX-USA Level 2 CE is required to appear before the SPC, which will evaluate the student’s situation and make a recommendation to the Associate Dean for Academic Affairs.
The Office of Academic Affairs then works with the students and the Office of the Student Affairs and the Office of the Clinical Affairs to follow the SPC recommendations and create an individualized remediation plan, which may include, but not be limited to, a pause in clinical rotations, directed studies courses (typically four weeks or six weeks in length) and/or a formal board preparation course.
Students who do not achieve a passing score on the Level 2 CE will be placed on academic probation. Students requesting a Leave of Absence (LOA) must follow the LOA policy.
Students who are delayed due to not passing COMLEX may want to confer with the CHSU Financial Aid office to see how their eligibility for financial aid is affected.
Unless instructed or approved otherwise by the Associate Dean for Academic Affairs, the student must re-take COMLEX-USA Level 2 CE within eight (8) weeks of receiving notification of failure.
Receiving a passing COMLEX Level 2 score by January 30 of the OMS IV year is a prerequisite to entering the NRMP Match. Students who do not pass the COMLEX Level 2 examination by this date will automatically be suspended from the Match program until such time as they achieve a passing score and are then invited to return to the COM as part of the following year’s OMS IV cohort. Similarly, Students applying for Urology, Military Match, and San Francisco match programs must pass COMLEX Level 2 by the end of September in order to complete the application process.
Students applying for Urology, Military Matching, and San Francisco match programs must pass COMLEX Level 2 by the end of September in order to complete of the application process.
COMLEX-USA Level 2 CE Third Failure
Students who fail COMLEX-USA Level 2 CE three (3) times are subject to dismissal from CHSU-COM due to insufficient academic progress.
COMLEX-USA LEVEL 3
Following graduation, the CHSU Registrar’s Office approves each graduate to take COMLEX- USA Level 3 through the NBOME website. Generally, graduates take this examination at the completion of the first year of post-graduate training; however, requirements for taking this examination vary from state to state. Graduates should contact the osteopathic medical licensing board in the state where they will have post-graduate training for further information. In most cases a residency program director must also attest to the candidate’s eligibility for this exam.
The COM will publish to the public the COMLEX-USA Level 1, Level 2 CE, and Level 3 first time pass rate for all students in each class of the COM.