How to Use COMSAEs to Excel on COMLEX: Study Tips & FAQs

How to Use COMSAEs to Excel on COMLEX: Study Tips & FAQs

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Preparing for medical licensing exams can feel overwhelming, with the endless study hours and the constant pressure to excel. A large part of exam preparation includes taking practice assessments to evaluate your knowledge and readiness for the actual exam itself.  

For those who are taking the COMLEX (the Comprehensive Osteopathic Medical Licensing Examination), COMSAEs (Comprehensive Osteopathic Medical Self-Assessment Exams) are often utilized as the main exam preparation tool.

That being said, there are some important things to know when it comes to COMSAEs, especially with how they relate to the COMLEX. Let’s take a more in-depth look at how to make the best use of a COMSAE exam, how to best study for one, and how it compares to the COMLEX.  

What to Know About COMSAEs

COMSAE exams are self-assessment exams designed specifically for students in osteopathic medical school. They’re tailored to help you prepare for the COMLEX-USA examinations, which are the required licensure examinations for osteopathic physicians. 

The COMSAEs are similar to the self-assessment exams that allopathic and international medical graduates take, known as the NBME self-examinations by the National Board of Medical Examiners, before taking the USMLE (the United States Medical Licensing Examination). 

COMSAEs + COMLEX vs. NBMEs + USMLE

Unlike NBME self-assessments, which cover broader medical knowledge areas without specific emphasis on osteopathic principles, COMSAEs contain content aligned with osteopathic medicine principles. This content includes a strong emphasis on Osteopathic Manipulative Medicine (OMM) and Osteopathic Principles and Practice (OPP) in addition to questions concerning traditional medical knowledge.

There has been discussion around the notion that DO students should possibly take the USMLE Step 1 in addition to the COMLEX Level 1. Ideally, osteopathic students should incorporate both the COMSAE and NBME into their practice schedule. 

But is this necessary? Maybe. Program directors are more familiar with USMLE scores, so osteopathic medical students could gain a competitive edge for residencies by taking both exams, especially since there is currently no widely accepted conversion formula between COMLEX and USMLE scores. 

This move could help enhance your competitiveness within your desired specialty, especially with USMLE Step 1 and COMLEX Level 1 transitioning to pass/fail. Consequently, though, if you’re an osteopathic student, you may find it necessary to take USMLE Step 2 to secure a competitive advantage for residency positions if you take up the double-exam option. Consider this carefully. 

COMSAE vs. COMLEX

We’ve discussed how COMSAEs and the COMLEX compare to the NBME practice exams and the USMLE. Now, it’s time to talk about how COMSAEs compare to the actual COMLEX exam itself. 

The COMLEX is a three-level, national standard licensure exam, with there being a COMSAE examination for each one of the three phases. 

There is a COMSAE Phase 1 testing experience to help students prepare for the COMLEX-USA Level 1 examination, a COMSAE Phase 2 assessment for the COMLEX-USA Level 2-Cognitive Evaluation (Level 2-CE) exam, and a COMSAE Phase 3 self-assessment exam for the COMLEX-USA Level 3 exam. 

Each Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) is similar to the format and structure of the COMLEX exam levels. Like the COMLEX, each section on a COMSAE consists of multiple-choice, stand-alone questions that may include audio, visual, or video components.

Note that COMLEX Level 3 also includes Clinical Decision-Making (CDM) cases, which pose a clinical scenario followed by two to four accompanying questions. COMSAE Phase 3 does not include CDM cases although they do appear on the actual exam. 

The biggest difference between the COMSAEs and the COMLEX, though, is found when it comes to the scoring process. While COMSAEs include a numerical score for results like the COMLEX exam, COMSAE scores are actually not accurate predictions or representations of what your COMLEX score will be.

More or less, your COMSAE simply gives an idea of if you’re in a position to pass or not; it’s not the most accurate predictor when it comes to your numerical score or in what results percentile you’ll end up in compared to other students. In fact, some medical school students scored 100-150 higher on the COMLEX than the COMSAE estimated.

Want to be sure you pass your COMLEX exams? Get 1-on-1 guidance from a 90th+ percentile tutor and impress residency directors with your score.

Studying Strategically

When it comes to studying for the COMLEX, of course you’ll want to utilize COMSAEs to get prepared. That being said, it’s important to incorporate a COMSAE exam into your study schedule strategically. Let’s take a look at the best ways you can prepare for your COMLEX-USA exam through key study practices.  

Timing is Everything 

Timing matters when it comes to preparing for the COMLEX. It’s recommended to start integrating COMSAEs into your study plan several months before your COMLEX exam. 

This timeline allows for strategic adjustments in study strategies based on the assessment feedback you’ll get after taking your COMSAEs. As of February 2024, answer keys should be provided with your Phase 1 and Phase 2 COMSAEs, allowing you to see what type of questions you should spend more time on studying, and what areas you performed strongly on. 

How and When to Take COMSAEs

We recommend you start with an initial COMSAE practice exam to begin your COMLEX studying journey. This helps to establish a baseline, and then you are able to regularly assess your progress to stay on track toward exam readiness.

Of course, there’s the debate of how often you should take COMSAEs. As we’ve gathered insights from successful students who’ve navigated their exam prep using COMSAEs, one student found spacing out their practice exams every two weeks helped maintain study 

momentum while allowing ample time for focused review. 

One student added that following this two-week rule of thumb and additionally simulating real exam conditions during practice sessions helped them build exam endurance and significantly reduced their test-day nerves.

What to Study

Adjusting study plans based on practice exam results is crucial for medical students preparing for the COMLEX. This is because the practice tests will help you know what you need to spend more of your study time on and where you can compromise a bit of study time.

For example, if you find yourself struggling in certain areas, like pharmacology, but thriving in others, like microbiology, consider ramping up your study time in your weaker areas rather than giving more time to your areas of strength. 

If you don’t know how to boost your studying in certain areas, consider using flashcards or joining group study sessions. You can also take advantage of practice COMLEX question banks on sites like Truelearn and UWorld, which all should have broad COMLEX practice questions in addition to area-specific practice questions.

FAQ

There is no limit to how many times you can take COMSAEs. However, it’s important to note that for each COMSAE, the cost is around $60 to take. Just a heads up in case you’re needing to add this self-assesment price to your monthly budget!

The two OMM question formats on the COMLEX are pure OMM questions and integrated OMM questions. 

Pure OMM questions focus specifically on evaluating your understanding of osteopathic concepts, philosophy, and medical practices, mirroring what you typically encounter in OMM exams during your coursework at a college of osteopathic medicine. 

Integrated OMM questions, on the other hand, mix osteopathic-specific and non-osteopathic-specific components. For instance, the question stem may incorporate an OMM finding with other non-OMM information, or the answer choices might reference both OMM and non-OMM treatments. These questions may differ from what you’ve already encountered in osteopathic medical school, since they integrate OMM and non-OMM concepts.

As of February 2024, all Phase 1 and Phase 2 COMSAE forms have a calculator function.

According to the National Board of Osteopathic Medical Examiners, COMSAE score rankings are as follows:

  • Lower than 400: Low performance
  • 400 to 649: Average performance
  • Higher than 649: High performance

The maximum score is an 800 on both the COMSAE and the COMLEX, so aim to get as close as possible to that for competitive score purposes.

Ace Your Exams With MedSchoolCoach

Passing the COMLEX exams is a huge milestone in the practice of osteopathic medicine. We can help you pave the pathway to success in your journey to becoming a licensed medical professional. 

Our experienced tutors have mastered COMLEX Levels 1 and 2, scoring in the 90th percentile or higher.  Learn more about how 1-on-1 tutoring can help you achieve your COMLEX goals!
Picture of Amar Mandalia, MD

Amar Mandalia, MD

Dr. Mandalia is an accomplished medical writer with multiple manuscripts in peer-reviewed journals and a practicing GI physician in the Orlando area. He is the Admissions Advisor for MedSchoolCoach and has extensive experience helping students get into medical school and residency.

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