This COMLEX Level 1 cheat sheet distills the NBOME's two-dimensional blueprint into a printable rundown of the facts examiners test most, from the foundational sciences to the osteopathic principles that set COMLEX apart. It's a premium cheat sheet built by Capital Prep — the one premium prep we trust — and it's yours free. Reinforce it with the rest of your free COMLEX toolkit: the practice test, study guide, and flashcards.
COMLEX Level 1 exam at a glance
- Questions: 320 multiple-choice (reduced from 352 in May 2026)
- Time: Two computer-based sessions of 4 hours each (roughly an 8-hour appointment)
- Scoring: Pass/Fail only — no numeric score reported since May 10, 2022
- Cost: $745 registration fee (dated anchor — verify on nbome.org)
- Certifying body: National Board of Osteopathic Medical Examiners (NBOME), delivered at Prometric
What’s on the COMLEX Level 1 cheat sheet
- Application of Knowledge (~60%) — the foundational sciences — anatomy, physiology, biochemistry, microbiology, pathology, and pharmacology — tested through the ten clinical presentations.
- Osteopathic Principles, Practice & OMT (~12%) — the four tenets, five models, somatic dysfunction (TART), Fryette's principles, viscerosomatic reflexes, Chapman's points, and OMT technique definitions.
- Osteopathic Patient Care & Procedural Skills (~6%) — structural diagnosis and the clinical application of osteopathic manipulative treatment.
- Practice-Based Learning & the competencies (~4% + the rest) — biostatistics and evidence-based medicine, plus communication, professionalism, and systems-based practice.
How to use it in your final week
- Front-load the foundational sciences — Application of Knowledge (Domain 1) is about 60% of the exam, so anatomy, physiology, biochemistry, micro, pathology, and pharmacology are where the points are.
- Bank the osteopathic content as guaranteed recall: the four tenets, TART, Fryette's principles, sympathetic levels (T1–L2), and OMT technique definitions are rule-based and rarely change.
- Read the sheet the morning of the test — with 320 items across two 4-hour sessions you have roughly 90 seconds each, so lock in the memory hooks and never leave a question blank (no guessing penalty).
- Pair each review pass with a short timed practice set to keep your Prometric pacing sharp rather than cramming facts in isolation.
The cheat sheet is your review layer — your COMLEX Level 1 practice test drives the exam-readiness ring at the top of this page. Download it, review, then take a full practice exam (or drill with the study guide and flashcards) to see where you stand.
COMLEX Level 1 cheat sheet FAQ
Yes — the COMLEX Level 1 cheat sheet downloads as a PDF with no sign-up and no account. It sits alongside Career Employer's free COMLEX toolkit: the practice test, study guide, and flashcards, all built to be reviewed the week before your Prometric appointment.
It compresses the highest-yield facts across the seven NBOME competency domains and the ten clinical presentations — foundational sciences, autonomic levels, the four osteopathic tenets, TART, Fryette's principles, viscerosomatic reflexes, and OMT technique definitions — into a fast, printable quick-reference.
COMLEX Level 1 has been Pass/Fail only since May 10, 2022 — the NBOME no longer releases a three-digit numeric score. The historical minimum standard was anchored at a scaled score of 400, but you now receive a Pass/Fail outcome plus a formative performance profile. There is no penalty for guessing.
Osteopathic Principles, Practice & Manipulative Treatment is Competency Domain 1 at roughly 12% of items, and osteopathic thinking is woven through the rest of the exam. The cheat sheet front-loads these facts because autonomic levels, the tenets, and OMT definitions are pure recall — reliable, memorizable points.
Click the download button or the preview card at the top of this page to open the PDF instantly. Bookmark the page so you can pull it up again on test morning for a final pass over the memory hooks.
References
- 1.National Board of Osteopathic Medical Examiners (NBOME). “COMLEX-USA Level 1 — Blueprint & Competencies.” nbome.org, 2026. ↑
- 2.National Board of Osteopathic Medical Examiners (NBOME). “COMLEX-USA Bulletin of Information 2025–2026.” nbome.org, 2026. ↑
- 3.National Board of Osteopathic Medical Examiners (NBOME). “COMLEX-USA Level 1 to Eliminate Numeric Scores.” nbome.org, 2026. ↑
- 4.American Osteopathic Association (AOA). “What Is Osteopathic Medicine?.” osteopathic.org, 2026. ↑
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