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I began working with Sean 9 weeks before COMLEX Level 1. At the time, my practice scores were low, I had zero confidence, and my test-taking strategy was honestly terrible.
Dylan M.
The official COMLEX practice exams are NBOME’s COMSAE forms, one phase for each level: Phase 1 for Level 1, Phase 2 for Level 2-CE and Phase 3 for Level 3. Each student or resident form costs $60 (NBOME COMSAE), and Phase 1 forms have 176 questions in four sections of 44 (NBOME COMSAE format). NBOME also publishes free sample questions for every level (NBOME practice resources).
NBOME is careful about what a COMSAE score means, and you should be too. This page covers what each phase contains, how timed and self-paced modes differ, how to read the results, and where the forms fit in a dedicated period.
COMSAE at a glance
| Topic | Official rule | Source |
|---|---|---|
| Phase 1 (for Level 1) | 176 questions in four sections of 44. Three student forms: ASA 107i, ASA 110i and ASA 111i. | NBOME: COMSAE examination format |
| Phase 2 (for Level 2-CE) | 160 questions in four sections of 40. The format page lists three student forms (BSA 113i, 114i, 115i); the main COMSAE page says two Phase 2 forms are for student purchase. | NBOME: COMSAE examination format |
| Phase 3 (for Level 3) | One form for residents: 200 questions in four sections of 50. Unlike Level 3, it has no clinical decision-making cases. | NBOME: COMSAE examination format |
| Price | $60 per form for students and residents ($55 per form for colleges buying in bulk). A form can be bought more than once, and student forms include answer keys. | NBOME: COMSAE |
| Timing modes | Timed mode: a maximum of four hours, with per-question pacing comparable to COMLEX-USA. Self-paced mode: no time limit per section, on student or nonsecure forms only. The mode cannot be changed once chosen. | NBOME: COMSAE examination format |
| Free NBOME practice | Free sample questions for each COMLEX-USA level (Level 3 samples include clinical decision-making questions) and a COMSAE sample examination. | NBOME: COMLEX-USA practice resources |
| What you are preparing for | Level 1 reports pass/fail only; Level 2-CE passes at 400; Level 3 passes at 350. | NBOME: scoring and reporting |
Which COMSAE phase matches which COMLEX level
| COMSAE | For | Questions | Forms you can buy |
|---|---|---|---|
| Phase 1 | COMLEX Level 1 | 176 (four sections of 44) | Three student forms: ASA 107i, 110i, 111i |
| Phase 2 | COMLEX Level 2-CE | 160 (four sections of 40) | Student forms BSA 113i, 114i, 115i (NBOME pages differ on whether two or three are on sale) |
| Phase 3 | COMLEX Level 3 | 200 (four sections of 50) | One resident form |
Some forms include videos, so bring headphones. Check the purchase list in your NBOME portal before you plan around a specific Phase 2 form, since the two NBOME pages disagree on how many are available to students (NBOME).
COMSAE Phase 1: the COMLEX Level 1 practice exam
Level 1 reports only pass or fail (NBOME scoring), so a Phase 1 form is the closest thing you have to a readiness check written by the people who write the exam. With three forms on sale, a common pattern is one as a baseline before dedicated study, one in the middle and one in the final two weeks, as in our sample COMLEX Level 1 schedule.
Remember the size difference. A Phase 1 form is 176 questions; Level 1 itself is 320 questions over an eight-hour day (NBOME exam format). A good COMSAE in four hours does not prove you can hold that standard for eight, so pair the forms with at least one long, timed practice day from your question bank.
COMSAE Phase 2: the Level 2-CE practice exam
Phase 2 now has 160 questions in four sections of 40, and its timed version stays at four hours to match the per-question timing NBOME uses on Level 2-CE (NBOME COMSAE format). That is 90 seconds a question, so a Phase 2 form taken in timed mode is good pacing practice as well as a content check.
Level 2-CE gives a three-digit score that passes at 400 (NBOME scoring). If you also sit Step 2 CK and use NBME forms, keep those results and your COMSAE results as separate trends; they are different scales. Our Level 2-CE format guide covers the exam blueprint the forms are built on.
COMSAE Phase 3: practice for COMLEX Level 3
Residents can buy one Phase 3 form: 200 questions in four sections of 50 (NBOME). It has no clinical decision-making (CDM) cases, and Level 3 does: from January 13, 2027 the exam is one day with 240 multiple-choice questions and 16 CDM cases (NBOME exam format). Use Phase 3 for the multiple-choice half, and practise CDM separately with NBOME’s free Level 3 sample questions, which include CDM items (NBOME).
With only one form, timing matters. Take it once you have covered most of the content, not as a baseline, so the result tells you something you can act on before the exam.
Timed or self-paced?
Every COMSAE phase offers two modes, and you choose before you start; the choice cannot be changed afterwards (NBOME COMSAE format). Timed mode allows a maximum of four hours and comes closest to real testing conditions. Self-paced mode removes the section time limit and is useful for learning, but its score says little about exam day.
If you want a number to plan around, take the form timed, in one sitting, with your phone in another room.
How to read a COMSAE score
NBOME says plainly that caution should be exercised in using COMSAE results to predict COMLEX-USA results; timed, proctored forms help most when read alongside other markers such as COMAT scores (NBOME COMSAE). In practice that means:
- Look at the trend, not one form. Two or three timed forms moving the same way tell you more than any single score.
- Check it against your question bank. If COMSAE and your recent timed blocks agree, trust the picture. If they disagree, find out why before changing your date.
- Read the misses by type. Knowledge gaps, misread stems and timing problems each need a different fix.
- Watch OMM separately. Osteopathic principles run through every COMLEX level, and a weak OMM area can hide inside an acceptable total.
Free and low-cost NBOME practice
Before spending on forms, use what NBOME gives away: sample questions for each COMLEX level and a COMSAE sample examination (NBOME practice resources). NBOME also runs WelCOM, a separate self-assessment series for Levels 1 and 2-CE on its CATALYST platform with answers and rationales shown as you go (NBOME). WelCOM is a learning tool; save the timed COMSAE forms for checkpoints.
Working with a tutor on COMSAE results
Dr. Sean Moazezi, DO, sat every USMLE and COMLEX exam he teaches, and Dr. Chelsi Flippo, MD, works with students on Levels 1 and 2-CE. In sessions we go through your COMSAE and question bank results together, work live questions while you talk through your reasoning, and set the next checkpoint from the data. Sessions run online by live video (Zoom or Google Meet), and you can text questions between them.
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