My COMLEX Step 1 Experience: You Call This an Exam?

Everyone told me how COMLEX was a weird and “craptastic” exam. I did not believe them and had to see it for myself. And they were right, it totally sucked.


For this reason: there is no way to prepare for half of the exam.

my comlex step 1 experience - craptastic

Wow, that looks craptastic! Just like my COMLEX Step 1 experience.

You Cannot Fully Prepare for COMLEX Step 1

You can read as much as you can to prepare for the board exam. You can do all the practice problems available. But on the day of the exam, when you finally take the COMLEX, there will be many, many questions you have never seen before in your life. For my exam, I estimate that I have never encountered half the questions in my studies.

I prepared for half a year (6 months), studying 8 hours or more every single day including weekends. And yet, I was not fully prepared. To give you an idea of what I did, I will list everything I have done:

That is a lot of things I did to prepare. I estimate I did 7,000 practice questions. Heck, I even stayed up all night (minus two hours for sleep) to memorize everything. And I do mean everything. But still, the COMLEX took me by surprise.

I truly feel you cannot prepare for it fully.

What Happened Exactly on June 4, 2012?

Let me recount to you my first board exam experience so you can get the full picture. Originally, my exam was scheduled for 9:00 AM but I showed up early I then asked to take the exam at 8:00 AM. The people in the Prometric center was very accommodating and granted my request.

(I showed up way early and was doing some morning cramming.)

Once I reached the testing computer, I started the tutorial on how to take the exam, which took 10 minutes or less. I highly recommend the tutorial. The only practice exam I took that was geared toward COMLEX was Combank. The interface of Combank did not exactly match that of COMLEX. I did not want to waste precious time during my exam to figure out how to use the interface. I will go into more detail about what I thought about Combank in a review later on. But bottom line is to take the tutorial.

My very first few questions were ridiculous. And if you down with slang, the best way to describe it is “redonkulous.” One of the questions asked was about a type of business model that I could not find the answer to, even to this day. Even Google did not spit out an answer. And if Google does not know, the question must be invalid.

(I cannot repeat to you the exact question because before taking these type of exams, the testing company makes you sign something saying you cannot reveal the exact questions. Trust me, I very much want to repeat the exact question to you so you can see for yourself how “redonkulous” it was.)

I can say that this particular question and many others do not truly test your medical knowledge, but instead, test how well you know trivial details.

Overall, my exam was heavy on neurology, neuroanatomy, microbiology, and obstetrics. The neurology and neuroanatomy questions were quite detailed and beyond what was covered in First Aid and the three question banks. My exam was also like Step 2 because there were many “best step in management” questions and “initial step for diagnosis” questions.

(And as a side note, I did the worse in the “diagnostic technologies” and “management” sections of the exams. They were not covered much in my review materials which I listed above. If you want to get an edge in COMLEX Step 1, start studying for Step 2.)

The whole exam took me about 8 hours and I thought I would finish it in 6 – 7 hours. When I was taking the Combank practice exams, I usually had about 20 minutes left over after each block of 50 questions each. But on the real exam I had only less than 10 minutes left over after each block. Towards the end, as I was getting mentally fatigued, I had only a few minutes left over after each block.

(Also, make sure you keep tract of the time you take for each block. The exam gives you 4 hours to complete 4 blocks. Then it gives you another 4 hours to complete another 4 blocks. So if you take more than 1 hour to complete a block, that will take away time from your other blocks. For example, if you took 2 hours to complete a block, you will only have 2 hours left to complete the other 3 blocks. You can read more about the COMLEX Step 1 exam if you follow the link.)

My COMLEX Step 1 Results

After finishing the exam, I honestly felt like I failed the exam and would have been happy just to pass, which translates to a score of 400.

Instead, I was pleasant surprised to receive a score of 520. This means I was in the 60th percentile. However, my score does not reflected upon the work I had to put in to prepare for it. Six months of 8 hours per day (including weekends) of studying just to get into the 60th percentile does not seem like a fair trade. My friend, who put in only a quarter of the work I put in, got a score slightly lower than mine. COMLEX results are a crapshoot. But hey, at least I did not fail.

Looking back I do not know what advice I would give you to do well on the exam (as in getting the 90th percentile). Maybe start studying for Step 2. I felt I could have done better on the USMLE. But I do have advice on how to at least pass this exam. I will post my study strategy in the next article.

New! Learn how to pass COMLEX 2-PE on the first try. See here to find out more.

This article is part of The Complete Guide to COMLEX. Click on the link if you want more tips and hints about the osteopathic medical board exams.


  1. How did you do on USMLE Step I if I may ask? I felt exactly like you walking out and am freaking out. Did you do better on the USMLE?

  2. you can absolutely prepare WELL FOR 98% of the exam… And do phenomenal. You only need 5 weeks to do questions after one solid read through first aid. TRUST ME, you CAN get > 600 by preparing …and knowing some of the questions will be vague, but combank (and comquest) provide ample practice with this. Good luck everyone!!!

    • Alex Ding says:

      Thanks for sharing, Roxanne.

      • Roxanne Man says:

        Roxanne is likely a trolling MD student. Or a COMLEX question writer.

        • She’s right tho…I took a full length mock comlex before ANY studying and I got a 512 …I really doubt the author really knew what he was doing in 6 months of time. I prepared for 6 weeks, did only 1 question bank, and did far better than him. True, there are BS questions, but they only count for like 5% of the entire test…

          • Alex Ding says:

            No need to brag about being an idiot-savant. Go work on your EQ score.

            Edit: J responded with as much bitterness as a scorned spinster, as expected when my words hit true. However, his wit was less than that of a first grader, again proving my point of his idiot-savancy.

  3. Stephanie says:

    I took my exam July 30th and felt awful afterwards, I’m wondering if the worst happens and I did not pass what happens next…

    • Alex Ding says:

      Hey Stephanie,

      I felt awful too after my first exam. But I did quite well. Chances are … you’re gonna do well too.

      Worst case, if you fail, you’ll just have to retake the exam. It is not the end of the world.

      But don’t stress about it. Stressing will not change your score. Just relax and enjoy life.

      • Hi Alex,
        I just got a score of 476 on my comsae D. It was quite difficult, random neuro. I am suppose to take the exam within two weeks. Should I push it back?

        • Up to you. If you feel there is still more you can do to prepare, then push it back. If you feel you learned as much as you can, take it.

  4. Delores Lyon says:

    Wow, I had no idea that the COMPLEX exam could be so taxing! I better start taking my studying seriously if I am going to pass this. I’ll also make sure to check out your guide on passing that exam on the first try. Hopefully I only have to pay those fees once!

  5. I just took COMLEX a few days ago. When my wife asked me how it went, I pretty much said exactly what you did. I’m glad to see I wasn’t the only one. Mine was 90% material that I wouldn’t have dreamed of studying for. Strange test. Thanks for sharing.

  6. I took mine a couple of days ago. Felt absolutely miserable afterwards. Honestly felt like I got 25% of the questions right. Everything felt like a blur. Petrified that I didn’t pass

    • I took mine yesterday and felt the exact same way. I know I didn’t study as much as I could have, but I honestly felt like no amount of studying would have prepared me for that. I went through first aid once, part of pathoma, most of Sketchy Micro, and around 3,000 questions mostly from Combank but also some from usmle world and Kaplan usmle. At this point I just want to pass…

  7. What a HORRIBLE exam!!!! I wish I had never heard about DO schools! I took the exam and was just stunned!!! It made no sense whatsoever!!! There was no correlation to clinical medicine or pathophysiology (case studies) at all, just random facts!!!! What a waste of time and money. I didn’t think I passed the exam and would you know when I received my test results I certainly didn’t. How disappointing! I started to take the USMLE just to prove that I was prepared for the exam but then I figured why do that? It will only be a waste of time and money and in the end it will be useless. Let’s get rid of this worthless exam by starting a petition demanding that the USMLE be used for licensing.

    • raybans says:

      Hjanie. Im in the same spot as you. It’s a horrible feeling. I felt so prepared. Did well on NBME and comsae then this slap in the face. Any suggestions.

  8. You guys are telling me. I take mine on the 23rd and am totally panicking. The USMLE questions make so much more sense. But do NOT FORGET!, Remember when we tried to get rid of Step 2 CK and Level 2 PE. Guess what, they retaliated by attempting to make it harder. Just take both exams. I start rotations in 1.5 weeks, but for 5 months im going to study for USMLE Step 1 and then take that then 6 months for CE/PE.

    Also Hjane, shame on you for saying you wished you hadnt heart of DO schools. I have helped so many people with OMM it is actually kind of hard to believe. I dont even believe it when I do it, but am proven wrong by my patients…so something there works. Keep your head up, just work hard and get through this. Life will suck less after.

  9. Holden Caulfield says:

    Just curious, the night you stayed up minus 2 hours of sleep, that wasn’t the night before your exam was it? 😮

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