Osteopathic medical students constantly ask one question: “What does my COMLEX score equal on the USMLE?”
The short answer: there is no official formula that converts a COMLEX-USA score into a USMLE score. What exists is concordance research — a published study that matched COMLEX-USA and USMLE score ranges statistically. The NBOME provides a COMLEX-USA/USMLE Concordance Table based on this research to help illustrate how scores compare across the two exams.
A concordance range tells you where two scores sat in comparable positions in the study’s distributions. It does not tell you what you personally would have scored on the other exam.
Key Takeaways
- No official one-to-one COMLEX-to-USMLE conversion exists.
- The published research gives concordance ranges, derived by equipercentile matching, not individual predictions.
- Level 1 and Step 1 are both Pass/Fail, so historical Level 1 tables cannot produce a current numerical estimate.
- Level 2-CE and Step 2 CK are the only relevant numerical comparisons today.
- Percentiles depend on the testing cohort and are not conversions.
- Check individual program policies rather than assuming a single standard.
Interpret your COMLEX performance as part of a complete application — not as an unofficial USMLE score from a calculator.
COMLEX-USA vs. USMLE
COMLEX-USA is the licensing series for osteopathic physicians, administered by the NBOME and scored on a 9–999 scale. The USMLE is scored on a 1–300 scale. The exams commonly compared are:
| COMLEX-USA | USMLE |
|---|---|
| Level 1 | Step 1 |
| Level 2-CE | Step 2 CK |
| Level 3 | Step 3 |
They assess overlapping constructs but use different blueprints, and COMLEX-USA also assesses osteopathic principles and osteopathic manipulative medicine (OMM), which are not part of the USMLE examination blueprint.
The Concordance Research
Barnum et al. published the key study in the Journal of Graduate Medical Education (February 2022). Five colleges of osteopathic medicine contributed data on students who took both exam series between 2015 and 2020.
After limiting the sample to students who took the paired exams within 150 days of each other, the analysis covered 2,114 students for Level 1/Step 1 and 1,468 students for Level 2-CE/Step 2 CK. The researchers used log-linear smoothing and equipercentile matching rather than a linear formula, because the relationship between the scales is curvilinear.
Correlations within the study data were 0.82 for Level 1/Step 1 and 0.77 for Level 2-CE/Step 2 CK — strong, but not interchangeable.
One caveat worth knowing: the study sample scored above the overall COMLEX-USA population (Level 1 mean 25.4 points higher, Level 2-CE mean 44.0 points higher), and a concorded pair does not necessarily sit at the same percentile within each exam’s own national cohort.
COMLEX Level 1 to USMLE Step 1 (Historical Only)
Both Level 1 and Step 1 are now reported as Pass/Fail:
- USMLE Step 1 — Pass/Fail for exams on or after January 26, 2022
- COMLEX-USA Level 1 — Pass/Fail for exams on or after May 10, 2022 (announced January 24, 2022)
Level 1 candidates receive a Formative Performance Profile rather than a three-digit score, and NBOME percentile conversions for Level 1 stop at the 2021–2022 cycle. So the table below applies only to historical three-digit Level 1 scores.
| COMLEX-USA Level 1 | Estimated USMLE Step 1 |
|---|---|
| 9–399 | 1–179 |
| 400–419 | 179–185 |
| 420–439 | 185–191 |
| 440–459 | 191–196 |
| 460–479 | 197–202 |
| 480–499 | 202–208 |
| 500–519 | 208–213 |
| 520–539 | 213–218 |
| 540–559 | 218–223 |
| 560–579 | 223–228 |
| 580–599 | 228–232 |
| 600–619 | 232–236 |
| 620–639 | 236–240 |
| 640–659 | 240–244 |
| 660–679 | 244–247 |
| 680–699 | 247–250 |
| 700–719 | 250–253 |
| 720–739 | 254–256 |
| 740–759 | 256–259 |
| 760+ | 259+ |
COMLEX Level 2-CE to USMLE Step 2 CK
This is the comparison that still matters, because both exams report three-digit scores.
| COMLEX-USA Level 2-CE | Estimated USMLE Step 2 CK |
|---|---|
| 9–399 | 1–196 |
| 400–419 | 197–201 |
| 420–439 | 201–206 |
| 440–459 | 206–211 |
| 460–479 | 211–215 |
| 480–499 | 215–219 |
| 500–519 | 219–223 |
| 520–539 | 223–227 |
| 540–559 | 227–231 |
| 560–579 | 231–235 |
| 580–599 | 235–238 |
| 600–619 | 238–241 |
| 620–639 | 241–244 |
| 640–659 | 245–248 |
| 660–679 | 248–250 |
| 680–699 | 251–253 |
| 700–719 | 253–256 |
| 720–739 | 256–259 |
| 740–759 | 259–261 |
| 760+ | 261+ |
A Level 2-CE score of 600–619 sits alongside an estimated Step 2 CK range of 238–241. That is a distributional statement, not a prediction that a 610 becomes a 240.
What About the “0.13” Formula?
Smith et al. (Cureus, 2021) reviewed 340 students at a single osteopathic school and derived:
USMLE Step 2 CK = 0.13 × (COMLEX Level 2-CE) + 163.5 — R² = 0.64, SE = 9.1
It circulates online as the conversion formula. It is not official; it comes from one school, and the later multicenter study specifically rejected linear modeling because it distorts the relationship at the tails. Give more weight to the concordance table.
Percentiles Are Not Conversions
COMLEX-USA percentiles are calculated against candidates who took the same exam level in the same testing cycle, so the same three-digit score can map to different percentiles year to year. Saying “a 600 COMLEX equals a 240 USMLE” collapses two different ideas.
Current Passing Standards
| Exam | Reporting | Minimum passing |
|---|---|---|
| COMLEX-USA Level 1 | Pass/Fail | — |
| COMLEX-USA Level 2-CE | Three-digit + Pass/Fail | 400 |
| COMLEX-USA Level 3 | Three-digit + Pass/Fail | 350 |
| USMLE Step 1 | Pass/Fail | — |
| USMLE Step 2 CK | Three-digit | 218 (exams on or after July 1, 2025; raised from 214) |
Do You Need to Take the USMLE?
COMLEX-USA is accepted for osteopathic licensure in all 50 states, so this is a residency-application decision, not a licensure one. Program requirements vary by specialty and change over time — check the programs you are actually applying to.
The better question is not “what will my COMLEX convert to?” but “does a Step 2 CK score give me eligibility or evidence that materially improves my application, and can I prepare well enough to earn one?”
Also note that the data behind the concordance table comes from 2015–2020 exam administrations, before recent blueprint and scoring changes on both series.
If you decide to take USMLE exams, Gold USMLE Review offers free courses to eligible VA military students preparing for USMLE Step 1, Step 2 CK, Step 3, COMLEX Level 1, Level 2, and Level 3. VA military-associated students may also qualify for reimbursement for eligible courses through their VA benefits.
For scholarship eligibility and enrollment information, call 1-866-446-5327 or email goldusmlereview@gmail.com.
Conclusion
There is no official formula for converting COMLEX-USA scores to USMLE scores. Concordance tables show statistical relationships, not personal score predictions.
For current applicants, the main numerical comparison is between COMLEX Level 2-CE and USMLE Step 2 CK. Since Level 1 and Step 1 are Pass/Fail, historical three-digit comparisons have limited relevance today.
If you are considering the USMLE, check the requirements of your target residency programs and use concordance data only as a general reference.
