Tips for success on COMLEX-USA Level 2-CE

Hey everyone! My name is Mark Miller, and I am a current OMS-IV at Lake Erie College of Osteopathic Medicine-Bradenton, hoping to match into orthopedic surgery. With the advent of pass/fail COMLEX and USMLE Level and Step 1 exams, performance on the COMLEX-USA Level 2-CE exam may play an increasing role in measuring the strength and aptitude of candidacy for residency. I was fortunate enough to score above the 95th percentile on the Level 2 exam, and would like to share some of the skills and tips I used to successfully prepare.

In this article I will outline a timeline for study, my favorite study resources and final test day tips. The approach described below worked best for me, but might not be the best fit for you. The most important takeaway is to find what works best for you and stick with it. My goal is to provide you with the info and insights I wish I had when I began studying for the Level 2 exam.

When and where to start?

The first question that comes to mind when studying for any exam is, “When should I start?” It may seem obvious, but I cannot emphasize enough that the best place to start preparing for Level 2 is building on a rock-solid foundation from the Level 1 exam.

During my third year, I was advised by my seniors to approach preparation for each COMAT exam as if it was the last time I would be exposed to that information. By adopting this mentality, you can focus your dedicated study time on reviewing material rather than teaching yourself new things. The confidence I gained by putting in effort throughout the year decreased my anxiety and allowed me to focus on performing to the best of my abilities.

My favorite study resources

• Anki: I owe much of my success in medical school to spaced repetition. Utilizing the Zanki Step 2 Deck allowed me to review material from all my rotations daily during my third year. If you’re looking for tips on how to use Anki efficiently, the Anking Med YouTube page offers a goldmine of information!
• USMLE(“UWorld”): Daily practice questions are a must for any test preparation, and UWorld is the best question bank I’ve encountered. I aimed to complete all the associated questions with each shelf during my respective rotations, then reset the deck and completed approximately 80% of the questions again during my dedicated study period. Utilizing the Anking Med’s advice on How to Review Missed Questions was a true gamechanger!
• White Coat Companion Text: I came across this textbook during the spring of my third year, and I immediately wished I had it at the beginning of third year! Jason Ryan, MD, has done it yet again with this review text, and I believe it will become for Level 2 what the infamous First Aid was for Level 1.
• Divine Intervention Podcast: This free resource produced by Divine-Favour Anene, MD, is an extensive audio-based review of high yield concepts that appear on the Level 2 exam. Throughout my third year, whenever I was driving to rotations, working out, cooking or even folding laundry, I found myself listening to Divine’s reviews. He helped me get at least three questions right on test day!
• Savarese OMT Review (“The Green Book”): This book is my favorite for review of high yield osteopathic manipulative medicine concepts.
• NBOME/NBME practice exams: These practice exams are great tools to gauge your performance. In total, I took two NBME Self-Assessment exams, two UWorld exams, 1 COMSAE exam and the Free 120.

A day in the life of dedicated study

I completed a four-week dedicated study period for Level 2. Most of the students I have spoken with averaged somewhere between 3-6 weeks. Each day, I would aim to complete four 40-question blocks of UWorld with review, an hour of White Coat Companion Text reading and an hour of Divine Intervention Podcast, which I listened to during my workout.

I took my first practice exam at five weeks out and completed one every Saturday, leading up to the the Free 120 on the Friday before my Monday exam.

Final tips before your test day

In the final days before my exam, I made sure to read over the US Preventative Task Force A/B Guidelines at night. I also took USMLE Step 2CK, with six days between the two exams. The day before each exam, I made sure to get up early and exercise, followed by minimal studying and time spent relaxing with family and friends. This has always been my recipe for waking up on test day feeling well rested and ready to perform!

Below is an excerpt from the NBOME for the breakdown of your testing day:

Make sure to bring enough food and drinks (granola bars, almonds, sports drinks, coffee and water are my favorites), as well as warm enough clothing for the testing center. A quote I always keep in mind on test days comes from an old sports coach of mine: “Play with the desire to excel and no fear of failure.” You have already put all the work in. Now it’s time to perform!

Related reading:

Pass/fail COMLEX: Considerations and outlook from a student’s perspective

Eliminating numeric scores for COMLEX-USA Level 1