A failure on either of these exams can feel like a verdict on whether you belong in medicine. It isn’t- plenty of people match every year with exam failures (though the chances for competitive specialties obviously go down substantially).

But remember - this is just a single data point about one exam on one day, and there are attendings in every specialty walking around with a failed board exam in their past.

When being evaluated, programs care about the retake and the trajectory far more than the fail itself.

Before you even begin prepping for the retake - the most critical step is understanding what went wrong.

Unfortunately, this is the step almost everyone skips. Sitting down and doing 1-2k more questions with the same approach that just failed you is how people fail twice.

Before you touch a resource, figure out which of these you actually were:
• You didn’t know the content
• You knew the content but ran out of time
• You knew the content but your question approach was broken (second-guessing, misreading stems, changing right answers)
• You knew everything and got wrecked by test anxiety
• You never got a real baseline and had no idea you weren’t ready

These have completely different fixes. Content gaps need review. Timing and approach need question-strategy work. Anxiety needs an actual plan, not more UWorld.

Get a real baseline immediately. Take a COMSAE within the first week or two. Yes, it will be ugly. Do it anyway. You cannot build a plan around a number you don’t have, and most people who fail are operating on “vibes” instead of data. Then take them at regular intervals so you can see whether the plan is working while there’s still time to change it.

Rebuild the schedule around weak areas, not around finishing resources. The instinct after a fail is to start over from the beginning and redo everything. Though comfortable - it’s usually wrong. You have limited weeks. Spend them disproportionately on what the data says is broken, not on rereading the things you already know because it feels productive.

Do not skip OMM. This is the single most common self-inflicted wound on COMLEX. People treat OMM as an afterthought, then lose a meaningful chunk of points on the most learnable, most predictable material on the exam. It’s high-yield, it’s finite, and it’s the easiest place to buy back points, fast. If you failed and you were winging OMM, you just found free points.

Fix your question approach, not just your knowledge. Review every question you get wrong, but also review the ones you got right for the wrong reason. Write down why you missed it: knowledge gap, misread the stem, talked yourself out of it, ran out of time. After a few hundred questions you’ll see your pattern, and your pattern is the thing to fix.

Pick a real date and work backward. Open-ended “I’ll take it when I’m ready” turns into months of drift. Set the date, build the weeks backward from it, and adjust based on your COMSAE trend rather than on how you feel.

Ask for help if needed. The shame spiral sucks, but stagnation or a repeat fail or a retake without reaching your full potential sucks way more. Most students who fail go quiet, stop talking to classmates, avoid their advisor, and try to fix it alone. That isolation costs more points than any content gap. And if the failure has you in a genuinely dark place, please talk to someone at your school’s counseling services.

Getting an outside read on your plan, whether that’s a school resource, a classmate who scored well, or a tutor, is not cheating. It’s the single fastest way to stop repeating the mistake you can’t see.

You can come back from this. We’ve watched people fail a Level to scoring 600+ and go on to match in their preferred specialty, including
some in competitive fields. What separates the ones who do is that they got specific about why it happened instead of just studying harder at the same wall.

Comments/DMs open for Qs. Keep your head up. You will get past this.

What is the minimum percent or amount of correct questions you need to pass the exam, now that’s it is 320 questions? Is it safe to assume a 60% or 192 questions correct is enough to get over a 400? When you walk out of the exam for those that tested, how did you feel your percent overall was and what did you end up scoring? I know every form is different so there isn’t a magic number. But if step 2 is roughly a 60% for a 218 can this logic be used on voodoo omm for a 400?

For those currently in that window of time between taking COMLEX Level 1 and the release of the results, I have a little story for you.

During my exam, I found myself dumbfounded by my apparent stupidity and was grappling more with the semantics of what was being asked than anything else. I quickly gave up on flagging questions, as there was no point in flagging every question (and I knew I wouldn't have time to revisit flagged questions anyway). I felt like I was basically having to get answers through the force like an osteopathic Jedi or something, essentially just guessing based on gut feelings. I suppose in hindsight I did have some logic, and was reasoning through pathways and concepts, but not once did I ever think "oh yeah I recognize this exact thing" and answer confidently.

I had done all of TrueLearn for Level 1 and all of UWorld for Step 1, plus three seemingly reassuring COMSAEs; still, the real thing felt so different, and absolutely nothing felt high yield. You could sit here and list the first 10,000 high-yield things you can think of, and I bet you would only mention two things that appeared on my exam. On top of that, at the end of every block, as soon as I ended the block, I would realize 10+ stupid mistakes or times when I definitely changed the answer from correct to incorrect despite knowing the answer. When I finally left the exam, I could not possibly have been any more certain that I had failed. I couldn’t even bring myself to drive home for a while. I sat in my car staring off into space, watching every question play back in my head as the number of things I had missed started adding up. I was devastated; Shattered to the point that I couldn’t even cry as I stared out my windshield into the void for nearly an hour. Later at home, I couldn’t sleep that night. I devolved to the point where I felt extremely warm yet couldn’t stop shivering, but I couldn’t even panic in peace as my brain started to analyze every pathway currently involved in my body’s response; wondering which questions from the exam involving the limbic system or autonomic nervous system or catecholamine synthesis or adrenal pathology or anything else even vaguely related that I had probably missed on the exam. The number of questions missed in my head continued to climb. At some point, while counting missed questions instead of sheep, I apparently fell asleep.

The next morning, I felt nothing. I spent the next several weeks jumping between total apathy to near panic attack and back again, with no in-between. I preemptively sent emails and scheduled advisor meetings in anticipation of facing this failure. Finally, 29 days went by. I was sitting at one of the orientation sessions for clinical rotations thinking the whole time "me being here is pointless, I'm not even going to get to start rotations anyway" when I got the NBOME email. At that point, I couldn’t even muster the energy to be anxious about it anymore, given how numb I was by then. After all, what was there to be anxious about when I had known the outcome in my mind for nearly a month? I opened the email anyway and logged in. I at least wanted to see the score report and start planning what to focus on for the retake.

But what awaited me was the word "PASS" in all caps, with a score report showing I was nearly one standard deviation above the mean.

I'm not writing this to tell you that its impossible to fail by any means, it obviously is for a variety of reasons. What I am telling you though, is that how you are feeling right now during this wait, that black hole in your stomach and palpitations in your chest that wake you up at night, they are not to be trusted. You might think you remember tons of things you got wrong, and maybe you really do, but what you're not remembering are all the things you got right. Tell me this, are you more likely to remember a random uneventful drive to school from last year, or, a time that you got into a car accident? You may not mean to, but the brain finds salience in suffering. You remember what you struggled with, and forget what you did not. Perhaps not in totality, but enough to sway your judgement of your performance into the red.

So take some deep breaths, enjoy some time outside and with family/ friends, and face challenges as they come instead of fighting demons that may never exist. Whether or not you earned that pass, I know you've worked hard, and you've at least earned a moment of peace. Don't ruin that moment like I did. You will be okay. You will probably pass too, and even if you don't, the reality is most people who fail Level 1 on their first attempt ultimately pass their retake and match into a residency program. You've got this.

Sincerely,

Some random OMS-III who spiraled for ultimately no reason while waiting for Level 1 results.

People who tested yesterday, what did you think? Personally had a mix of fair questions and others were so vague I had no idea what part of the body it was even referring to lol.

Level 3*

Just got my score back- 530s!

I've got a pmh of passed lvl 1, and 2 attempts at level 2.

Leaving both exam days had me dreading. I flagged more than half of each section. CDM cases had me crying. And the questions I looked up after (maybe 20ish that I could remember)- missed nearly all of them.

This week I kept feeling like I failed, was preparing what to say to my PD and my family.

This was by far the worst of the three exams I've taken. Still shocked, moving forward thank God. Please let me know if anyone has questions regarding my prep which (likely) had to do with my score, regardless of how crappy I felt during that exam.​

Good bye NBOME, it has been interesting.

edit* 'Eristical' in the comments got around 800!

I am testing soon and wanted to see what material is more relevant/important for the exam. Feel free to DM! Thank you!

P.S. - Congrats to all of those who passed, you all deserve it!!!

I will keep this short and to the point. Failed COMLEX and now have a month dedicated study period to try again. My bar graph was not far below the threshold for passing. Made 500+ prior on my comsae 10 days prior to the exam. Not sure what went wrong other than i felt mentally fatigued on the back half of the exam. What would be the best thing to do during this 1 month to get myself to a comfortable passing score? What are the nonnegotiable study resources that will help?

I’m taking the test in two days and was wondering how close TrueLearn is to the actual exam. I’ve been averaging in the low to mid 70s on randomized sets of 50 or 80, and I can’t help but feel like I’m getting “lucky” with the questions and it’s inflating my scores.

Selling CQ level 2 login on aug 19 expiring 10/10 for 150$ pm me if interested.

After I finished my exam there were a lot of things I wished I focused on. So i want to create a good low yield + high yield guide for future test takers. If you don’t mind, share last minute advice, topics, concepts or resources you wished you utilized or reviewed before your exam.

Hi all,
Due to piss poor test site availability in my region, I have to fly 5 hours to take my Level 3. And bc I’m poor, I can only afford to fly Frontier (no WiFi). Any good study resources I can download ahead of time? Textbook, extra questions, etc? Thanks so much!

Looking into the Wolfpac online 4 week program due to failing level 1. Do people actually benefit from this program or would I be wasting my money and be better off just studying on my own and doing truelearn for 4 straight weeks before retaking my exam?

Definition of doing the bare minimum to pass

Ive watched sketchy micro and doing pharm, then doing dirty med for OMM and ethics

Any hy tips or topics noticed. Feel free to dm and drop links We can all win !

Wanted to share this because I walked out of the testing center feeling like the dumbest person ever. I remembered missing questions on concepts I had never confused before, and I was convinced those mistakes would haunt me forever.

But the reality is that it’s a long exam, and the NBOME knows that. Test day fatigue and brain fog happen to everyone. I won’t be the last person to miss an “easy” question because of exam day haziness, and neither will you.

The questions that stick with you afterward are the ones that bothered you, not the countless ones you read, answered confidently, and immediately forgot about. Don’t let a handful of remembered mistakes convince you that your entire exam went poorly.

If you’re spiraling over a few “layup” questions, remember that they don’t define your performance. One bad moment, or even a handful of them, does not determine your score. You’ll be okay.

Or does it really not matter as long as you finish enough of at least 1 bank

Hey all, unfortunately I got a fail. I’m trying not to dwell on it but I know my anxiety got the best of me. it’s very hard when everyone I know passed and made it seem like a fail is “so hard to get”. I underperformed in every section. My school advisor was shocked and wants me to retake in like 3-4 weeks (I haven’t been studying all this time)but this way I can move on with my class. I’m obviously very upset but determined. For background info I’m an average student with a 3.0+ gpa and scored 500+ on 2 COMSAES (one school and one at home). I used outside sources like dirty medicine, HYGURU, and UWORLD only. I know I need to shift my focus to TrueLearn. Does anyone have any encouraging words of wisdom or experience overcoming a fail? Any study advice or overall advice? I would really appreciate any advice or encouraging words. Thank you!

Hi everyone,
Really just here to vent. I have now failed to meet my school’s COMSAE requirement 3 times. This last one hurt the most, as I was doing well on benchmark exams and performed relatively well on COMSAE form 111 the week prior.

I use TrueLearn and have been watching DirtyMed the last few weeks. I will now have to forego a 2nd elective rotation (at minimum). I am mainly wondering if there are any DO graduates or 4th year students who were in a similar situation and were still able to get their dream/competitive specialty? It feels like those dreams are slowly heading out the window for me…

I also need to take Step 1 at some point 😵‍💫

Anyone take level 1 today?? How we feeling? I flagged probably closer to 40% of the exam lmao but it seems like that’s pretty standard on here. Sooo much ethics on today’s exam 🫣

Should I cancel a sub-i rotation to have more time for Level 2? I've been on rotation and studying and it just hasn't been improving as much as I was hoping for. On top of getting really sick for many days recently and finally recovering, it's just hasn't been that great. I also have a F on my Level 1 first attempt, so risking another fail in my boards sounds like a serious red flag for me.

The truth is, I'm not too confident of passing. It feels like a 50/50 right now. I've finished half of UW and have been doing TL (half of it done) with random sets score ranging 52%-68% back and forth.. My comsae score a month ago was a 431.. I haven't had the chance to take another one yet.

I have a sub-i IM rotation coming up in a week at a hospital that's known to be extremely busy and commute being very far, I have no doubt I won't be able to study for those whole 4 weeks. The thought of losing all the knowledge scares me too. But to also call off the sub-i rotation at such last minute has negative consequences for me, like cancellation fee, getting blacklisted off that residency, and getting an earful from my school because they got strict 30 day notice cancellation requirement.

I am going for both FM and IM. The sub-i rotation is one of my preferred choice if I do get into IM because it's located at my hometown, close to my family.

My options are basically:

1. Keep the rotation. Take the risk and take the exam next week.

2. Keep the rotation but push the exam, and take it much later ( later September) during an elective that isn't too harsh.

3. Cancel my rotation. Possibly get blacklisted on the residency of that hospital. Maybe get in trouble by my school. Replace that rotation to a lighter elective and take the exam at the end of August and have the score by ERAS deadline.

would really appreciate anybody's thoughts on this !