COMLEX Level 2-CE Passing Score: What 400 Means
You open the NBOME email and see a 3-digit number staring back. The COMLEX Level 2-CE passing score is a standard score of 400 or higher, NBOME's recommended minimum.
That 3-digit standard score is derived from number correct. It isn't a percent or a percentile. A 399 fails, a 400 passes.
This page explains how the 3-digit score is built, why a state board can set its own minimum, and what your number does and doesn't tell residency programs.
What is the COMLEX Level 2-CE passing score?
The COMLEX Level 2-CE passing score is a standard score of 400 or higher. NBOME identifies 400 as the minimum passing level it recommends, and the pass or fail decision is based solely on that threshold. A score at or above 400 is a pass, below 400 is a fail.
Your Level 2-CE report shows a 3-digit standard score and a pass or fail result. That score is not a percentage, it's derived from your total number correct on scored items and then converted to the reporting scale.
NBOME's own wording says passing is solely based on achieving 400 or higher, with 400 reflecting the minimum passing level it recommends, per NBOME's example score report.
Context across levels helps frame the number. Level 3 uses a passing standard of 350. Level 1 is reported as pass or fail only as of May 10, 2022.
For the 2025 to 2026 cycle, 92.5 percent of 9,096 first-time takers passed Level 2-CE, and 82.1 percent of 780 repeat takers passed, per NBOME's performance data.
This is a written, computer-based exam, not an OSCE, where examiners score you live with checklists and global ratings, see how OSCE examiners mark.
How does the 3-digit standard score work?
The COMLEX Level 2-CE standard score converts the number of scored questions you answer correctly into a 3-digit scale, and that scale sets pass or fail at 400. Unscored pretest questions appear on the exam but don't count toward that raw total, and every scored item contributes equally before scaling.
Level 2-CE is a one-day, computer-based test with 320 single-best-answer questions delivered in two timed sessions of 4 hours each. You work through them in sections, but only your total number correct on scored items feeds the standard score.
NBOME describes the standard score as model based, meaning it accounts for your responses and the exam's psychometric properties after the equal-weight raw total is tallied. See NBOME's scoring page for how raw totals become the 3-digit standard score used for pass or fail.
A standard score is not a percentage and not a percentile.
How many correct answers equals 400? The NBOME pages we read don't give a raw cut, so you won't find a "get X right" threshold.
Other high stakes exams also report scaled scores. For context, here's how the NAC scale works for the Canadian clinical exam, which also uses a scaled score.
Why can a state set its own minimum?
For COMLEX Level 2-CE, licensing authorities may accept NBOME's recommended passing level or set an alternate minimum for their jurisdiction, per the score report. The COMLEX Level 2-CE passing score of 400 is NBOME's recommendation, but licensure decisions sit with the state.
Practical move if you plan to practice in one state, check that board's posted minimum before acting on a borderline result. We don't list state rules here because none were checked.
How the 400 line was set: NBOME uses criterion referenced standard setting, an absolute standard, not a curve against other candidates. Methods include a modified Angoff, with reviews every 3 to 5 years, last reviewed February 2023, implemented June 2023, next due February 2028, per NBOME's standard-setting page. A cut score can change after a review.
USMLE graduates later meet a different scoring format on Step 3's case component, see Step 3 case simulations.
What the score does and doesn't tell residency programs
A COMLEX Level 2-CE score is the 3-digit number DO students carry into residency applications, since Level 1 went pass/fail on May 10, 2022. It tells programs you met the passing standard of 400 and shows where your total sits on NBOME's standard-score scale. It doesn't describe how you take a history or talk to a patient.
NBOME supports review that looks at the whole application rather than one number, per the Coalition for Physician Accountability's recommendations, and notes growing support for the equivalent use of COMLEX-USA and USMLE in residency applications.
What it does tell you
- Pass status at 400 or higher, and your 3-digit standard score derived from total questions correct.
- Where that number maps within your cycle via NBOME's percentile converter, which varies by cohort and is interim for 2026-2027 until April 24, 2027.
- A Performance Profile across 7 competency domains, 10 clinical presentations, and 8 disciplines, situated against first-time takers who passed.
What it doesn't
- A measure of bedside behaviors like rapport, listening, or patient education.
- Stable subscores, since each rests on fewer items and is less reliable than your total.
- Material for applications, as NBOME strongly cautions against using the Performance Profile for rotations or residency.
If you want reps on clinical reasoning out loud, you can talk through a case with an AI patient.
Where the points sit: clinical reasoning in vignettes
COMLEX Level 2-CE concentrates much of its scoring weight inside clinical vignettes that test patient-care reasoning. Per NBOME's blueprint, Osteopathic Patient Care and Procedural Skills is at least 30 percent and Application of Knowledge for Osteopathic Medical Practice at least 26 percent, so most points sit in decisions about diagnosis and next steps within patient scenarios.
- Osteopathic Patient Care and Procedural Skills, 30%
- Application of Knowledge for Osteopathic Medical Practice, 26%
- Osteopathic Principles, Practice, and Manipulative Treatment, 10%
- Practice-Based Learning, 7%
- Professionalism, 7%
- Communication, 5%
- Systems-Based Practice, 5%
Some questions include images, videos, or audio clips, which you'll see in the Level 2-CE format.
NBOME announced Blueprint 2.0 on September 23, 2026, keeping seven competency domains and ten clinical presentation categories, so check the Level 2-CE blueprint before you sit.
The blueprint weights tell you where the points are. A vignette asks you to read a history, decide what matters, and commit to the most likely answer among plausible distractors, which is the same move as building a ranked differential.
Practicing the reasoning behind the questions
Practicing the reasoning behind COMLEX Level 2-CE vignettes means drilling the move from first symptom to working diagnosis under time pressure. Question banks test recognition; another way to practice the same move is to work a case from the patient's first words to a committed diagnosis, asking for missing data, ordering studies, and discarding distractors that don't fit.
Diagnosica is an AI clinical simulator for medical students and junior doctors: you take a history from an AI patient by voice or text, order labs and imaging, commit to a diagnosis and management plan, and get a competency scorecard. Patients appear as video avatars, it's free to start, no card needed, and there are apps on iPhone, Android, and web. Each case has a differential with named distractors, plus a two-minute quick case with five clues for a daily habit. It's used by learners outside the US. Not a COMLEX question bank, not built for or scored against COMLEX, no physical exam or OMT practice, and it won't tell you your score. It doesn't give advice about real patients, and it's not a diagnostic system. Treat every output as educational.
If you're comparing study aids, here's a roundup for the parallel USMLE exam: AI tools for Step 2.
Common questions
Is 400 a good score on COMLEX Level 2-CE?
A COMLEX Level 2-CE score of 400 is the minimum passing level recommended by the NBOME, and passing is solely based on achieving a standard score of 400 or higher. Whether a score is considered competitive depends on the percentile for your testing cohort from the NBOME Percentile Score Converter and on individual programs.
How long do COMLEX Level 2-CE scores take to come out?
COMLEX Level 2-CE scores are generally available within 2 to 6 weeks from the end date of a testing window. The NBOME sends an email notification once results post, and you access your score report through the NBOME Portal. That timing refers to the window's end, not your test day.
Can I get my COMLEX Level 2-CE score rechecked?
COMLEX Level 2-CE offers a score confirmation process, which is a single additional review of your score available by request for a fee. That option is limited to one extra review. The three digit standard score reported remains the basis for your pass or fail outcome.
What is the passing score for COMLEX Level 3?
COMLEX Level 3 has a passing standard score of 350, per the NBOME's scoring information. COMLEX Level 1 is reported as pass or fail only. Passing standards are criterion referenced rather than norm based and are reviewed every 3 to 5 years by NBOME standard setting processes.
