When to take it: Ideally 3–4 weeks before your COMLEX Level 1 date, after completing one pass of a Q-bank (e.g., TrueLearn, Combank) and reviewing OMT.
Score interpretation:
Post-exam review: NBOME provides a breakdown by system and competency. Do not just look at the score—analyze every OMM question you missed. Students often lose points on simple viscerosomatic reflex tables.
Students often ask: Which COMSAE should I take? Here is the hierarchy as of 2024–2025.
| Form | Difficulty | Predictive Value | Best Used For | | :--- | :--- | :--- | :--- | | Form 106 | Easier | Low (Over-predicts) | Early baseline (8 weeks out) | | Form 107 | Moderate | Moderate | Mid-dedicated (4 weeks out) | | Form 108 | Harder | High (Most Accurate) | Final predictor (1-2 weeks before COMLEX) | | Form 109 | Hardest | Moderate (Under-predicts) | Stamina/Stress test | | Form 110 | Variable | New (Limited data) | Extra practice if needed | comsae form 108
Verdict: Most academic advisors and high-scoring students report that COMSAE Form 108 correlated within 10-15 points of their actual COMLEX Level 1 score. Form 106 often gives a false sense of security (scoring 550 on 106 but 480 on COMLEX). Form 108 does not inflate.
The NBOME releases multiple forms of the COMSAE to prevent cheating and to provide retakes. The most common forms currently in circulation are:
COMSAE Form 108 is currently the most frequently mandated form for "mid-dedicated study period" assessments. Many schools use it as the final gatekeeper before allowing students to schedule COMLEX Level 1.
Form 108 is notorious for specific "weed-out" questions. Watch out for these traps: When to take it: Ideally 3–4 weeks before
Trap #1: The "Next Best Step" vs. "Most Likely Diagnosis"
Trap #2: OMM Timing Questions
Trap #3: Biostats Misreading
Trap #4: Pharmacology Side Effects
For osteopathic medical students, the transition from didactic learning to boards preparation is marked by a series of pivotal assessments. Among the most talked-about is the COMSAE (Comprehensive Osteopathic Medical Self-Assessment Examination) Phase 2 Form 108. Designed as a practice exam for COMLEX Level 1, Form 108 has gained a reputation as one of the more predictive and challenging self-assessments offered by the NBOME.
Because Form 108 is best taken 1-2 weeks before your real COMLEX, your prep should be aggressive.
Test-takers generally report Form 108 as a "fair" exam, but it is often noted for having vague answer choices in OMT and requiring distinct "buzzword" associations in Internal Medicine. The exam heavily tests the ability to differentiate between similar conditions (e.g., different types of anemia or skin lesions).
