(Note: exact field names/order vary by local version. Use these as a template.)
COMSAE Form 108 is a valuable, NBOME-endorsed self-assessment tool specifically designed for DO students preparing for COMLEX-USA Level 1. Its widespread use as a school-mandated readiness exam makes it a critical milestone in osteopathic medical education. While it offers strong predictive value for COMLEX success, students should supplement it with additional question banks and newer COMSAE forms (109, 110) for comprehensive preparation.
Report prepared for osteopathic medical students, faculty, and academic advisors. Data current as of 2025–2026 academic cycle.
The COMSAE Phase 1 Form 108 is a standardized self-assessment examination designed by the National Board of Osteopathic Medical Examiners (NBOME) to help osteopathic medical students gauge their readiness for the COMLEX-USA Level 1 licensure exam. Exam Structure and Format Total Items: Form 108 typically consists of 176 items.
Sections: The exam is divided into four sections, with each section containing 44 questions.
Format: All questions are in a single-best-answer, multiple-choice format.
Media: Some items may include images, visual exhibits, or videos. Content Coverage
The content of Form 108 is aligned with the COMLEX-USA Level 1 blueprint and is based on two primary dimensions:
Dimension 1 (Competency Domains): Covers seven categories of foundational competency in osteopathic medicine.
Dimension 2 (Clinical Presentations): Covers ten categories focused on clinical scenarios and patient presentations.
Core Topics: Questions test foundational biomedical sciences and Osteopathic Principles and Practice (OPP). Key Characteristics
Self-Assessment Only: COMSAE forms, including 108, are intended for self-evaluation and are not designed to be official score predictors, though many students use them to estimate their COMLEX performance.
Scoring Feedback: While it provides a numerical score, COMSAE generally does not provide correct answers or explanations for the questions, making it more of a "gauge" than a primary learning tool.
Correlation: Recent studies show a strong positive correlation (
) between COMSAE Phase 1 performance and actual COMLEX Level 1 results.
For more specific information on registration or accessing these forms, you can visit the NBOME COMSAE Phase 1 page. COMSAE Exam Guide: Structure, Scoring, Phases & Study Tips
The fluorescent lights of the library hummed with a frequency that seemed to vibrate directly against Dr. Evans' skull. It was 2:00 AM. The air smelled of stale coffee and desperation.
Evans stared at the screen. The text at the top read: COMSAE Form 108.
Legend among the medical students held that Form 108 was not merely a practice exam. It was a rite of passage, a psychological gauntlet designed by the NBOME not to test knowledge, but to test the limits of the human spirit. It was the "Ghost in the Machine," the form that seemed to know exactly which obscure metabolic disorder you had skipped, or which renal physiology concept you had only half-understood.
Evans clicked "Begin."
Question 1: A 34-year-old male presents with a feeling of impending doom...
"Classic," Evans muttered, rubbing his eyes. "Start with the panic attack, then hit me with the pheochromocytoma."
But the question didn't ask for the diagnosis. It asked for the specific enzymatic defect associated with a genetic precursor to the condition, located on a chromosome number that Evans was suddenly unsure existed.
He marked it and moved on.
Question 47: The room seemed to get colder. Evans was deep in the "Zone of 108." This was the section where the vignettes stopped making sense. A patient had a rash, but also a heart murmur, and had recently returned from a trip to a specific river in Egypt. The answer choices weren't bacteria or viruses; they were vectors. Snail? Mosquito? Sandfly? Tse-tse fly?
Evans knew the answer was Schistosomiasis. He knew it was the snail. But Form 108 was tricky. It offered Biomphalaria or Oncomelania. Did it matter? In Form 108, everything mattered.
He selected Biomphalaria and immediately felt a phantom sensation of a wrong answer, a ghostly tug of regret.
Time Remaining: 1:45:00
He was falling behind. The clock was the true antagonist of the story. He sped through a block of musculoskeletal questions, his brain auto-piloting through rotator cuff muscles and ankle ligaments. Then, he hit the wall.
Question 84: A graphic of a complex cardiac cycle is shown. Point Y indicates...
The graph looked like a seismograph reading of an earthquake. It wasn't a standard Wiggers diagram. The lines were jagged, distorted. Evans stared at it. The silence of the library pressed in on him. He looked at the options: A) Mitral valve opening B) Aortic valve closure C) Rapid ventricular filling D) The exact moment the patient realized they forgot to pay their taxes
"Option D looks tempting," Evans whispered to the empty room. comsae form 108
He was hallucinating. That was the effect of Form 108. It stripped away your confidence until you were a raw nerve, guessing between 'C' and 'D' not because you knew the answer, but because 'C' looked friendlier.
Time Remaining: 0:15:00
The final block. Evans was sweating. His heart rate mimicked the tachycardia of the patient in Question 112. He had five questions left. He was clicking blind, trusting his "gut"—a gut that had been wrong about so many practice questions before.
Question 148: A mother brings in her child...
He didn't even read the stem. He saw the buzzwords. "Blue sclera." "Multiple fractures." He clicked Osteogenesis Imperfecta. He didn't check the type. He didn't check if it was Type I or Type II. He just wanted to finish.
End of Exam.
The screen faded to black for a moment. Evans sat back, the adrenaline crash hitting him hard. The screen flickered back to life.
REPORT.
The loading bar was agonizingly slow. When the numbers finally appeared, Evans didn't scream. He didn't cry. He just stared.
Predicted Score: 475.
It was the threshold. The bare minimum. The 'P' in a world of 'F's.
He had survived Form 108. He had entered the valley of shadow and doubt and emerged, barely, on the other side. He closed his laptop. The sun was beginning to peek through the library blinds. He stood up, knees cracking, and walked out into the morning light, a survivor of the ghost story that haunts every medical student's dreams.
The COMSAE Phase 1 Form 108 is a critical self-assessment tool designed by the National Board of Osteopathic Medical Examiners (NBOME) for osteopathic medical students preparing for the COMLEX-USA Level 1 exam. It provides a simulated testing experience that aligns with the official COMLEX-USA blueprint, helping candidates gauge their knowledge of foundational biomedical sciences and osteopathic principles. Exam Structure and Format
Form 108 follows a standardized format consistent across Phase 1 COMSAEs:
Total Items: 176 single-best-answer, multiple-choice questions.
Organization: Divided into four sections of 44 questions each.
Timing: Candidates typically have up to four hours to complete the exam, mimicking the pacing required for the actual COMLEX-USA.
Features: Includes visual exhibits such as images and, in some forms, video clips requiring headphones. Key Content Areas
The content distribution of Form 108 reflects the COMLEX-USA Level 1 blueprint, covering clinical presentations and competency domains: Musculoskeletal System: ~13% Community Health and Wellness: ~12% Gastrointestinal and Respiratory Systems: ~10% each Nervous System and Mental Health: ~10%
Other Systems: Includes Endocrine, Genitourinary/Renal, and Integumentary systems, as well as Human Development.
Specific high-yield topics frequently encountered in Form 108 reports include Apgar scales, pulmonary embolism CT findings, and diagnostic tests for conditions like neonatal respiratory distress syndrome (NRDS) or mononucleosis. Scoring and Interpretation
COMSAE Form 108 provides a three-digit standard score that helps students categorize their performance: Lower Performance: Less than 400 Average Performance: 400 to 649 Higher Performance: Greater than 649
The COMSAE Form 108 is a practice examination developed by the NBOME to help osteopathic medical students prepare for the COMLEX-USA licensure exams. Form 108 exists for both Phase 1 (Level 1) and Phase 2 (Level 2 CE), and it is frequently utilized by schools to gauge a student's readiness to sit for the official boards. Examination Structure
The format differs based on whether you are taking the Phase 1 or Phase 2 version:
Phase 1 (Level 1 Prep): Consists of 176 items divided into four sections of 44 questions each.
Phase 2 (Level 2 CE Prep): Consists of 160 items divided into four sections of 40 questions each.
Question Type: All questions are single-best-answer multiple-choice and may include images, visual exhibits, or videos. Scoring & Performance Levels
The NBOME uses a standard score ranging up to 800 to categorize performance: Higher ( >649): Indicates high performance and readiness.
Average (400–649): Scoring above 400 is generally considered a signal of a high likelihood of passing the COMLEX.
Lower ( <400): Indicates a need for further remediation and continued study. High-Yield Content & Student Insights
Community feedback from forums like r/comlex suggests several recurring high-yield topics specific to Form 108: (Note: exact field names/order vary by local version
Osteopathic Principles: Focus heavily on Viscerosomatics, Chapman points, and Needle Decompression (reportedly appeared in multiple questions).
Clinical Specialties: Significant emphasis on OB/GYN, Ethics/Legal issues, and Endocrinology (specifically thyroid panels).
Diagnostic Tools: Be prepared for questions on PFTs (Pulmonary Function Tests) and interpreting screening guidelines based on patient demographics.
Difficulty Note: Many students report that Form 108 can feel "vague" compared to common Q-banks like TrueLearn. Some users noted a stricter grading scale where a single wrong answer may result in a significant point drop (up to 15 points). Correlation to COMLEX
COMSAE 108 (Phase 3) Clinical Reasoning & High-Yield Breakdown
Disclaimer: The following information is based on aggregate test-taker feedback and typical COMLEX testing patterns. It is intended for educational purposes and last-minute review. It does not reproduce actual exam questions.
Q: Is COMSAE 108 harder than COMLEX? A: Subjectively, yes. Many students find it harder because it has no experimental questions. Objectively, the topics are identical.
Q: Can I take COMSAE 108 at home? A: Depends on your school. Some allow remote proctoring; others require in-person.
Q: How many times can I take COMSAE 108? A: Once. NBOME does not allow retakes of the same form. If you need another assessment, buy Form 109.
Q: Do schools see my COMSAE 108 score? A: Yes. If your school paid for it, they receive the score report automatically. If you bought it independently, you can choose to share it.
Q: What is the passing score for COMSAE 108? A: There is no official "pass" for a practice exam, but most COMLEX-gated schools require >450 to sit for Level 1.
COMSAE Form 108 is a standardized self-assessment exam designed for osteopathic medical students to gauge their readiness for the COMLEX-USA Level 1 or Level 2-CE. Developed by the National Board of Osteopathic Medical Examiners (NBOME), this form mimics the structure and content distribution of the actual licensure exams. Exam Structure & Format
Question Volume: Standard COMSAE forms typically contain 176 items.
Question Style: Single-best-answer multiple-choice questions.
Time Management: Form 108 often features shorter question stems than the actual COMLEX, which can lead to timing discrepancies during the real exam if students don't practice with a manual timer.
Scoring: Students receive a standard score and a performance profile across different competency domains. Content Domains
The exam is organized around two primary dimensions defined by the NBOME:
Dimension 1 (Competency Domains): Covers clinical skills, patient safety, and osteopathic principles.
Dimension 2 (Clinical Presentations): Focuses on organ systems (e.g., musculoskeletal, cardiovascular) and specific patient demographics. Student Feedback & Preparation
Based on community consensus from platforms like Reddit's r/comlex, Form 108 is frequently cited as:
"Vague" and "First-Order": Many users find the questions simpler or more direct than the actual COMLEX but criticize the lack of detail in question stems.
Predictive Value: Students report mixed results regarding its score accuracy; some find it underpredictive, while others note it may not fully capture the complexity of the actual Level 2 exam.
High-Yield Subjects: Focus heavily on Osteopathic Manipulative Medicine (OMM), clinical ethics, and foundational medical sciences. Top Study Resources
Question Banks: TrueLearn and Comquest are the most common tools used alongside COMSAE forms.
OMM Review: "Dirty Medicine" YouTube playlists and the Savarese "Green Book" are highly recommended for the osteopathic sections.
Self-Assessment: Reviewing the score report bar distribution to identify weak organ systems rather than focusing solely on the numerical score. COMSAE Phase 2 - NBOME
You're looking for information on "Comsae Form 108" related to a paper, likely in the context of medical education or assessment. Here's what I found:
What is Comsae Form 108?
Comsae (Comprehensive Self-Assessment Modules) forms are practice exams or assessments used by medical students, particularly those in their clinical years, to evaluate their knowledge and preparedness for board exams or other high-stakes tests.
Specifically about Form 108:
Form 108 is one of the Comsae assessments, likely focused on a specific medical discipline, such as internal medicine, surgery, pediatrics, or another area. Encounter details
Paper-based or digital format:
Historically, Comsae assessments were provided in a paper-based format, where students would complete a printed booklet with multiple-choice questions. However, it's possible that digital versions or online platforms have been adopted since then.
What does the paper contain?
The Comsae Form 108 paper likely contains:
The exact format and content may vary depending on the specific Comsae assessment and the discipline being tested.
The COMSAE Phase 1 Form 108 is a 176-question self-assessment tool designed by the NBOME to evaluate readiness for the COMLEX-USA Level 1 exam. It is structured into four sections of 44 questions each, focusing on foundational biomedical sciences and osteopathic principles. High-Yield Content & Topics
Students and official resources identify several recurring clinical presentations and disciplines on this specific form: Osteopathic Principles and Practice (OPP):
Chapman Points: Particularly those related to the chest and pelvic organs.
Viscerosomatics: High emphasis on matching organ systems to their corresponding spinal levels, similar to OPP Shelf exams.
Techniques: Specific questions on Still Technique (starting in the position of ease) and direct vs. indirect methods like FPR. Clinical Disciplines:
OB/GYN: Heavy focus on this area, including screening questions based on age and demographics.
Respiratory: Pulmonary Function Tests (PFTs), diagnosing Neonatal Respiratory Distress Syndrome (NRDS) with chest X-rays, and identifying tension pneumothorax.
Pediatrics: Identification of Kawasaki Disease (CRASH criteria) and Measles (rubeola) requiring airborne precautions. Pharmacology & Ethics:
Drug Side Effects: High-yield triggers like drugs causing Stevens-Johnson Syndrome (CLAPPPERS: Carbamazepine, Lamotrigine, Allopurinol, etc.).
Public Health: Strong presence of ethics and different types of medical studies (e.g., cross-sectional studies for prevalence). Exam Structure & Scoring COMSAE Phase 1 - NBOME
COMSAE Form 108 is a Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) primarily used by students preparing for the COMLEX-USA Level 2-CE (Phase 2) [1, 5, 20]. It is designed by the NBOME to gauge a candidate's readiness and knowledge base before the official licensure exam [6, 17]. Core Content Areas
Form 108 follows the standard Phase 2 blueprint, which focuses on clinical presentations and competency domains [3, 9]. Key topic distributions typically include:
Musculoskeletal System (13%): High emphasis on OMM and orthopedic injuries [3, 14].
Community Health & Wellness (12%): Ethics, health promotion, and patient safety [3]. Major Systems (10% each):
Gastrointestinal System (e.g., chronic GERD, dysphagia) [2, 3].
Respiratory System (e.g., NRDS diagnosis, pulmonary embolism findings) [3, 8]. Circulatory and Hematologic Systems [3].
Nervous System and Mental Health (e.g., antipsychotic medications, delirium) [3, 8].
Specialty Areas (5% each): Endocrine, Genitourinary/Renal, and Human Development/Sexuality [3]. Exam Style & Characteristics
Students often compare Form 108 to other assessment tools like COMSAE Form 111 or TrueLearn [13, 21]. Notable characteristics include:
Question Format: Features short, "one-liner" or few-sentence stems, which can be significantly shorter than actual COMLEX Level 2 stems [20, 22].
Difficulty: Often described by students on Reddit r/comlex as having high repetition of Osteopathic Principles and Practice (OPP) questions [13, 20].
Answer Keys: Unlike older forms, the NBOME now launches answer keys for student-purchased COMSAE forms to aid in self-review [12]. Scoring Interpretation
The NBOME grading scale for COMSAE results is categorized as follows [18]: High Performance: Scores higher than 649. Average Performance: Scores between 400 and 649. Low Performance: Scores lower than 400.
Unlike the older 105b or 104, Form 108 was written to reflect the newer COMLEX blueprint, which includes:
Unlike the real COMLEX, COMSAE 108 does not have experimental questions removed from the scoring. That means it may feel harder than the real exam because every question counts. Many students report scoring 20-30 points higher on the actual COMLEX than on Form 108.
Case Study: Student A scored 465 on COMSAE 108 (failing threshold at her school). She delayed COMLEX by 3 weeks, hammered OMM and biostats, and scored 510 on the real exam.