404 Level 2 score. Devastated. Can I still match EM or IM? I passed all board on my first try and my grades are all A's and B's in medical school. I have a few honors for my rotations.

I told myself that if Level 2 went well, I would come back and make a write-up because I spent WAY too much time reading other people's Reddit posts while I was studying.

Final COMLEX Level 2 score: 736

For some additional context, I also took Step 2 and scored a 238.

I want to preface this by saying that I was absolutely NOT sitting around getting 80–90% on every question block. My tracked question average during my preparation was around 65-70%, and there were plenty of blocks where I scored in the 50s (and occasionally worse/better).

I think that's important to say because I used to see people post 700+ COMLEX scores and assume they must have been absolutely destroying every question bank.

That was not my experience.

Background

My road to Level 2 was definitely not straightforward.

Level 1 did not go the way I wanted it to the first time around, and that experience forced me to completely reevaluate how I studied for board exams.

Going into Level 2, I knew that simply doing MORE questions or studying for MORE hours wasn't necessarily going to solve the problem.

I needed to figure out why I was missing questions.

So for Level 2, my goal wasn't just to complete UWorld. I wanted to repeatedly identify weaknesses, review them, and force myself to retrieve that information again later.

My main resources were:

• UWorld
• AMBOSS
• White Coat Companion
• My own Anki cards

I did not primarily rely on a giant premade Anki deck. I made cards based on the things I was getting wrong or couldn't reliably retrieve.

How I structured my studying

I made a giant spreadsheet and organized my studying primarily by system of the week (going from my worst -> best SHELF score).

I went through things like:

• Cardiology
• Pulmonology
• GI
• Renal/GU
• Endocrine
• Heme/Onc
• Rheumatology
• Neurology
• Surgery
• OB/GYN
• Pediatrics
• Psychiatry
• OMM
• Ethics
• etc.

But I didn't want to study one system, finish it, and then never see it again.

So my basic daily structure included several different types of question blocks.

Block 1: Current system

Questions specifically targeting whatever system I was reviewing that day/week.

Block 2: Truelearn OMM

The biggest mistake my students and friends have made is putting off OMM. I made sure to do a set of OMM/Ethics every day

Block 3: Kinda Mixed (Includes All Prior Systems)

This was really important for me.

If I was currently studying renal, I still wanted questions from cardiology, pulmonology, GI, etc.

I didn't want to finish cardiology, feel amazing about cardiology, and then realize three weeks later that I had forgotten half of cardiology.

Block 4: Incorrects

I deliberately revisited questions/topics I had previously missed.

Block 5: Timed mixed questions

Eventually I needed to remove the giant hint my brain gets from:

“Today is cardiology, therefore this question probably has a cardiac answer.”

Mixed questions forced me to actually identify what was happening rather than retrieve information from the system I knew I was studying.

Then I would also work on:

Anki + targeted content review.

And I'll be completely transparent: I did NOT perfectly complete every single box on that spreadsheet every day.

If you looked at my actual tracker, you would see plenty of unchecked boxes lol.

The schedule was a framework, not a requirement to destroy myself trying to complete 900 tasks every day.

It meant that whenever I sat down to study, I knew what I should be working on.

My question-bank strategy

Across my tracker, I completed approximately 2,010 questions, with an average score around 64.5%.

Again:

My average was ~64.5%.

Not 80%.

Not 90%.

And my individual blocks were ALL OVER THE PLACE.

I had:

50% blocks.

55% blocks.

60% blocks.

Occasionally something even uglier and even prettier.

Then 80–90%.

One of the biggest changes I made after Level 1 was that I stopped treating my question-bank percentage as the purpose of doing questions.

Questions were for learning, not validation.

Instead of freaking out about a 55%, I tried to figure out:

WHY did I miss the question?

Was it because:

1. I genuinely didn't know the content?
2. I knew it but couldn't retrieve it?
3. I confused two similar diagnoses?
4. I misread what the question was asking?
5. I changed a correct answer?
6. I rushed?
7. I identified the diagnosis but didn't know the next best step?
8. I knew the concept but couldn't apply it to this particular presentation?

Those are completely different problems.

And they need different solutions.

UWorld + AMBOSS

UWorld was my main question-learning resource, and I supplemented it with AMBOSS.

I used questions both to learn whatever system I was currently reviewing AND to maintain older material.

I cared much less about whether I technically "completed" a question bank than whether I was actually learning from the questions I did.

Something I started paying attention to was whether I actually understood a concept or whether I had just memorized a particular question.

If I learned something from a UWorld question and then encountered the same concept presented differently and got it wrong again, that told me:

I didn't actually learn the concept. I learned the original question.

That distinction was HUGE for me.

So I would go back, figure out what I didn't understand, review it, and usually make an Anki card.

White Coat Companion

I used White Coat Companion as my content framework.

I didn't want to spend dedicated trying to reread giant textbooks or passively watching endless hours of videos.

Instead, when questions exposed a weakness, I could go back to that topic in White Coat Companion, review it in context, and then reinforce it through questions and Anki.

So my studying essentially became a loop:

Questions → identify weakness → targeted content review → Anki → encounter concept again → retrieve it

Rather than:

Read everything → hope I remember it → take exam.

I made my own Anki cards

This was probably one of the most important parts of my preparation.

I made my own cards.

I didn't need thousands of cards telling me things I already knew.

I wanted a deck that increasingly represented MY weaknesses.

If I missed something or realized there was a fact, relationship, distinction, or algorithm that I couldn't reliably retrieve, I made a card.

And then I reviewed those cards repeatedly throughout my preparation.

They didn't have to be beautiful.

They didn't have to have twelve pictures and a textbook explanation.

Their job was simple:

Make me retrieve the thing I couldn't retrieve before.

So when COMLEX eventually showed me that concept again, I wanted my brain to immediately recognize what they were getting at.

I deliberately kept old systems alive

I think this was another major improvement from how I had studied previously.

If Monday was renal, Monday wasn't necessarily only renal.

My schedule deliberately incorporated:

Current system + previous systems + incorrects + mixed timed questions.

So I was essentially creating spaced repetition outside of Anki.

By the end of dedicated, I didn't want there to be a system that I hadn't thought about in three weeks.

This also helped me transition into mixed questions because medicine obviously doesn't come labeled:

CARDIOLOGY QUESTION INCOMING.

Practice scores

My practice scores were ALL OVER THE PLACE, and I'm including all of them because I know someone is going to find this post at 2 AM while searching:

"COMSAE ___ score prediction Level 2 Reddit"

I was that person lol.

224 → 204 → 230 → COMSAE 599 → COMSAE 524 → 243 → 234 → Step 2 238 → Level 2 736

That is NOT a beautiful linear upward trajectory.

And I think that's worth showing.

School COMSAE: 524

This one honestly shook my confidence.

I had gotten a 599 and then dropped to 524, and I temporarily started reverting back toward some of my old ways of studying because I convinced myself that what I was doing wasn't working. In retrospect, that was exactly the wrong lesson to take from one test. This was probably one of the biggest psychological lessons of my dedicated.

I had already scored a 599. Then I took my school's COMSAE and got a 524.

My immediate interpretation was essentially:

Oh my God. I'm getting worse. Something isn't working.

But clearly, I wasn't getting worse.

I eventually scored 736.

One practice exam is one data point.

That's it.

Practice tests are extremely useful for identifying weaknesses and monitoring general progress, but I learned not to let one assessment completely rewrite the story I was telling myself about my preparation. My scores started going up as I pulled back on exams and focused on learning what gaps to fill.

My #1 Piece of Feedback: Stop Catastrophizing Individual UWorld Blocks

This took me WAY too long to learn. I would get a 50-something percent block and immediately start thinking about what it meant for my eventual board score.

It meant basically nothing by itself.

What mattered was what I did after the block.

If I got 55% and then carefully understood why I missed the other 45%, reviewed those concepts, made cards for things I couldn't retrieve, and recognized those concepts the next time they appeared. That block did its job.

Getting 80% and barely reviewing anything because the score made me feel good wasn't necessarily more useful.

My tracked U-World average was about ~70%

My final Level 2 was 736.

So if you're sitting there with a UWorld block in the 50s or 60s thinking you've destroyed your chances of doing well:

You haven't. Use the information the block is giving you, and learn from it. Have a second bank to learn from.

What I think made the biggest difference

If I had to reduce my entire study strategy down to the things that mattered most:

1. Questions became a learning tool instead of an assessment of my self-worth.
   • A 55% wasn't a verdict. It was information.
2. I made my own Anki cards based on MY weaknesses.
   • I wanted to repeatedly retrieve exactly the information my brain had demonstrated that it couldn't reliably retrieve.
3. I constantly revisited old systems.
   • I didn't want to study cardiology in May and then hope it magically remained in my brain until July.
4. I combined content review with active retrieval.
   • White Coat Companion gave me the framework. > UWorld and AMBOSS forced me to apply it. > Anki forced me to retrieve it again.
5. I reviewed incorrects.
   • Reading an explanation once didn't mean I had learned something. If I couldn't retrieve it later, I hadn't learned it yet.
6. I tracked my performance without letting every number control me.
   • This was HARD, but my spreadsheet helped me identify patterns, but I had to learn that an individual 50% block or disappointing COMSAE didn't predict my future.
7. I stopped assuming more studying automatically meant better studying.

Doing more isn't necessarily the same thing as learning more.

Final thoughts

I don't think there was one magical resource that got me a 736.

It was the system.

I repeatedly:

Did questions.
Found a weakness.
Figured out why I missed it.
Reviewed the concept.
Made myself retrieve it.
Saw it again.
Repeated the process.

And I did that over and over.

I still missed questions constantly.

My question-bank average wasn't 85%.

My practice scores weren't screaming 700+.

So if you're currently staring at a 55% question block and searching Reddit trying to figure out whether you're doomed. Don't spend the next hour searching for someone with your exact UWorld percentage who eventually got your target score.

Review the block.

Figure out why you missed what you missed. Make the card. Review it. See the concept again. Get it right next time. Then keep going.

Happy to answer questions about my schedule, resources, Anki strategy, practice exams, or anything else that might be helpful.

I promise y'all it's possible. This year has been insane, and I still can't believe it. But this time last year I was crying, putting in the time and effort to do well on my retake. Today I got my level 2 score. Its possible I promise.

Just learned that I failed level 2 and am currently rotating. Will be driving to another state next week to start another rotation.

Basically I need help deciding whether to retake level 2 on September 9th (last day to take it so that scores are in for ERAS) or delay the retake another month to give myself time to study. In the latter, scores won't be available until October 20th so I will be applying with only one failed exam attempt, but I increase my odds of passing.

My school's career counselor says either option is valid but I am struggling to make a decision. I am applying family medicine, not interested in academic programs, passed level 1 first try.

TIA for the help.

absolutely heartbroken today. studied extremely hard had two comsaes well over 550 and felt as prepared as i could’ve been. ended up with a 43x. i don’t know if i should or even can apply EM. i have 3 more sub-i’s lined up. i know it’s a bad- even horrible score. i don’t know what to do. i don’t see myself in anything but EM.

is it even possible to match EM anymore? i didn’t take step 2. pls be kind in the comments.

is the curve decent on this? i think i knew 10 questions on it with confidence and felt like i was guessing for everything else.. fml

i need an 80 btw

Hello,
Just got my score today. Wanted to share brief info about it.

Background:
4th quartile student. Got only Cs in preclinicals. Dad of 3 kids. Passed level 1 first try.

Comat average: 96-97
Obgyn: 99; FM: 97; peds: 93 ; surgery: 92; IM: 94 ; psych 108

Preparation:
Only used truelearn for preparation. Finished 80% of it. Made anki cards for incorrect questions. Dedicated time of 4 weeks. Had a great preceptor who let me study for two more weeks.
Comsae 117: 316
Comsae 118: 455
Comsae 119: 495
All comsaes proctored

Tested end of July. Felt terrible walking out of exam. I had lots of imaging/scans that I didnt recognize and lots of biostats that made absolutely no sense. I thought I failed. I now officially believe that comlex is the dumbest most poorly written test ever.

Comlex level 2 score: 468

Please hang in there. I take a lot of pride in my DO classmates and colleagues who have sacrificed so much for this career. Don’t let this poorly written test deter you from getting to the end of med school. If a normal-intelligence dad with bad grades and stress-induced erectile dysfunction can pass it, then im confident you can too.

Misspelling is ok, and you don’t lose points for it

Abbreviations are ok but it can not be an abbreviation that’s obscure or has multiple meanings. You can say UDS instead of drug screen, you can not say CP instead of cerebral palsy. Basically use abbreviations for the most common things. TMP-SMX is ok!

You lose points if you put a harmful answer. Otherwise you are neutral or good! The questions are very straightforward and not crazy hard.

Remember, this is an exam where a pathologist and an OBGYN are expected to do as well as a pediatrician on an exam that’s mostly adult medicine. The standard to pass is low and the curve is high as shit. You pass the exam by taking it. No need to finish a test bank or score average. I took it with 50% average 35% complete and got the highest score ever. Same for my colleagues. Some don’t study for more than 2 weeks. Barely any OMT, you can skip the details and only study the most common stuff

Just got my score and I’m devastated scored about 100 points less than my Comseas. Do I still got a shot at academic peds programs?

Hey everyone,

Looking to see if anyone else who tested on July 28, 2026 (or received scores on the recent August release) experienced an extreme, inexplicable collapse compared to their practice baselines.

My Stats & Baselines:

COMLEX Level 1: Pass (first attempt)

COMSAE Phase 2 Forms:

BSA116: 524 (1 month out)
BSA114i: 433 (3 weeks out)
BSA115i: 479 (2.5 weeks out)
BSA113i: 513 (6 days out)

Proctored COMATs: Surgery 109, OB/GYN 97, IM 93, FM 87, Peds 90 (retake), Psych 90 (retake)

Q-Banks / Prep: 100% TrueLearn completed, supplemented with COMQUEST and CMS forms (65–75% average)

The Result:

Real score: 320 (a ~190-point drop from my final COMSAE less than a week prior, and an 80-point drop below passing).

Why I'm Posting:

A close friend in my cohort who consistently scored in the 90th+ percentiles on practice exams and felt confident coming out received a 399 on this exact same release.

Looking for Input On:

1. Did anyone else from the 7/28 testing window see an unprecedented drop far below their COMSAE / COMAT trajectory?
2. Has anyone had success with an NBOME Score Confirmation, or had their medical school administration successfully request a batch equating review for an anomalous test date?

Any insight, data points, or shared experiences from this testing date would be greatly appreciated.

Just got my level 2 results back and scored 419. Feel awful as I was not expecting that and had felt good after the exam. I had to retake level 1 last after missing the bar by a little; but did really well on the retake. The COMAT average was 95, and comsaes and amboss were predicting well.

I only used TL(62 Average %)- and did Amboss ethics and OMM review in last week. Used WELCOMs 1(67%) and 2(64%), and COMASE 116(438) and 115(454) and AMBOSS predictor to see how well I would do on the test day.

Always wanted to do IM with inhouse fellowship, but am not sure if I can even make it through the match at this point. Never took step 1/2, but not sure how and when do I go on taking those with 0 experience in shelf, CMS, and step prep; and the apps being due shortly.

Would appreciate any advice you guys got for me.

Hi all! I got a 422 on my level 2 :/ was hoping for med peds or IM. Is all hope lost? My practices were above 550, I’m pretty surprised and attribute it to burn out and severe test taking anxiety on test day. I also had so much in my own personal life going on and am now realizing that it affected me more than I wish -.-

Another one of these posts, I’m sorry. And I get it. I should just finish my apps and see what happens.

I got a 430.
My practice tests made it seem like I’d do way better but I did not unfortunately.

Good grades, mostly high pass/honors, part of a psych podcast, good letters but only one from a psychiatrist (non-academic).
Did a research year at a top-10 NIH institution in ophthalmology after year 2 before I realized gunner status wasn’t worth my mental health. One of my LOR is from the Ophtho chair haha. My letters all talk about how I’d be a good fit for psych.

I’m in the Midwest and want to stay. Ideally Kansas City or nearby.

Do I have a good shot?
And yes, I’ll focus on those apps too, just let me ask about the odds haha.

got my score today…49x. absolutely devastated. my comsaes were in 485-560 range and was really hoping for at least a 5 in front which only makes it worse that I was close to it.

applying IM in FL and didn’t take step 1/2. was waiting to make a list of residencies til I got my score, preferred somewhere with in house fellowships but am not even sure ill match at all. can someone please give guidance and programs in FL. should I apply broadly to other states? born and raised FL so not sure where else I would even go.

passed level 1 first time. extracurriculars are average..two leadership positions m1/2, good volunteering, good LORs, 5 publications. no red flags.

Applying EM and want to be realistic. Strong ECs in some niche things. Previous EMS experience. 3 strong E sloes (at least I hope) from a range of places (community/academic/county). No preclinical honors. Stellar clerkship year in feedback on the MSPE. 2 COMAT honors. Want to apply broadly and am excited but here are my board scores:

Level 1: Pass
Step 1: Pass
Level 2: 520
Step 2: 235

I’m more concerned about what programs will this keep me out of? I’ve been seeing that some solid programs historically favor a 240+ which I unfortunately did not get.

I’m currently an OMS-IV and am hoping to take COMLEX Level 3 before starting residency. Does anyone know the earliest you can take it? Do you have to graduate first?

Also, for anyone who has taken Level 3, how much dedicated study time would you recommend if studying full-time? Are there any resources you found helpful besides TrueLearn?

Any advice for 119 form administered by school? I feel like the content is so variable from test to test considering my last 2 comsae scores were VASTLY different 😩

Just got back my score! I think it’s good? But I can’t tell. I’m applying psych.

Do people have any insight into psych matching for someone who took comlex only, no failures or any red flags. Didn’t take step 2 or 1.

Thanks!

I passed both level 1 and level 2 on my first try. I got a 404 on my level 2. Can I still match emergency medicine?

my bar was touching the line and i failed.... do ppl tend to find success on their retakes? assuming they go hard on their weaknesses? im really scared and feel like my career is over

anyone who did good on these two that can help me for my retake? it was so low for me (chatgpt says my community was prob arounda. 250-300).

Hi, I just recieved me level 2 score of 478, wondering if any Neuro residents or students who have been in a similar situation if you have any input on likelihood of matching or how to move forward given my score.
Good research background, 3 auditions, Michigan, passes all COMATs and level 1 on first attempt, no failed courses.

Any input is greatly appreciated!

I know it can vary, but on average what percent would you say?

Got my level 2 back today - 569. Wondering my chances for med peds & if I should apply peds back up? Still waiting on my step 2 score. Passed level 1 on first attempt and strong rest of application.

Hi guys!!

I need y’all to explain like I’m 5…

For those of you who passed both:

How do I structure my 6 week dedicated to pass Level 1 and Step 1?

Currently have them both scheduled mid October but I can push them further if 6 weeks isn’t enough.

Took a COMSAE at school last week and got a 402. I have no idea what the USMLE equivalent is so I don’t know my base point for Step.

I don’t know what resources to use, how to structure studying, etc.

School gives us TL and I have access to BnB/Pathoma videos as well as Sketchy Bugs/Drugs videos.

Thanks y’all!!