DO students are required to take the Comprehensive Osteopathic Medical Licensure Examination (COMLEX-USA) that is administered by the National Board of Osteopathic Medical Examiners (NBOME). This exam is a prerequisite for DO-associated residency programs, which are available in almost every specialty of medicine and surgery. DO medical students may also choose to sit for the USMLE if they wish to take an MD residency and about 48% take USMLE Step 1. However, if they have taken COMLEX, it may or may not be needed, depending on the individual institution’s program requirements.