Sophisticated high-stakes licensure and specialty certification maintenance examinations are educational requirements in osteopathic medicine. Passing the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) USA Level 1 is one of the crucial milestones that osteopathic medical students (DO students) must achieve while starting clinical rotations and before applying to residency programs. While standardized examinations are often used for gatekeeping purposes, the broader goal of COMLEX USA Level 1 is to assess competent osteopathic physicians. This manuscript aims to assist DO students as well as osteopathic medical educators, learning specialists, medical advisors, and administrators in preparing a successful plan for the COMLEX USA Level 1. The tips within this manuscript align with the information taught in osteopathic medical school curricula, including osteopathic principles and practice (OPP), osteopathic manipulative treatment (OMT) and the content outline found within the National Board of Osteopathic Medical Examiners (NBOME) blueprint. The planning tip system is (1) Doctor of Osteopathic Medicine (DO) curriculum focus; (2) OPP/OMT content study; (3) Practice using clinical scenarios; (4) Review the NBOME blueprint; (5) Effective practice using question banks; and (6) Practice using full-length exams. Issues related to allocating DO students' time in preparation for the exam while providing useful resources to learn planning strategies and practice with board-style questions are discussed. Using the DO PREP tip system in this manuscript, DO students can develop more effective board preparation strategies to improve their success on COMLEX USA Level 1. This opinion-based article describes some but not all tips for osteopathic medical students to plan their COMLEX USA Level 1 board preparation.