NBMEs for USMLE Step 1: What You Need to Know (2020)


One of the best ways to gauge your progress and predict your USMLE Step 1 score is through the NBME CBSSA (Comprehensive Basic Science Self Assessment) exams. Below I answered some common questions on using NBMEs for step 1 preparation.


When should I take my first NBME?

  • Considering that each test costs $60, it’s not a great idea to take one when you’re not ‘ready’. However, you need to take one early enough in your studying to serve as your baseline score. Personally, I took my first NBME after I completed one pass through the material. This was after week 2 of dedicated. I recommend taking your first NBME either week 1 or 2 of dedicated!

Which NBMEs should I take?

  • Midway through my dedicated period, NBME released new practice exams (Forms 20, 21, and 22). I took 17 and 18 when the newer ones weren’t available then took 21 and 22. Forms 23 and 24 will be released later this spring. I suggest taking the newer exams (try to take all 5 new ones!)

Should I take any other practice exams?

  • Yes! You can and should take Uworld Self Assessments (UWSA) 1 and 2. UWSA1 slightly overpredicts and UWSA2 is generally thought to be pretty accurate. I don’t recommend taking Kaplans or other practice exams because since they’re not superior to NBMEs/UWSA.

How often should I take practice exams?

  • Most students take 1 practice exam a week. This can be an NBME or UWSA.

How many practice exams should I take?

  • If you scheduled one each week of dedicated (starting at week 1 or 2), this would total to about 7 practice exams (5 NBMEs + 2 UWSAs) over the course of 7 weeks. Try not to take them too close together because you may get discouraged if you don’t see a significant increase in your score.

Should I take two NBMEs back-to-back to simulate an 8-hour exam?

  • This is a personal preference. I did, but I don’t think it’s necessary. Having studied pretty intensely for ~10 hours a day, taking an 8-hour exam is not much different. Personally, on test day I did not struggle with stamina (except for the last block). If you know this is something you’ll struggle with, then I would recommend simulating the full 8-hour exam with back-to-back NBMEs. However, try not to do it too close to your exam (to avoid burnout). If you do an 8-hour practice test, aim to do it at least 2-3 weeks from your exam.

Other notes:

NBMEs have been known to be the most accurate predictors of your score. However, I’m not sure if this is still true for the newer exams. I personally scored much higher on the real exam than I did with any of the NBMEs. The free 120’s that I took 2 days before my exam was the best predictor.

NBMEs aren’t as great for learning due to the lack of detailed answers. Since the NBMEs don’t provide answer explanations, you’ll have the search online forums for them. If you don’t find a good answer online and you still can’t find one after referring to your resources, take what you can from the question and move on. This is especially true for the newer NBMEs where there is not yet well-developed answers explanations.

In my experience, the actual Step 1 exam is more similar to UWorld and the free 120 questions.


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