Your first NBME is all about setting a baseline.
I will say it unequivocally: It is essential to take an NBME at the very beginning of your study period. This is an often overlooked and underappreciated test. There are a number of ways in which this will set the pace for your studying.
First off, your role as student and hardcore test taker are very different. In lectures, we are constantly on the receiving end of information, and we are guided along by instructors and syllabi. Once your intensive study period begins, you become the instructor as well as the pupil. You must develop the syllabus, hold the student (YOURSELF) accountable, and not only be an absorb information, but synthesize material, and produce answers. While it’s easy to say that you will flip the mental switch, starting this period with an NBME is a more effective way to set the pace, and begin to reframe your mind and attitude as a test taker.
Also, as we have mentioned in previous articles, NBME numero uno gives you an accurate 3-digit score and tells you where you are right now, and how far you’ve got to go. While you should give yourself entirely to studying during your study period, you might find yourself adjusting the length of the period based on your score. If you are close to your goal score, 4-5 weeks might be enough for a comprehensive review of material. Need to find a way to add 70 points to your score? Stretch that period out to 6+ weeks for sure. Another bonus: Your NBME score report will tell you, with complete objectivity, in which subjects you must focus your efforts greatest.
Your second (and third) NBME exams are about continuity and tracking progress.
These NBMEs serve as milestones in gauging the effectiveness of your studying. What you are looking for here is a general trajectory leading towards your goal score. While there may be a speed bump along the way, your NBMEs should show improvement over time. All along the way, you will get exposure to more and more different types of NBME questions, and in the end of your study period, more questions equals higher score.
In terms of continuity, NBME tests keep you in top form. They’re like the season games leading up to the championship, and they add to your weeks of practice and training. You bring your A-game and perform to the best of your ability, utilizing all of the training and knowledge you have assembled throughout the week(s). After a season full of weekend games, you will be ready for the championship—test day—in all of its glory.
Your final NBME does not necessarily tell you your final USMLE Step 1 score.
When it comes to your final NBME, you might think it’s sole purpose is to tell you “This will be my score on test day.” While it can serve as an accurate predictor of where you are, this is not your real Step 1 score. If you are satisfied with the outcome, continue to maintain knowledge, and keep doing what you are doing. If something went awry and you are below your goal, assess where things went wrong, what subjects tripped you up, and do what it takes in the final two weeks to patch up these holes. If you scored significantly lower than you wanted or needed to, figure out why, and put some serious consideration into postponing your test. Pushing test day back is not a disaster; performing less than your best on Step 1 can be.
Schedule your final NBME test with a comfortable 2 week buffer before your Step 1 exam. This will give you time to review the test, utilize what you have learned from it, and decompress a bit. You want to have full stamina and energy for the real test—you definitely don’t want to carry a tough NBME hangover into Test Day.
One last tip: Do not become downtrodden if your score goes down! This happens, and many students have a poor NBME performance along the way. Stay focused, utilize the test for it’s intention - to let you know where you are and where you can improve.