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Dr. Brian Radvansky contributed to this post, and we regularly keep this information up to date. 

NBME FAQ! Man, that’s a lot of capital letters. We often vilify the National Board of Medical Examiners for building hurdles for us to scale. Along with their right-hand man, the Federation of State Medical Boards, the NBME constructs everyone’s favorite tests, USMLE Steps 1, 2, and 3.

Luckily, we are not shoved off into the miasma of these tests without a little guidance. NBME self-assessments allow us to peer into the soul of the exam, and get a taste of what to expect. Sadly, NBME practice tests are a bit less user-friendly than our beloved UWorld, so we have compiled this simple FAQ to get you pointed in the right direction.

How do I sign up for an NBME practice test?

Start on the NBME Self-Assessment Services home page. Here you will find the links to the respective tests that you are looking for.

Where do I find Step 1 or Step 2 self-assessments on the NBME website? All I see are acronyms with a bunch of C’s and S’s!

It would be too simple to call the tests by the names you are expecting to see. Use this translation:

Comprehensive Basic Science Self-Assessment (CBSSA) = Step 1

Comprehensive Clinical Science Self-Assessment (CCSSA) = Step 2 CK

Comprehensive Clinical Medicine Self-Assessment (CCMSA) = Step 3 

What NBMEs are available for Step 1? 

Currently, the NBMEs that are available for the USMLE Step 1 are NBME numbers 18, 20, 21, 22, 23 and 24.

Are NBME self-assessments worth the $60 a pop if I already purchased and love UWorld and supplemental texts?

NBME tests are indubitably worth their $60 price tag. As much as we like shaking our fists at the company who already sets us back hundreds of dollars to register for their test as they milk us for another $60, paying the price is a necessary evil. NBME self-assessments offer you something that you cannot get anywhere else, making them invaluable.

Where can I find NBME self-assessment answer explanations?

As of this writing, NBME offers answer explanations for 16 forms in the Clinical Mastery Series:  forms 3, 4, 5, and 6 for Surgery, Medicine, Gynecology/Obstetrics, and as of January 2021: Pediatrics.

The great news for 2021 test takers is that NBME is adding answer explanations to ALL self-assessments over the next 18 months

2021 publication schedule for new NBME self-assessment answer explanations:

NMBE is releasing new answer explanations for self-assessments throughout the year.

Already available (as of January 4, 2021): Pediatrics forms 3, 4, 5, 6

Available February 19, 2021: Clinical Neurology forms 3, 4, 5, 6

Available March 4, 2021: CCMSA form 5

Available March 8, 2021: Psychiatry forms 3, 4, 5

I already purchased NBME self-assessments. Can I still get the new answer explanations?

If you purchased a self-assessment up to 90 days before the question explanations are released for that specific form, you will be able to access the explanations.

Where can I see the NBME self-assessment answer explanations?

You can only see the NBME-provided answer explanations after you complete your self-assessment. Whether you view the answers immediately or later on is up to you. Answer explanations are available in your MyNBME interactive score report. 

Are there any free NBME self-assessments?

NBME is not currently offering free self-assessments. A series of free self-assessments were available through September 2020 to provide students with extra study resources amid testing interruptions due to COVID-19.

However, the NMBE Free 120 is still available. 

2021 Changes to CBSSA NBME Self-Assessments

In October 2020, USMLE increased the number of communication skills questions on the Step 1 exam. As such, all NBME CBSSA (Comprehensive Basic Science) forms will increase the number of communication skills assessment questions starting February 3, 2021.

The total number of questions per subject examination will remain the same.

2021 Changes to CCSSA NBME Self-Assessments

As a result of November 2020 changes to USMLE Step 2 CK to include more questions regarding professionalism, patient safety, and legal/ethics issues, CCSSA NBME self-assessments will be updated to reflect USMLE changes.

What makes NBME practice exams so invaluable?

NBME practice exams provide questions directly from the test writers. A 3-digit score that tells you where your aptitude currently lies. Conditions that emulate the actual testing experience. A dedicated 4-hour time block to sit and give your USMLE preparations 110% of your attention. 

How do I fit NBME self-assessments into my study schedule? Won’t they interfere with my ability to actually study?

Make no mistake: NBME practice tests do not interfere with studying. They comprise a necessary stone in your study arch, a structure that would not otherwise stand on its own. Yes, NBME tests do demand a large chunk of time to complete and review. And no, they don’t give us the brilliant explanations that UWorld provides. Your study period will be more effective, and you will almost certainly perform better on your real exam by taking some NBMEs. 

How many NBME tests should I take?

Three NBME tests seems to be the number to shoot for Step 1 and 2 CK. There are six available Step 1 practice tests, three tests for Step 2 CK, and one test for Step 3.

Taking six NBME tests would be awfully grueling and might have you walking the fine line between well-prepared and burnt out, so tread lightly after your third test. At the absolute beginning of your dedicated study period, take an NBME to find out where you are today. Don’t stress about a low score. You will definitely score lower than your goal, but this is just the beginning! 

Should I take the Step 1 NBMEs in any particular order?

 
In the past, we would recommend saving the newer or most predictive NBME forms for closer to your actual test date. Now, however, since the NBMEs are nearly all on equal footing with each other, the order does not matter as much.

Which NBMEs are the most predictive for Step 1?

 
In our experience, since the new NBMEs were introduced, NBME form 18 has been the most predictive of students' scores on test day. (Of the retired NBMEs, form 16 was the most predictive.) We will also note, however, that whereas the UWorld self-assessments in the past used to over-predict students' final scores, the UWorld self-assessments 1 and 2 have recently been quite predictive of students' final scores on test day.

Is there any value in retaking an NBME test I took in the past?

Generally, there isn't a benefit to retaking NBME self-assessments. The effort-to-value ratio is pretty low for repeating an NBME test, unless lots of time has elapsed between tests. Strive to take different forms before repeating any. 

How do you recommend reviewing the NBMEs?

For your incorrect answers, don’t get hung up on what the correct answer is. Take the topic at hand, and put devoted time into elevating your consciousness on the subject matter. For some questions, it will be impossible to arrive at the correct answer because of ambiguity or poor writing, so your main goal should be developing a deeper, more complete understanding of a once frustrating concept.

When should I take my last NBME?

 
We strongly recommend that you DO NOT take an NBME or other self-assessment in your final week of USMLE prep.
 
This is for two reasons:
1. Self-assessments are one of the best ways to get a clear picture of your areas of strength and weakness so you can adjust the focus of your studies accordingly.
If you can take an assessment before your final week of studies, that is still enough time to adapt your approach accordingly. 
 
2. If you take an NBME in your final week of studying and you perform more poorly than you expected to, but you still move forward with taking your exam as planned, you will now have this data point hanging over your head making you doubt how well you will fare on test day. We go into more detail here about how to structure your Step 1 study schedule

Do you have any additional NBME advice?

But of course! Take the NBMEs seriously. I don’t mean this in the sense that you beat yourself up for missing your goal score, but rather, that you devote yourself entirely to the test while you are taking the test. Don’t complete a block and then post a picture of your frazzled self on Instagram. Don’t review 3 incorrect questions and go make a sandwich. Block off a dedicated chunk of time and channel some true focus. Start to foster your sense of concentration now so that it is in top form for Test Day.

What unanswered questions do you have about NBME self-assessments?

 

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