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Sometimes it all falls into place. You did well throughout classes, scored well on Shelf exams, and as second year is winding down, you have your sights set on the big dance: the USMLE. With a little guidance from your program, you blocked off 6 weeks for dedicated studying, and cordoned off your distraction-free study cave. The necessary books are fresh out of their wrappers, and your Step 1 study calendar is built.

After 2 weeks of doing UWorld, you are satisfied with progress and scores, and, in an effort to save time and money, you are considering eschewing the NBME self-assessment. After all, you’ve got 2000+ questions from UWorld with beautiful, catalogued explanations...what will an NBME practice test really offer?

Plain and simple, the NBME Self-assessment is the most underrated piece of essential study material while preparing for all of your USMLE exams.

When we discuss the dedicated study period: UWorld and First Aid steal the show, and everything else gets mentioned as an auxiliary “nice-to-have” item. Students say things like “I’ll probably try and squeeze in a practice test or two along the way.” But NBME practice tests are not to be “squeezed in,” nor are they “nice-to-have.” Read on to fully understand what makes these exams completely essential, and how to best use them during your dedicated study period for Step 1.

How do I begin?

First thing’s first - placing NBME self-assessments into your study calendar is a crucial step in plotting out your dedicated study period. In fact, your study period should begin with your first self-assessment. This will allow you to see where your score is today, and how much dogged effort is required to take you from here to there. It also serves as a starting gun for your study period. Once you click “BEGIN” on your first NBME, the dedicated study period has begun. It’s on! It is something you should get fired up about. You are going to perfect, compartmentalize, and patch-up an enormous compendium of knowledge. Flipping this hard switch will be a message to your brain that it’s time to get serious about your preparations. For the next X weeks, the totality of your intellect will be devoted to this one goal. Consider this the firm start to the period so that you don’t spend the first week or two doing any wishy-washy second-rate studying.

Once your first test is on the calendar, pepper your dedicated study period with a test about every 2 weeks, leaving a comfortable 10+ day buffer between your final NBME and your actual test date.

What makes the NBME practice test special?

This test will allow you to emulate the actual test using real test questions, published by the governing body who produces Step 1. While UWorld questions are second-to-none in terms of helping you learn the necessary information, NBME questions are the closest to what you might see on the real exam.

In addition, because you are paying for the test, and because of the relative scarcity of questions therein (compared to UWorld’s 2000+), whether you intend to or not, you will give more importance and effort to this test. Gone are the Tutor Mode blocks where upon review, you tell yourself “I knew it was B, but just wanted to see what happened if I went with C.” Much like the real exam, on your NBME, you will select what you think the best answer is, and then move on to answering another question. Nothing can be closer to the feeling of taking Step 1 than completing an NBME. Because of this, you will already be well-accustomed to creating the extreme seriousness and focus needed for the real test. Exposing yourself to Test Day-like conditions ahead of time will soften the blow of your real Test Day. 

What do I do when I finish the test?

As mentioned, the feedback that you will receive from your NBME practice test pales in comparison to UWorld explanations. At most, you will only receive a score, your relative aptitude in different subjects, and a chance to take a second look at questions that you answered incorrectly. Reviewing these incorrect answers is key, but most students go about this the wrong way. It usually starts with a google search like “NBME 4 section 2 question 3.” This leads to a hideous pink-background USMLE forum page that is riddled with incorrect information. Here you will read “I picked a) decreased preload and got it right” alongside another comment that says “I picked b) increased preload and got it right.”

The thing to do here is not dwell on which of the answer choices is correct. For all you know, this was a poorly written question that got thrown out of the actual question pool and found a happy home on a practice test. What you should strive to do is take the 20 minutes of time you would have spent trying to reconcile misinformation on the forums, and use it to attain mastery of the concept at hand. Revisit that cardiac physiology section in BRS, and understand the concept in its totality. That is far more important than knowing if a or b was correct. Stay off the forums! 


In short, the NBME self-assessments are not to be glossed over. They are an absolutely essential part of your study period that begs to be taken seriously. Don’t make the mistake of the self-assured student who “doesn’t need” to take a practice test. Do yourself a favor and get at least 2 or 3 of these tests onto your study calendar, and give them all you’ve got.

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Brian Radvansky

Brian Radvansky

Brian believes that excellence comes from never taking "no" for an answer, and putting as much work into organizing one's studying as into studying itself. After producing an incredibly average MCAT score, he decided he was going to quadruple his efforts in preparing for Step 1. His greatest successes have brought students who were going to drop out of medicine altogether for fear of not matching to matching into their specialties of choice. He reminds students the importance of performing well on a single test, or even learning how to sell themselves can make an extreme difference in their futures. Students can rely on Brian to hold them accountable and make sure that they don't sabotage themselves with excuses. He can help them to totally reevaluate their approach to USMLE questions in a methodical, protocolized way that ultimately leads to more correct answers and a higher score. With his help, you will trim the excesses, and put all of your collective efforts into only the work that will improve your score. Through his residency admissions consulting, Brian has consistently revamped students applications by helping them to highlight their best (and sometimes hidden) characteristics, and get them to match into the programs they had ranked number one. He can help you to master your personal statement, and craft the story as to why your program of choice needs to have you as a resident. Brian will help you find that all too difficult balance of being proud of and selling your accomplishments, without coming forth as someone who is merely checking boxes to bolster their application.
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