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Robert Meekins and Dr. Brian Radvansky contributed to this article.


Let’s not mince words: NBME self assessments are an essential part of your USMLE Step 1 preparation. Nothing will provide the same simulative or predictive value of an NBME practice test. Not UWorld, not Kaplan Q-Bank, not USMLE Rx —nothing. These other resources can all serve a purpose (especially UWorld), but only NBME practice exams will give you assurance that you are ready to pass Step 1 and achieve your goal score.


So, this brings us to our real question: Where do I start with NBME self-assessments, and how do I use these tests as a part of my Step 1 Study Plan?


1. Create a MyNBME account.

The old clunky NBME Self-Assessment Service (NSAS) website has been replaced with the shiny new MyNBME portal. Thankfully, it’s much more polished and user-friendly than the former system. Create an account if you haven’t already, and click the PURCHASE tab at the top of the screen. 

2. Select the correct test!

Your next very important step: Choose the right exam! While it sounds obvious, these exams have cryptic names like “Comprehensive Basic Science Self-Assessment (CBSSA),” so it can be difficult to decipher. 

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

All of the tests are $60, and come with what was once known as “Expanded Feedback” built into the package; that is, you will get to see your incorrect questions after the test. As we are focusing on Step 1, you will see that you have the most tests to choose from. There are 6 complete tests (called “forms”), each NBME form containing 200 questions, and you are granted 75 minutes to complete each 50 question section.


Now that we’ve laid the groundwork, let’s talk about how to use these valuable tools.

The Do's of NBME Self-Assessments


1. Take an NBME practice exam early!

The first thing we tell students, even before we match them with a tutor, is to take a “diagnostic” NBME test.

A diagnostic NBME exam allows you to pinpoint your areas of weakness and your baseline score, so that you can create the most effective and realistic study plan. This objective takeaway is so important; too many students confuse enjoying a subject with being well-versed in it, and vice-versa.

Your NBME score report will give you hard data that you can share with everyone on your Step 1 journey to guide your study. This will also give you exposure to test-like conditions and questions right away, which can help put material into context as you study. 


2. Choose the “standard-paced” (timed) setting.

Since NBME practice tests function best as assessments of your progress and readiness for the real USMLE Step 1 exam, you absolutely must take them under test-like conditions. This means with proper timing and break time. Without this setting, the predictive value of the exams will not be the same.

Take older forms earlier in your study period, using the newest forms as you get closer to the test. While the pool of test questions changes very slowly, you will want the most “real-time” test to be closest to your actual exam, as it should be most likely to mirror the real Step 1. 


The Don’ts of NBME Self-Assessments


1. Do not rely on publicly-available answer keys.

Many students attempt to review their NBME tests using shoddy answer keys available online. We have examined many of these “answer keys” only to find that most contain countless inaccuracies. Consult your First Aid or a professional to get the right answers. It will take time, but it is worth it. In addition, the act of reviewing incorrect answers and drilling down deep into questions you missed is far more important than the actual correct answer. Further your understanding on the topic as a whole. 


2. Do not wait to take all NBME self-assessments at the end of your study period.

Doing so will not only burn you out as your exam approaches, but it will also limit your ability to learn and improve between tests. Ideally, NBME self assessments should be done roughly once every 1-2 weeks throughout a 5-8 week study period. We know that it can be nerve-wracking to take a simulated exam, but confronting your fears and weaknesses early and often will help you score higher on your USMLE exam.


3. Do not ignore what the scores are telling you.

NBME practice tests are the most precise predictors of your USMLE Step 1 score. It does not matter which NBME form you are taking, they have all been scaled by the NBME to reflect your likely performance on the real USMLE. Our experience with hundreds of test-takers shows us that NBME tests tend to predict your real score within approximately +/- 10 points. If you are not yet there, consider postponing your test or seek guidance about the best move for you.


Of course, there are other factors and observations to consider when integrating NBME practice tests into your USMLE Step 1 studying. We’d love to hear any other questions/comments you have on this topic and also learn your experiences using NBME self-assessment exams. The more we all know about using these crucial tests, the better all test-takers will be prepared for their Step 1 exams.


For more information about NBME correlation with the real USMLE exam, visit these links:

Relationship between performance on the NBME® Comprehensive Clinical Science Self-Assessment and USMLE® Step 2 Clinical Knowledge for USMGs and IMGs.


Relationship between performance on the NBME Comprehensive Basic Sciences Self-Assessment and USMLE Step 1 for U.S. and Canadian medical school students


Using the NBME self-assessments to project performance on USMLE Step 1 and Step 2: impact of test administration conditions


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