Today, we will talk more about the NBME self-assessment tests. We previously discussed what the NBME self-assessment tests are and how they impact your USMLE review. You can read the posts here. Now we will cover three important topics. When to use the NBME self-assessment tests, how to use the NBME self-assessment tests and how wise it is to use the USMLE World self-assessment tests instead.
We now know that the NBME self-assessment tests are accurate in predicting actual USMLE performance. And we also know that the main reason for this accuracy is the correlation study done by NBME between the two tests using AMGs performance in both tests rather than to any real similarity between the 2 tests. This correlation has also been borne out by most test takers who narrated their experience in forums. It can be used to gauge whether you will pass the examination and even if you have a good chance of achieving the score you are aiming for.
So when is the best time to take the NBME? The best time is when you think that you are ready for the USMLE. When all parameters indicate that you are probably ready for the examination, you take the NBME to confirm that you are ready for the examination. In other words, use the NBME as a diagnostic or confirmatory test, instead of a screening test. You can use your performance in USMLE World or Kaplan Q Bank as a screening test.
The practice of many to take the NBME to identify weak points and measure progress in review is not very practical. First, there are only 6 NBME tests (for Step 1) and second, you can take it only once. Taking it more than once invalidates the correlation and therefore its accuracy in predicting actual USMLE performance. Therefore, what do you do if you are still not ready after taking all six tests? You just used up your most valuable tool for predicting your actual performance in the USMLE.
Personally, I used the NBME exam to confirm my readiness to achieve my targeted score of 99. In preparing for Step 1, when my Kaplan scores were hitting 84 and above, I felt I was ready for the test. I took NBME form 1 only and 740 confirmed my readiness for the exam since I was aiming for a 99. 600 was enough for a 99, but I would have postponed if I got less than 660. Why? Since I decided I want only a 99, I was giving myself a 10 point leeway (600=240 and 660=250) to make sure I make it to a 99 no ifs, ands, or buts. 
The same thing holds true for Step 2 CK, I took the exam when my one and only NBME test scored 700, way above what I needed for a 99.
Another common question is whether to take the examination timed or self-paced. Since you are trying to test your actual readiness for the examination, it is best to simulate actual exam conditions. In my case, I took self-paced but finished everything in the 1 hour allotted for it. I may look over the questions after 1 hour, but I will not change them so as not to alter the score predictability too much. Make sure everyone in the house knows not to disturb you while doing this. Although you can pause the exam, it is not recommended. Also I do not recommend you do it in a public library. There was one person who took the USMLE despite getting a low score in NBME. He attributed it to the fact that he took it in a noisy public library and “upward adjusted” his predicted score. He failed. So, take it properly and trust the score. One warning, though, correlation is not 100% therefore always give yourself some leeway in case things do not go too well. Never, ever go for the examination if you scored 400 or less. Your chances of failing is too high and even if you passed 75 and 76 are with you for life.
Recently, USMLE World started offering their own assessment tests for US$ 30 each, US$ 15 cheaper than NBME’s assessment tests. The question foremost in everyone’s mind is, can I switch to UW assessments tests instead of NBME’s. How wise is a decision like that?
The reason for using assessment tests is to make sure you are ready for the USMLE and to lessen the risk of getting an adverse score. NBME has proven throughout the years, after thousands of test takers, that it is a reliable predictor of your actual score in the USMLE. It is also backed up by correlation studies that have been published in journals. Now, although USMLE World’s assessment test may also be a reliable predictor of your actual USMLE performance, all we have is their word for it. No study has been cited or provided to independently verify such claim. And not enough empirical evidence from test taker’s experience forums allow us to make any judgment on its accuracy at all. Surveying forum after forum reveals variable experience with the tests as of now.
My take is that since you only have one shot at the USMLE, it is better to go with what is proven and tested rather than take a risk. Although, you can retake the USMLE if you fail, that failure is recorded and counted against you. If you pass, the score is with you the rest of your professional life. If you chose to, maybe you can use the UW assessment tests as a screening tool. Just be sure to use the NBME assessment test, whatever form to confirm your readiness before actually sitting for the USMLE.
Loading ...
July 29th, 2008 at 5:04 pm
actually u r doing a great job…a lot of valuable information in this blog
wish u the best
August 1st, 2008 at 9:11 am
also would like to ask:
which nbme to take as there r 6 nbmes?
r they all the same dificulty as i hear from some usmlers they vary in difficulty
so if so which form is the best correlated to usmle scores?
August 16th, 2008 at 5:25 pm
Thank you for your incredible effort in this website.
I’d like to know; if my score is below 400, and I postponed the exam for more preparation, can I re-take NBME again? and which form?
And in general, which form is the most accurate in prediction?
August 19th, 2008 at 7:38 am
Each NBME form should only be taken once as retaking them can inflate your score and lower predictability. Based on the first 4 forms, Form 1 has highest correlation. No information on Form 5 or 6 yet. But even so Form 1 has only 0.89 correlation and therefore not 100% guarantee. Some would use 2 forms and if they agree with each other than possibility that predictability is high. Since each form should only be taken once to maximize predictability, it is poor practice to use up all forms in your review. Since if you’ve done all 6 forms and the last form predicts below 400, you’ve just run out of forms to accurately assess your readiness for the examination. Now, if you’ve actually used up all 6 forms, suggest you use UW assessment, since preliminary reports state it is fairly accurate although not yet proven as NBME has been. This time try to conserve it and use it only if all other parameters like UW Qbank or Kaplan Q Bank indicates you are scoring high.
August 31st, 2008 at 5:13 am
Thanks so much for the inciteful info. I’ve been searching out info on all the blogs about the Uworld assessments. I am taking the the test on Tuesday, about a week ago I took the first Uworld assessment and got a score of 224. Two days later I took the second Uworld assessment and got the same exact score. Yesterday I took NBME 3 (because I heard this was the most accurate predictor) and received a 209. I do not know which one I should assess myself with. Should I just go by what NBME says? Thanks so much…
August 31st, 2008 at 6:22 am
Hi Jay,
The assessment tests usually have good internal correlation with each other. So the close correlation between tow UW forms is expected, just as close correlation between 2 NBME forms is expected. There is no data on correlation between UW results vs. NBME results although that would be interesting. Personally, I would still go with NBME since it has been tested against the USMLE more times the UW. Again it does not mean UW is less reliable, just less proof of reliability and that is not the same thing. But for now, at least it appears you have a very good chance of passing this exam.
Good luck on your exam. Remember to rest well the night before and don’t eat too much on the day of the exam (more carbo than protein) so you don’t get sleepy. After lunch is worst, and the more full you are, the sleepier you get. (increase visceral blood flow for digestion and metabolic alkalosis as HCl stays longer in GI for digestion. metabolic alkalosis = hypoventilate = less O2 to brain)
September 13th, 2008 at 6:07 am
Hi, i failed twice in usmle, and now feel confuse what to do.
Can u pl tell me my attempt will affect to get residency, if i get good score.
Pl be helpful.
Thanks
September 14th, 2008 at 8:38 am
Hi,
Can u pl say about form 5 and 6?
September 18th, 2008 at 9:57 am
hi dr patel,
Failing the USMLE twice will negatively impact your chances for a residency. However, as in everything there are ways to remedy them. One is to get a good score once you pass it. The higher the better, but nothing less than 90. Even then you need to work harder than other people though to get a residency. The reason is as always supply and demand. Too many applicants and too few positions which makes programs especially choosy.
As to commenting about form 5 and 6, if you read my post on Donating to Askdoc’s USMLE Blog, you know why I can’t really comment on form 5 and 6.
September 23rd, 2008 at 4:41 am
Hello, doc.
Thanks you very much. Can u pl tell me how can i assess my self & be sure i am ready for exam? usmlerx or usmle world , which one is worth ?
I appreciate ur help.
Dr patel
October 10th, 2008 at 11:29 pm
I am so thankful to you askdoc that i can only pray God blesses you forever,Your input for USMLE has made a great difference to alot….I myself wasnt so motivated and very stressed out as to how to start and where to start and what if i fail and all those i asked just gave answers which i already new….study kaplan books n do this n do dat but i wasnt sure where i stand and i was getting scared of myself that i know nothing and becoming a hipocrit….but after reading your post i am back to my senses and i will start from today evalute myself and see how to start and its basically from scratch the learning phase is what i need to get the basic concept then i can move ahead or else i will never reach my goal…..is there anyway i can reach you by means of mail or contact incase i get stuck n need advise???Please let em know.God be with you always.Thankyou.
October 12th, 2008 at 8:05 am
Hi Asiya,
You can reach me through personal messaging system in my forum at http://forums.askdoc-usmle.com. My callsign is of course askdoc
If you have to start from scratch you need to start with textbooks and not reviewers and you should cover the subjects in the order your medical school did it which is Anatomy and Physiology first, then Biochemistry, then Microbio/Immuno and Pharmacology, then lastaly Pathology. Behavioral Sciences, you can just use a reviewer. After you finish your learning phase, you can use the review methodology I outlined in my forum, “Askdoc’s Method of USMLE Review for Step 1″
Good luck in your prep. Feel free to contact me for help if you need them.
Mike aka “askdoc”
November 27th, 2008 at 9:28 pm
Hi, can u pl tell me, if i registered for usmle in india, can i able to trasfer my testing region from india to usa?
Thanks