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.
Hey Askdoc
Are you there? Waiting with baited breath for your response
Hi Ria,
I’m here. but I have 3 emails, 9 personal messages and 2 questions from my forum to answer before I get to answer yours. Not to mention the questions in the blog. Unless you want me to give short answers, like you’ve made a very big mistake in your prep if you are aiming for 95++ rather than long responses that explains why this is so and what remedial measures you might take to score at least 90′s although you have to be very, very lucky to get high 90′s
Askdoc
Hi Ria,
Now for the long answer. If you are aiming for high 90′s, your prep strategy is wrong. If you are aiming for 80′s with some chance of hitting 90′s then it is right. The problem with first aid is that it is enough to pass but not enough to score high. Another thing, Goljan’s forte is Pathology not Clinical medicine. If your problem is pathophysiology which is 20% of Step 2 CK, Goljan is good but if it is clinical medicine which is 80% of Step 2 CK, then Goljan will not help much. If you look at most effective prep strategy used by those who got high 90′s and 99′s. It is centered on 2 things. Kaplan Notes which is read multiple times and UW Q bank which is studied and reviewed not just answered. CMDT is wonderful. For Step 3. It emphasizes clinical practice more than theoretical clinical medicine which is what Step 3 is all about. In fact if you want to do really well in Step 3, then use CMDT. However, for Step 2 CK it’s emphasis on the practical does not jive as much on Step 2 CK’s emphasis on theory.
Even if you did go to Kaplan, CMDT etc. with problems, what is wrong with that strategy is that YOU decided what you needed to learn, rather than letting Kaplan decide what you needed to learn to score high. Again nothing wrong with your strategy if you are aiming to pass or get average scores. Big problem if you are aiming for a high score – high 90′s or 99′s.
If you read my post on What to Study for the USMLE, I mentioned that the reviewers you pick have certain assumptions about your goal in the exam. This is because, they’ve set the amount of information you will learn when you use their reviewer. This in turn limits the scores you can achieve, even if you studied them a hundred times. Also in my post on High yield topics, you will know that only knowing the high yield can at most give you average scores, not high scores in the high 90′s or 99′s.
So what can you do to remedy this. Well one month is not much to work with. However, from my explanation above, the answer is a bit obvious. It now depends on how fast you can do all of this.
First, you need to go back to Kaplan rather than First Aid or Goljan. If your time is absolutely limited. concentrate on IM, then OB, then Pedia in that order. When you read through the topics, concentrate on building an algorithm for each topic you studied. For example, given a patient with dysphagia, how do you work up the patient. Given a solitary pulmonary nodule in an xray, what are the steps you will take. Patient came in with chest pain, what will you do. 12 year old girl with amenorrhea, how will you proceed. What if she was 18. and so on and so forth
Then review UW q Bank, you must pay attention not only to the right answers but why other answers are wrong. If you do not know why they are wrong then you are not using the q Bank for it’s maximum effectiveness.
These steps will raise your scores, however, I cannot be sure it will be enough to help you get up to high 90′s. Again depends on how much information you are able to absorb in a month.
Askdoc
Hi Dr. R,
Any score above 90 will give you a good chance to get interviews. However, your LOR’s are also very important in getting interviews. Your GC is definitely an advantage as there are significant number of hospitals that will not sponsor visas, so competition will be less stiff there. As to which NBME correlates best with step 2 CK, they all seem to correlate well based on what I have seen on scores reported in the various forums. I would suggest you try to get good LOR’s especially from NYMC.
Askdoc
Hi Askdoc
Thanks for your reply and valuable input. Sorry for hurrying you but I wanted to get your input asap for obvious reasons!Did not realise your are such a busy guy.
Anyways, well my consistent problem has been psychiatry, mental health, preventive and social medicine.I am going back to Kaplan and reading it up thoroughly from there (Psychiatry).
Paediatrics and Obs & Gynae were poor initially but have managed to bring the scores up in them but reading Paediatrics from Kaplan now.All along I have also been drawing flow charts for management plans for difficult topics / problem areas and revise these seperately. IM has been just average/above av in few topics like endocrine, musculoskeletal), will try to do the whole lot from Kaplan as well time permitting
Regarding uw I have reviewed the answers thoroughly, writing down the additional info in the relevant chapter in first Aid so that I revise it along with First Aid. Today also got a score of 80 % in IM . However I take your views seriously and if nothing it will compel me to work harder and make the most of this 1 month. Thanks a lot for your input, much appreciated.
What should I do for Psychiatry? I do really mess up the biases and interpretation of studies.
Will wait patiently for your reply this time.
Thanks
Thank you very much for your help. That puts me at ease. Your doing great work here.
Hello Askdoc,
It is me again. Two days before my CK exam I came to your website seeking encouragement and you said if I got a score above 90, I would get interview calls.
My score came two days ago and I got a 99/245
Thank you for the last minute boost.
Godbless!
Hi Ria,
Psychiatry is a very small subject. I also had problems with psychiatry and I still got a 99 / 258. It was not a small problem but a rather big one. So very strong scores in the other subjects can cover low psych scores. Nevertheless go through them again at least once. Concentrating on the bigger subjects are a good idea.
Now please understand that it will probably take 2 to 3x the amount of work to get from 90 to 95 as from 85 to 90. That is what most fail to understand. The higher the score you want, the amount of work you need is not additive but exponential. So many make the mistake of thinking, “Oh I’ll do just a little bit more and my score will go up.” In reality, you have to do much, much more the higher the score you are aiming for.
Now for last 2 weeks, you enroll in Kaplan and do as many as 6 to 8 blocks per day. If you are scoring at least 72% you have a good chance at above 90 scores probably even high 90′s. Get mid 70′s and you have a good chance at high 90′s score. You’ve used up your NBME and you have to rely on a less consistent measure.
Askdoc
Hi Dr. R
You’re welcome
Askdoc
Hi Kay,
Great work! Knew you’d make it. Now concentrate on great LOR’s (from US physicians). Carefully select programs that meet your criteria. Apply on September 1st 2 weeks to maximize interview opportunities. Prepare for the interviews really well. And good luck on the Match.
Askdoc
Thank you (again!), AskDoc,
I don’t know how you do it – answering so many questions while still being so encouraging even for a “thank you. i got xx score” comments. Not that I’m complaining!
I am taking the CS in 10 days. Will definitely be back after that with hundreds of questions regarding the application process. Now that I’ve been here once, I’m sticking around till the whole shebang is done.
Will keep your pointers in mind. Also, even though having a green card means I do not need a Step 3 right now, I was planning on getting out of the way before September – do you think it will harm/improve my chances of getting matched if I have Step 3 scores too?
Merci beau-coup, AskDoc!
oops! edit – “i was planning on getting IT(step3) out of the way before september”
Hi askdoc
Thanks a lot for your advice. Will concentrate on IM and keep working hard. I will take kaplan q bank after 15th May so that in the final 10 days I do many practice drills and also identify my weaknesses just before exams . I now have a strategy.I will keep you posted on my results
You are doing a great job indeed!
Thanks again
Ria
Hi Kay,
Since you already have a green card and do not need to take Step 3, I suggest you don’t. The reasons are as follows: First of course is you don’t need it. Second, most programs will help pay for your Step 3 Review once you are a resident. That is extra cash. Third, currently with your scores, you are golden. Programs will love to interview you. If you get a score lower than 90 or worse fail it, it will tarnish you. I mean you will still get interviews, but their impression of you will be lowered. So why even risk it. The only really valid reason you want to do your Step 3 before residency is to get an H1B, which you do not need.
On the other hand, some people just want it over with. Rather than trying to review during residency, where duties can be quite demanding, you can concentrate on just working. Also there are cases of residents unable to pass Step 3 after multiple tries and face the prospect of losing their residency positions or if not required by the program to Pass Step 3 as condition for continuing with the program, face the prospect of unemployment after residency if they cannot pass Step 3. In this case, I recommend if you want to take Step 3, take it so the results come out after 2nd Week of September. Why? because you will need to transmit your USMLE result to programs when you apply and you cannot choose which Steps to show or not show. So if you file your application first 2 weeks of November, you can claim your Step 3 results are pending and transmit your other Step results. If the Step 3 results turn out to be very good, then rerelease them. If they turn out to be bad, present them only as needed or if requested, hopefully after you’ve clinched an interview.
Askdoc
PS. Most people do score much much lower in Step 3 than in Step 2 CK if they try to take it before residency. So you can expect your score to be lower as a rule.
Hi Ria,
Good Luck on your prep. Hope you get your dream score.
Askdoc
Thank you very much, Askdoc. It is worth the number of times I check this page just to land here today and see two whole paragraphs from you.
Trust me, totally worth it.
I have my CS next week. And once that is done, I will just give up the ghost for a few weeks and relax without worrying about Step 3 then. I just figured, since I do not have any USCE, research etc, maybe a Step 3 score ( if 90+) will bulk up my rather scrawny CV. But what you said makes absolutely sense, times a million.
And sorry for being such a leech, Askdoc – but I have another loaded Q.
For two years in between, I did my MS in Biology here in the States but I did not complete the degree because the thesis involved lab research and the time period for graduation was going to take another 4 yrs. I worked as a Teaching Assistant in Bacteriology for a year and a half at the same univ. Have one LOR from that US professor. I enjoyed my teaching experience – I used to teach the Bacteriology labs for Nursing students and I had great Evaluations every semester (did that for three semesters).
I finished all my core classes with a GPA of 3.87. I just did not complete the research/thesis. It was a toss up between 2008-12 spent trying to isolate DNA or trying to get into residency (and finishing it).
My question is – should I include all this info in the resume? I do not want 2006 to 2008 to be a big gap but I also do not want this info to dig me into a pit.
I believe every institution in the States loves research oriented candidates – but I am the kind who gave up on research in the middle and I confess no great love for pipetting/isolating DNA/inoculating mice etc. On the other hand, I did enjoy all my classes and did very well on journal oriented research (writing up papers based on other people’s already published research etc). And I think I would be quite okay with Clinical Research.
So should I tell the hospitals about my MS years? Will that raise all sorts of Qs about “why” I quit it?
Anyway, that is my question and I promise you I will try not hound you more after this (no guarantees though.
)
Thank you so very much in advance. God bless you.
Hi Kay,
Sorry for the really late reply this time. Got sick, so was backlogged for days in my prep course and day job. Finally able to answer q’s here. Anyway, first do not leave blank years in your resume. That would raise more questions than being honest about what you’ve been doing. Not everyone would ask why you did not finish your MS but everyone would ask what you did those two years and that might make them ask why you did not finish. However, in the instances that people ask why you did not finish. Be honest. Say that you want to be an M.D. You feel doing 4 more years will make it harder for you to get a residency since year of graduation is used as a cutoff in most residency programs. So you decided to do residency first. I don’t know if your MS means you can pick up where you left off after you finish your residency, If you can then say that you can finish the MS after residency, anyway. But finishing your MS first may mean you may have to forgo residency. Tell them I love Biology but I love medicine more.
Askdoc
Thank you, AskDoc! (I’m starting to sound like a broken record now
)
Your reply gave me all the valid points that I would like to make to the interviewers without highlighting the “quitter” part. As usual, it was worth the wait and I am sorry to hear that you were sick. Hope you are totally better now.
Have a wonderful day!
Kay
Hi askdoc,
I’m amazed by your efforts to extend a helping hand to those in need. I’m an old IMG going to sit for Step 1 at the end of June. I was about to extend my eligebility period as I felt little confidence in my preparation , but with their new law its going to be complicated for me to secure the updated (Form 186) on time. Anyhow, being all confused now it seems that I’ll have to sit for the exam on-date which means I only have 1 month to go, so I took UW assessment form 1 and got 550/230 . I’m already through with 60% of UW qbank with an overall of 63% .So based on these circumstances:
-Should I rely on this score or should I try and take NBME ? if yes which one?
- Do you think that I can manage to raise my prospective score during this month ?
-or should I really consider extending my period ?
I’d like to add that my studying schedule was a bit chaotic and I missed out on some subjects like Immunology & Nueroanatomy.
Any further advice will be highly regarded.
Hi DrIzzo,
Your assessment score already shows a great score. First I suggest you spend around 2 days each to cover Immunology and Neuroanatomy. Because these two are relatively high yield. Neuro is the highest yield subject in Anatomy, whereas Immunology is the highest yield section in Micro/Immuno. Second, you do not need to extend your eligibility period as your scores seem to be good. You will increase your scores as you progress. However, after finishing the two subjects, concentrate on high yield information either from First Aid Rapid Review or my High Yield Fast Facts Course.
It is also important to note the average scores so far for the blocks you have finished in UW. 63% is how many points above the average score for those blocks. 10 to 14 points would more or less confirm you 550 / 230 in the assessment form. You can take an NBME form around 2 weeks before you sit for the exam. If you are one who likes challenge, do form 5. However, if you tend to be disheartened by a lower score, take form 1 to 4. Form 5 will slightly underestimate your probable score, while form 1 to 4 will slightly overestimate it.
Askdoc
Thanks a million Askdoc
That was so reassuring.
also in case someone else might benefit from any of it.
I shall follow your advice. I will try to post results of my assessment exams so I can get more support from your wise words
Thanks again and keep up the good work.
DrIzzo
I am so scared…. I got 230 on UWSA1, 252 on UWSA2, 590 on NBME (this was earlier on in studying).
My USMLEWorld scores were 65% cumulative, last 10 blocks were ~70%.
I took the exam the other day and I feel HORRIBLE about it. I think I failed. Is it possible that i did worse than my first practice test ? I am just SO SCARED
Hi worried,
Don’t worry. With your NBME score, if you fail this exam, they should write a thesis on it.
Unless of course you are using the downloaded version with the alleged regression table, then all bets are off.
It is normal to feel that the exam is hard and to be nervous. I did and I still got a 99. In fact, I’m more worried about people who feel the exam is easy, because either they are geniuses or know too little to realize they know nothing. So don’t worry. The assessment tests are fairly reliable. Now just relax, watch a movie. Take time out with your family.
Mike
Dear askdoc,
I took an NMBE self assessment, form 3, and scored a 480/218. What does this score mean? Does it reflect an approximate of the actual Step 1 3-digit and 2-digit score? I have a little over 2 weeks to go till my exam date and I have only completed 5% of USMLEWorld Qbank. I intend spend the next 2 weeks doing questions. How much of an improvement can be expected if I take another assessment after that? Which assessments would you say are more representative of the actual STEP 1 scores? Do you have any suggestions for how to best use my remaining time?
Thanks a lot!
Hi NeedSomeDirection,
The NBME is fairly accurate +or- 10 on the 3 digit scores. But only if you do it properly. Strictly one hour per block and doing all four blocks continuously with at most 5 minute break. Otherwise, it may tend to overestimate your score. 480 is a good enough score. You have a good chance of passing this exam. However, there is a small chance of failing. You need a 500 for a sure pass. But on average people with that score get about 80′s. So if you are aiming for 90′s you have a long way to go. Doing the UW Q bank will increase your scores as you get better at doing q’s and you learn from the qbanks. 2 weeks though is very tight if you are aiming for high 90′s, but not impossible. I would suggest you finish q banks and also do high yield review. (Actually last 2 weeks should be focused on high yield review since you should be about 90% finished with q bank by this time, ideally) Anyway, you can use First Aid or my High Yield Fast Facts course for high yield review. Take an NBME at least 7 days before the exam (so you can still have enough time to move your exam date if needed) If you do not like the score than move the date. In your case an additional 2 weeks would have been more ideal or a total of 4 weeks to maximize the benefit of q bank plus high yield review on your score. But we’ll see what will happen in the next week or so. You need to work on q bank fast though.
Askdoc
PS. Form 5 tends to underestimate your score while the earlier forms tend to overestimate them a little.
Hi askdoc,
I took UWSA 2 ( I already had a subscription ) and scored 700/256 , but to further assess my situation because USWA 2 felt quite easy I decided to take NBME5 and I scored 560/236 !! It was somehow disappointing as I ,uncomfortably, felt good while doing the exam. Although I notice that you say that form 5 tends to underestimate my predicted score I’m not sure where does that put me as my target is around 240+.
I also seem to score the lowest on Reproductive & Renal systems + Physiology. With my exam on 6/30 should I focus on these weaknesses or just keep on with the general review ?
Thanks alot
DrIzzo
Hi DrIzzo,
Continue with high yield items only. Learning new things in the last week will only complicate things. Anyway, whatever actual score you get, it will be high. Read my post on What to do on the day of the USMLE exam. and Good luck on your exam.
Askdoc
Hello ask doc, came across this website when checking NBME for 3 correlation. I have taken 2 NBMEs for Step 2 CK, form 2 -660, form 3 – 760. I know this is supposed to be a good score, but why do I feel like I just got lucky?? Form 3 seemed very simple as compared to Form 2…is that possible? or does it mean that I was better prepared? Taking the exam in 2 days….
Hi chits,
Lots of reasons for having that kind of discrepancy in your NBME scores. First of course, correlation is never perfect. An 80% correlation is considered high, so discrepancies do occur. Plus each set is a subset of a full exam and therefore not all topics could be represented equally. Therefore if the form happen to cover a few more questions on your favorite topic, you tend to score higher. The same holds true for the actual exam. Being lucky can boost your score a few points. Plus exam conditions can affect your score, too. ie. whether you are well-rested, in a good mood, etc. Anyway, your 2 NBME points to a fantastic score. And short of a disaster on exam day, you will get a very good score indeed. Good luck on your exam.
Askdoc
Thank you for your prompt response. Its like a cool misty breeze on a hot afternoon….dramatic, I know, but thats how I feel right now with only 1 more day to go for the exam….
Hi Askdoc
I don’t know if you remember me. I had asked for your help & advice 1 month before my Step2 CK exam about my prep strategy. I took my exam in end of May, got my result 97 / 235.
I don’t know how I did it, but I did manage to get my dream score (>95) . Thanks a lot for your input and advice. It was a big help.
I am now going to Mount Sinai in NYC to do observership and selecting programs. I am also contemplating on doing Step 3 asap while the knowledge is still very fresh. Can you advice me now how to prepare for Step 3 please (this time I am going to follow your advice from the very beginning rather than 1 month before the exam)
Thanks again, you are doing a great job out there
Ria
Hello Askdoc:
Thank you for these valuable comments in the post.
I am a first time writer, having a concern about Step 2 CK.
Here is what I did so far. I read Kaplan review books twice. I finished all UWorld Q’s (accumulative average: 55%) within two months. I did not purchase any Kapaln Q’s. I have not done any NBME’s. My Step 2 CK is in three weeks. I really want to ace this exam since my Step 1 was high 80. I am not so sure that I have been studying in a right way past three months. Would you recommend taking one of NBMEs or UWSA, just to find out where I stand exactly now?
Also, is there any recommendation that you can make in terms of my study?
Thanks.
Toshi
hey there
I am taking the test saturday. I have taken a few nbmes, one month ago I got a 255 and then fell into an unfocused slump for a few weeks. 5 days ago I took nbme 6 and got a 251. I am still freaking out and dont feel ready. My ave on world is 75%. I still havent even learned everything (ie embryo/anatomy and forgot meds) You really think these scores are predictive???
Hi Ria,
Sorry for the delayed reply this time. Been really busy. But first congratulations on getting a great score. Now as to taking the Step 3. My advise is not to take it unless you need it for visa issues. The main reason is that with your current scores, you are golden and you will get lots of interviews. So a Step 3 score will not add anything to that except if you need it for visa purposes. (H1B). I have yet to see somebody score higher on Step 3 than they did on Step 2 CK. There are a variety of reasons why this is so, but having at least a year of residency on your belt can help you a lot in scoring high in Step 3. So getting a low score in Step 3 can tarnish you a bit. More so if you fail. (Knock on wood). So my suggestion is this. If you really have to take Step 3, then take it so the result will come out after September. This is because you apply for interviews in September. When you release your USMLE scores to the programs, all available scores are released not just the one you choose. So on September when you apply, you can transmit your step 1 and step 2 scores and rightfully state that you are waiting for your Step 3 results. If it is a great score >90 then retransmit the scores. If it is a not so great a score, then do not retransmit the scores. Wait for the interview and show your scores when they ask for it. This way you already got the interview and your step 3 scores cannot affect whether you get an interview or not. Whether you get matched or not depends on your performance in the interview and not so much on your scores (although they still are very important)
I’ll post more advise on how to study for the Step 3 in future posts. Suffice it to say, you still need Kaplan Notes (Step 2CK not Step 3) and either Washington manual or MCDT (instead of Step 3 Kaplan notes) So prepare this materials ahead. Plus the algorithms are more important then ever. You also need to be able to identify pictures of skin diseases, ECG tracings, x-rays, etc.
Askdoc
Hi Toshi,
First, I would say you need to do at least one NBME, the online one of course and do it under exam conditions, one hour each and limited breaks. That will give you an indication on where you stand and what you need to do in the next few weeks. Reading Kaplan review books twice is adequate as far as knowledge needed to score in the high 80′s to low 90′s, however, it now depends on how much you have mastered and retained. The only way to have a gauge of that is your NBME score. Your UW score is a bit on the low side if you are aiming for high 80′s although passing should not be too difficult. However, you probably also did it by subject as a review rather than simulate the actual examination.
I would suggest that you plan to get Kaplan q bank so you can use it to simulate actual exam conditions. Believe me that helps a lot on actual exam day. That means 7 blocks in 8 hours with timed breaks. Random, mixed and timed. Again how much you need to do depends on your NBME score, so do that first.
Askdoc
Hi j,
If you took the NBME under exam conditions. That is one hour per block, limited breaks. Plus you did not review the questions before, in those discussion forums. Then predictability is high. Usually + or – 10 points from predicted score. I suggest you relax. Your NBME predicts a good score, although not necessarily the exact predicted score but nevertheless a good score. Your UW seem to agree with your probable score. So unless some disaster happens on the day of the exam, you will do well.
Read my post on What to do on the day of the USMLE exam for pointers. Plus do not study or do anything in the next 2 days, just relax and stay focus on the exam.
Good luck and may you get your dream score.
Askdoc
Hello Askdoc:
Thank you for your advice. It helped me a lot. So, I took the online NBME (the first one) for Step 2 under exam conditions, one hour each, and limited breaks inbetween. The outcome was rather very disappointing. I got 330/171. I was very upset, disppointed, and discouraged after I got this result. Should I risk it? Well, I don’t want to risk it anyways…so, I am pretty sure that I have to postpone it at this moment. My biggest questions are WHAT I DID WRONG (did I go too fast? did I just finish the UW qbank just to get by as quick as I can?) and WHAT I SHOULD DO NEXT then. Even though it is very hard to accept the fact, I know (by reading your other blogs) I have to accept it and do the damage control now. I have to go back to the rest of my clinical rotations from August, so I will not have this two to three months off for a while. But I am glad that I took the NMBE to find out where I stand. I can think of this fact as a wake-up call. Regardless my schedule from now on, I can still study hard and efficiently. It is obvious that I have not retained and mastered enough of materias for the Step 2 preparation. I can recall that I had some KA problems and majority of KR probelms during the NMBE assessment, leading that I was very irritated.
Well, I would very appreicate if you could help me out for some more guidance.
What did I do wrong? What should I do next then?
Thank you so much for your attention and support.
Regards,
Toshi
Hi Askdoc,
Could you help me solve my puzzle? I got 440 in NBME form 4, which is generally considered very low. But I heard that form 4 was considered the hardest of all forms. Is 440 bad or still acceptable? I did the first three forms with the downloaded version. As there are no official answers to them, so I don’t know how much I can trust of the scores of forms 1,2,3 (If the answers provided are right, I got 71%, 75%, 78% correct rate, respectively ). But for form 4, I did it on NBME website and got only 440. So I was wondering what was going wrong. Thank you very much in advance for your replies.
Hi askdoc..stumbled on your blog..awesomw stuuf here..find it hard to believe that selfless sould like you exist..
my question..I scored 510(224) on form 2…3 weeks later took form 4. scored 560(236).my exam is on 18th august..how do i go from here..i seem to be plateauing..
thanks a ton..
Hi Abdur,
I was wondering whether you could answer my question ( see the paragraph above yours). As you got higher score in form 4, so does form 4 seem easier for you? Also do you have a rough idea what percentage of the questions you got right answers for form 2 and form 4? Thanks a lot in advance.
Xij
Hi,
I was wondering about the NBME self assessment exams, which of Form 1 and Form 2 in your opinion is more accurate. I did both and Had 740 on Form 1 and 640 on Form 2. quite a difference. so what to make of that?
Thanks
Hi Toshi,
Sorry for the really late reply. Really busy for the past 2 weeks. Anyway, what did you do wrong? Well it is hard to evaluate since I do not have enough details of your situation. However, I will try. Presuming people studied enough, most people who have problems in Step 2 CK are due to the following.
1. Around 25 to 30% of the questions in Step 2 CK are about the next best step in the work up and management of the patient. The best way to learn this is to make diagnostic algorithms (to work up a patients) and treatment protocols (Step by step management of a patient) rather than reading them in a narrative. When you read Kaplan, these facts are in narrative form. It makes it that much harder to consolidate the information when you have to answer a next best step question. So organize Kaplan notes into algorithms to help you with this type of questions.
2. Pathophysiology or Mechanisms of disease is around 20% of Step 2 CK. If you didn’t do too well in Pathology in Step 1 or you are an old grad (which you are not) more versed in clinical medicine than in basic science. This is a problem.
3. Atypical cases or clinical vignettes. Unlike in step 1 where the clinical vignettes are classical. Vignettes in Step 2CK are atypical, which means they are harder to diagnose. Plus the question makers like to put in a lot of useless clinical data to confuse you. In actual clinical practice, majority of the cases you will see are typical presentation of common cases, then atypical presentation of common cases, then typical presentation of uncommon cases then atypical presentation of uncommon cases. Step 2 CK primarily focus on more common cases. Therefore think of common cases rather than uncommon cases. I mean when you have a case of a male teenager with nosebleed, think of trauma (nosepicking) rather than nasopharyngeal angiofibroma.
4. Of course, it might just be that reading through Kaplan text twice was not enough for you to master the details.
Which one is the main problem, you must analyze and decide accordingly. The qbanks can help you refine your knowledge and improve your ability to analyze and answer tough questions. But they cannot cover a deficit in knowledge.
Askdoc
Hi Xij,
sorry for late reply. My problem with using the downloaded version is the reliability of first, the answer sheet and second the correlation table you are using for your estimated scores. So it is hard for me to answer your question. However, one thing that bothers me a lot is that NBME q’s are being discussed in forums and these same q’s or variations of them are appearing in published q banks. This can skew the results of the NBME forms and affect their predictability. In fact, since the earlier q banks seems to be the one most discussed in forums and have found their way to other qbanks, I am beginning to think that people should use the later forms like form 5 and 6 rather than the earlier forms
Askdoc
Hi abdur,
You should be doing your last revision by now and studying high yield stuff only. Go through your qbanks and review the answers. Everybody plateaus eventually and the higher the scores you have, the slower your progress will essentially be. It may be due to fatigue or it may be due to the fact that you’ve reached your maximum capacity to absorb information. In either case, there is nothing you can do about it right now. Just take it easy. Your main goal is that you don’t go into decline. Studying just high yield stuff and taking enough rest is the best way to go. Do not try to study new lower yield stuff in an effort to boost your scores. Those things should have been done at the beginning of your prep not near the end.
Anyway, you have good scores in the 90′s which isn’t bad.
Askdoc
Hi Oshafez,
First, the assessment tests uses correlation studies to predict your scores and as we know, correlation is never 100%, more like 70 to 80% and therefore difference will exists. When I took the exam in 2006, the predicted score has a 2 SD variance of around 10 points in the 3 digit score scale.(based on scores I picked up from various forums) or about 60 in the 800 score scale.
In your case it is about 100 in the 800 scale. Firstly, this is based on the online NBME tests and not the downloaded one. The problem with the downloaded one is the correctness of the answer keys and the accuracy of the correlation table available. (There is only one, when there should be 1 per form since question difficulty in each form is different) So if your scores are the result of the downloaded tests, then this could be the simplest explanation.
Another case I have noticed is that NBME questions from earlier forms have been discussed to death in forums and variations of them have appeared in various published qbanks. This can compromise the predictability of these forms since the testtaker may know the answers to a few of the questions beforehand. Therefore a case may be made to use the later forms for better predictability.
Askdoc
I’m talking about the online forms not the downloaded ones, and I’m talking about the Step Ck exam not the Step 1. but what do you think should I go ahead and do the exam in 5 days or what?
and I didn’t know any answers beforehand.
Hi Oshafez,
Okay. But either of your scores is quite good. And what I said about Step 1 also applies to Step 2 CK. except of course that they are less discussed in forums than the Step 1 exam. Both your scores indicate somewhere in the 99 range. As someone who got a high 99 once told me, he believes how high you get above 250 is a matter of luck already. Since there’s probably less than 20 questions between 250 and the highest score, he may be right. Anyway, good luck with your exam. So long as you keep your cool during the exam, you’ll probably have no problem getting a really high score.
Askdoc
Thank you very much askdoc, you’ve been really helpful. thanks
Dear Askdoc:
Thank you so much for your advice. Very helpful and concise. These 4 points you made were very clear and pin-pointed some problems that I currently have. I started making some flashcards to master each topic now. I have also started making my own algorithm chart for management in each case that I am not clear about.
I just would like to ask you whether you know a good book to purchase for pathophysiology. When I checked my Step 1 score distribution yesterday, I did just OK (not excellent) on pathology. If you know anything about a good review book for pathophysiology, I would very appreiciate your advice.
Thank you again for your time and support. ~TOSHI