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.
How to use the NBME Self-assessment tests
Best time to take the NBME Self-assessment tests
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 USMLE 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 Q Bank or Kaplan Q Bank as a screening test.
Use NBME Self-assessment Tests to assess readiness, not identify weak points
The practice of many to take the NBME Self assessment tests to identify weak points and measure progress in review is not very practical. First, there are only 7 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 USMLE 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 USMLE 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 assessment test scored 700, way above what I needed for a 99.
Timed NBME Self-assessment Tests for best results
Another common question is whether to take the NBME examination timed or self-paced. Since you are trying to test your actual readiness for the USMLE 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 self assessment test. 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 USMLE 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.
What about the USMLE World Self-assessment tests
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.
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Hi Bella,
First, depends again on score you want. Kaplan Notes and UW Qbank will be good for 80′s up to mid-90′s. If you want higher you need to supplement. Prep time. Average should be about 4 to 5 months. although there will be significant numbers that will take up to 8 months. Since your second round, you should be able to cut down total prep time a bit. Remember you need to concentrate also on details not just general understanding of the concepts.
Askdoc
Hi Kiran,
There is always hope. If you need a 95 to get a residency positions then about 20% of the residency position will remain unfilled since there won’t be enough people with those scores to fill all position. So don’t believe those posts as they do not present complete picture. Of course higher scores means better chance at getting residencies, especially highly competitive positions. Scores are most important to get interviews. Although scores do have impact on being matched, the interview occupies a bigger weight in match decisions for most programs. Just make sure you research your programs very well.
Askdoc
Hi askdoc
I just took nbme 5 and got 550 (234 3-digit) do I still have
a chance of getting 99? my exam is 1 month away. I would like to
get into IM residency. Am I doing ok? Please advise
thanks
Hi
I did nbme form 4 with 480 which is equivalent to usmle three digit score 225. I did it timed mood. and I did not take any advantage to improved my score. After one month I took real usmle step 2 ck exam with 188/74(fail). 37 points devaluation has been occurred .How could it possible,
Hi Morshed,
Very hard to say without additional information, but I will give you the possibilities. You plateaued then declined. All reviewees experience a plateau, when additional studying does not raise your scores. It means your rate of forgetting is equal to your rate of learning. Then eventually you go into decline where rate of learning is slower than rate of forgetting. If you are in decline when you took the NBME, you could wind up with a lower score.
A second possibility is that you participated in those posted questions in the forums. A lot of those questions are from the NBME and if you did, that will artificially inflate your scores in the NBME.
A third possibility is you perform poorly under stress. 37 points is almost 4 SD drop in scores. The average is about 2 SD drop. Anything greater than that can be caused by poor performance due to stress.
Or it could be all three.
Askdoc
Hi
i did my step 2 ck.I failed.I had done UW qqbank and also self assessment 70 percentile. Also did kaplan lecture notes and questions..I did not do any nbme. I wish to retake the exam in three months..wat do you think shd i do ..pls advice..really in desperate need..i used to study around 12 hrs/dayfor 3months . i am a person who gets tension 1 week before any exam (this also affected me)could you pls advice me me on a specific study plan or sme thing..pls
can i reapply after 60 days from my last attempt..??
Hi Silby,
My suggestion is this. First take a few days off to recover from this. Restart your prep this time reading up on my posts on Step 2 CK Prep. You can find them by clicking on the USMLE Step 2 CK Category. Pay special attention to the article on Most Common Mistakes in Step 2 CK Prep and note if you have any problem. Follow the suggested remedies. Ask question for clarification. Make sure you take the NBME this time. And do not reapply until you are reasonably sure you will pass this time. Trying to rush it and failing again is not recommended.
Askdoc
Hello! I was scheduled to take my USMLE step 2 CK in a week. I have been studying for 5 months (3-4hours a day, cause have a full time job) did USMLEworld 3 months ago, end up with 65-70% average after doing 60% of the bank, most of it random and timed. After the USMLE world self-assessment, I got 213 which was around 89-90. then i review my notes again started kaplan and got 59% after 40% of kaplan q-bank. I took the NBME self assessment form 2 weeks ago and got 500/230/96,I felt that my problem was basically of recall and memory, so I though that 2 more weeks of intense study will be enough to polish it. So I dedicated to study 6 hours a day for the last two weeks, read againg the FA, keep doing questions and took the NBME form 2, and now got 450/218/90 again. I freak out, so i canceled the exam, but i don’t know what strategy to use, to be sure of getting a better score.
Any recommendation?
Thanks
Hi JA,
My problem is I can’t be sure if your lower score is because you are burning out or it’s just the result of standard deviation in score. Remember 2SD can be as high as 20 points in the 3 digit score. How are you doing in q bank? Are scores going up or going down too? If you are burning out, then postponing the exam was the wrong decision as that could cause you to have an even lower score later. So it’s important to know if that is the problem.
Askdoc
Hi, thanks for your response! I think i was burning out due to that high pressure I put over last week, working 9-10 hours and studying 7 hours a day,besides the actuall stress for the proximity of the test, i think was not healthy. Although is possible that was the results of the 2SD. I was doing worse on q banks too. But after 1 day of complete rest, calm down, and re-focus, I started studying my 4-5 hours a day and I’m going up on q-banks again. Now my average in kaplan q-bank is 63%, (it was 55% the week before). I’m planing to take the test in 2 weeks if I keep doing better! Let me know if have any other recomendation!
Thanks again, I’ll keep you posted!
JA
Hi Askdoc, I am an img graduated in 2010, have passed step 1 with a score of 194 this year and now prepping for step2ck.
I have finished reading Kaplan notes (IM more than twice, others twice and Pysch once) and Secrets(2001 ed.)(which I still haven’t finished..) for almost 5 months now. About 8 hours of reading. Been doing kaplan qbook and qbank since 1 month now. I take mixed blocks including all subjects and I do one block of 44 qs. at a time, been getting around 55-60% only..
I have actually scheduled my date in Aug 1st week but I am probably going to postpone it. Took NBME form 1 (offline) today and got 100/184 if the source answers were right and reliable.
I have First aid and UCV also, been referring and reading FA but still left with more than 50% of it, and haven’t touched UCVs yet.
Now my questions are:
1. Shall I start with UWorld before trying and waiting to finish Kaplan Qbank? As you said I am trying to master Horses along with the Zebras, kap qbank has a lot of questions on zebras..and i’m aiming for a 99 in ck in light of the low score of step 1.
2. How to deal with difference in the management of conditions cited in different ways in KL notes v/s FA?
I am aiming for 2013 match, i do have plenty of time but I wanna finish my CS before the end of this year and give my next year to O’ships.
3. All the forums say that “Don’t spend much time on books, solve more and more questions instead.”..Does it really help? coz after properly completing and grasping the KL notes thrice it still doesn’t feel cofident.. And the new kap qbank of 2010 has so many new kind of questions on zebras that take up a lot more time to read explanation, with those explanation videos included. As you said we shouldn’t use kap qbanks for learning but use for assessments, then what about those new qs which we can’t answer right even after finishin KL notes properly?
Looking forward to your best tips and suggestions.. Studying for this exam feels like swimming in atlantic ocean and not able to see any shores..
Thanking you,
isolveurprobs@gmail.com
hi Ask doc… how are you??? i am studying for step 2 ck now…
have been doing uworld questions…
i took nbme 4 two weeks ago and got a 188
i took nbme 2 yesterday and got a 207…
do you know how close is nbme 2 to the exam? i am so scared… my exam is in 2 weeks… please help…
thanks…
HI drsharma,
Based on NBME alone, you have a good chance of passing. However, there is still a small chance of failing. You need at least a 210 for a sure pass. What is your qbank average?
Askdoc
hi ask doc,
plz need ur advice, i’ve been studying for CK for the past 4 months, have done KLN 3 times, mtb2 and 3 atleast 4 times, UW first time cumulative score of 64% n second time 80%.
took nbme2 n got 370/200 studied more for 1 week n took nbme4 n still got 380/202.
my exam is in 15 days, i dont know what to do, i dont wanna fail n i dont wanna pass with a low score. my eligibility ends with the end of december. plz tell me what to do.
thanks
i took uwsa today n got 231 in it, plz askdoc tell me what should i believe, nbme or uwsa?
i wanted to get the nmbe step 2 ck forum 4 .. am an international medical graduate … can you please post the link for it .. as i searched for it cant find it .. thank you
hi drsbQaisrani,
NBME
Askdoc
hi
m preparing for step 2 ck before step 1
what u say how shuold i proceed and what should i ndo differntly from others to have a good score even with this plan
have done with 2 readings of kaplan
going to have 3rd after which i m planing to start UW
what are ur suggestions
thanking in anticipation……..