Which NBME Self Assessment Form to Use for USMLE Step 1

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Which NBME Form should you Use for USMLE Step 1?

This is one of the most common question that I usually encounter both in my blogs and in the various forums. And you have as many answers as there are NBME forms, in fact more. Various answers include the following

  • Use all 7 NBME forms to track your progress
  • Use at least 2 NBME forms and get the average
  • Use NBME form 5 to 7 as they are harder
  • Use NBME form 1 to 4 as they are easier
  • Use NBME form (#) as they are most predictive

As you can see recommendations vary and reasons vary. My recommendation is to use at least 2 NBME forms, one from the easy set of NBME form 1 to 4 and the second one from the harder set of NBME form 5 to 7 and then get the average. If you want to know why, then read on.

What You Need to Know About the NBME Self Assessment Forms

In order to determine what NBME form you should use, you need to answer 2 questions.

  1. What is the main purpose of using NBME self assessment tests for USMLE Step 1 Prep?
  2. What is the difference between the various NBME forms if any?

I had written extensively about the NBME self assessment tests and how they should be used for USMLE Step 1 Prep. Those interested may read Part 1, Part 2 and Part 3 by clicking on the link.

For this discussion it is important for you to know the following,

  1. The NBME question pool is different from the USMLE question pool and therefore the style of the questions are different although the content that they are testing is the same.
  2. USMLE questions are more similar in style with the online qbanks than NBME.
  3. The basis for using NBME self assessment tests to predict your probable USMLE score is due to the extensive correlation which NBME has done between both test results
  4. Therefore, the best use of NBME self assessment test is to predict your probable USMLE score and decide the optimum time to take the exam
  5. Although NBME self assessment tests can be use to assess your progress, there is some limitations. It measures your knowledge of USMLE content but it fails to detect any problem you have answering USMLE type questions.

What are the Difference in Difficulty Levels of the Various NBME Forms

There are differences in the difficulty level of the different NBME forms. The higher the NBME form number, the more difficult the questions. Therefore, NBME form 1 is the easiest while NBME form 7 is the toughest.

However, since all 7 NBME forms are normed and correlated to the same USMLE exam, the predictability of all 7 sets are fairly similar but not exact. In other words, even if the NBME form 7 is tougher than the other exam, the number of correct questions you need to get an equivalent score in the USMLE is actually lower.

I have also observed that the lower NBME forms tend to overestimate your actual USMLE score a little, while the higher NBME forms tend to underestimate your actual USMLE scores a little. But overall, they are still within the SD level of + or – 11 points on the 3 digit score.

So What is the Best NBME Form to Take for USMLE Step 1?

If the purpose is to predict the probable score you will get if you were to sit for the USMLE, then my recommendation will be to take two NBME forms and get the average score. One NBME form from the easy group Forms 1 to 4 and the second one for the harder group of NBME Forms 5 to 7.

If you only have the financial resource to take 1 form then either NBME form 4 or 5 will be a good choice as they are of intermediate difficulty.

What you should not do of course is to take the “downloaded” or “pdf” version as aside from issues of copyright, it is the predicted USMLE score that is important and not the actual percentage of correct answers you got.

If the purpose is to assess the progress of your USMLE Step 1 review, then my recommendation is not to use the NBME forms at all but use 4 blocks of UW or Kaplan Qbanks on a random, timed, mixed unused basis.

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25 thoughts on “Which NBME Self Assessment Form to Use for USMLE Step 1

  • March 22, 2011 at 1:24 pm

    HI ASKDOC.. i m not sure if u remember me.. i asked for your advice last year in september..i had a poor step 1 correlation and i took your advice by taking a break and postponing my exam.
    I started almost 2 months later, and now i have my exam 10 days away..on this 31st. I took my nbme form 6 online and i got a score of 500/223
    i would appreciate your opinion on the correlation of nbme 6.. i m also wondering whether or not i should take another nbme to confirm my score projection and if yes.. i need your suggestion on which nbme has a better correlation between 4 and 5 as i have used all other on previous ocassions.

    Thanks in advance.. and your blog is just great.

  • March 24, 2011 at 1:10 am

    Hi Bella,

    Glad you took my advise! You seem to be doing well. You can take form 5 although the difference with form 4 is not really that big. Don’t forget to read my post on What to Do on the Day of the USMLE Exam. And Good luck. Keep me posted on the result.


  • April 12, 2011 at 11:17 am

    my exam is in next 2 wks…which nbme exam i shud do?i havent done any oyet….

  • April 30, 2011 at 1:41 am

    Hi askdoc. I wrote my exam last month and got 99/235, but what I’m concerned about is my nbme and real exam score irrelevance. I did only one nbme (form 7, standard paced mode, with 5 min breaks among blocks)2 weeks before and got 610/247. My UW world cumulative was 74% in mixed, unused, timed mode. So is such high deviation from expected nbme score (in my case 12 points on three digit score) normal?

  • May 9, 2011 at 3:02 am

    Hi ostati,

    Actually, for Step 1, 1 SD is about 6 points and 2SD would be 12 points on the three digit score. It’s wide but still acceptable.


  • July 23, 2011 at 4:05 pm

    hi askdoc!!! I really need all the info about books or courses or something that can help me to pass my step 1. I’m an IMG I came here and since then I’ve been studying for my step 1 I failed once and now I’m worried I have no money enough how to get the kaplan course I read by my self the FA and the medessentials!!! but do you know another book do you know if there is another courses (cheaper) I’m studying by my self but I guess is not enough could you help me please!!! also my mail is tkd46@hotmail.com

  • October 8, 2011 at 8:37 pm

    i got 256/700 on USMLE simulated exam for step 1. having my exam next week. which NBME should i take? what shuold i do in my last week to potimise my resutls?

  • November 5, 2011 at 11:07 pm

    Hello Askdoc,

    I am once again in the study home stretch for the daunting step 1 exam. The first time through I was unfortunate enough to fail with a 186 score. I am in line to take it again in 3weeks and today I took nbme 7 with a score of 186 (nbme of 360). I have done all Uworld with a first pass cumulative score of 60%, I am on my second pass. I did form 6 two weeks ago with a score of 172 (nbme 290) which is a score that I was not getting even the first time studying for this test and took form 5. I took a review course the first time through which I used way too much time in and did not focus on trouble areas. I will be starting my 3rd FA pass in 2 days and I am at a loss at the current grades I am obtaining. I know my weak areas are biochem, respiratory, immune and general principles of health and disease. Of course money is already tight and I can’t buy more practice tests or resources. Any advice will be welcome as how I am right now just staring at my computer looking for a solution to this problem. The email is: techy19798@hotmail.com

  • January 17, 2012 at 11:49 pm


    I need your help.
    I have being preparing the step 1 the last 6 months. I finish kaplan center, q bank, read goljan and listen goljan audiolectures. I read first aid one time.
    I was planning to take the step 1 exam in february 22.

    But I just took NBME 7 and I got 350/186. I am worry because it is a very low score.

    What should i do next?

    Thanks for any help.

    I really appreciate it.

  • January 18, 2012 at 12:09 am

    hi mavi2012,
    My suggestion is to use the qbank and the result of NBME 7 to find your weak points. Restudy those weak points for the next 3 weeks and do another NBME. If your score goes up, good you can proceed with the exam. good score means at least 204 in the NBME. Anything lower than that then there is a chance you will fail the exam. If your score does not go up, it means you have plateaued and sitting for the exam will be a mistake because you will fail. You need to take a break, restart your review and postpone your exam. So next 3 weeks is crucial. Keep me informed and Good luck.


  • February 14, 2012 at 1:48 am

    I am preparing to take the SPEX which I believe to be similar to the USMLE Step 3 exam. I took a self assessment from the NBME and scored a 300 with areas in which I need obvious review. What does a 300 mean on the NBME, and can this be correlated with a USMLE test score? I see lots of info regarding step 1 and 2 but remain unclear about step 3. Also there is one more self test that I can take. When should I do so if I am studying full time at this juncture?
    Thank you

  • March 28, 2012 at 9:08 am

    hi Doc,
    im preparing to take the step 1 in 11 days. i took the NBME form 7 and got 510(224) and then took the NBME form 11 and got 540 (231), all within the last 2 weeks. Am i good to go or do i study more, im confused with the correlators

  • April 1, 2012 at 9:27 am

    Hi sopolisky,

    You will pass. You will get a good score. You are good to go. Read up on my post on what to do on the day of the exam. You are good to go.


  • April 2, 2012 at 11:49 am

    hey ASKDOC,

  • April 7, 2012 at 2:42 pm

    Hi Askdoc,
    I was wondering if you happened to have any idea of the correlation between step 1 score to the NBME from 13? I know it’s a new form and I’m worried that it is like forms 1-5 and over estimates one’s score. I got a 550/233 reading FA one time and doing 1/2 of the Kaplan Q bank. I’m thinking about postponing my test a few days to see if I can pump my score up a bit more.

    Thank you,

  • July 20, 2012 at 8:04 pm

    Hi !!! I’ve been studyig for the step for about 4 months. I took the NBME 7, 11 and 13. First ( before the review ) when I took the 7 form I scored 400 and the same for the 11 form ( after the review). Then study for about two weeks going through my notes and scored 530 in the 13 form. What is your advice when I should schedule my test? The higher the form, of NBME the higher the harder it is?

  • August 3, 2012 at 8:34 am

    Hi Becky,

    Theoretically, yes, the higher the form the harder it is. However, results are now being skewed by two factors. Too many forums are discussing the nbme form questions in their discussions. Second some q banks are incorporating questions similar to the nbme into their q bank. This can skew the results as in both cases the test taker already know the answer to the exact questions. Self-assessment tests are only predictive if used as intended. That is its the first time you encountered all the questions. Anyway, I suggest two things correlate with your q bank score, with a 530 you should be getting mid-70’s correct on online qbanks and do one more NBME. When you have the score you want, schedule your exam and rock it!


  • September 4, 2012 at 8:29 pm

    Hi Askdoc,

    I’m preparing for USMLE step 1. I have got the offline NMBE self assessment questions and recently I did the offline NBME form 12 questions and got 63% correct. From this result, can you tell I am closer or in the range of passing the actual exam?


  • September 9, 2012 at 11:49 am

    Hi Dave,

    If you read the rest of my NBME post, you know that the value of NBME in predicting your score lies in its score correlation. That is why it reports your predicted score not your raw score. By using the downloaded version, you really get no benefit. You may have forums telling you what they think the percentage correct should be so you will pass. But how sure are you they are right. NBME’s reliability for predicting scores lies in their correlation table, not what some third party thinks it is.

    Its like asking a quack doctor to perform neurosurgery. He assures you that expert neurosurgeon gets a 90% survival rate with the procedure, so he’ll do exactly the same steps as what he read in the text on how neurosurgeons will do it if they were doing it. Don’t worry if he did not graduate high school. Remember, he is doing it exactly how an expert neurosurgeon would do it since he read the book. You and I know its not exactly the same, so he should not agree to have that quack operate on him. So too between the downloaded version and real version and yet you see so many people are willing to risk their medical career for it. I know its not as valuable as your life, but for me my career is a close second.

    You also see so many people using download versions of qbanks from Kaplan or UW. Again, the reason people are scoring high using both qbanks is they get used to the exam conditions. That is why both qbanks take great pains to make the interface almost the same as the real one. That is not coincidental. And yet you see lots of people using downloaded versions. Then they email me or post on my blog wondering why they got a low score or are failing. If I used downloaded versions in my prep, I would barely pass this exam, much less ace it. So do yourself a favor and get the real one. Also the real qbanks. Your medical career is not worth one months worth of food. It’s worth what you will be eating the rest of your life.


  • October 24, 2012 at 5:03 am

    hi!! ive been studying for usmle for about 5months,i took usmle world and was getting between 50s n 60s and few in 70s. i took nbme form 7 and got 207. what should i do??? i was planning on taking the test in mid november. how should i improve my score???

  • January 28, 2013 at 8:46 pm

    hi i gave nbme form 7 and i got 200 three digit score and then i gave uworld self assessment and i got 230 and i am preparing u world and i have exam in some 20 days what nbme and what 8hr practice test should i give as i had not practiced for that and any sought of long tests before ?????

  • February 10, 2013 at 9:25 am

    I am on my last leg to be denied to ever enter residency. So I will work as hard as I can the next six months( august) and let all hang out there .In the meantime I need all help or advice I can get! How can you help me?

  • February 20, 2013 at 3:38 am

    Hi Jean,

    Only you can help yourself pass this exam. I can only show you the door. You must still pass through it yourself. I suggest you read through this blog for advise on how to prep for Step 1 and pass it in one take. You could also buy my book from Amazon, How to Master the USMLE Step 1, which discusses in more detail how you should prep for this exam. IF you need more hands on help, then enroll in my course on Step 1. You can get more details at http://main.askdoc-usmle.com.

  • February 20, 2013 at 3:43 am

    Hi Fahad,

    NBME is more reliable.


  • March 6, 2013 at 11:55 pm

    On the self assessment website they no longer have Forms 1-4 available. I did Form 5 today as my first one and have 4 weeks before my exam. I got a 217 three digit Step 1 score, which is ok but not as much as I wanted, although I have a lot of review that needs to be done still. They only have 5-7 and 11-15 now. Do you have any advice as to which may be harder or easier and when we should take them?

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