NBME Self-assessment Tests and USMLE Review – An Update

Share if you like this post
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  

It’s been over a year since I first published “NBME Self-assessment Tests and USMLE Review.” Little did I know it will become the most popular of my post with over 14,000 pageviews in the past year. Since that time a lot of things have changed, hence this update.

If you have not read the previous two posts on this topic, please do so as I will not be repeating what I have said there in this post. You can access Part 1 here and Part 2 here.

How well does NBME predict your USMLE Score?

That has been the number one question asked of me since I wrote about this topic. My answer is still the same. Fairly well. Although correlation is never 100% more like 70 to 80%. However, certain development in the past few years have made the assessment tests less reliable for some people.

One of the reasons for this problem is that a lot of NBME questions, especially the earlier forms of step 1 have been discussed extensively in various forums. What’s more some of these posters did not even bother to warn people that what they are discussing are NBME form questions. Going into the NBME assessment tests knowing some of the answers already can invalidate the predictability of those assessment tests. In fact just knowing some of the questions beforehand can also invalidate the results. The reason is that knowing the questions ahead, means you’ve had time to consider the questions and possible answers before, not just the 1 minute or so that you will actually have in a real exam. That can skew your result.

It has also come to my attention that some NBME questions or variations of those questions have come out in online qbanks. That is bad news, too as it has the same effect of invalidating some of the questions in the NBME forms. Even if you did not get the answer, encountering the questions in the NBME form for the second time rather than the first time means you had more than the 1 minute allowed in the exam to think through the questions and look for the answers.

So what are the remedies for these problems that seem to have cropped up recently. Well first is to actively avoid discussing posted NBME questions in the forums. Of course since some posters do not have the courtesy of even warning people about it, avoid participating in any discussions on questions in forums unless you know for sure that they did not come from an NBME form.

Another solution is to try to use the later forms. In Step 1 this would be form 4. 5 and 6. NBME forms for Step 2CK does not suffer from the same problems as those in Step 1 as they are not discussed as often as those of Step 1.

Doing at least 2 forms instead of just 1 as I recommended before may also help. Just make sure one of the form is not the first 3.

What about the “Downloaded” NBME Self-assessment test version.

I can never understand the popularity of the so-called “downloaded” version of the NBME. IF saving a hundred dollars or so is worth scoring low or failing the USMLE altogether, then it is understandable. But ruining your long term career to save a couple of bucks is not a very intelligent move.

In earlier posts, I have said that the value in the NBME does not lie with the fact that the questions mimic the USMLE. In fact, in general, they are much easier than the USMLE. The main value of the NBME forms is that they are fairly reliable predictors of performance in the USMLE due to the correlation they’ve done with NBME results vs. actual USMLE performance.

However, recently, some posters in my blog have commented that they are able to “predict” their USMLE scores, since there are answer keys and correlation tables available with the downloaded version. So I decided to give it another look.

So what did I find out? Well, first, there is a problem with the answer keys. There were some answers that I completely disagree with. In some cases where I myself am not sure what the right answer is, I tried to verify the possible correct answer by researching them and I still cannot decide what the right answer is even after searching through textbooks and the internet. Therefore, there is a question of how accurate the raw score one is getting for each of those NBME forms are. And that is a major problem. In my case, anywhere from 2 to 8 answers in each form fall into this category and for me, an “unknown” of 4 to 16% in the raw scores completely shoots down any chance of actually knowing the exact raw score you should be getting.

A second major problem is that there is only one correlation table in existence, instead of the 6 correlation table I am expecting. That is one per form. There might be additional correlation tables out there, but the one I got is just 1. Why six tables? Because the forms are of different levels of difficulty, you expect the same person will get different number of questions right in the different forms depending on the level of difficulty. So you need a correlation table for each form to make them comparable. Having only one correlation table means we don’t even know to which form this correlation table belongs. See the problem, now.

A third really big problem is that people who used this downloaded forms has a tendency to keep on using them throughout their prep multiple times. Probably because it’s free. In fact, it was justified that since they did not try to look at the answer, they can redo the same form and expect it to still be accurate in predicting their scores. That is actually wrong. Again, one of the reasons why USMLE is hard is the time limit imposed in answering questions. When you go through the same question multiple times, you’ve had more than the 1 minute per question limit imposed by USMLE to think of the answer and therefore will tend to score higher. That skews the predictability of the NBME.

Therefore, again, do yourself a favor and use only the online NBME assessment tests and use them only when you feel you are ready for the USMLE, to confirm your readiness. The “downloaded” NBME forms may seem free, but it’s hidden costs may be greater than you are willing to pay.

USMLE World Assessment Tests

I’ve had more time to gather information about this relatively new resource. So far based on talking to my students, posters in my blogs, people who have emailed me and reading various forums, my conclusion is that the UW assessment tests is just as good as the NBME assessment tests, so far.  Although there have been some observations that UW tend to be overestimate your scores in comparison to NBME, this does not seem to happen in all cases and the score difference is not too big. So all in all, I believe the UW assessment tests have enough track record by this time that we can safely say, they are fairly accurate in predicting USMLE scores. But as in all assessment tests, correlation is never 100%, therefore expect some deviation from predicted scores in the final result.

 

Related Posts:

Like This Page!
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
About the author

    askdoc

  • olumide says:

    Hey, Nice blog u have here, wish I had found it earlier I just started USMLE World, I’ve done like 6 tests now, 66-72. I got a little bit confused about registering and confirmation of materials by ecfmg. I thought I had up to 2 months to continue with my preparations, but they sent me a mail yesterday that my eligibility period is Aug 1 to Oct31. The first problem is I will be reloating to the UK On the 14th of september from Nigeria. I picked the Africa testing Region. I already sent a mail to ecfmg asking if I can change my region but they will take up to 15 days to reply me. Is it possible to change my testing region for the step 1. Also, apart from the 66-72,% score so far on USMLE World, I had 65% on kaplan Diagnostic and 86% on the free USMLE 150 pratice questions. I’m confused as to what I am confused about. What do you think.

  • askdoc says:

    Hi olumide,

    For the past few years, everyone I know who tried to change testing region were turned down by ECFMG. However, I personally never went through the process, so all I know is from what other people had told me or written in forums. People wind up having to fly out to a different region just to take their exam. But my suggestion is you wait for reply from ECFMG. Who knows, they may have changed policies recently. If they do allow you to change testing region, would appreciate it if you would report back here so others in similar situation in the future can be helped.

    Now for the good news. based on your UW scores and Kaplan Diagnostic scores, you seem to be doing very well, especially if you still have more than a month before the exam. Did you do your UW random, mixed, timed or by subject or tutorial mode? Usually, you score lower in UW than in Kaplan. however, both scores indicate somewhere high 80’s to low 90’s. With over a month left to review, you have the potential to get a really high score. Important to go through one more revision of the subjects, but do not study anything new. Do all the q’s preferably timed, random mix blocks and take notes.

    Askdoc

  • KluverBucy says:

    Hi, In response to changing testing regions.
    I did successfully change my testing region from Europe to North America. In this case, they had to send me a brand new scheduling permit and cancel the old one. However, I did not have to resubmit any documents. It took them 2 weeks to send me my new permit.

  • askdoc says:

    Hi KluverBucy,

    Thanks for the info. Really appreciate it.

    Askdoc

  • ming says:

    Hey askdoc,

    First I just want to say a huge thank you for putting up all these info about the step 1. And I had a few questions:

    For these NBME forms, when you pay yo get them you get all 6 right? Or is it pay per form?

    Also, I am scheduled to take the step 1 in May of 2010..so about 8 months from now. And I know I have a knowledge base problem because I would cram for tests and pretty much barely pass through my classes (and believe me I am regretting and hating myself for doing that). But what is done is done and I have realized the grave situation I am in and thus I am wondering is it possible to attain average and mayb even a little bit above average (220 or so) with the amount of time I have between now and May 2010? I am thinking about trying to go through the big robbins text while annotating/note-taking into First Aid along the way and then try to branch off to other topics as it is relevant (immuno/micro, anatomy, biochem, cell bio, etc.)

    I was planning to take a NBME form 4 before any studying just to see where I am at right now, and then I was going to take another NBME form 5 about 4 months into studying to see how much progress I’ve made and then I was gonna do NBME form 6 about 2-3 weeks before Step 1 date. Is that a good plan?

    Thanks alot for your help askdoc!

  • askdoc says:

    Hi Ming.

    First, NBME is paid per form. So it will be expensive to use all 6 forms. For most people 8 months of prep is more than enough to do well. However, how well you do depends on a lot of factors. Your memory capacity, your analytical ability and how well you study will limit the top score you can achieve. Your reading speed, intelligence, ability to concentrate, ability to retain information and how fast you tend to forget information will affect the study period you need to achieve your maximum potential.

    Although studying Robbin’s is a very good way to get a high score, what you are planning to do have some problems. First you are relying on your own judgment on how much and what you need to study in order to achieve your desired score. There is no problem with that if you are good at judging how much or how well you need to know the topics to achieve your desired score. However, my experience is that 80% of people do not really know how to do that. That is why I talked about substituted judgment in the What to Study for the USMLE posts. Substituted judgment is when you depend on other people’s judgment to decide what you need to study and how much you need to study to achieve your scores. You do this by using specific resources or enrolling in specific courses that have been tailored to help you achieve a certain performance.

    For example, Kaplan Notes contains enough information so that if you retain (not just read or study) >85% of it, you have a good chance of > 220 score. However, even if you retain 100% of FA, I doubt you could score higher than 210. If you just read through the material once or twice, chances are you will just retain anywhere from 20 – 60% of what you’ve read which may result in failing the exam. Retaining around 80% of Robbins (Of course it has to be the correct 80% as Robbin’s include low yield materials and you need to separate the chaff from the grain so to speak) you can get > 230 but only on the pathology portion. Not on the whole USMLE Step 1. So your final score still depends on how you covered the 6 other subject.

    For example, my prep course is designed so that if you retain 80% of the material, you’ll probably score > 230 and if you retain 90% of the material, you’ll probably be scoring > 250. It includes lectures which teaches you how to study in order to achieve your goals, plus study materials that emphasize what to study and how much to study to reach particular scores.

    So it is very hard for me to assess if what you are planning will achieve the scores you desire. It depends on how good your judgment is.

    When you take your first NBME depends on how much reviewing you have finished and not on a fixed time period. For example, my course requires 3 revisions minimum to pass. (some people can pass with just 2 revisions, but a lot won’t. I took 3 revisions to get my 256. Others may need more than 3 to get a 99) My students take their first NBME after the third revision and at least half of qbank if they are using only one online qbank. If they decide to use both Kaplan and UW qbank, the first NBME is after third revision and completing one online qbank.

    Askdoc

  • docjay says:

    hallo askdoc,
    thanks for such great information regarding step1. im gving my step1 in nov 09.how should i plan taking other step exams so that i can apply for 2011 match. i m done with UW(tutor mode) and my scores are in range of 50-60%. any suggestion to increase my scores in step1.
    thanks…

  • Dr.Brightside says:

    Hello Doc, I have been preparing for the USMLE step 1 for about 9 months now, I studied from Kaplan, Goljan and FA, did USMLE World and scored 57%. My exam is in 15 days. I took NBME 2 and scored a 560(236 on the real deal according to the chart). I Plan on taking NBME 3 a week prior to the test. I’m aiming for a >90 grade. My question is if with that score on NBME 2 i have any degree of certainty i can score >90? Another thing is that i did really well on the UW Self assesment with i took 2 months and 1 month ago. I got the same grade (216…95) on both. Thanks in advance doc.

  • askdoc says:

    Hi Dr. Brightside,

    Just curious, are you using the online NBME assessment test, or one of those downloaded one. If it is the downloaded one you have a big problem. One reason I asked is you have a 57% in UW qbank and that is equivalent to at most a 75. One of my students got a 56% in UW qbank and was told by me that there is a good chance of failing the exam. Took one of those “hard” copy NBME, despite being warned about the lack of reliability unless using the online version , got a 228. So sat for the exam with confidence and failed the actual exam. So before giving you any suggestion, I would like to ask which exam you actually took.

    One more thing, if 57% is enough to get a 236, then one of my current students who is now averaging mid-70’s in the qbank would be equivalent to what score? as of now, he is still doing additional revisions to insure he will get a 99. 2 of my students who were averaging mid to high 60’s in the qbank got high 80’s to low 90’s. One student who got average 59% barely passed the exam.

    Askdoc

  • Dr.Brightside says:

    Thanks for the quick reply doc . I used the online form. I had never entered any forums before although i recognized some of the questions for their content and not because i had been asked those questions before. One thing I should mention is that I didnt really memorize the First Aid prior to doing the Usmle World Questions (which i also took online and not the pirated version). 57 was my final average but during the last weeks I was constantly above 60%. Once I was done with World i read First Aid once again and realized that had I memorized most of the things in there I would have done a lot better in World, I didnt really do well with any of the straight recall questions, so that’s what i basically did prior to the NBME i took last sunday.

  • askdoc says:

    Hi Dr. Brightside,

    An average of mid-60’s is more consistent with a low to mid-90’s predicted score in the NBME. Remember, there is no assessment test that is 100% foolproof. Therefore, the more parameters you use to gauge your readiness (NBME and UW in this case) the better the chance that you will get that score. So based on those points, you have a very good chance of hitting mid-90’s. Read up on What to do on the day of the USMLE exam and you are good to go. Good luck on getting your dream score.

    Askdoc

  • Dr.Brightside says:

    Thanks Doc. I’ll let you kno how i did once I get my score

  • docjay says:

    hallo askdoc,
    i scored 248 in usmle world self assesment form 2 and 230 in form 1. only 2 weeks are left for exam.

  • YK says:

    HI, i’m planning to take my exam in end january , I’m doing a 3rd revision of the subject should complete it in the 1st week of december and I’ll do the kaplan q bank after it then I’ll do the online NBME…. then I’ll do the UW .
    so I can say I’ll spend the whole month ( december) in doing q banks( kaplan + UW ) then in january I have 20 days left to do another revision ( 2 weeks ) then in the last 5 days I’ll go over the 1st aid and my notes from the q banks.
    I don’t know if this is a good schedule??? I heared doing the questions are the most important …so do you think it is a good idea to spend the last 20 days before the exam doing another revision or I should repeat the UW or there is no pointe to do that , I’m confused. I’m thinking of doing both like spend half of the day going over the UW blocks and reviewing the wrong answers then the other half in going over the books quickly , do you think this is better???

  • YK says:

    please one more question…..I’m planning to take 95 or above I hope.
    so what the average scores in kaplan and UW to get such a mark??
    and if I’m planning to do one NBME which one to choose?? I”m thinking of 3 or 4. and if my score is not good I’ll do another one but if it is good + scores in kaplan + UW , one is enough.
    thank you so much in advance.

  • askdoc says:

    Hi docjay,

    That is good to hear. However, my statistics on UWSA is that they tend to overestimate scores and correlation is a bit wide. However, based on those scores, you will probably do high 90’s with a very small possibility of a 99. Spend the next 10 days doing high yield review. Also if you can do at least 1 NBME assessment, so much the better so you can get an accurate assessment of your current status. Another thing, if you did UW Qbank or Kaplan Q bank, an average of > 72% in the last 10 blocks, timed random mixed will correlate with a high 90’s score, too.

    Askdoc.

  • askdoc says:

    Hi YK,
    That is a good schedule. However, I suggest the following. Start with UW qbank rather than Kaplan Qbank. Do 4 blocks per day. Reason is you need to review the questions afterward. So for every block you need to reserve at least 2 hours. One for doing the block. One for reviewing the answers. Plus if you have any really bad weak point, you need to go back to revising that particular topic in your notes or text. Then do an NBME. If the score you get is good enough. Do Kaplan qbank concentrating on simulating exam conditions. make sure to have at least one day where you simulate 7 blocks in 8 hours including controlled breaks. You should spend the last 2 weeks, doing high yield review. Do not redo the qbanks at this stage, since you’ve done your review in December. take a break on the last 2 days before the exam to make sure you are in tiptop shape. Read my post on What to do on the Day of the USMLE exam in this blog.

    Askdoc

  • askdoc says:

    Hi YK,

    OK, for a 95 or higher, the minimum average for the last 10 block, mixed, timed and random should be at least a 70. However, if you want to be sure, then go for around 72%. There will probably be a 2 to 3 percentage point difference between UW qbank and Kaplan qbank. So I would say around 70 in UW around 72 in Kaplan.

    Askdoc

  • YK says:

    thank you , but I already purchased the kaplan for the next month…
    so what the pointe of doing UW before kaplan.
    what if I didn’t get a good score in the NBME after the 3rd revision + one of hte q banks??? do u recomend to do the other Q bank then the final reciew before the exam…. or should do a 2 weeks review then the q bank then the exam???

  • YK says:

    one more thing doc. I’m planning to do 3 blocks in a day cause I need at least 3 to 4 hrs per block cause I’m reading the explanations , I heared they are important , do you think this is a good thing or I’m wasting alot of time and should go over the blocks quickly and spent the other time in reviewing the texts.

  • docjay says:

    my score in kaplan simulated exam was 69.should i solve kaplan q bank now..or stick with revision of notes.

  • askdoc says:

    Hi docjay,

    69 in Kaplan should be about mid-90’s. So if you are satisfied with that than there’s no need to do kaplan qbank. But with 2 weeks to go, I believe you’ll benefit more with revision of notes than doing additional qbank. 3 to 4 weeks then qbank is advised.

    Anyway, good luck on your exam. Remember to read my post on What to do on the day of the USMLE exam. You will have a good score. Maybe not a 99 (Maybe a 99) but a good score nonetheless.

    Askdoc

  • askdoc says:

    Hi YK,

    Read the explanations. In fact even if your answer is correct, read the explanations if it took you a long time to answer that particular question. Also in cases where you are down to last 2, even if you guess correctly, you have to read the answer. For q’s you have no problem with, don’t even bother. For concepts you had problems with in the first 2, be sure to go back and read the text, but only for those concepts you have problem with, OK.

    Askdoc

  • plz helppp says:

    hi ask doc

    i did my step 1 and i got my results back, i failed and got 182– soo close but definitely not wnat i wanted.. so in my last month before the exam i memorized FA as well as i could and i always forget things i dont think my memory is that good, but anyway, now im studying with a plan to do usmle world 2-3 times, write in explanations etc i dont know into my FA and do an assessment exam every weekend and then go over that and learn from it, im doing 2 blocks everyday after reading a chapter in FA ( same subject, same questions).. last week my exam mark was 196 this week its 195, i really need to improve this, it’s been 2 weeks since i have been studying again, is there something i can do ? please help, i cannot fail this time:(
    i really need to do well to compensate for this failing grade:(

    btw i have 49 percent of the u world qbank left to do and the practice exams i did were uworld assesment form 1 and 2

    thanks

  • askdoc says:

    hi plz helppp,

    I don’t know if you will be happy to hear this. But what you are doing will just lead to frustration and in fact is the worst way to study. I know I would fail the USMLE if I used your method. There are 3 things you need to know in order to be able to prep properly. First, is What to Study and your choice of study materials and what you propose to do shows you have no idea what you need to study. Second, you need to know How Much to Study. The fact is you are trusting that combining UW and FA is enough for you to pass shows you do not know How Much to Study. Lastly, you need to know How to Study. The methods you are using clearly show you do not. And judging from your results and methods. The best you can do on your own is barely pass this exam.

    Of course, since you have failed your first one, just passing the exam is not an option if you want to match later. You need to get a high score. The question is can you do it on your own. You have 2 options, learn how to prep on your own, or have somebody tutor you on how to prep. For the first option, all the materials you need are in my blog and in the various forums. In fact that is what I did. Learn how to prep properly and then prepped properly. For the 2nd option, you need to either find a very good and knowledgeable friend who is willing to sit beside you for about 4 to 5 months to couch you on How to Study, or you need to enroll in a prep course. But make sure it doesn’t just give you a bunch of reviewers to study but actually teaches you how to study it.

    Since you’ve failed your first exam, I doubt you will be able to study on your own. Some people fail the first exam because of overconfidence or unavoidable personal problems. They can usually do it a second time. But if you had prepped the best way you know how the first time, I don’t think it’s possible to do the same thing and get a different result. You have to learn how to prep properly first. I cannot just give you a short prescription and magically it will help you pass. To illustrate, my six one-hour lecture on How to Study in my prep course (Excluding what to study and how much to study) has morphed into 6 1.5 hour lectures already. And from what gets discussed in the group chat session. Those 6 1.5 hour lectures may turn into 10 or even 12 – 1.5 hour lectures soon. Again this just covers How to Study. So I doubt in your case a few words of advise will work.

    Askdoc

    Just a quote and word of advise.

    “You learn more quickly under the guidance of experienced teachers. You waste a lot of time going down blind alleys if you have no one to lead you.”
    – W. Somerset Maugham, The Razor’s Edge, 1943

  • plz helppp says:

    hi

    im sorry but i find it confusin to find where you have put the information regarding how to study, can you please direct me to it? i dont have much time left and i really need to study the right way:(

    thanks

  • askdoc says:

    Hi plz helppp,

    There is no one article on How to Study that exists. You need to do your own research on How to Study and How to Study for USMLE Step 1. My prep course is the only course or resource I know that covers How to Study for the USMLE Step 1 via 6 1.5 hour lecture or a total of 9 hours. Even then it is evolving and may eventually extend to 18 hours. If I were to write a book on it, it will probably be about 300++ pages long. When I started my prep 4 years ago. I actually went around trying to look for a book that will teach me How to Study for the USMLE Step 1. I was willing to pay hundreds of dollars, if only I can find one that works. People said FA is the one. So I spent ~ $40 to buy it only to find out it doesn’t. So I bought other books. After spending hundreds of dollars on books, I still can’t find one that teaches me How to Study. What to Study, yes, but nothing about How to Study. So I did my own research, starting with exam experiences of people in the various forums. However, there was a lot of disinformation going around, so you need to know what are outright lies and what has a grain of truth. You would be surprised at how many people followed fraudulent advise just because they were what they want to hear. So they wind up failing the exam or scoring low. So after about 6 months, I had a master plan on How to Study the USMLE Step 1, but the only way I will know if it will work or not is after I have finished my prep. So now I know it works. And one year after I started my prep course, I know it works for others, too.

    To get you started, go to my forum at http://forums.askdoc-usmle.com and read the posts under Askdoc’s method of USMLE Review. Follow the sequence. That will provide you with a brief overview of where to start. It is by no means complete of detailed. As I said, if I were to write a book, it would be at least 300 pages long. The posts are at most a couple of pages long, but it is a good start. The rest you have to research.

    Askdoc

  • Samspade says:

    Hi Askdoc,

    I’m a foreign grad who just did step 1 exam and have nt recieve score yet.
    Well i agree that the irrational idea of “1st Aid +UW ” is nonsence,and i felt so in my exam.
    I appreciate the NBME for their new more comprehensive smart USMLE which can really gauge the REAL doctor from PRETENDERS !.

    Plus i really misunderstand those who keep thinking of the exam as exam ;they miss the idea of learning for their future to save themselves from liability of error in USA !

    accept my regards,
    much blessing

  • docjay says:

    hello askdoc,
    im preparing for my step 2 ck. i scored 243 on uw sim exam and my score on uworld is 67%.

  • askdoc says:

    Hi docjay,

    that’s pretty impressive, keep up the good work.

    Askdoc

  • Cookie says:

    Hello,

    I am so worried and I need some advice. Please!!! I did NBME online yesterday and I got 200. I took form 7 and I felt really disappointed because some questions were nothing to do with USMLE. Another thing many people say that I need form 3 becauser this one is closer to the real USMLE. Could you please tell me if my score is really low???? I felt confident and very good before and now I’m not.

    I don’t want to fail I cannot do that! but if this NBME is very predictable I’m dead! My test is on May 28th I have less 25 days in advance. I am studying 1st aid, and high yield from Dr. Goljan as well as listening to his audio lectures.

    Please tell me were I am right now. Am I dead or I’m in the average score or very low? My plan is to study as much as I can and take NBME form 3 days before the real USMLE.

    Thank you so much.

  • askdoc says:

    Hi cookie,

    I’m sorry to be the bringer of bad news. But 200 is as low as it gets. And I don’t see how you can pass this in 25 days. At least I don’t think I can. Your problem is that the materials you chose to study is not enough for you to pass this exam, even if you were able to retain 100% of it, which of course you can’t, since very few people can do that. If you had added at least Kaplan notes or BRS (Pathology, Physiology, Anatomy, Biochemistry) into the mix of your review, you would probably be doing better. I suggest you listen to my video on How to Master the USMLE Step 1 to understand why it is important to study the right materials first in the right amount of detail in order to do well here.

    Askdoc

  • docjay says:

    hi askdoc,
    thanks for all ur suggestions and guidance i cleared both steps with 99.step1 237 and ck 241. preparin for cs. i just wanted to know can i get neuro residency on my scores only without any USCE or research.im fresh graduate.

  • askdoc says:

    Hi docjay,

    Congratulations on your great scores. Whether you need USCE or research depends on the particular program you are interested in applying. Some programs want USCE, some want research, some do not really care whether you have either so long as you have good scores. Having both USCE or research just means more programs who require them will consider you for interview. But in the end whether you get accepted or not is very dependent on the result of your actual interview. So important to research very well the program requirements and preference and apply to them.

    Askdoc

  • alex says:

    Hi,

    My exam is in two weeks and I’m worried.

    UWSA#1 = 204 (440) 2 weeks ago.
    UWSA#2 = 216 (490) 2 days ago.

    Should I be worried? Should I push my date back? I’m scared. I really want to get a 230 at least but what would these scores mean?! please help.

  • 99rocks says:

    hello askdoc,
    i heard IMG dont get residency easily even with 99 without any USCE or research?
    so its must to have LOR from US?

  • askdoc says:

    Hi alex,

    The problem with your scores is that there is still a possibility of failing. You can still pass with those scores although they would be low. Whether pushing back your exam will help depend on what stage you are in your prep. If you are plateauing already, pushing back the exam date will not help. You may go into decline. If you are not yet plateauing then yes it will help. My suggestion is to push back the exam anyway and try to see if an additional exam will push your score up. If not, then you may need to push it back for 3 months or more and find a better prep method.

    Askdoc

  • askdoc says:

    Hi 99rocks,

    If you research programs very well, then you will be able to get into a position even with average scores. If you have double 99’s but applied to the wrong programs, then you can’t get in. For example, Mayo clinic can fill its roster with AMG with double 99’s. So what is the chance of an IMG with double 99’s of getting a position there. You can dream but it won’t happen. There are programs that require USCE and others that require research. Then there are programs that require both and some that require neither. Apply to the programs that fit your qualifications. As to US LOR, they are effective only if the writer is famous. Or if they are well known in the community where the hospital you are applying for is located. For example, a friend of mine who is an IM in Detroit has successfully helped IMGs with average scores get positions, but only in Detroit. His LOR is not really effective in other areas. So again, get US LOR’s either from really famous doctors or doctors who are known to the hospital you are applying for.

    Askdoc.

  • Jones says:

    Dear askdoc,

    I read through your article, the questions, and the responses. I was wondering if you can help me out. Right before I started Kaplan, I took a practice NBME #6 (real one that I paid for), and I got a 188, then I started Kaplan, and in the middle, I took Uworld exam 1 and got 192. Then after Kaplan, I took Uworld exam 2 and got a 211. My exam is in two weeks, and I’m worried about a rumor that the second uworld exam is an inflated score compared to the first one. Could it be one because it is exam number two and everyone is more prepared? Heard anything along those lines?

    On side note, I’m obviously going to take one more NMBE 5 days before the actual exam. what are you thoughts?

    -S

  • askdoc says:

    Dear jones,

    The problem with uworld is I have been getting reports that it tends to inflate the score you get. I am not quite clear why this is the case, but I’ve seen it happen. I suggest you take the NBME just to be sure. A score of 211 is good enough to insure that you will probably pass, but your score might not be too high. Again it depends on your goals.

    Askdoc

  • AJ says:

    Hey AskDoc,

    Preparing for Step 2CK. Did 2 NBME self-assessments. First one done last week was 480/213, form 4. I did form 2 yesterday and got 550/229. I have about 9 days before taking the real thing. Just wondering your opinion on what I should realistically expect in terms of scoring, provided I continue to review First Aid and do UWorld qbank, which is 65% overall so far with a lil more than halfway done. Also, do you believe that churning through more questions is better or more focused reviewing of topics in first aid/other resources that I seem to be weaker in (based on both NBME profile and UWorld profile). Thanks in advance for your help.
    -AJ

  • askdoc says:

    Hi AJ,

    I think you are going to do well in this exam. Probably in the 90’s but not a 99. Whether your score will continue to go up or not in the next 9 days depends on whether you are plateauing or not. But it still is a good possibility. I suggest you continue doing questions the next 2 days, then shift to high yield review on all topics with more detailed review on weaker subject. Do not ignore high yield review of strong topics as newer knowledge tends to push out older knowledge and concentrating only on your weak topics may push out some high yield knowledge that you already possess. Last 2 days before the exam, relax, take a break and build up energy for exam day. Read my post on What to do on the Day of the USMLE exam for tips on what to do starting last 2 weeks until exam day itself. Good luck.

    Askdoc

  • AJ says:

    Thanks for the help. One quick followup question re: the free 100 step 2 questions. Any thoughts on whether they help and if so, when should I take them..like day or 2 before or now? Thanks again, askdoc.
    -AJ

  • askdoc says:

    Hi AJ,

    Sorry for late reply. Anyway have no experience with free Step 2 Questions. But doing additional questions can only benefit. Do it ASAP.

    Askdoc

  • AJ says:

    Hey AskDoc,

    Just wanted to say thanks for your advice. Gave me some confidence going in for the exam yesterday. I think it went alright, definitely thought the first 4 sections went much better than the last four sections. I’m hoping that is similar for other people as the questions did seem to get harder and also the fatigue factor begins to settle in. Regardless, your advice was great and I wish you the very best. Thanks again.

    -AJ

  • askdoc says:

    Hi AJ,

    You are welcome. Hope you get a great score.

    Mike

  • Masoom says:

    like, i see ur post about the UWSA, and if they predict well, how come m doing poorly on the nbme? i dont get it.

  • karen says:

    dear askdoc

    i need help if im doing fine for step 1…

    i did Uworld qbank for 2 months, my average for timed, unused, mixed in about 50% and then i studies FA, Kaplan for few weeks and did qbank again, timed, mixed, incorrect and i was averaging 70-75%.. i did nbme 3 (CBSSA-290)… my exam is in exactly 2 weeks, am i ready for the exam? i need to pass step 1 and hoping for 85ish… please help me.. thanks..

    karen

  • luckmaster says:

    dear askdoc
    getting usmleworld scores average 68% finished all the questions have i month to go. read kaplan notes, doing third revision now..yet to take the simulation uw/mbme test do you think i will get a good score

  • askdoc says:

    Hi luckmaster,

    68% in Uworld should get you in the high ’80s to low 90’s. But you do need to confirm it with an NBME test. How much you will improve in the next month depends on whether you are plateauing or not. So I suggest to proceed on schedule.

    Askdoc

  • Marjan Habib says:

    I have my Step 1 in 2 weeks. I have only done form 7 of NBME and got a 240. I was very very upset as I was aiming for a score in the 260s. I had a first average of 78% on the UWorld question bank and a 93% average on the USMLE official questions and a 256 on the UWorld Self Assesment test. So why was my NBME score so awful? I have taken this in a good way and have made my study habits even more intense but I desperately want to get above 265. Any advice?

    -Heartbroken

  • askdoc says:

    Hi Marjan,

    Just so you can do a comparison. My NBME was a 740, so predicted score of 265. My actual score is 256. My average for Kaplan qbank (uworld qbank for Step 1 did not yet exist) is 84%. I got 98% on USMLE official questions. UWord self-assessment grossly overestimates your score. So your NBME score is not awful, just right for your other areas. My suggestion is do not obsess about a certain score. Just do the best you can. Too much obsession creates too much tension. This pressure can even cause you to perform poorly in the actual exam. Relax take things in stride. 240 is a 99 already, so not bad.

    Askdoc

  • Bill says:

    I took CK exam on March/2/2010, For me the exam questions is longer and more difficult than NBME. I could finish questions on time but did not have time to review most of marked questions (around 5-10 per 1 block. When I went home, I was recalling quite a lot of questions, especially that I considered much to take one of the two similar options. So far, I found at least 12 wrong answers among them couples of stupid mistakes.

    My NBME 2 one month before exam 570/246
    NBME 10 days before exam 540/239

    I am aiming at 99 for CK(step 1 224/96 Aug/11)because I am an old IMG-graduated in 1995. But now i am not feeling secured at all although I though what i did in the exam is ok. When I did NMBE I could guess my score since the questions is straightforward but the questions in real exam is somewhat vague.

    I read a lot of your replies in this forum and I try to assure myself that my worst possibility is 20 point lower than NBME, I still got 226 and that is enough for 99 at this time. I am checking many test takers in forums and found a very small percentage of them got the real score lower than 20 point or more form NBME.

    Though I know everything can happen, but you are so experienced in this, please give me advice for my case, how likely i will get 99?

    Thank you so much

    Bill

  • askdoc says:

    Hi Bill,

    I know its easier said than done, but I am giving you this advise although I did not really take it that well too when I was waiting for my results. What’s done is done. There is nothing you can do about it. Your results will be out in about a week. Wait for it and hope for the best. If you read my post, the exam is always more difficult than the NBME contrary to what everyone is saying. NBME is a relatively good predictor of USMLE performance but with limitations you just cited. If you did not panic during the exam, then you will probably be within the score you are expecting. Whether that is a 99 or not, I cannot really tell as the 3 digit score that corresponds to a certain 2-digit score changes a bit depending on the question set you got in the actual exam.

    Also if you are able to remember your mistakes, its usually because you have so little of them that you can actually remember most of them. So it may be good news. Note the maybe. Anyway, good luck. I think you will get a good score nonetheless.

    Askdoc

  • Harry says:

    I did my first NBME yesterday. I decided to do it earlier because I need to know where I stand now. Since it costs lots of money I will only take 2 NBMEs (NMBE 6 and 7). So yesterday I took NBME 6 and I got 570/238 on this exam. I am not really happy with the 3 digit score because I aim for +250. It’s also not co-related with my USMLE World Qbank performance. I have done 25% of the Qbank and averaging 79% so I expect to score higher on NBME.

    Do you think I have to review my lecture notes again or I just finish the remaining questions on UW qbank ? I am lil bit depressed now and loss confidence. I know 238 is a good score, but I expect to get higher. I wish to give my exam early May, what best should I do now to utilize the remaining time ?

    Thanks for your assistance

  • askdoc says:

    Hi Harry,

    You sound just like me when I was preparing for the exam. Anyway, it’s good to aim high, but bad to be obsessed about it. You need to relax. So far so good actually. You still have about 5 weeks before your exam, that will give you enough time to raise your scores. I suggest you do both. Go through lecture notes again but concentrating on high yield stuff and finish q bank. Just beware of burning out early or what we call plateauing. And being depressed or pressuring yourself too much can increase burn out. So relax, continue your review. But make sure you sit for the exam first week of May. Further delay increases the chance of burnout and you may even go into decline, where further study can cause your score to go lower, as some people found out eventually.

    Askdoc

  • Worrisome says:

    Hi Doc,

    Thanks so much for sharing your insights on this topic. I have learned a lot from you. I’m glad that I read your post before taking the NBME offline version. I plan on taking all the available NBME exams (thanks to student loans!), and I have scheduled them ~5 days apart throughout my 6wks study time frame. I know that you mentioned to not use them as a screening test for my weak spots, but do you think my plan is wise since I want to take all of them? Currently, I have taken 1 UW self-assessment (before I started my 6wk plan and got a 214) and have completed 65% of the UW Qbank. I know you always mention to not obsess over the score but it was disappointing since most posters on the USMLE forums score much higher…so it’s difficult not to worry. I have 5 weeks left in my studying, so please advise!

    Thanks!

  • josh says:

    hi askdoc
    I have been preparing for CK for past 3 months, My first problem is , i can not finish exam on time.. i miss about 7 questions on each block..so my scores don’t come good.
    i Have been taking NBME self assessment to see my progress and check my scores.. i used #1 without studying.. and then #2 in june, and #3 july(finally got near passing score), and now i am taking #4… my first concern is once i run out of #4, what can i use as assessement priort to exam…currently i am scheduled for sep 6th, but i will only take if i have quite a bit improvement from #3… do you know any other assessment test which is accurate enough? also, how can i improve my speed? i have been reading the questions first , and then,go back and read the vineett…
    i have been told by my school that “Don’t take it unless you are ready, even if that mean you take the exam in end of september or october, and just apply on september 1st” I goto Ross, i am IMG, and US citizen…
    Thank You for ur kind help

  • askdoc says:

    Hi josh,

    First, you should not have used NBME Self assessment tests to check your progress. You run out of a reliable test to know if you are ready to sit for the exam. That is the first rule you have broken. Second you should not use online qbanks to practice speedbuilding. Use another qbank software to do so. Going thru questions fast is mostly a matter of habit. Therefore you need to practice to go thru questions fast. You can’t use online qbanks because you need them to practice another skill, answering tough questions. Your school is correct. Taking the exam when you are not ready will just result in you failing it. It will not help you in the match.

    Askdoc

  • Struggle says:

    I am struggling obtaining a residency, because my step scores are borderline. I desparately hope to improve chances by performing well on the step 3. But I cannot understand what I am doing wrong. I have read the kaplan master the board for step 3, have completed the uworld q bank (avg 56%), finished the qbook step 3 (avg 73%), but an NBME of 240 (equiv around 140 or so). My exam is scheduled in 7 days!!!!!!!! how can I use the nbme to improve? It’s saying that I am weak on things like continuing care… how does one target this?
    thank you for your guidance

  • Rodolfo says:

    Hi ASKDOC

    I need your help!!
    Is the second time I take the Step 1, I just finished with de NMBE (7) and I got 310, I finished the UW bank and I got 56% porcent.
    I am from CHile and I am studing soo hard for the step

    What do you recommend me?

  • askdoc says:

    Hi Rodolfo,

    First, I believe you need to know what you are doing wrong in your prep. So I suggest you go to Amazon and buy my book How to Master the USMLE Step 1. Read it and try to see what study methods you did not implement in your prep that is suggested in my book. List them down. Then decide if you can implement those study methods in your own. If you can, then do so and try to do periodic self-assessment during your prep as suggested in the book so you know if you are studying correctly from the start. Your scores should be improving as you progress. Finding out after the end of months of prep that there is no improvement is a waste of time. So read the book and decide if you can follow them on your own.

    If you cannot or you tried and nothing is happening, I suggest you enroll in a prep course as there is no way you can pass this on your own. You need to know how to prep properly and you need to be able to implement the study methods needed to prep properly.

    Askdoc

  • Rodolfo says:

    Hi Askdoc,
    Thank you for your help, I passed the step 1.

    Now I am studying for step 2ck for the last 2 and half months, USMLE world 64% AND NBME 4 440.

    I want to take the test in 3 weeks and I only need to past the test. should I take test in 3 weeks or postpone it?

    Thank you again!

  • DStern says:

    Hi,

    A little bit uncertain about where I am at. 234 on Uworld assessment 2, 234 on Kaplan step 1 simulation. I recently did nbme 15 today and scored 210. I found nbme to be far more challenging than anything I have done to date. A friend who has written step, claims that nbme is not largely reflective of the real thing, and that uworld questions are more accurate. Nonetheless, based on this recent score, I decided to postpone my exam by 2 weeks. Ideally, a I would like to score minimum 220, but I am not sure what else I can do except read first aid again, and do more questions. Suggestions???


  • >
    %d bloggers like this: