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How to Interpret the New NBME Score Reports

The Clinical Basic Science Self-Assessments (CBSSA), released by the NBME, are integral practice tests in any USMLE Step 1 exam study plan. These tests are traditionally referred to as NBME practice tests. They consist of retired exam questions reformatted into practice tests and provide a reliable prediction of how you will do on test day.

With Step 1 going pass/fail also come changes in the scoring of these practice exams. Read on to learn more about these changes and the way they may influence the interpretation of your performance on the CBSSA.

What has changed in the score reports?

Because the Step 1 examination has become pass/fail, the score reports for the associated practice tests also have converted to a similar format with retirement of three-digit scores. You will receive the two following numbers on your score report.

The equated percent correct score is an approximation of the percentage of questions you answered correctly on the exam. Some adjustment is made for any individual exam depending on its difficulty in order to standardize this number. This adjustment allows for comparison between different tests. In other words, if you have a harder test, your true percentage will be curved up to a higher equated percent correct score. 

The probability of passing Step 1 is easier to interpret: it is simply an estimation of your likelihood to pass the exam if you are going to take the exam in the next week. This number is difficult to convert back to a three-digit score, but a 50 percent likelihood of passing should be roughly equivalent to the previous passing score of 194.

What will my exam day score report include?

Because the exam is now pass/fail, your score report will specify only whether you passed. It will not include your equated percent correct score. In other words, passing scores will not be stratified, and you will not receive any numerical representations of your performance. If you fail the exam, however, the report will provide more information to help you understand the result and to identify areas for improvement if you take the exam again. You will receive graphical representations of how you performed relative to your peers overall and within different disciplines to determine your strengths and weaknesses.

What does this change in the score reports mean for me?

As before, you should schedule the exam once you have taken enough practice tests and scored comfortably within passing range. A general rule of thumb is to try to have at least 3 practice tests with a 95 percent or greater likelihood of passing; however, the ideal threshold may change with time as we get more accustomed to this format. Regardless, if you are consistently achieving a greater than 98 or 99 percent likelihood of passing on multiple practice tests, this is a strong indicator you are ready to proceed with Step 1.

The full adjustment to the new structure of Step 1 will take some time, but as you navigate preparing for the new pass/fail format of the exam, remember that the preparation itself remains the same. You should still rely on the question banks, textbooks, and video resources used in the past. Don’t let these changes cause concern about how you prepare for the exam – you’ve got the resources you need!

About the Author

Originally from the Kentucky suburbs of Cincinnati, OH, Mike finished his undergraduate degree at a small Kentucky liberal arts school called Thomas More University. From there, he attended medical school at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, PA, where he was involved in the Medical Student Government, Dermatology Interest Group, and University City community clinic. He completed a preliminary internship in Internal Medicine at Brigham and Women's Hospital in Boston, MA and is currently a dermatology resident in the Harvard combined program. Outside of medicine, Mike enjoys hiking, playing tennis, and just generally being outside. Though the Patriots and Eagles might have Super Bowl wins behind them, he will always be a Bengals fan at heart.