We discuss using practice tests as part of your USMLE Step 1 prep, paying special attention to UWorld Self-Assessments.

No Step 1 study plan is complete without practice tests, but there are many to choose from. For example, popular qbanks like UWorld and AMBOSS both offer self-assessments, and many students incorporate NBME practice tests when they need to gauge their progress. Even with so many options, there seems to be a consensus that UWorld Self-Assessments (for short, UWSA 1 and 2) are indispensable.

Why do med students speak so highly of UWorld Self-Assessments? At Cram Fighter, we hear a common refrain of three key points.

1. UWorld Self-Assessments mirror the format of the actual USMLE Step 1.
2. UWorld Self-Assessments come with useful explanations for each question.
3. UWorld Self-Assessments are challenging but high yield.

Med students back up the first point. According to USMLEPro’s article on practice tests, “the user interface of the NBME practice exams is different from that of the actual exam, despite originating from the ‘official’ organization, the NBME. Surprisingly, the UWorld question banks and practice exams best recapitulate the actual testing interface.” In our blog post, Three Tips for Using USMLE Practice Test in Your Step 1 Study Plan, med student Ronald Russo agreed, saying “The UWorld self-assessment questions were really close to the actual Step 1 questions.”

The second and third point have support as well. Many med students set aside time specifically for reviewing UWorld’s explanations, which are useful content in their own right. In a recent and well-received Reddit post, one med student made the case that the UWSAs are far superior to the NBMEs on content. The NBME questions, they said, “are often on incredibly vague, experimental, random things that are like Mariana-Trench low yield.” Furthermore, “the formatting is terrible. They use the same pictures over and over and over again. (I’m looking at you stupid kidney with a blue background).” Harsh words.

The UWorld self-assessment questions were really close to the actual Step 1 questions.

Ronald Russo, Medical University of the Americas, USMLE Step 1 Score: 244

So, if you are deciding on a practice test, keep in mind that UWorld Self-Assessments come highly recommended. There is one point of contention: the predictiveness or accuracy of UWorld’s scoring. Many students take a practice test the week before their exam to track their progress, and some, like Ronald Russo, found that UWorld was not as accurate as the NBME. However, others such as Anthony W., a student at NYITCOM, suggested the opposite, saying “UWorld Self-Assessment 2 felt exactly like my real exam, and my USMLE score was within 3 points of the self-assessment.” We interviewed Anthony in How to Study for the USMLE Step 1: Med Student Interviews, Part 1.

Med students should decide for themselves, but based on the advice of their peers, UWSA 1 and 2 appear to be strong additions to any USMLE Step 1 study schedule.