Is the CBT Your USMLE Secret Weapon?

  • /Reviewed by: Amy Rontal, MD
  • Taking practice exams is an important part of preparing for the USMLE Step 1 exam. While key resources like UWorld, First Aid, and Pathoma are great learning tools for students, practice exams are needed to provide a benchmark of progress before taking the real exam.

    These practice tests may come in many different forms such as a school-issued comprehensive basic science exam (CBSE), comprehensive basic science self-assessments (CBSSAs) which can be purchased online from the National Board of Medicine Examiners, Uworld self-assessment examinations (UWSA), or the USMLE computer-based practice test (CBT) at a prometric center.

    The latter practice test offers a unique opportunity but may not be ideal for everyone. The following are the major pros and cons of taking the CBT at a prometric center so that you can decide if this opportunity is right for you!

    PRO: You can get exposed to a prometric testing center.

    For many, one of the greatest fears concerning the USMLE Step 1 is the fear of the unknown. Personally, I had a negative experience while taking my MCAT exam including rude staff and a disruptive testing area; which left me concerned that all prometric centers were less than ideal.

    Fortunately, my experience at a different prometric center for my USMLE step 1 exam was considerably better and made me realize my fears were unfounded. However, the point is that not all prometric centers are the same. Some may provide different amenities, have larger testing spaces, differ in layout, etc.

    The advantage of taking a CBT for Step 1 at a prometric center is that you can fully experience what that prometric center is like and truly simulate test day conditions. For many students, this helps to relieve anxiety and eliminate fear of the unknown before the big day. Other students really like to be able to run through their routine — the drive, the check-in process, etc. — and feel relief in knowing exactly what test day will be like. Exposure to the prometric center is the primary advantage to taking the CBT for Step 1.

    CON: No new practice questions are provided and taking the CBT is time-consuming.

    The CBT is divided into a tutorial and 3 sections of approximately 40 questions for a total of 3.5 hours. What some students may not realize is that the CBT is not providing new practice questions to testees; it simply re-uses the free practice questions which are available online, but for a fee of $75 (or significantly higher outside of the US).

    Some students, like myself, have the luxury of living less than a mile from the testing center. However, many students live 30 to 60 minutes from the testing center and some even travel to new cities to get to a center. For this reason, taking the CBT often is a full day affair, just to walk out with a printed sheet stating your percent correct score.

    For a student on limited time, taking a full day away from studying may be too costly. Keep in mind that you are always free to stop in and visit your local prometric center and look around. While you will not be able to enter the actual exam room, you will get to see what the break room and lockers are like to learn the layout and you can look through the glass to see how the testing room is organized.

    In the end, taking the CBT at a prometric center may not benefit everyone. I typically recommend the CBT to students who are extremely anxious about test day and feel that this anxiety would hinder their test day experience. I encourage these students to take the CBT to fully simulate test day and alleviate some of their fear of the unknown. However, for students on limited time, who with lower anxiety, or who have visited their prometric center before, taking the CBT may offer little benefit.