The ABCs of NBME Self-Assessments

  • /Reviewed by: Amy Rontal, MD
  • Although there are a few ways people take the NBME self-assessments, there’s one method that stands above the rest. In short, take it how you would take the actual USMLE Step 1. Sounds easy enough, but what steps should you take to treat this exam like THE Step?

    Here are some tips to help you get the most out of your NBMES:

    Be well-rested.

    You want to make sure you get a good night sleep the night before and make sure that you don’t over study. The best thing about taking an NBME is that the day before is usually a lighter day. I’m not saying don’t study the day before (that would be the equivalent to blasphemy in medical school), but maybe end your review a little early so you can unwind a bit, pack a lunch, and do your pretest routine (mine involved a can opener) before hitting the hay. On the actual test day, you will need a good night’s rest and it’s good to try and get into that habit in advance. Now on to the actual taking of the NBME itself.

    Take the exam seriously.

    One thing I can’t stress enough is that practice assessments should be treated like the actual USMLE Step 1. You can do this by taking your test at the same time you will on the actual test day and by making sure your environment is distraction-free. Some people like to simulate stressors by taking the test where there is some background noise, but 99% of the time that won’t run into these scenarios on test day. (If you do — there are various acceptable ways to report distractions in the testing center.) Once you have your quiet space and have gotten your morning of routine down, you should try and figure out how to…

    Pace yourself.

    The NBMEs are four blocks of 50 while the actual step is 7 blocks of 40. This means you’ll never truly be able to mimic the test unless you want to break the NBME up into blocks of 40 while using your own timer (I tried this, and it changed nothing for me personally). As for the number of questions, you can always add two or three blocks of Uworld (more stamina never hurts). One under-valued portion of the exam is breaks. Make sure you take all your breaks when you are taking the NBME just like you would for the actual exam. Even if you don’t think you need a break, take one. This is where you can snack, finish your coffee, take an energy shot, use the bathroom or even just stare at the ceiling. Trust me, this exam is grueling, and those 5-10 minutes will be crucial for the latter portions of the test.

    Review, reassess, and recover.

    A final note about the NBMEs involves what you do when you finish (after you finish the Step you usually do nothing). Again, this assessment tool should be treated like the Step when you are taking the exam. Once you finish though, you should check it and see what areas you did poorly in and what areas you did great in. Taking it one step further, you need to analyze the questions you missed and even the questions you got right but were a little iffy on. You want to know why you missed a question and what topics you need to revisit. Sometimes, you miss a question because it’s a random fact, while other times you answered the incorrect question rather then what was being asked, and every now and then you may just be completely lost. Identifying these issues is one of the best uses of your NBME. Once all that is done then you can relax (a little).

    Try and take half a day to a day for yourself (also med school blasphemy) to recoup. After all, studying for the step is a marathon; you don’t want to be the runner at the end who passes out and needs their temperature taken rectally all because you overheated right? Anyways, good luck studying everyone!