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Understanding Your NBME Score Report (And Using It To Direct Your Studies)

Whether you’re studying for Step 1, Step 2 CK, or Shelf Exams, you’ve probably taken (or have plans to take!) a practice NBME to assess your progress. When you receive your score report, do you only pay attention to your “Assessment Score”? If so, you may be missing out on a wealth of valuable information that can be used to tailor your continued studies to achieve the highest score possible.

Below, I’ll give you a breakdown on how to better understand and incorporate a CBSSA/Step 1 NBME Score Report into your studies (though it can be applied to whatever USMLE exam you are preparing for).

  1. First, look at your NBME Assessment Score in the top right hand corner: Write down this number, then scroll down to the bottom of your score report where you see the conversion chart for CBSSA Score to Approximate Step 1 Three-Digit Score. Under the CBSSA Score Column, find your Assessment Score number, then look at the column directly to the right of it to determine your equivalent Step 1 score.
  2. Next, check out your NBME Performance Profile: This is the most useful part of taking an NBME (other than approximating what score you are at).

NBME/CBSSA Score: This ranges from 10 to 800, and is scaled to have a mean of 500 and standard deviation of 100. Your number of incorrect answers does NOT directly correspond to a score, as the NBME tests have varying difficulty and thus scale the scores according to previous data from first-time Step 1 examinees.

Approximate Step 1 Three-Digit Score: This ranges from <128 to 290. The national mean for Step 1 in 2016 was 228, with a standard deviation of 21. A passing score is currently set at a 194.

The first four categories are for Physician Tasks: Your performance in these areas gives you a general overview of what type of questions you are strongest and weakest at.

Foundational Science: includes biochemistry, biology, genetics, pharmacodynamics and pharmacokinetics, microbiology, and normal age-related findings and care of well patients.

Diagnosis: includes interpreting history and physical examination, laboratory and diagnostic studies, disease diagnosis, and prognosis/outcome.

Principles/Management: includes health maintenance and disease prevention, pharmacotherapy, clinical interventions, mixed management, and surveillance for disease recurrence.

Evidence-Based Medicine: includes biostatistics, ethics, epidemiology, and quality and safety measures.

The next nine categories are for Disciplines: These correspond to the “High-Yield General Principles” topics in First Aid, along with the subsections of the “High-Yield Organ Systems.” In UWorld, these Disciplines correspond to the “Subjects” that you can select from when making an exam.

  1. Behavioral Sciences
  2. Biochemistry & Nutrition
  3. Genetics
  4. Gross Anatomy & Embryology
  5. Histology & Cell Biology
  6. Microbiology & Immunology
  7. Pathology
  8. Pharmacology
  9. Physiology

The final ten categories evaluate Systems knowledge: These correspond to the “High-Yield Organ Systems” topics in First Aid, plus the Immunology and Public Health Sciences sections from “High-Yield General Principles.” In UWorld, these Systems correspond to the “Systems” that you can select from when making an exam.

  • General Principles
  • Blood & Lymph, Immune Systems
  • Behavioral Health, Nervous System/Specific Senses
  • Musculoskeletal/Skin/Subcutaneous Systems
  • Cardiovascular System
  • Respiratory/Renal/Urinary Systems
  • GI Systems
  • Reproductive and Endocrine Systems
  • Multisystem Processes & Disorders
  • Biostatistics/Epidemiology/Public Health

Now that you understand how to read your Performance Profile, customize your study schedule based on your NBME Score Report.

What were your weakest areas? You should also set aside 1-2 hours per day to focus on these areas (reviewing one weak area per day). This can consist of a 10-20 question UWorld test plus review of that subject in First Aid/subject-specific resources.

What were your strongest areas? You should still review these subjects, but you do not need to dedicate as much time/UWorld questions to them as your weaker subjects.

  1. After you take your next NBME, compare your Score Reports to see if you improved in these weaker areas. Is biochemistry consistently your archenemy? Consider dedicating an entire day or two of extra studying to biochemistry if it is consistently one of your weakest areas on NBMEs.

And there you have it! Following these steps will make sure that you get the most out of your NBMEs to reach your full potential on USMLE exams!