NBME Practice Exams For Step 1

NBME Practice Exams For Step 1 [Ultimate Guide]

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In reviewing for Step 1, the best approach for every med student is to take practice exams as their utmost priority above First Aid and all their study resources. In this post, I’ll be walking you through what is the best and highly-sought-after NBME Practice Exams for Step 1.

Basics of NBME Practice Exams

basics of nbme practice exams

What Are NBME Practice Exams?

The NBME Practice Exams are self-assessment exams that medical students use to help them prepare for taking USMLE exams and subject exams in medical school. It gives med students a baseline idea on the contents of the exams and provides accurate estimations of scores they should expect after they have taken them.

These NBME Practice Exams are released by the National Board of Medical Examiners (NBME), the same body that administers the Step 1. It is developed by committees of content experts all across the U.S.

The NBME has released numerous NBME Practice Exams for all the three steps involved in the USMLE, for subject exams, and for IFOM Clinical Science Exam:

  1. Self-Assessments for USMLE
    • Comprehensive Basic Science Self-Assessment (CBSSA) – 6 forms for Step 1
    • Comprehensive Clinical Science Self-Assessment (CCSSA) – 6 forms for Step 2 CK
    • Comprehensive Clinical Medicine Self-Assessment (CCMSA) – 1 form for Step 3
  2. Self-Assessments for Subject Exams or Clinical Sciences
  3. Self-Assessments for IFOM Clinical Science Exam

To access the practice exams, visit MyNBME Examinee Portal and create an account.

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Here are more information about these practice exams to give you a comprehensive idea on what to expect:

Self-Assessments For Step 1

The Self-Assessments for USMLE assist students in evaluating their degree of readiness to take the USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 examinations.

Under that is the Comprehensive Basic Science Self-Assessment (CBSSA), which contains self-assessment forms for Step 1.

Below is a breakdown of what each form contains:

  • Total of 200 multiple-choice items
  • Four sections with 50 items each
  • Official score report accessible via INSIGHTS
  • Includes answer explanations
  • Item formats are similar to USMLE Step 1
  • Standard-Paced: Up to 1 hour and 15 minutes per section
  • Self-Paced: Up to 5 hours per section.

Self-Assessments For Step 2 CK and Step 3

Additionally, within Self-Assessments for USMLE, there are the Comprehensive Clinical Science Self-Assessment (CCSSA) for Step 2 Clinical Knowledge and the Comprehensive Clinical Medicine Self-Assessment (CCMSA) for Step 3.

The Step 2 CK forms follow a similar breakdown to the Step 1 forms, but with item formats resembling Step 2 CK.

Similarly, the Step 3 form mirrors the breakdown of Step 1 forms, with item formats similar to Step 3. Also, it doesn’t contain Computer-based Case Simulations (CCS) and does not offer an approximate Step 3 score.

Self-Assessments For Subject Exams Or Clinical Sciences

The Self-Assessments for Subject Exams or Clinical Sciences assesses an examinee’s understanding and baseline knowledge of the clinical sciences and readiness for the clinical science Subject Exams.

Here are the included subjects:

  • Clinical Neurology
  • Emergency Medicine
  • Family Medicine
  • Medicine
  • Obstetrics and Gynecology
  • Pediatrics
  • Psychiatry
  • Surgery

Self-Assessments for the IFOM Clinical Science Exam

The IFOM Clinical Science Self-Assessments are indicators of readiness to take the International Foundations of Medicine Clinical Science Exam.

It is created with the same content specifications as the IFOM Clinical Science Examination which is primarily for medical students in pursuit of assessing their knowledge on the clinical sciences before taking their exam.

How Much Do They Cost?

The NBME Practice Exams for Step 1 cost $60 for each form. This can be purchased through their official website by going to the MyNBME Examinee Portal and creating an account.

Practice exams for Step 2 CK and Step 3 are also $60 each. The Clinical Science Mastery Series and IFOM Clinical Science Self-Assessment Series, on the other hand, cost $20 and $35, respectively. But we won’t be needing any of those for Step 1, so moving on!

Now, you might be thinking that $60 is such a waste of money for mere practice exams. After all, $60 is not cheap. But then again, these are not just any practice exams.

The NBME Practice Exams for Step 1 are released by the same body that administers Step 1. This should give anyone a good idea of how accurate the questions are presented in these practice exams to the contents of Step 1.

Someone who may not be well-off may just brush the NBME Practice Exams since it could not sit well with their budget. I understand that. I mean, not everyone’s financial situation is the same.

You could always resort to practice exams that you have randomly seen on the Internet and download it for free. However, there’s no assurance that content on these practice exams came with the rights to reproduce it online. Neither would it have questions that reflect the questions released by the most recent Step 1.

Not investing for your Step 1 is dangerous and may cost your Step 1 score – which in turn harms your applications to residency programs. The $60 wouldn’t hurt if all you want is to be a licensed physician. Take this risk, you might regret not doing so once you see a below satisfactory Step 1 score.

FYI: Want to learn more about how to crush Step 1? Check out this article: How To Study For Step 1 [Study Like A Top Med Student]

How Do You Sign Up For NBME Practice Exams?

how to sign up for nbme practice exams

You first have to create an account through the MyNBME Examinee Portal. Once into the system, click the PURCHASE tab to be seen at the top portion of the page.

The next step couldn’t be any simpler. Proceed to choose which exam you are studying for. Seeing how you have made your way to this post, choose “Self-Assessments” and then “Self-Assessments for USMLE”. For Step 1 NBME practice exams, choose “Comprehensive Basic Science Self-Assessment (CBSSA)”.

You may have a hard time navigating the page since the names of the self-assessments are kind of perplexed.

To avoid confusion, here are the equivalent names of the practice exams for each step of the USMLE.

  • Comprehensive Basic Science Self-Assessment (CBSSA) – Step 1
  • Comprehensive Clinical Science Self-Assessment (CCSSA) – Step 2 CK
  • Comprehensive Clinical Medicine Self-Assessment (CCMSA) – Step 3

How Long Are NBME Practice Exams?

These self-assessment NBME Practice Exams are shorter than the actual Step 1. Step 1 consists of 7 blocks with 40 questions per block with 1 hour allotted each. There are a total of 280 questions.

Each NBME Practice Exam has a total of 200 questions divided into 4 blocks of 50 each. Each block has a time allotment of 1 hour and 15 minutes for the standard-paced option.

If you want to simulate the USMLE as much as possible, the UWSAs (USMLE World Self-Assessment) are the way to go. The practice exams are taken within 8 – 9 hours, with breaks provided.

However, UWSAs tend to overestimate one’s score as compared to NBME Practice Exams which have a high percentage of accurately predicting your Step 1 score.

I’d suggest you simulate an 8 to 9-hour exam with the UWSAs first, then proceed with NBME Practice Exams as an indicator of an estimated prediction of your score.

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How Many NBME Step 1 Practice Exams Are There?

how many nbme practice exams are there

There are 6 NBME Step 1 Self-Assessments exams which come in forms 26, 27, 28, 29, 30, 31.

The NBME retires forms and releases new ones usually in early March. It is observed that they retire the lowest-numbered forms first rather than the succeeding numbered forms. It is for this reason that med students are advised to start with the lowest numbered forms.

In other words, these forms are updated and always in line with the latest released version of Step 1. Since this is the case, there is no use for you to access older forms of the NBME Practice Exams.

Even those who did very well on their Step 1 found no reason to scavenge these forms. These provide only little additional value, in my experience.

FYI: Studying for Step 1 with review materials like NBME Practice Exams is great, you also need the right Step 1 guide to accompany you through the process.

[Free Download] Want to have everything you need to be a top student on your medical journey? Get FREE access to our Med School Success Handbook to get 60+ tips including the best study, time management, mindset tips you need to be a top student. Download it here. 

Tips For Using NBME Practice Exams For Step 1

Now, how can you maximize the use of these NBME practice exams? Let’s get on it.

How Many NBME Practice Exams Should I Take?

It is most optimal and recommended to complete 4 NBME Practice Exams at a minimum. But of course, it’d be of much more advantageous for you to complete all the available forms if you have enough time.

A lot of my students ask me if 6 weeks before Step 1 would be enough time to complete all forms of the NBME Practice Exams. Yes, this would be enough – but you would be rushed.

FYI: How about if you only have 4 weeks left? Check out this article: Can I Pass Step 1 In 4 Weeks?

Remember, the purpose of these NBME Practice Exams is for you to create a baseline and use this to assess your progress. In order to have some significant progress, two weeks would be the optimal time allotment for you to study in between NBME Practice Exams.

Study your class notes, review your resources, and your First Aid. Review your answers and try to derive why the answer is like that. You will never have such progress from practice exams to practice exams if you rush yourself.

It’s most advisable for you to start with your NBME Practice Exams as early as possible to achieve progress on the increase of your score over time.

Is It Better To Do NBME Self-Paced vs Standard-Paced?

standard and self pace

You can either take your Step 1, Step 2 CK, and Step 3 NBME Practice Exams in two different testing conditions: Standard-paced or Self-paced.

Each form/practice exam has a total of 200 items divided into four sections with 50 items each.

For Standard-paced, you have 1 hour and 15 minutes to complete each section, while for Self-paced, your have 5 hours to complete each section.

As you can see, following the self-paced timing method allows the student to have more time in answering the practice exams. The Standard-paced may look unrealistic and involves a lot of pressure, but believe me, this is the only way to approach these NBME Practice Exams.

You want to simulate a real-life Step 1 experience as much as possible. This trains you to think fast and efficiently when you’re taking Step 1.

Research on NBME Self-Assessments to project performance on USMLE Step 1 also indicates that Standard-paced conditions produced better estimates of future Step performance than Self-Paced ones.

What Is The Best Order For NBME Practice Exams For Step 1?

Most students will often make the mistake of taking their first NBME Practice Exams once they finished their first pass on the First Aid. They would usually postpone their first try on these self-assessments and review everything on their review resources first due to several reasons.

I would usually hear reasons like they already know their score is going to be low since they haven’t reviewed yet and that it’s going to damage their confidence, so what’s even the point? This may be reasonable, but let me refute this in the most straightforward way possible.

You have to take your first NBME Practice Exams before your first pass on First Aid or UWorld. This enables you to create a baseline that you will use to assess your progress. It also points out your weaknesses and strengths which in turn helps you create an effective and bullet-proof study plan.

When it comes to the forms, there is no specific order in taking the NBME Practice Exams that guarantees the best way to utilize it.

It wouldn’t matter which form you would take first because each exam has its own scale. However, considering how the NBME always retires the lowest-numbered forms first – the only way to approach this is to always start with the lower numbered forms.

Again, there’s no evidence that this is the best way to utilize these self-assessments. You just don’t want a form to retire on you when you’re just about to start taking your NBME Practice Exams.

Where Can I Find NBME Answers and Explanations?

answers and explanations

NBME offers answer explanations, which can be accessed either through the Question Details section in INSIGHTS or by opting for the View Your Results Interactively feature under My Exams on the MyNBME Examinee Portal.

This is generous on the side of NBME since previously, they will only tell students which questions they got wrong. It was ineffective for not providing the right answers because after all, it’s still a resource for students to rely on so that they could improve their score for Step 1.

Thankfully, they have given out more and more information over the years, but this is just how good as it gets. Most of the time you’re going to have to rely on your First Aid and other review resources to derive an explanation to your answers.

As much as possible, refrain from checking online message boards since the explanations there are not verified by experts and could possibly misinform you. There’s nothing worse than answering your Step 1 with a wrong understanding of the concepts involved in the questions.

Finding explanations for every answer will most likely be consuming all of your time. It wouldn’t be advisable to review every answer since your time could be used to try other practice exams.

But if you do decide to understand how the answers are derived, just make sure to set a time limit for yourself to ensure that you won’t be running out of time.

[Free Download] Want to have everything you need to be a top student on your medical journey? Get FREE access to our Med School Success Handbook to get 60+ tips including the best study, time management, mindset tips you need to be a top student. Download it here. 

FAQs on NBME Practice Exams

Here are frequently asked questions med students ask about NBME practice exams and how to use them for Step 1:

How Accurate Are NBME Practice Exams?

One reason to have faith in the NBME Practice Exams is that they are released by the same body that administers Step 1. Plus, researchers have proved that there’s a relationship between performance on the NBME Comprehensive Basic Sciences Self-Assessment and USMLE Step 1.

The CBSSA explained 67% of the variation in Step 1 scores. To better comprehend this, let’s take a look at the charts below provided by the National Board of Medical Examiners (NMBE).

how accurate are nbme practice exams

Actual Step 1 Scores Minus Score Predicted by NBME Within 1 Week of Exam

As we can see from the chart above, most of the actual Step 1 scores minus the score predicted by NBME within 1 week of exam are within the rage of 0 to 9.

This implies that the score in your last NBME within 1 week of exam will most likely be the score on your Step 1 and could increase by a chance of 68%, and decrease by a chance of 32%.

You could also see that the next high ranking frequency groups are still relatively significant. This could mean that NBME still has the tendency, to underestimate (by a chance of 31%) and overestimate (by a chance of 9%) your scores by +/- 9.

However, an increase or decrease of 20 or more points is quite uncommon and rare, with estimated chances of 7% and 3% respectively.

Nevertheless, results in these researches prove that NBME self-assessment examinations serve as an accurate and realistic basis for predicting performance on particular Step exams with a bit variation in predictive accuracy across provided test administration conditions.

What is A Good NBME Score?

A good NBME score will always depend on whether you had improved from your previous try on a practice exam. These NBME Practice Exams are self-assessments and a progress tracker, after all.

One would usually make the mistake of only taking the NBME Practice Exams only once and never again.

You see, the purpose of taking these practice exams is to assess your progress. Therefore, you need to establish a baseline for comparison. If you only took one form, how will you know if you are ready enough to take Step 1?

Let’s bring the scenario to 2 weeks after and this student changes his mind and decides to take another NBME. Then, he scored a lot higher. Now, we can assess and conclude that he had improved.

How Should I Manage Interruptions To My NBME Practice Exam Schedule?

can you pause self assessments

We understand that sometimes, students build a well-thought study plan when it comes to their NBME Practice Exams, but some tend to withdraw from this schedule along the way due to personal reasons and put it aside for the time being.

In this case, you might be wondering when would be the best time for you to resume your NBME Practice Exams. If so, you must have already taken a lot of NBME Practice Exams before.

It’s not advisable to repeat old NBME Practice Exams. Just make sure to review your answers and the concepts involved in the questions to retain information.

Thus, once you resume, it would be best for you to space out the remaining NBME Practice Exams in your archives accordingly to make sure you don’t run out of forms months before your Step 1.

Can You Retake NBME Exams?

The majority would think that you have to repeat your NBME exams in order to retain the answers. Not going to lie, when I was studying for Step 1 with the NBME Practice Exams, I thought the same. However, my tutor advised me to do the opposite.

In fact, it’s best for you to never take an NBME Practice Exam more than once.

Okay, wait. You might be confused and exclaiming “Earlier on you said that NBME Practice Exams should establish a baseline and track my progress by taking these exams on an interval, and now you want me to never take a practice exam more than once? Am I the only one not getting how this is going?”

Well, in general, you should take different NBME Practice Exams for the purpose of tracking progress and validating the predictive power of these self-assessments. This strategy also enables you to review your wrong answers between the tests you take on an interval. Thus, there is progress.

My point being – taking the same form of an NBME self-assessment will reduce its predictive power. Recalling the questions while understanding and mastering the concept behind it will do you much better and could even increase your score.

Are New NBMEs Predictive?

There would be no reason for the newly released NBME Practice Exams to not be predictive since NBME always releases new forms and retires old forms to remain aligned to the latest version of Step 1. Hence, its predictive power will remain as they were in the retired forms.


That’s it for the ultimate guide on NBME Practice Exams for Step 1! I hope you found this post informative and helpful to make sure you use your self-assessments in the best way possible.

We give credit to Yousmle, Med School Tutors, and USMLE Pro which served as sources for this blog post. Charts, announcements, and other information were derived from the official NBME website. Check it out for more updates.

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