Should I Take my NBME Practice Test Scores Seriously??

One of my MS2 friends recently reached out to me asking, “Kevin, I just took my first NBME before dedicated and I’m just on the border of passing, when should I start freaking out??” This brought me back to my own emotional turmoil surrounding these practice tests. Are these scores real? What tests are the best indicator of the score? Is NBME 17 different than 18 different than 19???


The thing is, you should not be looking at these practice tests to find out what you’re going to score on Step. That’s not a good use of your time. There are better ways to use them and I am going to give you what I believe are the 3 most important.


1. Simulate the test conditions

Step 1 is a marathon. Seven one-hour sections with an hour of break time to use. That is 8 hours at the testing center and it’s hard. So use these practice tests to practice how you take the test. The NBME is structured differently with four sections being an hour and fifteen minutes each. It is a total of 200 questions. Step 1 is 280 questions. So when you take an NBME, make sure to add on two UWorld 40 question blocks to get the total up to 280 questions. Bring any snacks you want to do this and only allow yourself ONE hour total of break time. Creating a mock test environment for the practice exams will help you when taking the real thing.


2. Find gaps in your knowledge

What I really like about the NBME practice exams are the bar graphs that show how well you performed on the respective topics. This tells you what you need to study! This is no surprise, but that’s what a practice test is for. Make sure to dedicate more study time to the areas that you didn’t score so well in (focusing on the areas that need improvement will help bring your score up).


3. Learn from what you got wrong

While there are no long explanations of the wrong answers like there are for UWorld, you still need to go over your mistakes. I actually kind of enjoyed this. I spent a chunk of time researching and actively working out how to get to the correct answer. This active learning is good and kept me engaged. It does suck that you can’t see the questions you got correct though. Working through the tougher questions with a study partner might be helpful too.


Back to the question about how these scores relate to the actual Step 1 score. I spent hours on reddit looking up all of this when I should have been studying. This is after I took NBME form 19 just twelve days before my test date and scored WELL below a score I would have been comfortable with. So I did what every medical student does and I scheduled a meeting with a student dean to see if I should move my test date back. Thankfully I was talked down from this and reassured with stories of my colleagues going through the same thought process about form 19. When I did take my exam, I actually scored over 20 points higher than this NBME score that almost had me change my test date!


I’m sharing this to reassure you that your NBME score is is not necessarily indicative of your Step 1 score (it may not even be close!). Of course every student falls on a different place on the bell curve, but don’t be too hard on yourself, especially if you take a practice test close to your exam date.

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