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Run Out of NBMEs? Get the “New” Free NBME Self Assessments

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by Alec Palmerton, MD in Plan

COVID-19 has disrupted life for everyone. This includes medical students who were planning on taking their USMLEs but had their tests canceled because of Prometric center closures. This was particularly devastating for those students who had used all of their NBME Self-Assessments. Why? Because now they had to continue their studies for an indeterminate duration, but couldn’t track their progress.

But even if you ran out of practice tests, you’re in luck. The NBME has just released free NBME Self-Assessments for Step 1, Step 2 CK, and Step 3. These are “new” in the sense that they were not previously available. However, they are, in fact, the previously retired NBMEs.

Per the NBME announcement:

To help students continue to enrich their knowledge during testing delays that may result from COVID-19, seven free NBME® Self-Assessments will be available starting April 3 through May 31. Free Self-Assessments include the following exams:

    • Comprehensive Basic Science (CBSSA) Forms 13, 15, 16, 17, and 19
    • Comprehensive Clinical Science (CCSSA) Form 7
    • Comprehensive Clinical Medicine (CCMSA) Form 5

In other words, until May 31, you can “purchase” additional NBME practice tests for free.

(NOTE: it appears you will have 90 days of access from the date of “purchase.” In other words, you could have access until late August, 2020 if you “purchased” the exams at the end of May. See more below for details).

Table of Contents

How to Access the Free NBMEs Until May 31 (And Beyond)

The NBME explains how to access the forms:

To access these free test forms starting on April 3 after 9 a.m. EST, please go to www.MyNBME.org and follow these instructions. (For the best online experience, use the latest version of Chrome, Edge, or Firefox):

    1. Enter your log-in information on the MyNBME sign-in screen.
    2. If this is the first time you’re logging in to the site, click First Time User to set up an account in the system.
    3. On the Home page, use the Product Search to find the self-assessment you’re looking for.
    4. Click on the name of the product, and select any form listed as “FREE”:
      • Comprehensive Basic Science (CBSSA) Forms 13, 15, 16, 17, and 19
      • Comprehensive Clinical Science (CCSSA) Form 7
      • Comprehensive Clinical Medicine (CCMSA) Form 5
    5. Choose your preferred pacing mode (Standard or Self-paced).
    6. Click Add to Cart, and then follow the on-screen prompts.
Free NBME Shopping Cart

Price of the Free NBME: $0.00
Having a Practice Test When You’d Run Out: Priceless

Can You Access the Free Self-Assessments After May 31?

The announcement said, “seven free NBME® Self-Assessments will be available starting April 3 through May 31.”

What does “available” mean, though? Does that mean, if you “purchase” an NBME now, that you’ll lose access on May 31? That doesn’t appear to be the case.

I went ahead and “purchased” a free self-assessment. Here is what it said.

NBME Self Assessment Access in 90 Days

NBME Self-Assessment Expires in 90 Days NOT May 31, 2020

This implies that you will have access for the full 90 days, so you would NOT have to take all of the exams before May 31, 2020. Instead, if you purchased them on, say, May 30, you’d have until late August to take them.

Note that this is a fluid situation, and could change. The NBME could decide tomorrow to restrict access to fewer than 90 days. However, at the moment of this writing, it appears you would likely get the full 90 days access from “purchase.” And again, since the “purchase” is $0.00, there really is no reason not to load up on these free practice exams as May 31 approaches.

Just How Old Are the Free NBMEs, Anyway?

One thing you might be wondering is: when were the free NBMEs released in the first place? While typically not accompanied with an official announcement, the prior to March 2019, the NBMEs were released every year in March. I’ve written before about NBME 18, which had a release date of March 3, 2016. Assuming each NBME was released 1 year apart, that implies the following release dates:

  • CBSSA (Step 1) 19: March 2017 (~3 years old)
  • CBSSA (Step 1) 17: March 2015 (~5 years old)
  • CBSSA (Step 1) 16: March 2014 (~6 years old)
  • CBSSA (Step 1) 15: March 2013 (~7 years old)
  • CBSSA (Step 1) 13: March 2012 (~8 years old)

Finding data on the Step 2 CK and Step 3 practice exams was more difficult. I found message board posts referencing CCSSA (Step 2 CK) Form 7 back to 2014, implying it is at least 6 years old. I couldn’t find reliable information re: CCMSA Form 5.

  • CCSSA (Step 2 CK) 7: 2014 (~6 years old)
  • CCMSA (Step 3) 5: ???

Free vs. Paid NBMEs: Who Should Take Which?

Given that most of the tests are at least 5 years old, it begs the question: who should take a free NBME? Wouldn’t it be better to pay for a newer form, given that the NBME presumably retired these for a reason?

Opinions will vary. Here is mine. If:

You’ve Used All the Prior NBMEs: Go with the Free Ones

If you have no more practice tests, you don’t have much of an alternative. You should use the free NBMEs. Just try not to use all of them, in case there are more exam delays.

You’re a First Year Med Student/Have 1+ Years: Do 1-2 Free Ones

As I describe below, I think all first-year students should take an NBME. Why? Because you need to know how to prepare for Step 1 before you get to your dedicated study. For more on why first-years should strongly consider taking at least 1-2 free NBMEs, see below.

You Have More Than One Paid NBME Available: Use the Free Ones Sparingly

If you’ve been prudent with how you’ve used your practice exams, you likely have some paid tests available. If so, I’d still prioritize taking those, since they are more recent. If you’d like, you can use the free ones sparingly. However, for the last test you take within 2 weeks of your test, I’d recommend it to be a paid one.

No test is perfect. We’ve discussed before how predictive the self-assessments are of your final score. However, given how the USMLEs have evolved over time, I’d trust data from newer exams than ones that are 5+ years old.

Which NBME(s) Should You Take?

If you’re studying for Step 2 CK or Step 3, you don’t have any choice. There is only one free self-assessment for each of those exams:

  • Comprehensive Clinical Science (CCSSA) Form 7 = Step 2 CK
  • Comprehensive Clinical Medicine (CCMSA) Form 5 = Step 3

However, for Step 1, you now have five self-assessments to choose from:

  • Comprehensive Basic Science (CBSSA) Forms 13, 15, 16, 17, and 19

For those studying for Step 1, which should you take?

Traditionally, my recommendation is to take the oldest (i.e. the lowest-numbered form) first. That’s because the NBME traditionally will retire the oldest ones first, so you should take the test before it is retired. This situation is different, however, since all NBMEs will be made unavailable at the same time.

I’d Assume NBME 17 Will Be More Accurate

My unscientific opinion is that NBME 17 is likely to be the most accurate since it is:

  1. More recent than all of the free NBMEs (minus NBME 19), and
  2. NBME 19 is likely flawed, otherwise, they wouldn’t have retired it and kept NBME 18

Anecdotally, NBME 19 didn’t seem to have as good predictive value as the other self-assessments. Normally, I give little shrift to anecdotal evidence, however, in this case, the NBME seems to agree, since they retired NBME 19 but left NBME 18.

Why would you retire the most recent NBME (at the time) but leave its predecessor if there wasn’t an issue with that practice exam?

I have no reason to doubt the predictive value of the other practice tests. However, the lower the numbered assessment, the older it is. As we discussed, NBME 13 was likely released more than eight years ago, and Step 1 has evolved since then.

Why You Shouldn’t Take All of the Free Step 1 NBMEs

You may or may not want to take all of the new NBMEs before May 31. (For a discussion of the pros and cons, see this article). In short, you should take the self-assessments to track your progress, NOT as a source of questions.

The exception would be if you’ve already finished Kaplan and UWorld, and need new things to learn from. Otherwise, I wouldn’t suggest using these practice tests as sources of questions. Why? Generally speaking, learning from NBME self-assessments is challenging since they lack explanations. (More on the explanations later).

Will you learn more from doing QBank questions than an NBME? Most likely. As such, I’d still stick with a schedule of taking a Step 1 NBME at most every 2 weeks.

In addition, all timelines have a high degree of uncertainty due to the COVID-19 cloud.

  • Will test centers re-open on time? Maybe, maybe not.
  • How easy will it be to schedule a test when everyone else who had their exams canceled is trying to do the same? Likely not very easy.

The worst scenario to be in would be to still not have a test date but have taken all five of the free NBMEs.

My recommendation is to always have at least one NBME available, and unused. This is doubly true in uncertain times like this where test centers could be closed last-minute. As such, I would not recommend taking all of the free Step 1 NBMEs at this time.

Who Should Try and Take All of the NBMEs?

No one. See my advice above.

How Many of the Free NBMEs Should You Take?

For Step 1, I’d still follow the general strategy of taking an NBME every 2-4 weeks. Especially since you’ll likely have access beyond May 31, what’s the rush, especially given the uncertainty?

How Many Times Can I Take Each Self-Assessment?

It appears you can take each self-assessment multiple times. I “purchased” NBME 13 twice, and the site allowed me to do so. That said, I do NOT recommend repeating NBMEs.

Purchasing NBME 13 Multiple Times

I “Purchased” NBME 13 Twice (But I Wouldn’t Recommend Doing It More Than Once!)

When Should You Take the Single Step 2 CK or Step 3 Self-Assessments?

If you’re studying for Step 2 CK or Step 3, you only gained one extra self-assessment. Given how few NBMEs there are for those exams, when should you use the free one?

Ideally, you would use it to assess whether you are ready to take your exam or not. As such, I’d recommend waiting until:

  1. You have a definite test date scheduled (objective), AND
  2. COVID-19 isn’t running rampant and your test center looks like it might actually stay open (very subjective)

Given none of us has a crystal ball, to be safe, if it were me, I’d take the free Step 2 CK or Step 3 NBME 1.5-2 weeks before my test. That way, if my score were low, I’d have enough time to decide if I’m ready to take my test or not. But two weeks is also close enough to the test date that I’d limit the chances of having my test canceled last-minute.

(To read Are You Ready to Take Your USMLE or Need More Time?, click here).

Explanations Coming Soon??

Also buried in the announcement was this gem:

Students have expressed a desire for receiving explanations of correct and incorrect answers on NBME® Self-Assessments. Starting April 2, Self-Assessments will include these explanations on Medicine forms five and six of the Clinical Mastery Series.

Students can look forward to seeing answer explanations on additional Self-Assessment forms later in 2020. Jennifer Wise, NBME Product Manager, said NBME plans to release all Self-Assessments with answer explanations over time.

What this means is that:

  • Starting April 2, the CMS Medicine forms five and six will have explanations
  • Other self-assessments will receive explanations at some indeterminate later date in 2020
Why Explanations to Self-Assessments Are a Big Deal

Originally, the Self-Assessments gave you a score, and nothing else. After some years of this, they added correct answers. Now, it appears the NBME will add explanations behind why an answer was right.

The details are hazy, but the intent is clear. It is much easier to learn from a question if you know WHY a particular answer is right (or wrong). From the announcement:

Explanations for the right and wrong answers can help students maximize valuable study time,” Wise said. “Students can more easily learn from mistakes and reinforce what they already understand.” (Emphasis my own)

We’ll keep you updated as we learn more, but I consider this a positive change.

First-Years: Fancy a Practice Test?

I’ve long recommended that preclinical students – particularly first years – take an NBME before it gets retired. Why? Once it’s retired, you’ll never have access to it. In other words, if they retire NBME 18 next year, but you’ve never taken it, you’ve lost your chance.

Most people would agree that med school exams are (very) different than the USMLEs. Med school exams tend to be much more rote/memorization, whereas USMLEs are much more about application and mastery. The problem is that first- and second-years adapt to the memorization-heavy school exams, but then are grossly unprepared for Step 1.

The solution is to take a practice test and see what Step 1 is actually like. Don’t listen to the hype; ignore the rumors. Just take a test for yourself, and see.

Yes, you won’t have studied a large part of the material. Yes, your score will be low. Who cares?? The score that residencies will see is your final score – the practice scores are there for you.

So, if you’re a first-year, I highly recommend taking at least one of the free NBMEs. You likely won’t get the chance to take these again, so taking them won’t “waste” them. Plus, you’ll see what actual Step 1 questions are like, which can help you modify your approach to your classwork before it’s too late.

Concluding Thoughts

COVID-19 has thrown the world into turmoil. Med students have not been spared. In this uncertain situation, the NBME has released free self-assessments to help tide exam-takers over.

Now, is it ideal to use 5+-year-old practice test? No. However, it’s great to see the NBME recognize the uncertainty and allow access to additional self-assessments, despite their age.

If your test date has been affected by current events, these extra practice tests can help you keep your studying on track. And be sure to mark May 31 on your calendars to “purchase” any unused free NBMEs before they expire!

How have your preparations been affected by COVID-19? What are your plans for the new self-assessments? Let us know in the comments!

Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored 270 on the USMLE Step 1 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

Subscribe