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How to Read the New Pass-Fail Step 1 and NBME Self Assessment Score Reports

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by Alec Palmerton, MD in Step 1 Pass-Fail
New NBME Self Assessment Performance Report Step 1

Are you wondering what to make of the new NBME Self Assessment reporting changes? Do you want to have a better idea of how you might do on Step 2 CK, the likely “new Step 1”? Want to know what you would have scored on Step 1 before the pass-fail changes? Curious to know how much each question is worth on the Step 1 NBMEs?

With Step 1 moving to pass-fail, the NBME Self-Assessments have changed, as well. The score reports are dramatically different. Importantly, the score reports no longer give a 3-digit score.

In this article, you will learn:

  • How much each question is worth on each Step 1 NBME Self-Assessment,
  • What the NBMEs tell us about how Step 1 and Step 2 CK are scored,
  • How to use our NBME to predicted Step 1 score converter,
  • Which Step 1 NBME is “hardest,” and
  • Much more

Table of Contents

The New USMLE Step 1 Score Report

With Step 1 becoming pass-fail, the USMLE Step 1 score report has changed, as well. The most important change is that if you pass, you will NOT see a 3-digit score.

USMLE Step 1 Pass Will NOT Show a 3 Digit Score

If you pass the USMLE Step 1 you won’t see a 3-digit score anymore. (Source)

Instead, you will only see a 3-digit score if you fail Step 1.

USMLE Step 1 3 Digit Score Only Available If You Fail

You will only see a 3-digit Step 1 score if you fail. (Source)

Step 1 is Pass-Fail – Why Would I Want to Know My Score, Anyway?

You may be wondering, “if Step 1 is pass-fail, is it even useful to know my score? Why does it matter, anyway?”

The answer is that Step 1 scores have traditionally been the best single predictor of Step 2 CK scores. And since Step 2 CK is the new Step 1, most students will be anxious to get a sense of where they stand.

Here is data from research on the best predictors on Step 2 CK, which we’ve discussed before:

PredictorStep 2 CK
score
correlation r
When is
data
available?
Average subject exam score with three subject exam scores (Combination A)0.81***Year 3
Average subject exam score with three subject exam scores (Combination B)0.80***Year 3
Step 1 score0.75***Year 2 – end
Preclinical mean exam score0.54***Year 2 – end

***p<0.001. Combination A = internal medicine, surgery, and pediatrics subject exam scores; Combination B = internal medicine, surgery, and obstetrics and gynecology subject exam scores

Note that Step 1 is the best single test that will predict Step 2 CK scores. The best overall indicators combine your IM + Surgery + Peds/Ob-Gyn shelf scores.

Step 1 NBME Self-Assessments No Longer Give 3-Digit Scores, Either

Given the changes to the Step 1 score reports, it’s not surprising that the NBME Self-Assessments for Step 1 are changing their reports as well. In a change that mirrors the USMLE Step 1 Score Report differences, the CCSSA (Step 1 NBME practice tests) no longer give a 3-digit score.

Instead, they give you a “Total Equated Percent Correct Score,” out of 100%. In addition, they estimate your likelihood of passing Step 1 if you take your exam within a week of the practice test.

New NBME Self Assessment Performance Report Step 1

If Step 1 is an Excellent Step 2 CK Predictor, How Can I Find My Step 1 Score?

If Step 1 is the single best predictor of Step 2 CK scores, how do you figure out your score? Thankfully, we’ve gone through and calculated the predicted Step 1 scores for each NBME. We did so by graphing students’ predicted Step 1 scores vs. # correct for self-assessments taken prior to the change to the new reporting.

Predicted Step 1 Score for NBME (CBSSA) 25

Each question on Step 1 CBSSA 25 is worth 1.05 points.

To get a 250 on CBSSA 25, you could only miss 21 questions.

For the NBME/CBSSA 25 to Step 1 score converter, click here.

Predicted Step 1 Score for NBME (CBSSA) 26

Each question on Step 1 CBSSA 26 is worth 1.11 points.

To get a 250 on CBSSA 26, you could only miss 23 questions.

For the NBME/CBSSA 26 to Step 1 score converter, click here.

Predicted Step 1 Score for NBME (CBSSA) 27

Like CBSSA 26, each question on Step 1 CBSSA 27 is worth 1.11 points.

To get a 250 on CBSSA 27, you could only miss 23 questions.

For the NBME/CBSSA 27 to Step 1 score converter, click here.

Predicted Step 1 Score for NBME (CBSSA) 28

Each question on Step 1 CBSSA 28 is worth 1.05 points.

To get a 250 on CBSSA 28, you could only miss 23 questions.

For the NBME/CBSSA 28 to Step 1 score converter, click here.

Predicted Step 1 Score for NBME (CBSSA) 29

Each question on Step 1 CBSSA 29 is worth 1.09 points.

To get a 250 on CBSSA 29, you could only miss 23 questions.

For the NBME/CBSSA 29 to Step 1 score converter, click here.

Predicted Step 1 Score for NBME (CBSSA) 30

Each question on Step 1 CBSSA 30 is worth 1.15 points. It is widely considered to be the most challenging NBME, and the best-fit line backs that up.

To get a 250 on CBSSA 30, you could only miss 24 questions.

For the NBME/CBSSA 30 to Step 1 score converter, click here.

Concluding Thoughts

With Step 1 now pass-fail, both Step 1 as well as the self-assessment (practice test) score reports are different. The big difference is that there is no longer a 3-digit score.

I understand the rationale to eliminate 3-digit scores for Step 1 reporting purposes. I can even understand why they would take away the 3-digit score for NBME self-assessments for Step 1.

That said, the Step 1 score is a valuable measure of your mastery of the USMLE material. Practically, as well, it can serve as a milestone on the way to taking Step 2 CK. Using the score calculators, you can determine your predicted Step 1 score based on the old scoring rubrics prior to the Step 1 pass-fail changes.

What do you think of the new Step 1 and NBME score report changes? Should they still give a 3-digit Step 1 score? Let us know in the comments!

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Want FREE Cardiology Flashcards?

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

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