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NBME to Replace 80% of Step 1 Self-Assessments in March. What to Do?

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by Alec Palmerton, MD in Plan

There is a bombshell of a USMLE rumor percolating through the internet. Reportedly, the National Board of Medical Examiners (NBME) will replace 80% of the Step 1 Self-Assessments starting March 25, 2019. The NBME – writers of the USMLEs – announced this only to participants in the Voucher Program. However, the news has dramatic effects on anyone planning to take Step 1 in 2019 and beyond.

The NBME Self-Assessments are the only “official” practice tests for the USMLEs. The Self-Assessments for Step 1 and Step 2 CK give 3-digit scores that estimate your real score on test day.

(To read my Ultimate Guide to the NBME Self-Assessments, click here.)

What Did the NBME Say Exactly?

Here is the full announcement:

“Three new forms (Forms 20, 21, and 22) of the Comprehensive Basic Science Self-Assessment (CBSSA) will be available on MyNBME on March 25, 2019. In late spring of 2019, two additional new forms of CBSSA (Forms 23 and 24) will be available. The performance feedback provided will remain the same.

CBSSA Forms 13, 15, 16, 17, and 19 will be retired when the new forms are released. CBSSA Form 18 will continue to be available to purchase. Participants who purchased CBSSA Forms 13, 15, 16, 17, or 19 prior to March 25th will have 90 days to launch and complete their self-assessment. Participants will receive a performance profile following the completion of the self-assessment.

Unredeemed vouchers associated with CBSSA Forms 13, 15, 16, 17, and 19 prior that have not yet expired will automatically be designated for the purchase of any form of CBSSA. If you wish to assign a specific form to these unredeemed vouchers, please view instructions for Form Assignment in the Voucher Information Program system.

Thank you for your support of the Voucher Information Program. If you have any questions, please feel free to contact us at”

In other words, the NBME will retire 80% of ALL Step 1 Self-Assessments this spring. It will immediately replace three of them with new NBMEs, on March 25, 2019. Then, in late spring, it will release two new exams.

Are the Rumors True?

Yes, this announcement is real! My first thought when I saw this was: “this is either huge news or a very well executed farce.”

However, I called the NBME and spoke with someone from the Self-Assessments division. He confirmed the contents of the announcements. He stated Forms 13, 15, 16, 17, and 19 will be unavailable for purchase starting March 25, 2019. If you buy any of these forms before March 25, you will still be able to take them, for up to 90 days after purchase. He also confirmed that the NBME will release three forms on March 25, 2019, and two others later. (He said “later in the spring” but couldn’t give a definite time).

The person I spoke with on the phone expected a broader, general announcement in the next few weeks.

Why is the NBME Replacing 80% of All Step 1 Self-Assessment Forms?

You may be wondering: “if I took a previous NBME Self-Assessment, are the results invalid? Will the score not be predictive?”

I asked whether they’re replacing the forms because they are no longer valid. The person I spoke with on the phone said that the forms are NOT being retired because they are not predictive of your final Step 1 score. He stated that it was “time for new forms.” The NBME hasn’t released any new Step 1 forms for the past two years, so this reasoning makes sense.

My take? Previous NBME Self-Assessments will still be reasonable predictors of your Step 1 score. These new ones are unlikely to be dramatically different in content or form.

Should I Buy Any Unused Forms Before March 25, 2019?

This is a personal decision. Each Self-Assessment is $60, so you have to weigh the costs against the benefits.

At most, you should take an NBME every 2-3 weeks. If I did an NBME every 21 days, I could take roughly four Self-Assessments in 90 days. So at most, I would purchase four Self-Assessment forms.

You should also take into account your timeline. For April/May 2019 test-takers, the three to-be-released Self-Assessment forms are plenty. As such, you may not need to purchase any additional Self-Assessments.

However, what if your timeline is longer? If you’re planning on taking Step 1 in Fall 2019 or later, I would recommend buying at least 1-2 Self-Assessments before they’re retired. Why? It’s been two years since they released new Step 1 NBME forms. There is typically a maximum of 6 available at any time. Taking an NBME before it’s retired increases the NBMEs available before taking Step 1.

For further recommendations about taking NBMEs, read my Ultimate NBME Guide here.

Should I Purchase an NBME if I’ve Already Taken It?

I don’t recommend taking an NBME Self-Assessment Form more than once. In my tutoring practice, students who repeat NBMEs up to a year apart often overestimate their final score.

Is it possible you forgot everything since the first time you took it? Yes, of course.

Would I be willing to risk over-estimating my score on the most important exam for residency applications? Absolutely not.

How Are NBMEs Different From Other Tests I’ve Taken?

USMLE questions are different from other med school tests. Many med school exams focus on regurgitation of facts gleaned from professors’ PowerPoints. USMLE questions focus on having you apply information that you’ve learned.

The NBME gives test-writers extensive training on how to write effective test questions. The remarkable thing? They release those instructions publicly.

Tired of reading anonymous Redditor’s opinions on how to prepare? Instead, you can learn how the NBME writes USMLE questions, for insights on how to get the best score possible.

To read about how the NBME writes USMLE questions, click here.

Has the NBME Ever Done Something Like This Before?

Not in my recollection. Typically, the NBME releases 1-2 Self-Assessments every March. I can’t recall a time when 80% of the Self-Assessments turned over.

Will There be Any New Step 2 CK Self-Assessments in 2019?

The person on the phone I spoke with did not anticipate that the Step 2 CK Self-Assessments would change this year. This fits with the slower historical pattern of releasing Step 2 CK Self-Assessments.

What Should I Do Next?

For May/April 2019 test-takers: I don’t recommend changing your plan for taking NBMEs.

For Fall 2019/beyond test-takers: I’d strongly consider buying 1-4 unused NBMEs on March 24, 2019.

Want more advice on how to use the NBME Self-Assessments most effectively? Click here.

To learn how the NBME writes USMLE questions, and how to maximize your Boards scores, click here.

Concluding Thoughts

It’s rare that the NBME releases so many new forms at once. If inclined, it’s a unique opportunity to take more self-assessments than a typical Step 1 cycle. This is particularly valuable if your timeline is longer, or if you’ve already used most of the available Self-Assessments.

What do you think? Are you excited about the new Self-Assessments? Nervous? 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 USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.