But do they really need to be complicated ?
This article will answer EVER question you have ever had about the NBME tests and bust all the
myths about the NBME forms. Use this and you will surely improve your score by 30-40 points as i
have improved my score.
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
➣ Introduction:
The NBME self assessment exams (also known commonly as the NBME Tests of NBME Forms or
NBME Test Forms) are a set of tests for USMLE Step 1, Step 2 CK and Step 3. These tests are widely
known to closely approximate the actual exam and have a very high PREDICTIVE value. This article
will show you how to use these tests not just as a predictive tool but also as a learning tool. There
is a lot of mystery around how to use the NBME forms ? When to give the NBME Practice Tests ?
etc. This article will solve all your queries about NBMEs. This article has been written by a student
who has scored over 260 on his USMLE. I recommend you READ THIS POST COMPLETELY… It may
help you score maybe 15-20 points more at the least. You can skip the basic parts if you know and
go down to the last few headings.
➣ What are the NBME Forms ?
The NBME is the organization which makes the USMLE Step exams. While the USMLE Step 1 has
more than 300 questions each NBME form has just 200 questions. The forms are meant to be
roughly gauge your potential on the actual exam. They can be bought on the NBME website for
$50 (basic) & $60 (extended feedback). In basic you get just the final score. In extended feedback
you get the questions you got incorrect. In neither do you get the questions you got correct with
the correct answer.
➣ How many NBME forms are there & how many questions ?
There are 15 NBME test forms, however, they are not sequentially numbered. There is NBME 1,
NBME 2, NBME 3, NBME 4, NBME 5, NBME 6, NBME 7, NBME 11, NBME 12, NBME 13, NBME 15,
NBME 16, NBME 17, NBME 18, NBME 19 There there is no NBME 8, 9, 10, 14… so there are 15
NBMEs in total with 200 questions in each. Hence, there are 3000 questions. The NBME forms in
themselves thus represent the largest and most important question bank. 3000 questions of
NBME are larger than UWorld or Kaplan or
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
On forums you will see people say I did 6 NBME tests online and 7 offline or something like that.
What it means is: Online = You pay and you buy the test via NBME website Offline= You don’t pay
and you do it via screenshots pdf (i.e. screenshot version).
PROs and CONs of each : Online you can give the test in a controlled environment and the test will
be timed. Offline you can give it in a similar way too but you have to setup your timer and be
precise with timing. Online you pay, offline you don’t. Online you get only test forms 13, 15, 16 ,
17, 18,19. Rest 9 forms… i.e. 1,2,3,4,5,6,7,11,12 have to be done offline only as the NBME sells only
6 at a time. So you decide whichever you want…online or offline. I was just explaining the lingo as
sometimes people don’t understand it. Online : Paid, Offline : Free… this is basic meaning.
When you give it offline use following formula:
Total correct questions out of 200 multiplied by 1.39 and that will give you the score as online
roughly… plus or minus 2 points…
So 180 correct out of 200 makes it 250 approx. score… This is quite accurate actually…
➣ What is the difficulty level and question pattern of the NBME forms with respect to actual
USMLE ?
While no one can give a precise answer to this as the USMLE does not divulge their questions and
neither are people allowed to talk about it but following is a rough non-specific general idea. The
real USMLE questions are a bit longer than the NBME questions. The core concept is the same but
sometimes they may put extra information in there. Like instead of saying that a person has
hyperuricemia perhaps an entire panel of lab values may be given and then finally Uric acid is
given somewhere in the list. It is same concept but they make it lengthy by putting irrelevant info
to make you feel like it is tougher.
Further differences between the NBME and the USMLE can be looked into by
checking out this article which enlists the differences between the NBME and the
USMLE as well as means to solve this discrepancy.
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
➣ What is the usage of the NBME Forms ?
The NBME forms may be used for 2 purposes: Assessment & Learning.
- Assessment tool: These tests are the most predictive assessment tools out there. Use NBME
16, 17, 18, 19 for predictive value as they are the latest and hence the most accurate. UWorld
Self Assessment forms are the worst kind. It will over predict by 20 points…use at your own
peril. It is worthless to me. The most predictive nbme step 1 is usually the latest NBME. As of
now, NBME 19 is the most predictive nbme. However some students report NBME 19 as an
nbme underestimates your score as it is very new. Conversely earlier NBMEs overestimate
your score. - Learning tool: The NBME questions…all 3000 are extremely high yield. Whether it is NBME 1
or 19…there is a likelihood to encounter similar test items. While the USMLE has never and
will never say so but it is a logical conclusion as the USMLE test is created by the NBME
themself. Also many examinees report getting test items directly from NBME on actual test.
➣ How best to use the NBME questions as an ASSESSMENT TOOL to IMPROVE YOUR SCORE ?
NBME tests are highly predictive of not just the actual USMLE score but also of subjects and
sections within subjects you may be weak at.
For example : After taking your first NBME, you see the subject areas you are weak in are
Behavioural Sciences and Neuro Anatomy. You look at the exact questions you got incorrect and
see that the Behavioural Sciences questions are all Patient – Physician Relations (PPR). If the
Neuro Anatomy questions which are incorrect are related to brainstem cross sections &
brainstem syndromes… then from the above two you can deduce that you need to focus on those
2 parts specifically. If before the next test you prepare these 2 areas well (and anything else you
were getting wrong questions on) then your score will likely improve. I know this because i did this
and my score improved from mid 230s to mid 260s over the course of 4 online NBMEs i gave (and
many offline). When you assess yourself and look at the incorrect questions it is essential that you
look at them in an objective way.
You could be facing one of the following mistakes:
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation - You did not know a fact which was covered in the books you read.
- You knew all the facts but your thought process was incorrect.
- You knew it all but your brain was not alert and you were half asleep. It feels terrible to get
these type of questions incorrect. - Stuck between 2/3 options.
- You had no f*cking idea what the question is asking and have no clue about anything… Try to
assess questions properly as in NO NBME test are there more than maybe 2 questions like
this out of 200. Very rare and you can’t get these correct no matter what you study. - You read question incorrectly…perhaps one or two words you overlooked or read incorrectly.
- You knew it all but you saw one option and went with your first hunch… first option you saw
lured you in. You need to pick best possible answer. Not the first you see because the first
you see may not be the best. It may be correct but not right 100%… there may be better
option. Ceftriaxone can be given for Lyme’s and cures lyme’s well but doxy is DOC as
cephalosporins are parenteral and tetra is oral. So while ceftriaxone may be correct and may
cure…it is a good option and not BEST option. - You saw a question via a cursory glance and made a pre-formed opinion and went ahead
with the biased thought process and got the answer incorrect.
WAYS TO MITIGATE THE ABOVE PROBLEMS : - If you did not know something which was given directly in books then go back to your books
and start memorizing it. No other way out. Work hard and you will score higher. - If you knew facts but thought process was incorrect then you need to do more questions as
practice. Best practice is doing the 8 earlier forms of NBME. NBME 1, 2, 3, 4, 5, 6, 7, 11… they
combined make up 1600 questions. It is the best possible practice. - If alertness is an issue then you need to buck up. You worked hard for a year and now you
are letting your hard work go down the drain. Sleep well before the test day and be on top of
your game. This is the most important test ever.
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation - Again answer is same as point 1. You need to do your course material well. Problem 4 is not
as bad as problem 1. Atleast you could come down to 2/3 options. In problem 1 you did not
even know the concept. Atleast in 4 you knew concept but didn’t know it well enough. Go to
your books and read them well. - WTF questions are just that… wtf !! However, even when you think it is a wtf question think
hard. Sometimes, you may get a clue hidden in question stem…sometimes options
elimination may work…sometimes you can do good guesswork. If nothing works…just say
wtf…and move on…lol… no point wasting excessive time on questions which ask you crazy
stuff. - Again as point 3… read well !! be alert !! You absolutely cannot afford to be wrong on this test.
Your career depends on it. Take it seriously. - and 8. Always think well and be in sync with the examiner’s psyche… UWorld will train you to
overthink as if every question is trying to fool you. It is not so in actual exam or on NBME.
The questions which look like they have an obvious answer do indeed have an obvious
answer. Do not over think and make pre-formed opinions. Ofcourse you must think well and
deduce a correct answer but UWorld is terrible simulation for actual exam. It makes you
overthink a lot. I had to train myself not to do so as it was costing me valuable points. Be
careful to be in-sync with the examiner…try to question yourself and the question…what
realistically is the examiner asking me here ? That usually turns out to be correct and the
examiner is usually asking you the simpler topic…not the weird logic you created in your
head.
➣ How best to use the NBME questions as a LEARNING TOOL to IMPROVE YOUR SCORE ?
Now I will let you in on a big secret: While the NBME is not providing any answers or explanations
to their questions. A group of top scorers who have got more than 270 on their test have created
an answer & explanations list which has everything explained in depth. I did this after every
NBME. I would do an NBME and then i would do answers and explanations. The answers and
explanations were unbelievably good. As good or even better than UWorld answers and
explanations. I recommend you do this for sure. The value of this great resource is
underestimated. Guys 3000 questions & answers of amazing content ! Questions are made by
USMLE themselves and many people including myself who did the NBMEs in depth before their
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
exam felt that the NBMEs an amazing resource for exam prep. If someone tells you NBMEs aren’t
that helpful after their exam you ask them whether they had really done it well… whether they
really understand slipped strand DNA mismatch abnormality & they really know the differences
between Pelger Huet and Pseudo Pelger Heut anomaly…these both are in NBME as options… you
must dissect NBME inside out…not just read superficially. Many people will give you an opinion
that it’s not so helpful…but make sure you ask them well and understand if they had actually done
this resource well or had just glanced over randomly. I believe that doing the 3000 questions is
the SOLE reason for me going from 230s to 260s.
➣ Where can I get Answers and Explanation to the NBMEs ?
Previously there were no concrete 100% correct answers and explanations… I have seen the
circulating pdfs… every one of them has atleast 5% or more incorrect answers. Many have more.
Some even give incorrect explanation and incorrect logic to incorrect answer choice. There is one
team of 270s and 260s scorers working on the explanations… they have posted it for free online
on their own websites…so make sure you join the following group and page it has the links to
answers and explanations. 10 or so people are involved…it is a group initiative. Go to following FB
Group & FB Page. Answers are available there:
https://www.facebook.com/NBMEExplanations
https://www.facebook.com/groups/NBMEGroup
➣ When should we use the NBME tests / Timing of when to do the NBME questions ?
People do not do the NBME questions till the very end. It is so prevalent among the USMLE
community that it feels almost like an epidemic. Guys, NBME is same organization which makes
USMLE. When we all have heard how people get many repeats from the NBME directly onto their
actual exam then why would we ignore this amazing resource ? This is my recommendation. It is
what I have done and it is what I believe everyone should do. It s what helped me get a 264. Give
NBME s early on and don’t wait till then end. I have seen people try to do all 3000 questions &
answers with explanations in 1 week and sometimes I laugh (i know i shouldn’t laugh but it is
hilarious)… Guys change your thinking…as USMLE and the match process gets tougher and tougher
every year we need to understand that taking such a valuable resource lightly and not adapting to
change is a mistake. Darwin once said: “it is not the strongest nor the most intelligent of a species
that survives but the most adaptable to change”. Adapt and win or ignore and lose… your choice…
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
If people really follow a proper system then they can score so high that 260s will become a regular
phenomenon… It is not that tough if you plan. Just every week for the last 4 months… on a
weekend do one NBME… But make sure you do all the answers along with explanations which i
talked about above. The explanations have some hidden gems from which many questions are
repeated on the real test. So this should be a ideal plan: start form number 1 and go to 19… this
way you have 15 total and you can do for like 3.5 months. Ever week you must assess yourself &
then do the explanations with it… you must try and understand your mistakes. What areas you are
weak in… being blindfolded and having AK – 47 gun in your hand if you go to war you may lose
against someone with a small pocket knife in their hand. You don’t want to be shooting in wrong
direction. Doing easy stuff repeatedly but not recognizing one’s mistakes can be fatal. Also, don’t
keep NBME till last, if you don’t have time at the end you will feel that you will not be able to do
anything new and then you will not do NBME at all. I have seen so many people who make such
mistakes. Do it from a while ago. Many people do NBME in last month. I kept last month without
NBME… You may think how is this possible…well let me tell you…i finished all NBME in 3
months…then in that time i assessed my weakness and gradually improved my score from 230s to
260s… in last month I knew myself and my prep inside out… I knew what I had to do…what is
frequently asked questions and how to prepare. I see people fumble at last moment. I was at peak
on my test day. Doing NBME 3 days before exam will cause only one thing: Anxiety… think about
it… you wanna score 260…havent given single NBME till last month… you give and get 240s… you
work hard and think you will improve…now 3 days before exam you give another test and get
230s… then what will happen to your confidence ? It will be finished… do it early ! At last moment
don’t assess… Assess in advance…and prepare in advance… Have you seen Troy ? Did you see
Achilles (Brad Pitt’s role) do bench press 15 minutes before going to fight ? Have you heard any
great athlete like Mohammed Ali try to do revision 2 minutes before a world championship ? They
may warm up… but will not be actually trying to like grow muscle 1 week before a fight… Prepare in
advance folks… at last moment everything you think can go wrong…might all go wrong at once…and
it would be tough to give test in such high stress environment… Sleep is essential too… so last few
days…my rule was…no exam…no test… only revise the stuff already done…can’t be doing all that and
causing anxiety to yourself… Well this is my advise… If you think you know a better method…then
by all means…do your style… but just remember… Achilles never bench pressed a day before going
to war… you cant grow muscle at last moment…its all long term kinda thing… Do all NBME along
with answers and explanations in advance !
➣ Ending Notes:
10/9/2018 [Complete Guide] THE RIGHT WAY TO USE NBME FORMS - USMLE Experiences & Best Books for USMLE Preparation
Do the the NBME forms from the beginning and use them for self improvement as stated in the
list of mistakes one may do. Analyse yourself objectively. Analyse where you stand and how you
can improve. Understand that a lower score is a product of lower level of planning usually and
hard work can mitigate all problems. Just work hard and you will make it. I will be posting more. I
hope this helps you.
While the NBMEs are a great assessment tool and a great learning tool for USMLE
prep es[pecially if done with all answers and explanations, there are also some
differences between the NBME and the USMLE. It is worth checking out this
article which enlists the differences between the NBME and the USMLE as well as
means to solve this discrepancy