An Interview with NBME Free 120 Explanation Guru: Ben White

Meet the Master Behind the NBME Free 120 Explanations

Every year the NBME releases a set of practice questions colloquially known as the “USMLE Free 120” or the “NBME Free 120”.  These questions are in fact called the ‘USMLE Sample Test Questions’ and they are posted in PDF form on the official USMLE site. This question set provides an additional practice test with which students can gauge their performance on the USMLE Step 1. Additionally, this set of questions offers another chance to get accustomed to the writing style of the actual test writers. There are algorithms and many opinions regarding the predictability of these questions for one’s actual test, and the consensus is that this set of questions should be considered an additional practice exam. Importantly, every year students report that several questions from the Free 120 are used verbatim on their actual USMLE Step 1 exam.

What is the Free 120, and How Can it Help You Study for Step 1?

The USMLE Free 120 questions are largely retired USMLE Step 1 questions that can be taken at home via the PDF form or in a simulated practice test at a Prometric testing center. The actual length of the test varies from year to year between 115 and 120 questions, but because we like round numbers ‘Free 120’ has stuck. Each time that the new Free 120 question set is released, a small portion of the questions are changed from the prior year.  So, there is not too much utility in digging through older copies of the exam if one can find them. 

Although the NBME provides an answer key to the ‘Free 120’ questions, there are no answer explanations.  Fortunately, there are people who provide explanations for these questions that are freely accessible to all students.  The most notable of these is Dr. Ben White, a practicing neuroradiologist.  For many years, Dr. White has been posting these questions on his own website, along with lots of fascinating self-written articles and commentary about medicine, finance, and law. Many months ago, we had a chance to speak with Dr. White (we are both neuroradiologists) about his work on the Free 120 and his website and career.

*Please note, that this interview was conducted prior to the NBME’s announcement that the USMLE Step 1 will go to pass/fail starting as early as 2022.  For more information on that topic please refer to our blog page which has several comprehensive posts on the announcement, and the implications for IMGs, DO students, and medical school curricula.

As a part of our interview series with individuals and organizations positively contributing to the medical education space, we had the pleasure to interview Ben White, MD.

Perhaps most well-known for his website benwhite.com Ben has been writing about medical education, healthcare, personal finance, productivity, and physician wellness for more than a decade– both on and offline. Born in New York, Ben grew up in Dallas, got his AB from Harvard in neurobiology, and then went back to Texas and graduated AOA from UT Health San Antonio.

Completing his radiology residency/fellowship at UTSW, he finished fellowship in 2018 and currently spends his days as a practicing “privademic” neuroradiologist, which means that he works at a university-affiliated private practice that manages a large radiology residency. Writing online in the medical education space since 2009, Ben has become widely recognized by students particularly for his work with the NBME Free 120 (which we will be focusing on today). He has also successfully published 3 books, which aim to help medical students navigate student loans, as well as the Texas Medical Jurisprudence Exam.

Thank you so much for doing this interview with us! How did you come to the idea of working through the NBME Free 120 and posting these for others to use? 

When my wife was going through her USMLE Step 3 prep in 2013, we were looking at the free sample questions, and it struck me that it was frustrating that there weren’t explanations on any of the practice questions I’d ever done. The core of my site for the past decade has been me writing up the answers to my own questions for the benefit of others, so it seemed like the obvious thing to do. 

Do you plan to continue updating your USMLE Free 120 answer explanations? And if so, how long? 

I’ve been doing them for around seven years, which is essentially forever in internet years. So probably forever?

You are a board certified neuroradiologist. How do you find the practice and/or process of looking up and explaining these questions affects your overall medical knowledge and helps your work as a Radiologist? 

I’m continually surprised at how much I remember. I think a lot of this stuff is permanently ingrained now, but being a doctor’s doctor does help me keep a pretty broad view of medicine. I still see everything I learn/do as how it could play out as a test question. That’s of course outside of the absurd biochem nonsense. I’ve never known the Krebs cycle for more than a few days at a time.

You have previously worked as a private tutor. What advice would you share with students regarding studying for and preparing to take the USMLE Step 1, and the other USMLE / NBME exams?

It’s depth, not breadth. Medical students suffer from a self-defeating FOMO when it comes to resources. There are just too many. There were too many even when I was a student and that was before Pathoma, Sketchy, the Anki craze, or any of the ever-growing number of video-course/qbank/curricular replacement companies like AMBOSS, Lecturio, etc. came around. People were crushing Step back then, too. Just pick a limited number of high-quality resources with a strong focus on questions. Not everything that appears in a resource is of equal importance. Be diligent, be methodical–but try not to make yourself miserable.

Your website has very insightful articles about medical, legal, and financial issues. Is there anything that you’d like to say or highlight from your prior writings that relates medical education generally and/or the USMLE or NBME? 

I have so many thoughts about medical education (so many that I’m very slowly writing a new book about it). I keep a list of the some of my highest yield posts here.

But one of the things that never came up during my medical school experience was the finance part. I lived almost 100% off student loans and then had to learn the personal finance part to make it all work. A couple years ago I wrote a full-length personal finance book for medical students and residents that really clarifies the elephant in the room: managing student loans (including things you can do during school to minimize your debt). I started giving it away last year and will do so forever, because the hardest part of the personal finance problem is getting people to sit down and self-educate. It’s free, so no excuses: Take control, it’s not Monopoly money!

Thank you so much for these insights! It was an absolute pleasure to speak with you!