If you’ve spent weeks (or months) grinding through UWorld and finally feel like you’re “getting it,” opening your first NBME practice exam can feel like a rude awakening. Scores dip. Confidence wanes. Questions suddenly feel vague, unfamiliar, and, frankly, unfair. You might even catch yourself thinking, Did I actually learn...

Summary: There’s no perfect number of NBMEs to take before your shelf exam, and honestly, that’s what makes this question so frustrating. Most people don’t need as many as they think. For me, I learned the hard way that fewer, well-used exams are way more valuable than trying to do...

Let’s face it - there are a few things in medical school that will drain your spirit quite like seeing a low score on an NBME Step 1 practice exam. After the days and nights of review, Anki cards, reading First Aid, and watching Pathoma, a disappointing practice test score...

Why tricky questions aren’t “tricks”, and how to start thinking like the test writers.   If you’ve ever left an NBME feeling like the test was out to get you, you’re not alone. Students often describe NBME exams as filled with tricks, traps, or wordplay designed to confuse you. But...

This blog was originally published in October 2025 by Dylan Eiger and updated in April 2026 by Kala Frye Bourque.   NBME shelf exams have evolved. Today’s shelves are longer, more reasoning-focused, and often mirror Step 2 CK in style. They emphasize next-step management, guideline-based care, and outpatient medicine more...

As an MD/PhD student, I am often thinking about data. What are the trends? Are there differences between my groups? How am I going to graph this? Any solid biostatistician will tell you that making something “meaningful” out of data requires three things: a sufficiently large dataset, reliable outputs, and...

TL;DR Form 33 feels less like a content exam and more like a reasoning challenge. Expect experiments, mechanisms, and figure interpretation woven into nearly every block. The question style now mirrors real-world medical reasoning - integrating physiology, pharmacology, and behavior rather than isolating them. Use Form 33 as your final...

TL;DR - My Quick Take  Form 32 is longer and more figure-heavy than most prior recent forms, signaling Step 1’s continued tilt toward applied reasoning, multi-step interpretation, and research/biostats skills. Expect fewer “buzzword” giveaways and more integration across systems (e.g., pathophysiology → mechanism → data → best next step in...

Almost all students preparing for the USMLE Step 1 or Step 2 will take at least one (hopefully more!) practice test leading up to test day. While various practice tests are available to assess your performance, many students will turn directly to the NBME practice tests to estimate their chances...

This blog was originally published on March 21, 2023, and was updated in September 2025 with new information.   There are innumerable resources available for Step 1 preparation. No one study approach will work for everyone or guarantee success. Whatever plan or resources you decide to use, everyone will need to...