As you may have heard, as of March 25, 2019, the NBME will be retiring most of the currently available exam forms and releasing 5 new forms in two different release dates. This is big news for those students currently preparing to take USMLE Step 1 later this Spring and this Summer.
The question we are trying to answer here is: What students should attempt to glean from the new exam forms (NBME forms 20, 21, 22, 23 and 24) once they are released?
As with all NBME practice exams, it is important to self-analyze in order to understand the questions you have answered incorrectly and the material you may have understood poorly. It’s also important to use the NBME as a predictor of your current level of score performance. However, we will need to see how well the new exams predict scores once they are released. NBME Form 19 which was released in Spring 2017 has had a very poor track record of score prediction.
Beyond score prediction, there are deeper points to be uncovered when examining the new forms. At Elite Medical Prep our tutors analyze these practice tests very carefully to look for indicators of how the test is approaching certain topics. For example, we look to see if the wording for certain diseases has changed. Over the years (since NBME Form 4–yes we have analyzed NBMEs going back nearly a decade!), buzz words have been progressively replaced with something more akin to buzz phrases. Eponyms (diseases or structures named after people) have been replaced with corrected names (e.g. Wegener’s disease is now Granulomatosis with polyangiitis). The NBMEs have progressively included more high yield radiology images that are better quality overall. Our team will look to see whether these trends continue or even accelerate with the release of the new NBMEs.
Our team of tutors at Elite Medical Prep will be looking at the distribution of tested topics. This effort will require analysis across multiple tests, as well as a baseline familiarity with how the NBME has historically tested certain topics. It’s not enough to look at the cardio questions in 1 or 2 NBME forms. You need to look across many NBME forms to really start to see patterns.
We will assess whether certain minor topics are covered at all. At the same time, we want to get a sense of how many of the questions are devoted to a major topic like diabetes, a disease that has complications that span many organ systems. Diabetes has classically been one of the most highly tested medicine topics on the NBME. Here are a few examples of diabetes concepts the NBME likes to test:
- Weight can be harder to control in type 2 diabetes because of down regulation of insulin receptors
- Diabetic patients who develop orthostatic hypotension and loose stools have autonomic dysfunction
- Plasma osmolarity is increased due to increased glucose in serum
- Sorbitol accumulation causes milky opacity in the eye and progressive decreasing vision
- ACE inhibitors and ARBs slow the progression of proteinuria
In the end, we expect these new forms to be quite helpful to students preparing for Step 1. Once the tests are released, you can expect that Elite Medical Prep will not only know the answers but be able to offer deeper insights to the students we tutor.