When to Take the NBME Practice Exams

Deciding when to take practice exams is a dilemma that many students face when preparing for USMLE Step 1. Practice NBME exams are undoubtedly one of the most useful and important resources you will use in your Step 1 preparation. They can help you assess your own readiness to pass your exam, identify knowledge gaps and areas for further study, and give you exposure to the types of questions you will see in Step 1.

There are also many common misconceptions about when to take practice exams during your dedicated period of exam preparation. Many students think they need to save all practice exams for the last weeks or days before their test date. Some students put off taking a practice exam so they can focus on content review. If you incorporate practice exams early and make them an integral part of your USMLE Step 1 study plan, you can keep yourself on track for success on Step 1. Before we talk in more detail about when to take the exams, let’s discuss what practice exams are available to you.

What USMLE Step 1 Practice Exams are Available?

The NBME (National Board of Medical Examiners) currently has six practice exam forms available for purchase for Step 1. They are called Comprehensive Basic Science Self-Assessments or CBSSAs. These forms 25-30 are $60.00 each. But your medical school may provide vouchers to take one or more of these exams. These forms are frequently updated and reflect similar question style and content to what you will see on the real exam. This makes them a great predictor for USMLE Step 1 performance.

Each form has a total of 200 questions split into four sections of 50 questions. You can choose to take the exam at standard pacing, where you will have one hour and 15 minutes for each section, or self-pacing, where you will have 5 hours for each section. I recommend that students use the standard pacing option to simulate real testing conditions. In addition to the CBSSAs practice exams offered by the NBME, UWorld also has two self-assessments (UWSAs) that are included with your subscription. This leaves you with a total of eight high-quality practice exams that you can use in your Step 1 preparation.

Which Practice Exams Should You Take for USMLE Step 1?

So how do you decide which exams to take and when? First, you should take one CBBSA at the very beginning of your dedicated study period. It’s perfectly ok if you don’t quite feel “ready” to take a practice exam yet! This exam will give you a baseline of your performance. It will give you an idea of where you stand as well as inform you which subjects you should focus more time studying. It can also help you identify whether you might need additional help from a USMLE Step 1 tutor and give you time to arrange one.

Incorporating Practice Exams into Your Study Schedule

Thoroughly review your first NBME practice exam and understand your score report. Based on this practice exam, you should now create a study schedule for the rest of your dedicated period. Check out our 10-week and 6-week study schedules to help you get started. For most students, your plan should include a minimum of three total practice exams. Obviously, the more practice exams you can take and pass, the better chance of success you will have on Step 1.

For a 6-week dedicated period, a good basic schedule would be to take one practice exam at the ends of weeks 2, 3, 4, 5 and 6. You can leave yourself some time to take an additional practice exam early in week 6. However, it is a good idea to give yourself at least a few days between your last practice exam and your test day to avoid extra anxiety and burnout for the exam. If you are struggling to decide which practice exams you should take, read my other article (NBME 25- NBME 30: Which is the best predictor for passing step 1). However, all of the CBSSAs and UWSAs are good resources, and taking multiple practice exams will give you a good idea about your likelihood of passing Step 1. 

If you need additional help with your Step 1 preparation, consider meeting with a tutor. USMLE tutors are a great resource, and can individualize a schedule for you and help you achieve Step 1 success! Schedule your complimentary consultation today to learn more about how Elite Medical Prep tutors can help you succeed!