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Activity Forums USMLE Step 1 Forum NBMEs vs. UWSAs

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This topic contains 2 replies, has 3 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 2 years, 2 months ago.

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  • #270
    Dan S., MST USMLE Tutor
    Reputation: 30
    USMLE ExpertMD or DOContributor

    Some of the most common questions I see are about the difference between NBMEs and UWorld Self Assessments (UWSAs), and when to do each.

    Big picture
    UWSAs: There are two UWSAs that are included in UW subscriptions if you buy at least a 180 day subscription. These involve four forty question blocks (160 questions total), and are similar in format to the rest of UWorld. The questions tend towards slightly shorter prompts and slightly fewer steps to arrive at the correct answer, both of which are more in line with the actual step exam. Upon completion, you can review the question blocks, and the answer explanations are up to UWorld’s general (very high) standards. You are provided with a score estimation and a diagnostic summary of strong/weak areas.

    NBMEs: There are six NBMEs called Comprehensive Basic Science Self Assessments (CBSSAs) that are geared towards Step 1. They can be found here ( ) and they cost $60 each. The question style mimics the actual exam, though the questions are sometimes more confusingly/poorly worded than true exam questions. Upon completion, you can review questions, with correct/incorrect answers marked, but no answer explanations provided. As with UWSAs, you are provided with a score estimation and a diagnostic summary of strong/weak areas. The score estimations tend to be lower than UWSA predictions.

    What to do when?
    While NBMEs can be useful diagnostic tools, in that they give you a sense of where you are relative to your last NBME exam both overall and by topic area, they are not useful learning tools. To look up answer explanations can be a huge waste of time that is generally better spent doing more questions in a question bank with solid explanations built in. UWSAs, on the other hand, are useful both diagnostically and for review. For this reason, I recommend saving UWSA 1&2 to be your last practice exams, completed in the 2 weeks and 1 week before your exam day. This approach means that you aren’t taking an exam right before your test day, and the last exam you take provides you with useful explanations and guidance for areas of focus for your final week(s). Together, these factors help alleviate some of the panic that may set in after a final practice score slightly below your goal score. In part because UWSA 1&2 tend to be taken towards the end of studying, I have found that among my classmates, myself, and my students, folks generally score somewhere between their estimated scores on these two practice exams.

    For NBMEs, I would recommend taking one every two weeks or so up until the final two weeks of studying. Two weeks should also be about how long it takes you to cycle through a pass of the FA material. As you get into your last few weeks, you can consider doing one NBME a week, but not at the expense of completing less of UWorld. As far as which NBME to take when, some folks swear by NBME 18 being more predictive than some of the others, but its hard to say since the other NBMEs (all of the 20s) are pretty new, so data is limited. Here is some data we do have for NBME 18 and UWSA 1/2 from 2018 Reddit users:

    Post below with any questions!


    Great advice, Dan! I personally always recommend to my students just what you said in the last paragraph – weekly NBMEs (or every two weeks based on how much time you have) during dedicated, and typically waiting until the end to get the UWorld exams, as those tend to be best predictive. At the end of the day though, if you have to prioritize just a few exams, UWorld and NBME 18 or later are best.


    Just to add on to that excellent responses, I normally tell students to schedule nbmes and UWSAs backwards from your test date. Meaning you’ll want to take the gold standard three (UWSA 1/2) and NBME 18 as your last three in the last 2-3 weeks, kinda like Dan mentioned. This will let you get the best data points when you’re the best prepared.

    Further out you can get more creative. If your study plan is longer than the standard 6-7 weeks, I’ll typically say to start with the Kaplan Diagnostic Test so you get some good practice without wasting one of the big gun exams.

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