Self-Assessments for USMLE® Step 1: The Right Tool for the Job

Sean Robert Huff, MD - Jan 20, 2021

USMLE® Step 1 is often regarded as the most difficult and important exam a medical student will take. Sound scary? It doesn’t have to be. 

Each year, thousands of students succeed on the USMLE Step 1 after building and following a study plan that meets their needs. And every student’s choice of resources usually features one particular mainstay: a USMLE Step 1 self-assessment.

What is a self-assessment?

A self-assessment can be thought of as a simulation (or mock) of the official exam you’ll eventually be taking. In other words, a self-assessment aims to provide takers with a window into what the exam may look and feel like. This extends not only to the timing and format (although most self-assessments contain fewer question blocks than the real thing) but also the range and difficulty of content that will be featured on the exam.

At any one time, approximately five self-assessment exams are made available for purchase from the National Board of Medical Examiners (NBME®), the testing body that writes the official USMLE Step 1 exam. Additionally, third-party self-assessment exams can also be purchased from a variety of companies, and future USMLE Step 1 test-takers can also participate in the AMBOSS Step 1 Self-Assessment Week.

Why take a Step 1 self-assessment?

There are many reasons you may be interested in adding a self-assessment to your Step 1 approach. Some of the main reasons to include self-assessments in your study regimen are to: 

  1. Develop familiarity with the test-taking environment and give yourself a sense of comfort with the pace and interface. This makes sense especially early on when test-taking habits are still forming.
  2. Steer your studying with the help of analyses alongside score reports that detail your relative strengths and weaknesses.
  3. Get regular feedback that can be useful in modifying your own timing, resources, or goals--especially if you take multiple self-assessments over the course of weeks and months.
  4. Establish expectations, or help make last-minute decisions about exam timing.

Things to consider when using self-assessments

Here are some general tips to consider  when implementing self-assessments into your study routine:

Be deliberate. Whether from an official or unofficial source, the amount of high-quality self-assessments available is limited. Therefore, it’s best to use self-assessments in a strategic way, with a particular goal in mind for each.

Similarly, the timing of self-assessments matters just as much as your own goal. A self-assessment taken two weeks before the exam will not be very helpful in building a study plan. Similarly, a self-assessment taken before you’ve started studying will not help identify your “true” weak points in a very precise way. 

Do the math. The scoring systems of self-assessments are often unique, with some requiring students to complete a conversion in order to better understand the three-digit score they would receive from the official USMLE Step 1 score report. In the case of the AMBOSS Step 1 Self-Assessment Week, participants will receive a three-digit score that approximates their performance in real terms.

Furthermore, it is important to remember that, unlike AMBOSS’, most self-assessments are not free. Official self-assessments from the NBME are available at $50, and many offered by private companies can be purchased for a similar price. Don’t forget to include these costs into your overall USMLE Step 1 budget.

Sample matters. One of the core science concepts you will learn during medical school is the importance of proper experimental samples in reaching valid medical conclusions. The same basic concept applies to calibrating an examinee’s performance.

Self-assessments offered by the NBME and others compare your current performance to the performance of assessment-takers from previous years. This can lead to an overestimation of your score as content from previous self-assessments makes its way to the study resources that takers use today. 

In contrast, AMBOSS' free self-assessment compares your performance to your peers’, so you can be confident in its scoring system and study recommendations.

Keeping the above strategies in mind, USMLE Step 1 self-assessments can become the tool that allows you to succeed on USMLE Step 1 with as few headaches as possible.