Comprehensive Subject Exams | NBME (2024)

Assess student learning progress and readiness to take the USMLE® and access national normative data

  • Overview
  • 2022 Score Report Changes
  • How to Purchase
  • Score Reports
  • Resources

Overview

Educators use the Comprehensive Subject Exams to assess students' learning progress and readiness to take the USMLE Steps 1 and 2. The exams must be administered securely and are not intended to be used for practice purposes.

In addition to helping you save the time and resources that go into creating your own assessment, the Comprehensive Subject Exams enable you to:

  • Access overall and content area scores that can be compared with those of relevant national comparison groups, so you can measure your cohort against studentson a national level
  • Gain a more thoroughunderstanding of you examinees' readinessfor the USMLE Steps 1 and 2
  • Provide your students with actionable feedback throughin-depth score reports that help them progress on their learning journey
  • Ensure quality with questionsthat are written and reviewed with the same rigor used to create USMLEStep 1 and Step 2 items

Exam Content

Click on each Comprehensive Subject Exam below to view content outlines and sample test questions.

Comprehensive Basic Science

Comprehensive Clinical Science

Administration

The Comprehensive Subject Exams are available for web-based administrations at both your school and Prometric test centers.

All Comprehensive Subject Exams are available for administration at your school. Web-based exams must be administered in a secure, proctored setting. NBME provides a web-based utility that checks both hardware and software configurations and downloads a plug-in that secures the browser.

The computer is locked down, preventing the examinee from accessing applications such as e-mail or notepad. It also includes a function designed to detect any recording applications and programs that may be running on workstations or examinees’ personal laptops prior to the start of the exam.

The Comprehensive Subject Exams can also be administeredat Prometric’s worldwide network of secure test centers.

Prometric testing may be preferred for students serving on clinical rotations in a distributed hospital network or for those located at a site without web-based test delivery capability. It may also be useful for makeup tests. This option requires advance planning to allow students sufficient time to schedule testing appointments.

Learn More

2022 Score Report Changes

Comprehensive Clinical Science

Beginning on December 5, 2022, NBME will update how we report scores for the Comprehensive Clinical Science Exam (CCSE).Learn more about this update below.

Updated Sample Score Reports

Tour the New Score Report

View Answers to Common Questions About the Changes

If you have any additional questions or concerns regarding the changes, please submit a requesthere.

Comprehensive Basic Science

Beginning in late February of 2022, the Comprehensive Basic Science Subject Exam (CBSE) score reports will include an equated percent correct score. Learn more about this update below.

Updated Sample Score Reports

Interview with NBME Specialists About Score Report Changes

Tour the New Score Report

    View Answers to Common Questions About the Changes

    If you have any additional questions or concerns regarding the changes, please submit a requesthere.

    How to Purchase

    The Comprehensive Subject Examsare available to purchase through the online ordering system on theMyNBME® Services Portal.

    NBME Executive ChiefProctors at medical schoolsand those with parallel responsibilities at residency programs or other organizations will have access to this portal.

    The following information must be provided in the web-based exam order:

    • Test date
    • Expected number of examinees
    • Number of any examinees who need extra testing time and the corresponding exam length (1.5x or 2x the standard time limit allocated for other examinees)
    • Test session start and end times

    Exam Fees

    Score Reports

    All scoring feedback, norms, and grading guidelines for the Comprehensive Subject Exams can be accessed through theMyNBME® Services Portal.

    A brief description and samples of the various types of score reports and associated downloadable text files is provided below.

    • Provides detailed information about the computation of scores, the contents of each type of score report and the contents of downloadable data files.
    • It is included with the Roster Report and can also be accessed separately on the portal under the Score Reports tab.

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Provides the total score for each examinee and descriptive statistics for the administration. A downloadable roster text file includes the total score and content area scores for each examinee.

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Available for any Subject Exam administration with at least 5 examinees and for which equated scores are available.
    • Provides information on the performance of your examinees and a national group of examinees on the major content areas on the exam.

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Available for any Subject Exam with at least 5 examinees testing during a single form administration and for which equated scores are available.
    • Provides information on the performance of your group of examinees and a national group of examinees on each item.
    • Helpful in determining the extent to which your examinees have learned the content of individual items.
    • Provided for institutional use in assessing the performance of examinees. The written authorization of NBME must be obtained prior to any additional use of the data (e.g., in research papers).

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Provides information about overall performance and performance on major content areas on the exam for each examinee.
    • Intended for distribution to examinees as an aid in self-assessment.

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Provides information on the performance of each examinee and a national group of examinees on each item.
      • Available for any Subject Exam administration with at least 5 examinees and for which equated scores are available.
    • Intended for distribution to examinees as an aid in self-assessment.

    View Sample (Basic Science)

    View Sample (Clinical Science)

    • Provides information enabling you to compare your examinees’ performance with a nationally representative group of examinees from LCME-accredited medical schools at the same stage of training.
    • The most recent norms for each exam are included with the score reports and can also be accessed separately on the MyNBME Services Portal along with earlier norms (when available) under the Score Reports tab.

    Resources

    Visit the links below to learn more aboutthe Subject Exams.

    • Subject Exam Program Guide
    • Subject Exam TimingChart
    • Score RecheckRequest Form
    • Arranging/Administering an NBME Web-Based Exam
    • Administering Subject Exams at Prometric Test Centers
    • Laboratory Reference Values
    • System Requirements
    • FAQs

    Related NBME Products

    Comprehensive Subject Exams | NBME (1)

    Self-Assessment Services

    Purchase self-assessment vouchers to support your students practicing and evaluating their readiness for the USMLE® Step 1 or Step 2 CK

    Learn more

    Interested in learning more about the Comprehensive Subject Exams or another NBME product?

    Complete the consultation request form to get in touch with NBME staff.

    Request a Consultation

    Stay Up to Date

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    Comprehensive Subject Exams | NBME (2024)

    FAQs

    Who takes shelf exams? ›

    During stage two of the MD curriculum, you take shelf exams. The results of these tests measure your understanding of specific instructions and hands-on experiences covered in the core clerkships—the clinical rotations that help you transition from classroom studies to patient care.

    Are shelf exams harder than Step 1? ›

    Shelf exams are generally designed to be of comparable difficulty to those you will see on USMLE® Step 1 and Step 2. In fact, many of the questions are retired from previous Step exams!

    Why are they called shelf exams? ›

    However, the majority of clerkships in the U.S. use the National Board of Medical Examiners (NBME) Medicine Subject Examination as an end-of-clerkship examination. Because this exam is not developed locally and is obtained from the NBME “off-the-shelf,” it is commonly referred to as the “shelf” exam.

    What does EPC mean in NBME? ›

    Your equated percent correct (EPC) scores indicate the percentage of the content that you have mastered.

    What happens if you fail a shelf? ›

    If your medical school allows retakes, if you fail a Shelf exam, it is advisable to retake it within 90 days of your first attempt. This is because initial Shelf scores can be completely expunged and replaced with the retake score if the retake occurs within 90 days after the original exam.

    Do all med schools use shelf exams? ›

    While the shelf exam is not required by all medical school programs, and it's not a requirement of obtaining a US medical license, shelf exams remain a popular way to test medical students on the knowledge acquired during their clinical rotations.

    Do residencies see shelf scores? ›

    Program Variability: Residency programs differ in their approach to evaluating applicants. While some programs may weigh shelf scores heavily, others may prioritize letters of recommendation, clinical evaluations, and other qualitative aspects of a student's performance.

    What is the average shelf score? ›

    How do you interpret a shelf exam score? The NBME shelf exams were originally scaled to a mean of 70 and a standard deviation of 8. Keep in mind, this is not recalculated every year. The actual average in a given year has tended to creep up and is usually somewhere in the low-to-mid 70s.

    Is it hard to pass a shelf exam? ›

    While shelf exams are challenging assessments, designed to evaluate students' readiness for clinical rotations, passing these exams is achievable with adequate preparation and study strategies.

    How many minutes is a shelf exam? ›

    NBME medicine shelf exams are 165 minute exams that happen at the end of each core rotation, also known as clinical clerkship.

    How do you score high on shelf exams? ›

    Try to leave the 2-3 days immediately before the shelf exam for dedicated studying. Use this time to review the material and practice questions you've covered over the past few weeks. Take at least one NBME for each rotation.

    Can you take breaks during shelf exam? ›

    Unlike the USMLE Step exams, you are free to get up, stretch, eat a snack, drink some water, and use the bathroom at your leisure during the shelf examinations.

    Are shelf exams curved? ›

    1. How is the exam curved? This question is actually more broadly broken up based on the following questions. - The exam score sheet states that the exams are curved to a mean of 70 with a standard deviation of 8, but when the percentiles are given they don't match up.

    What is a 90% chance of passing Step 1? ›

    A 90% estimated probability of passing Step 1 within a week still means that 1 out of 10 students with the same level of performance will fail based on the predictive model. The estimated probability is not the same as the percentage of the content mastered.

    What score is a 70 on Step 1? ›

    The subject examination score is scaled to a mean of 70 and a standard deviation of 8. A CBSE score of 70 is approximately equivalent to a score of 200 on the United States Medical Licensing Examination® (USMLE®) Step 1.

    Does everyone take the same shelf exam? ›

    Unlike Step 1 and Step 2, shelf exams are standardized for you. Everyone takes them on the same day through the same proctoring. Whoever is on your rotation will be taking the exam with you as well.

    Are shelf exams important for residency? ›

    In the journey to residency, medical students' shelf exam performance holds significant weight in applications. Shelf exams, designed to assess students' knowledge and clinical reasoning in specific core clerkships, can play a pivotal role in shaping the narrative of a medical student's academic capabilities.

    Do shelf exams cost money? ›

    The Basics: Cost, Where to Sign Up

    All NBME Self-Assessments cost $60 (see below for more). Subject (Shelf) exams cost $20 each.

    What is the average for shelf exams? ›

    How do you interpret a shelf exam score? The NBME shelf exams were originally scaled to a mean of 70 and a standard deviation of 8. Keep in mind, this is not recalculated every year. The actual average in a given year has tended to creep up and is usually somewhere in the low-to-mid 70s.

    References

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