Important Information on Step 1 Changes

The following relays important information regarding the recent policy changes to the United States Medical Licensing Examination (USMLE): 

According to the USMLE, Step 1 pharmacology items will continue to focus on the test-taker’s understanding of drug mechanisms rather than on pharmacotherapy. Step 1 examinees will generally not be required to identify specific medications indicated for a specific condition. Instead, they will be given information about a drug (e.g. name, mechanism, or side effects) and asked for other information about that drug. Step 2 CK examinees will be asked to identify the specific medication indicated for a given disease, as before. 

(Taken directly from the March 2, 2021 announcement put forth by the National Board of Medical Examiners (NBME) entitled “Learn More Than Your Score: Upcoming Improvements to NBME® Self-Assessments”)

In addition to providing predictive scores, the 2021 NBME Self-Assessment forms will now feature in-depth answer explanations. This gives you access to comprehensive feedback so you can:

  • Quickly identify mistakes and learn the rationale behind the correct answer
  • Reinforce your knowledge as you prepare for your upcoming exam
  • Maximize your study time with less need to consult external sources

Better Alignment to Recent USMLE® Step 1 Changes

Although answer explanations will be available across all 2021 NBME Self-Assessment forms, there will be additional updates to the Comprehensive Basic Science Self-Assessments (CBSSA). These will be revised to reflect the August 2020 amendments to the USMLE Step 1 Exam, which now includes questions on communication skills to expand the assessment of soft competencies.

Six updated forms will be introduced and six will be retired:

• Updated form numbers: 25, 26, 27, 28, 29, & 30

• Retired form numbers: 18, 20, 21, 22, 23, & 24

(Taken directly from the June 1, 2020 announcement put forth by the National Board of Medical Examiners (NBME) entitled “New and Expanded Learning Resources Available”)

Free NBME Self-Assessments Available Through September 30, 2020

To help students continue to sharpen their knowledge during testing delays that may result from COVID-19, seven free NBME Self-Assessments are available. Free Self-Assessments include the following exams:

  • Comprehensive Basic Science (CBSSA) Forms 13, 15, 16, 17, and 19
  • Comprehensive Clinical Science (CCSSA) Form 7
  • Comprehensive Clinical Medicine (CCMSA) Form 5

After ordering any of the free Self-Assessments, students will have 90 days to complete it. Students will have unlimited time access their interactive score report on MyNBME and review each question, option set, and correct answer.

To access these free test forms, please go to and follow these instructions.

(Taken directly from the February 12, 2020 announcement put forth by the National Board of Medical Examiners (NBME) entitled “USMLE program announces upcoming policy changes”)

“Today, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®), co-sponsors of the United States Medical Licensing Examination® (USMLE®), announced upcoming policy changes to the USMLE program.

These new policies will continue to enable the USMLE program to provide high-quality assessments for the primary user of exam results (state medical boards) while also addressing other considerations, such as exam security and unintended consequences of secondary score uses. The secondary uses of Step 1 scores for residency screening, in particular, have been the focus of extensive discussion over the past year at the FSMB and NBME, within the USMLE program, and with multiple stakeholders within the broader medical education and regulatory communities.

“These new policies strengthen the integrity of the USMLE and address concerns about Step 1 scores impacting student well-being and medical education,” said Humayun Chaudhry, DO, MACP, President and CEO of the FSMB. “Although the primary purpose of the exam is to assess the knowledge and skills essential to safe patient care, it is important that we improve the transition from undergraduate to graduate medical education.”

“The USMLE program governance carefully considered input from multiple sources in coming to these decisions. Recognizing the complexity of the environment and the desire for improvement, continuation of the status quo was not the best way forward,” reported Peter Katsufrakis, MD, MBA, President and CEO of NBME. “Both program governance and staff believe these changes represent improvements to the USMLE program and create the environment for improved student experiences in their education and their transition to residency.”

These policy changes are currently planned to be phased in over the next 11-24 months. For specific information on each policy, consult the links above to the detailed statements accompanying each policy change.”

NBME has also generated a podcast (Three Decisions to Result in Future Changes to USMLE) outlining these changes.  The podcast is a part of their “NBME Connection” station on Soundcloud.  

Note: The Office of Student Learning and Academic Advising (OSLAA) will endeavor to update this page with new USMLE Step 1 information from NBME as it is generated.  For the most recent announcements and updates, though, please visit the NBME Announcements page.