Subject Examinations allow you to measure your students’ knowledge and understand how their performance compares to examinees in medical schools throughout the United States.

Program Guide

Compare Performance Against National Norms

When assessing your students at the end of a course or clerkship, it helps to know how their performance compares to examinees on a national level. That’s why medical schools rely on our Subject Exam Program. It provides national normative data that reflects the performance of examinees from medical schools accredited by the Liaison Committee on Medical Education (LCME).

The Subject Exams are developed by committees of content experts and include score reports that deliver actionable performance feedback.


The NBME Subject Exams include the following:

  • The Basic Science and Clinical Science Exams, which are designed to assess basic and clinical science knowledge at the end of a course, clerkship, or other unit of instruction.
  • The Health Systems Science Exam, which faculty can use to support the implementation of health systems science curricula and education initiatives.
  • The Advanced Clinical Exams, which help measure the effectiveness of the fourth-year emergency medicine and internal medicine sub-internship experiences.
  • The Comprehensive Exams, which reflect the content of the USMLE® Step 1 and Step 2 Clinical Knowledge Exams and are typically used to identify areas of strength and weakness prior to taking the USMLE.

Exam Content

Select a subject area below to view specific exam topics and click Content Outlines button to access full content outlines and sample items.


The Subject Exams are available to request through the online ordering system on the MyNBME Services Portal.

NBME Executive Chief Proctors at medical schools and 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
  • Names, telephone numbers and e-mail addresses for the Chief Proctors assigned to each testing room

2022 Score Report Changes

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

Interview with NBME Specialists About Score Report Changes

Tour the New Score Report

View Answers to Common Questions About the Upcoming Changes

Updated Sample Score Reports

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

Score Reports

NBME provides a variety of performance feedback depending on the Subject Exam and mode of administration. These include score reports, item analysis reports, performance profiles, and year-end reports.

Click the report type below to learn more and view the Sample Score Reports tab.

We provide an alphabetic roster of examinees with corresponding equated scores or non-equated percent correct scores.

For exams that report equated scores, the score report set also includes the following:

  • Score interpretation guide
  • Norm tables
  • Grading guidelines (available for all Clinical Science Subject Exams)
  • Frequency distribution on total test equated score (if at least two examinees were tested)
  • Modular exam subscores (if available)
  • Content area item analysis reports (detailed and/or summary)
  • Individual examinee performance profiles
  • Summary school performance profiles (for Basic science and Comprehensive exams)

A detailed item analysis report is provided for any Subject Exam with at least 10 examinees testing during a single form administration and for which equated scores are available. This report provides a short description of the content of each item on the exam, along with the proportion of examinees from your institution and the projected proportion of examinees nationally that answered each item correctly.

Item analysis data and descriptors of the items can be helpful in determining the extent to which your examinees have learned the content of individual items.

Individual performance profiles are available for many Subject Exams. Profiles are intended for distribution to examinees as an aid in self-assessment. For each major content area on the exam, examinee performance is displayed graphically with performance bands representing areas of strength and weakness.

We also provide a summary performance profile, which is an aggregate report of examinee performance for the major content areas on the exam for a specific administration. This report is available when there are 10 or more examinees. 

We provide year-end reports for all Clinical Science Subject Exams and most Advanced Clinical Science exams to institutions that administered them in the previous academic year.

Each report compares the performance of first-time takers from the institution with a comparison group of examinees from LCME-accredited medical schools, who took the exam for the first time under standard testing conditions during the previous academic year.

Sample Score Reports

View samples for score reports and other performance feedback.


2022-2023 Subject Exam Fees*

  July 1, 2022 - June 30, 2023

(Per Examinee)

Prometric Test

(Per Examinee)†

Basic and Clinical Science Exams


 Basic Science

 Clinical Science

 Introduction to Clinical Diagnosis








Not Offered


Not Offered

Health Systems Science Exams $48 Not Offered
Advanced Clinical Exams


   Emergency Medicine

   Internal Medicine








Not Offered

Comprehensive Exams


   Comprehensive Basic Science

   Comprehensive Clinical Science










* Fees subject to change

† Administer NBME Subject Exams at Prometric Centers


Prometric Test Centers Extra-Time Testing Fees

Exam Extra-Time Testing Fee (Per Examinee)†
  1.25X       1.5X         2X
Clinical Science   $121        $126        $131
Comprehensive Basic Science   $170        $181       $202
Comprehensive Clinical Science   $170        $181       $202
Emergency Medicine Advanced Clinical   $121        $126        $131


† There may be additional fees connected with a different type of accommodation, which will be assessed after the scores have been reported.