Customized Assessment Services
Build exams tailored to your unique curriculum
Custom exams with NBME-quality questions
Customized Assessment Services (CAS) is a flexible exam-building tool that gives you access to thousands of NBME questions developed by committees of subject matter experts. This means you can create exams that align with your unique curriculum, all while spending less time writing questions and dedicating more time to your students.
Use detailed filters and a keyword search function to easily find questions that match the topics covered in your course
Combine foundational and clinical science questions to create tests that support a variety of curricular approaches
Select between proctored and non-proctored options to increase the flexibility of when and where you administer your exams
Designate your desired difficulty during the exam-building process to match the needs of your course or a specific administration
View performance data at a question and examinee level to identify knowledge gaps and provide targeted remediation
Provide your students with access to their results through the INSIGHTS® dashboard alongside their other NBME assessments
Facilitate student learning with the CAS Practice option
Administer exams without room reservations or proctors, so you can test students early and often throughout your course. Share immediate feedback on their performance to facilitate learning, foster group discussion, and provide specialized instruction.
Share results through the INSIGHTS® dashboard
All results for CAS Proctored and Practice exams are available to students through the INSIGHTS dashboard three days after being provided to schools. Skip the hassle of distributing score reports and enable your students to view their results alongside other NBME assessments.
Dive deeper with the Item Analysis Application
View performance across score categories on your exam to identify knowledge gaps and filter by examinee, so you can provide individual students with targeted feedback. A PDF summary of the information provided in the Item Analysis App is also available for download.
CAS provides a user-friendly portal to quickly review questions for content, map them to course objectives, and build examinations—all while balancing additional professional responsibilities.
Assistant Dean at a U.S. Medical School
Case Studies
See how other schools use CAS to meet their unique needs
Saving time for faculty and delivering high-quality exams for students
Successfully shifting to a fully integrated curriculum
Pricing
With CAS, you can create unlimited customized exams during a 12-month subscription period for an annual fee of $1,500.
This subscription includes:
- Program set-up
- Support for test construction and administration activities
- Construction of all examinations
- Score reports for each examination
Administration fees are based on the number of test items in a customized exam and will be assessed when your exam is ordered for administration.
CAS Practice Administration Fees for July 1, 2025 - June 30, 2026
| Number of items on test | Fee per examinee |
|---|---|
| 1-25 | $10 |
| 26-50 | $22 |
| 51+ | $32 |
CAS Practice Administration Fees for July 1, 2026 - June 30, 2027
| Number of items on test | Fee per examinee |
|---|---|
| 1-25 | $11 |
| 26-50 | $23 |
| 51+ | $33 |
CAS Proctored Administration Fees for July 1, 2025 – June 30, 2026
| Number of items on test | Fee per examinee |
|---|---|
| 1-25 | $20 |
| 26-50 | $34 |
| 51+ | $43 |
CAS Proctored Administration Fees for July 1, 2026 – June 30, 2027
| Number of items on test | Fee per examinee |
|---|---|
| 1-25 | $21 |
| 26-50 | $35 |
| 51+ | $44 |
Sample Score Reports
Common Questions
How does Customized Assessment Services differ from the NBME Subject Exams?
Rather than a fixed-form exam, Customized Assessment Services provides medical school faculty with the ability to review and select individual items to be included on an exam. Because Customized Assessment Services exams are unique to an institution, we can only provide item-level comparative data for your students’ performance. Samples of the Customized Assessment Services score reports can be viewed here.
How much does a Customized Assessment Services exam cost?
Customized Assessment Services operates on a subscription basis, with an annual subscription fee of $1500 per institution. Additional fees are assessed when ordering exams for administration, which is based on the length of the exam. The per examinee fees for exam administration can be viewed here.
Where are Customized Assessment Services exams administered? How is the exam delivered?
Customized Assessment Services (CAS) Proctored exams are administered locally at your institution on either university or student-owned laptops or tablets, while CAS Practice exams can be taken anywhere. Exam administration is not available at Prometric Test Centers.
What is the item pacing on Customized Assessment Service exams? How can I accommodate my students that require extra time?
The standard item pacing on all Customized Assessment Services exams is 90s/item. Once an exam has been ordered for administration, a roster of students will be created for that administration which you can use to assign a student additional time.
When will my Customized Assessment Services score reports be available?
Percent correct scores are available to the proctor at the immediate close of a test session. Score reports are posted to the MyNBME® Services Portal 2-3 business days after the administration.
What resources are there for medical school faulty learning how to use the CAS system?
Faculty can reach out to support@nbme.org or call 215-495-6000 for assistance navigating the CAS system. All CAS users are provided helpful tutorial videos and access to the CAS User Guide.
Questions Related to the 2024 USMLE® Content Outline Update
Will the CAS blueprinting system adopt selection/filtering based on the updated content outline? If so, will this be a replacement for the current CAS content outline tagging, or an additional set of filtering options?
Currently, we are not planning to update the Content Outline classifications on the CAS item banks. This is in part to avoid downstream complications of Score Category counts changing on live CAS exams and any potential impacts to score feedback.
The new outline moves the existing normal aging sub-topics out of the x.1.x level to a new top-level area “1 Human Development” topic, replacing “1 Gen. Principles of Foundational Science.” However, the rest of the x.1 “Normal processes” are not covered by the new 2024 USMLE content outline. Will questions about normal processes be phased out to reflect this, or how will those be categorized under the new outline structure, since they aren’t addressed under Human Development?
For our plans to add items to the CAS item banks in the calendar year 2024, any new items added will be categorized on the existing Content Outline codes in the CAS application.
How will content areas currently tagged under Gen. Principles of Foundational Science be handled moving forward?
NBME will issue official communications in advance for any future changes to the CAS Content Outline classifications, with explicit instructions on potential impacts to existing CAS exams and future considerations for CAS Blueprinting.
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