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Date Updated: December 11, 2018

Subject Examinations

The primary mission of the NBME Subject Examination Program is to serve medical education by providing high-quality assessment tools as well as information and assistance to medical educators.

NBME subject exams are achievement tests in a broad sense, requiring medical students to solve scientific and clinical problems. Although students’ performance on the exams will reflect the learning specific to their course and clerkship experiences, their test scores will also reflect educational development resulting from their overall medical school experiences. These exams are constructed to be appropriate for a broad range of curricular approaches.

The NBME offers standardized, objective, discipline-based exams for use in assessment throughout the medical school curriculum. The exams are designed to provide institutions with effective evaluation tools and useful examinee performance data that can be compared with a large representative group of examinees at the same stage of training. Subject exams are cost-effective, available globally, and provide faculty with valuable feedback on the performance of their examinees.

The comprehensive and clinical science web-based subject examinations may be ordered for administration at Prometric’s worldwide network of 350 secure, convenient test centers.

Prometric testing may be preferred for students serving on clinical rotations in a distributed hospital network or for those located at sites without web-based test delivery.

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Subject exams are developed and reviewed by committees of content experts following the same rigorous protocol used to build Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®). NBME subject exams have distinct advantages over locally constructed exams in the assessment of student achievement:

  • The exams provide national norms and relevant descriptive information. These norms reflect the performance of examinees from Liaison Committee on Medical Education (LCME)-accredited medical schools.
  • Items are selected only after extensive review and pretesting.
  • Item formats are similar to those used on Step 1 and Step 2 CK.
  • The exams concentrate heavily on application and integration of knowledge rather than on recall of isolated facts. Many items are framed in the context of clinical vignettes.
  • Multiple forms of each exam are available for use in successive courses or clerkships.
  • Several basic science exams are divided into modules to accommodate course structure.

NBME subject exams are intended to complement other sources of information about the educational progress of medical students and others who take these exams. The results of NBME subject exams should not be viewed as the beginning and end of evaluation. They should be interpreted in light of other available information, just as curriculum evaluation cannot be based on exam results alone. The quality of teaching can and should be evaluated by frequent peer observation and personal feedback, not inferred solely from the level of test scores.

Subject Exams can be administered in conjunction with Customized Assessment Services (CAS) exams by creating a Customized Test Battery.


Program Goals

Our multifaceted program goals are to provide:

  • High-quality assessments that are efficient and cost effective
  • New forms of assessment that promote improvements in learning and instruction
  • Opportunities to conduct and disseminate research that informs medical school faculty and policymakers and promotes their understanding of assessment
  • Information on student educational accomplishments to help advance educational improvement and equity
  • Support services for a range of assessment and educational programs


Policy on Use of Subject Examinations

The NBME provides subject exams in the basic and clinical sciences for the purpose of assessing the educational achievement of individuals in specific content areas.

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These exams may be provided to medical schools and other institutions with a legitimate interest in the education of physicians or other health professionals. All institutions using these examinations must comply with test administration standards, including security protocols.

Subject exams are primarily designed for use as final examinations after courses, clerkships, or other units of instruction. Scores achieved on NBME subject exams cannot be used by examinees for credit toward the examination requirements for medical licensure in the United States.


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