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Students, Residents & Practicing Physicians

USMLE Exams

NBME Self-Assessment Services (NSAS)
International Foundations of Medicine Individual Registration (IFOM)
Health & Wellness Coaching Exams

Administrators, Faculty & Program Directors

Subject Examinations
Customized Assessment Services (CAS)
International Foundations of Medicine (IFOM)
NSAS Voucher Program
USMLE Support Services

Chief Proctor Resource Site

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 does Customized Assessment Services differ from the NBME Subject Exams?

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.

How much does a Customized Assessment Services exam cost?

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.

Where are Customized Assessment Services exams administered? How is the exam delivered?

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.

What is the item pacing on Customized Assessment Services exams? How can I accommodate my students that require extra time?

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.

When will my Customized Assessment Services score reports be available?

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.

What resources are there for medical school faculty learning how to use the CAS system?

Questions Related to the 2024 USMLE® Content Outline Update

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.

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?

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.

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?

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.

How will content areas currently tagged under Gen. Principles of Foundational Science be handled moving forward?