Shelf Exams

A Comprehensive Guide To NBME Practice Shelf Exams

Don't stress about your practice shelf exams. Know the information and tools necessary to boost your performance and achieve great results.

Jun 14, 2024

Shelf Exams

A Comprehensive Guide To NBME Practice Shelf Exams

Don't stress about your practice shelf exams. Know the information and tools necessary to boost your performance and achieve great results.

Jun 14, 2024

Shelf Exams

A Comprehensive Guide To NBME Practice Shelf Exams

Don't stress about your practice shelf exams. Know the information and tools necessary to boost your performance and achieve great results.

Jun 14, 2024

student infront of laptop - Practice Shelf Exams
student infront of laptop - Practice Shelf Exams
student infront of laptop - Practice Shelf Exams

Are you gearing up for your Shelf Exams and wondering, "how long are Shelf Exams?" These pivotal tests can either make or break your clinical performance evaluation. Scoring well on the NBME practice Shelf Exams and understanding how to tackle these assessments is crucial for excelling in your medical school journey.

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Table of Contents

What You Need To Know About The NBME Practice Shelf Exams

a book for self study - Practice Shelf Exams

The National Board of Medical Examiners (NBME) writes the USMLE and Shelf exams. To help students prepare, the NBME also releases practice exams, which are the official practice exams for both exams. 

There are currently 29 NBME Subject Exams for Shelf exams, designed to help students prepare for the actual exams they will be taking. The NBME tracks students’ scores on these practice exams and measures them against their actual scores, making them the most accurate predictors of a student's performance on their Shelf exam.

Cost and Registration

All NBME Self-Assessments come for $60, while the Subject (Shelf) exams each cost $20. One can visit the NBME Self-Assessment Services website to sign up for these practice exams.

Open to All

Anyone can register for the NBME Self-Assessment Services practice exams. There is no need to register for any USMLEs, possess ECFMG certification for IMGs, or have any verifiable form of credentialing. This means these practice exams are accessible to a wide range of individuals looking to gauge their preparedness for the Shelf exams.

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Benefits Of Taking The NBME Practice Shelf Exams

person in exam hall - Practice Shelf Exams

Improved Performance

Practice shelf exams are crucial in helping students prepare for the actual exams as they familiarize students with the questions' format, content, and difficulty. By practicing with these exams, students understand what to expect and can better prepare themselves mentally and emotionally. 

Practicing with these exams can help students identify areas where they need to improve and receive feedback on their performance. This immediate feedback loop helps students learn from their mistakes and improve their performance for the actual exams. 

Enhanced Knowledge Retention

By studying for practice shelf exams, students reinforce and retain their knowledge better, which translates to better performance on actual exams. Through spaced repetition, a learning technique that involves revisiting materials over increasing intervals, students can reinforce their understanding of complex concepts, making them more likely to remember and apply this knowledge during exams. The process of testing itself, even in a practice setting, is an effective learning strategy that helps consolidate information in students' minds.

Better Time Management

Practice shelf exams help students manage their time more effectively during actual exams, ensuring they can answer all questions within the allotted time. Time management is crucial during exams, and practicing with timed exams can help students get a feel for how much time they should spend on each question. This practice ensures that students don't spend too much time on one question and run out of time before completing the rest of the exam. 

Identifying Knowledge Gaps

Practice exams help students identify areas where they need to focus their studies, allowing them to target specific topics and improve their understanding. This targeted approach to studying can help students make the most of their study time and ensure that they focus on the areas that need the most improvement. Identifying knowledge gaps early in the study process can help students address these weaknesses and feel more confident in their knowledge leading up to the exam. 

Boosts Confidence

Practicing shelf exams can increase confidence in one's abilities, reducing anxiety and stress during exams. When students can practice before the exam, they can build confidence in their knowledge and test-taking abilities. This confidence can help students perform better during the exam and reduce test anxiety's negative effects. 

Realistic Expectations

Practice exams provide a realistic assessment of one's performance, helping students set achievable goals and adjust their study strategies accordingly. They aim to mimic the format and difficulty of the actual exam so students can gauge how they might perform under similar conditions. Based on their performance on practice exams, students can set realistic goals for themselves and make informed decisions about what study strategies are working and what areas need more attention.

Better Preparation for Step 2 CK

Shelf exams are similar to the Step 2 CK exam, so preparing for shelf exams helps students prepare for the actual Step 2 CK exam. The Step 2 CK exam is a critical milestone in a medical student's career, and preparing for it can be overwhelming. By utilizing practice shelf exams as a study tool, students can familiarize themselves with the format and types of questions they might encounter on the Step 2 CK exam. This familiarity can help students perform better on the Step 2 CK exam and feel more confident.

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NBME Self-Assessment Length For Shelf Exams

Shelf exams are typically 110 questions long and last 2 hours, 45 minutes each (1.5 minutes per question). The only exceptions are the family medicine shelf exams, which lack MSK. The shelf practice exams (AKA Self-Assessments for Subject Exams or Clinical Sciences) are each 50 questions long and last 1 hour 15 minutes (also 1.5 minutes per question).

Subject Exams Available for Shelf Exams

Here are the current NBMEs available for Shelf exams. As of this writing, there are 29 NBME Shelf exams in total.

  • Clinical Neurology (4 Assessment)

  • Emergency Medicine (2 Assessments)

  • Family Medicine (4 Assessments)

  • Internal Medicine (4 Assessments)

  • Ob-Gyn (4 Assessments)

  • Pediatrics (4 Assessments)

  • Psychiatry (3 Assessments)

  • Surgery (4 Assessments)

How To Improve Your NBME® Practice Scores In The Final Weeks Of Prep

person trying to improve - Practice Shelf Exams

Evaluating Study Methods

To improve your performance on NBME practice exams, it's important to evaluate your study methods honestly. You must determine if you are truly learning and retaining new information, understand how vignettes are structured, and know what information to look for in question stems. If you find these areas challenging, it may be time to reassess how you are spending your study time.

Focus on Weak Areas

Identifying and focusing on your weakest areas is crucial for improving NBME practice scores. These are often topics you have struggled with in the weeks leading up to the exam. Tools like AMBOSS analysis can help pinpoint these areas and guide your study efforts.

Maintaining Well-being

Your mental and physical well-being is paramount when preparing for NBME Shelf exams. Medical school and residency can be highly stressful, so taking good care of yourself is essential. Managing stress through self-care benefits your overall well-being and enhances your ability to retain information and perform well on exams.

Optimizing Practice Test Timing

Taking practice exams is an effective strategy for preparing for NBME Shelf exams. It's important to optimize the timing of these practice tests. Ensure you allow enough time between tests to learn and understand new information. Focus on areas where you struggled in previous tests, and dedicate time to mastering those concepts before moving on to the next self-assessment.

When Should I Take My First NBMEs?

person preparing for exam - Practice Shelf Exams

Starting Early at the Beginning of Your Clerkship

I recommend taking an initial practice test early in your clerkship to establish a baseline understanding of your strengths and weaknesses. This will help you tailor your study plan effectively from the beginning. It will also help you identify high-yield topics and areas needing improvement, guiding your focus throughout the clerkship.

Midway Through the Clerkship

By this time, you should have covered a significant amount of content and have a good grasp of the basics. Taking the practice test at this point can help identify areas where you need to concentrate your studies. Take note of your weak areas from the practice test and allocate more study time to those topics.

6-8 Weeks Before the Exam

This timing allows enough time to address weaknesses identified by the practice test while leaving room for additional practice tests and reviews. Use the results to guide your study plan, focusing on high-yield topics and those you found challenging.


Consider taking another practice test 2-3 weeks before the actual shelf exam to gauge your progress and adjust your study plan as needed. Continuously review high-yield and weak areas up to the exam day. By strategically timing your first NBME practice test, you can maximize your study efficiency and increase your chances of performing well on the shelf exam.

How Often Should I Take NBME Self-Assessments?

woman doing self assessment - Practice Shelf Exams

I recommend students take an NBME every 2-4 weeks. Why? The general goal is to see if you’re making progress and how quickly. People’s scores don’t go up week by week. It takes 2+ weeks to see significant progress. As such, I don’t recommend taking an NBME more frequently than every other week. If your timeline is more than 6 months, I will wait 1-2 months between practice exams. It’s terrible (and avoidable) to run out of NBME Self-Assessments. Space out your practice tests accordingly.

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