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10 NBME habits that took my students from 60% to 80%

For IMGs in their NBME phase. They get more underrated as you go.

By Dr. Marish Asudani · Published

What NBME habits raise your score from 60% to 80%?

Give your first NBME only after every system is done. Give every form offline, in blocks of 20. Start at 8 am with no phone and take glucose every 2 blocks. Finish your first pass in about 23 minutes. Torn between 2 options, write both down, flag it and move on. Think of your answer before you look at the options. Only change an answer if a line in the stem rules another option in or yours out. Review every form the same day. File every miss by system, not by form. And go through the NBME Booster Anki before NBME 32.

None of these is a new resource. They're how you give, solve and review the forms you already have.

Each card is 1 habit and why it matters. The full how-to lives in the guide each card links to.

Tap the part you need. It opens that card.

1

Give your first NBME only after every system is done

A form you give early only breaks your confidence and wastes a form. For Step 1 you only get 8 to 9 of them, so never burn one on a baseline.

Taking your first NBME: the dedicated week and NBME 27 →
2

Give every form offline, in blocks of 20

Online gives you 50 questions in 75 minutes and inflates your score by about 4 to 6%, so you'd be planning on a number that was never real. Offline is 10 blocks of 20, 30 minutes each, the pace of the real exam.

Why offline, and how to give it →
3

Start at 8 am, no phone, glucose every 2 blocks

Give it in the morning, just like the exam, with no phone in the room. Take glucose every 2 blocks, so your brain stays energised to the last block.

24 hours of an NBME day: breaks, glucose, review →
4

Finish your first pass in about 23 minutes

Most lost points aren't questions you didn't know. They're the last few you had to rush. A first pass in 23 to 24 minutes leaves the last 6 to 7 minutes for your flags.

The 2 passes inside every block →
5

Torn between 2 options? Write both down, flag it, move on

Write B / C on your paper, pick one, flag it and keep going. 1 hard question should never eat the time of the next 5.

How flagging works in the 2-pass method →
6

Think of your answer before you look at the options

Most silly mistakes come from the options pulling you away from the answer you'd already thought of. Read the stem, decide, then check the options.

The NBME MCQ Protocol →
7

Only change an answer when the stem tells you to

Change it only if a line in the stem either rules another option in or rules yours out. Never out of doubt.

Stop making silly mistakes: 6 steps →
8

Review every form the same day

After 24 hours, you forget why you picked the wrong option, and knowing that reason is the whole point of giving an NBME.

The NBME Review Protocol →
9

File every miss by system, not by form

It's usually 2 or 3 systems carrying most of your misses, and that's exactly where your next points are.

How to file and fix your misses →
10

The NBME Booster Anki before NBME 32

The NBME keeps asking the same concepts on new forms, so you walk in already knowing its patterns.

The NBME Booster Anki: Step 1 and Step 2 CK →

The NBME Booster AnkiBuilt from NBME questions, system by system, so the patterns are already in before NBME 32.

Open the NBME Booster →
Every NBME date, already on your calendar.
The schedule places every form, the dedicated week and the review, built backwards from your exam date.
Open usmlevault.com/schedule →
usmlevault.com · free for your first 3 days
Every NBME guide

Taking your first NBME — the dedicated week and NBME 27.

The exact NBME order — 26 through 33.

The NBME MCQ Protocol — how to solve every question.

The NBME Review Protocol — same day, every form.

The week before your NBME — day by day.

The night before your NBME

24 hours of an NBME day — breaks, glucose, review.

24 hours after a bad NBME

Stop making silly mistakes — 6 steps.

2 PDFs = a 10-point jump · 2 decks = a 30-point jump

Stuck at 62–65% · Above 75% · Ready or not

USMLE Vault · 10 NBME Habits That Take You From 60% to 80% · Created 2026-11-12
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