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Step 1 NBME 4: what's on it and how hard it is
NBME 4 has 160 questions in our copy. The average question is 47 words long and 69% take two or more steps to answer. It leans most on general principles, heart and vessels and GI and liver.
- Difficulty (0–100)
- 51
- Average question
- 47 words
- Take 2+ steps
- 69%
- Have an image
- 13%
When to take it
Extra practice early on. It is an older form: shorter questions and more straight recall than today's exam, so don't read much into the score.
Students say it feels easier than the questions really are.
Our original practice examsSystems it tests most
Share of the questions in each system.
- General principles18%
- Heart and vessels13%
- GI and liver10%
- Brain and nerves8%
The full breakdown
Every system and subject, what the questions ask, and what changed from older forms.