Most USMLE preparation is built on third-party interpretations of the exam: question banks, review books, flashcard decks, videos. They're good. But the organisation that writes your exam has published, for free, exactly how it thinks, and most students either don't know it exists or use it badly.
This page lists every free official resource from the USMLE program and the NBME, what each one is for, and how I used it while scoring 257 on Step 1 and 273 on Step 2 CK as an IMG from Portugal. We link to the official pages rather than copying the material, because that's where it belongs and where it stays up to date.
Newton said that if he saw further, it was by standing on the shoulders of giants. You don't need to reinvent the wheel either. Start with the original.
What it is. A set of more than 100 sample questions per Step, written by the same people who write the real exam, released by the USMLE program. Students call it the "Free 120". It comes as a PDF and as an interactive version that reproduces the real testing interface, including the tutorial you'll see on exam day.
Why it matters. It's the only free material that is 100% representative of the real thing: length of vignettes, wording, the way the lead-in is phrased, the interface. Question banks imitate it; this is the source.
How to use it.
Take it as a simulation, not as a question bank: timed, in one sitting, in the interactive version, before you read any explanation.
• Do it twice. Once early, in your first month, to see what the exam looks like before you commit to a study plan. Once again about two weeks before the exam, as a timing and interface rehearsal. Don't reuse it for scoring; you'll remember the questions.
• Answers are provided, but explanations are not. After the block, write one sentence per question on what the examiner was testing. That exercise is worth more than the score.
• The set is refreshed periodically; make sure you're doing the current version.
What it is. A video series in which NBME staff sit down with medical students and walk through real, retired USMLE questions, explaining how the question was built, what it was meant to test, and where students go wrong. Episodes cover neuroanatomy, acid–base physiology, immunology, neurology, paediatric infectious disease, endocrinology, obstetrics and gynaecology, and the gastrointestinal system. One episode explains item analysis: how the NBME judges whether a question is good.
Why it matters. This is the closest you'll get to watching the examiner's mind at work. Everything we teach about the anatomy of a vignette (opening line, hidden clues, distractors, decision point) is visible in these videos, from the people who design it. Almost nobody watches them.
How to use it.
• Pause the video after the question is shown, commit to an answer, and only then watch the discussion.
• Pay attention to why the wrong options were written, not just why the right one is right. That is how the examiner thinks about distractors.
• Watch the item-analysis episode even if you don't care about statistics. It explains why long vignettes exist and why well-prepared students are less affected by them.
What it is. The NBME's manual for the people who write the questions. It's public, it's free, and it's the source of much of what we teach: the anatomy of a vignette, how a lead-in should be phrased, which flaws favour the test-wise student, and how discrimination is measured.
Why it matters. If you understand how a question is constructed, you can take it apart. The guide is written for examiners, so it's dry, but chapters on vignette structure and on item flaws are directly usable by a student.
How to use it. Don't read it cover to cover. Read the chapter on writing one-best-answer items and the one on technical item flaws, then go back to the Free 120 and find each flaw and each structural element in a real question.
Where. Search "NBME item writing guide" on nbme.org. The 2020 edition is the current one at the time of writing.
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NBME Self-Assessments. The Comprehensive Basic Science (Step 1) and Comprehensive Clinical Medicine (Step 2 CK) self-assessments are 200 questions each, about 62 USD per form, with a score report, answer explanations and performance by system. They are the best score predictor available. I used them in the last months before each Step to calibrate timing and to decide when I was ready; my practice scores are in the IMG's Guide.
• Practice session at a Prometric centre. A paid half-day at a real test centre with the sample questions. Useful only if test-centre anxiety is a specific problem for you.
Everything else you'll use (UWorld, Anki, First Aid, Pathoma) is an interpretation of what these resources show directly. Start with the original, then use the interpretations.
If you want to see how we read a vignette using exactly these principles, watch an episode of 90 Seconds, where we solve a USMLE-style question live in the time you'd have on exam day. And if you haven't yet, read The IMG's Guide to USMLE Success for the full method, resources and timeline behind the 257 and 273.
