NBME Study Guide 2026

Everything you need to pass the NBME exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 NBME Exam Format at a Glance

110
Questions
165 min
Time Limit
62%
Passing Score

📚 NBME Topics to Study (88)

✍️ Sample NBME Questions & Answers

1. The cloacal membrane divides into the urogenital membrane and anal membrane at approximately which embryonic week?
Week 7

The urorectal septum divides the cloaca into the urogenital sinus and anorectal canal by the end of the 7th week, separating the urogenital and anal membranes.

2. During eukaryotic DNA replication, which enzyme complex synthesizes the RNA primer at origins of replication?
DNA polymerase alpha-primase complex

DNA polymerase alpha associates with primase to synthesize short RNA primers that provide the 3'-OH needed by replicative DNA polymerases.

3. A 36-year-old woman with hypertension well-controlled on lisinopril asks about contraception. Which method is CONTRAINDICATED in this patient?
Combined estrogen-progestin oral contraceptives

Combined oral contraceptives are contraindicated in women with hypertension due to increased risk of stroke and myocardial infarction, especially over age 35.

4. A disease has a prevalence of 50 per 1,000 and an incidence of 10 per 1,000 per year. What is the average disease duration?
5 years

Using the steady-state formula Prevalence = Incidence × Duration: Duration = 50/10 = 5 years.

5. A 40-year-old woman with lupus has been on hydroxychloroquine for 5 years. Which monitoring study is most important to perform annually?
Ophthalmologic examination with visual field testing

Hydroxychloroquine can cause irreversible retinal toxicity that is dose- and duration-dependent, requiring annual ophthalmologic screening after 5 years.

6. Which study design provides the STRONGEST evidence for a causal relationship between an exposure and outcome?
Randomized controlled trial

Randomized controlled trials eliminate confounding through random assignment, providing the highest level of evidence for causality.

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1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation
NBME Study Guide 2026 — Exam Format, Topics & Practice Questions