Question 1

How accurate is UWSA 1 for predicting Step 1?

Accepted Answer

UWSA 1 has an R² of 0.619 with actual Step 1 scores, according to Seal et al. 2020 (Cureus, PMC7198101, n=360). That ranks it fourth among all individual practice assessments in that study — behind UWSA 2 (R²=0.680), NBME 16 (0.660), and UWorld QBank percent correct (0.656). It is a meaningful predictor, but its accuracy is materially lower than UWSA 2, and it overpredicts actual scores by an average of +10.5 points.

Question 2

Why does UWSA 1 overpredict more than UWSA 2?

Accepted Answer

Two factors explain most of the gap. First, the regression slope for UWSA 1 is 0.486, compared to 0.694 for UWSA 2 — the further a slope is from 1.0, the less precisely the practice score maps to a real exam score. Second, timing: UWSA 1 is taken 3–5 weeks before the exam, when preparation is still in progress. Research by NBME staff (Fan et al. 2024, Med Sci Educ, PMC11933626, n=23,271) found that practice test classification accuracy drops from 88.2% when taken 1–2 weeks before the exam to just 50.2% at 5–6 weeks out. UWSA 1's larger overprediction is partly a measurement-timing artifact — it captures a snapshot of a student who is still improving.

Question 3

By how much does UWSA 1 overpredict, and how should I adjust?

Accepted Answer

The published academic average is +10.5 points (Seal et al. 2020). A practical rule of thumb: subtract 10–12 points from your UWSA 1 predicted score for a conservative estimate. As a reference: the last published Step 1 score distribution (2019) showed a mean of 232 and a passing standard of 196. A UWSA 1 score of 220, adjusted down 10 points, puts your estimated actual score at approximately 210 — about 14 points above the passing threshold. That is a real safety margin, but not a large one. If your adjusted score is not comfortably above 196, do not schedule based on UWSA 1 alone.

Question 4

When should I take UWSA 1?

Accepted Answer

UWSA 1 is best taken during dedicated Week 3–5. At that stage, it serves as a gap-identification tool: use the score to spot subject areas where you are losing the most points, then spend the remaining dedicated weeks addressing those gaps. Take all 4 blocks in a single sitting to simulate exam-day pacing. Do not treat the resulting score as a readiness verdict — practice test accuracy is materially lower when taken several weeks before exam day than in the final 1–2 weeks.

Question 5

Can I use UWSA 1 to decide my exam date?

Accepted Answer

No. UWSA 1 alone is not a reliable scheduling signal. The recommended two-test readiness protocol is: (1) take UWSA 1 in Week 3–5 to identify gaps, (2) address those gaps, (3) take NBME 29 or 30 as a strict, conservative second benchmark, (4) take UWSA 2 in the final 5–7 days as your primary scheduling signal. Only after UWSA 2 — adjusted for its ~7-point average overprediction — exceeds your target threshold should you consider scheduling.

Question 6

What is UWSA 3, and should I use it for Step 1?

Accepted Answer

UWorld now offers three self-assessment forms for Step 1 (Form 1, Form 2, and Form 3). UWSA 3 is a newer addition. As of this writing, no peer-reviewed study has published predictive validity data (R², mean overprediction, or regression slope) for UWSA 3. Without published accuracy data, UWSA 3 cannot be evaluated with the same confidence as UWSA 1 or UWSA 2. Use UWSA 1 and UWSA 2 as your primary self-assessments until peer-reviewed data for UWSA 3 becomes available.

	UWSA 1	UWSA 2
R² (Seal et al. 2020)	0.619	0.680
Avg overprediction	+10.5 pts	+6.9 pts
Regression slope	0.486	0.694
Recommended timing	Week 3–5	Final 5–7 days
Primary use	Gap identification	Scheduling decision

Wrong	Correct	% Correct	Predicted Score	Pass Prob
0	160	100%	294	99.9%
5	155	96.9%	289	99.9%
10	150	93.8%	283	99.9%
15	145	90.6%	278	99.9%
20	140	87.5%	272	99.9%
25	135	84.4%	267	99.9%
30	130	81.3%	261	99.9%
35	125	78.1%	256	99.9%
40	120	75%	250	99.9%
45	115	71.9%	244	99.9%
50	110	68.8%	239	99.9%
55	105	65.6%	233	99.9%
60	100	62.5%	228	99.7%
65	95	59.4%	222	99.1%
70	90	56.3%	217	97.8%
75	85	53.1%	211	93.7%
80	80	50%	206	85.8%
85	75	46.9%	200	67.3%
90	70	43.8%	195	45.5%
95	65	40.6%	189	22.1%
100	60	37.5%	183	8.8%
105	55	34.4%	178	3.8%
110	50	31.3%	172	1.3%
115	45	28.1%	167	0.5%
120	40	25%	161	0.2%
125	35	21.9%	156	0.1%
130	30	18.8%	150	0.1%
135	25	15.6%	145	0.1%
140	20	12.5%	140	0.1%
145	15	9.4%	140	0.1%
150	10	6.3%	140	0.1%
155	5	3.1%	140	0.1%
160	0	0%	140	0.1%

UWSA 1 Score CalculatorStep 1 Score Conversion & Overprediction Guide

UWSA 1 vs UWSA 2 — Step 1 Predictive Accuracy

UWSA 1 Score Conversion Table — Step 1

About UWSA 1

Other Step 1 Practice Exams

UWSA 1 Step 1 Calculator — FAQ