"Shelf exams are purchased by medical schools and graded by those individual medical schools. How those grades are normalized is up to the school that purchased the particular exam. The raw scores are reported back to the NBME but not any percentiles or normalized scores.

You have no way of knowing whether exactly how your score is normalized unless the faculty at your school is willing to share that information with you. Again, one course may normalize a "shelf" to one mean while another may use another score as a mean. Many schools, mine included, do not even administer these subject-based pre-clinical science exams because they are not very useful. Since most curricula are integrated, subject-based basic science shelf exams are obsolete.

Depending on where your school/department sets the mean, those "percentiles" can end up across a spectrum of grades that are only meaningful to your particular class (and definitely not a means of comparison).

Shelf exams for clinical sciences can be used in a similar manner but in general, a raw percentage of 50% is the mean across the U.S. Our school would normalize that percentage to a mean of 45% and would grade us from there. This meant that we had to score above the national mean in order to pass the shelf. We also had in-house exams for every clinical subject that we took at the end of rotations."

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