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Exam Overview
The Internal Medicine Certification Exam is a one-day, computer-based examination given by the American Board of Internal Medicine at Pearson VUE test centers. Passing it, together with completing accredited training and meeting ABIM's licensure and professionalism requirements, earns initial board certification in internal medicine.
Format and Timing
| Element | Details |
|---|---|
| Questions | Up to 240 single-best-answer multiple-choice questions; about 35 are new, unscored questions |
| Sessions | Four sessions of up to 2 hours each, with up to 60 questions per session |
| Breaks | 100 minutes of optional break time, shared among three breaks |
| Other time | Optional tutorial (up to 30 minutes), instructions and honesty pledge, optional survey |
| Total day | About 10 hours from check-in to finish |
| Delivery | Computer-based at a Pearson VUE test center, scheduled first come, first served |
What the Questions Look Like
Most questions describe a patient: age, setting, history, examination and test results, followed by a lead-in such as "Which of the following is the most appropriate next step in management?" Some items include electrocardiograms, radiographs, photographs, blood films, Gram stains, urine sediment, or heart and lung sound recordings. Laboratory values are shown with their reference ranges in brackets and flagged high or low, and results are given in both conventional and SI units.
- Making a diagnosis
- Ordering and interpreting tests
- Recommending treatment or other patient care
- Assessing risk, determining prognosis and applying epidemiologic principles
- Understanding pathophysiology and basic science that applies to patient care
The Content Blueprint
ABIM publishes the share of a typical exam devoted to each content category. Cardiovascular disease alone is about one-seventh of the exam, and five more categories each account for about 9%. Hypertension (about 5%) is cross-listed under cardiology, endocrinology and nephrology. Questions may also address critical care, prevention, clinical epidemiology, ethics, nutrition, palliative care, adolescent and occupational medicine, patient safety, substance use and health equity.
| Content category | Share | Content category | Share |
|---|---|---|---|
| Cardiovascular Disease | 14% | Neurology | 4% |
| Gastroenterology | 9% | Psychiatry | 4% |
| Pulmonary Disease | 9% | Dermatology | 3% |
| Infectious Disease | 9% | Obstetrics and Gynecology | 3% |
| Rheumatology and Orthopedics | 9% | Geriatric Syndromes | 3% |
| Endocrinology, Diabetes, and Metabolism | 9% | Allergy and Immunology | 2% |
| Hematology | 6% | Miscellaneous | 2% |
| Medical Oncology | 6% | Ophthalmology | 1% |
| Nephrology and Urology | 6% | Otolaryngology and Dental Medicine | 1% |
Scoring and Results
The pass/fail decision is based on performance on the whole exam, judged against an absolute standard set by ABIM's internal medicine board; candidates are not graded on a curve. Unanswered questions count as incorrect and there is no penalty for guessing, so answer every question. Questions found not to have a single best answer are removed from scoring. Results are released through the ABIM Physician Portal, usually within about three months of the last exam date.
Registration, Fees and Eligibility
| Topic | What to know |
|---|---|
| Exam dates | Offered once a year on a few dates in late summer; check the ABIM website for the current dates |
| Registration | Opens in early December and closes in mid-April, followed by a short late-registration period |
| Exam fee | $1,430 at the time of writing; late registration adds a non-refundable $400 fee |
| Cancellation | Partial refund depending on timing; cancel in the Physician Portal, not through the test center |
| Eligibility | Completion of required accredited internal medicine residency training with program director attestation, plus ABIM licensure and professionalism requirements |
| Accommodations | Available for documented disabilities, including separate testing dates |
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