The ABIM Board Exam: A Comprehensive Guide  

We're here to help you tackle the ABIM board exam, a crucial milestone in your career as an internal medicine physician. Think of this exam as more than just a hurdle; it's a reflection of your dedication and skill. We'll walk you through the details of the ABIM exam, providing insights, study tips, and strategies to bolster your preparation. With our support, you'll gain the confidence and knowledge needed to navigate this important challenge successfully.

Your Exam Structure

The ABIM Certification Exam is composed of 240 single-best-answer, standard multiple-choice questions that follow the ABIM Blueprint. Each question is in paragraph form with an answer set containing one correct answer and three or four incorrect answers.

The exam is divided into four sessions each lasting two hours, separated by scheduled breaks. The entire exam appointment takes approximately ten hours to complete; eight hours in front of a computer and another two in breaks.

Each section of the examination consists of both pictorial and non-pictorial multiple-choice questions. Pictorial questions refer to stimulus images such as photos of X-rays, ECGs, rhythm strips, pictures, etc. These images will be presented in a separate tab along with the relevant test question on the computer screen. You will need to interpret ultrasound images for pictorial questions on the certification exam. Two reference documents are available to you during the exam: a list of common abbreviations used in the exam, and a list of normal laboratory values.

2024 Exam Dates

You'll select your date and Pearson VUE location when you sign up to take the exam.  

Pearson VUE 2024 ABIM Instructions

ABIM Become Certified Instructions

Exam Features

Let's get the preliminaries out of the way.  

The ABIM certification Exam is composed of 240 single-best-answer, standard multiple-choice questions that follow the ABIM Blueprint. Each question is in paragraph form with an answer set containing one correct answer and three or four incorrect answers.

The exam is divided into four sessions each lasting two hours, separated by scheduled breaks. The entire exam appointment takes approximately ten hours to complete; eight hours in front of a computer and another two in breaks.

Each section of the examination consists of both pictorial and non-pictorial multiple-choice questions. Pictorial questions refer to stimulus images such as photos of X-rays, ECGs, rhythm strips, pictures, etc. These images will be presented in a separate tab along with the relevant test question on the computer screen. You will need to interpret ultrasound images for pictorial questions on the certification exam. Two reference documents are available to you during the exam: a list of common abbreviations used in the exam, and a list of normal laboratory values.

Question Styles

As a medical resident, you probably have horribly hard-won expertise at learning theory, but let's recap question types briefly.

Assessment questions: these are the "boards style questions".  Assessment questions are designed determine your knowledge level, not really teach or remediate.  They normally consist of (a) the correct answer, (b) two or more distractors that you'd guess at if you were vaguely familiar with the topic, and (c) one or more distractors that you'd guess if you were completely unfamiliar with the topic.

Teaching questions: these are the more in-depth case study questions, or complex questions that require thought.  Teaching questions are designed to remediate and drive long term retention of material.  Challenger uses both (and you can select the types you want to use for your tests).

If you're going to do an assessment of your knowledge level, work through it in short exams over topics, not in marathon sessions.  If you've missed questions in the topics, then switch to completing all the questions in a topic, or mix the exams up into assessment and teaching questions.

Purpose of the Exam

The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified internist in the broad domain of the discipline. The ability to make appropriate diagnostic and management decisions that have important consequences for patients will be assessed. The exam may require recognition of common as well as rare clinical problems for which patients may consult a certified internist. 

Content Specifications

Exam content is determined by a pre-established blueprint, or table of specifications. The blueprint is developed by ABIM and is reviewed annually and updated as needed for currency. Trainees, training program directors, and certified practitioners in the discipline are surveyed periodically to provide feedback and inform the blueprinting process.

The primary medical content categories of the blueprint are shown below, with the percentage assigned to each for a typical exam:

Exam questions in the content areas above may also include topics in Critical Care Medicine, Prevention,Clinical Epidemiology, Ethics, Nutrition, Palliative and End-of-Live Care, Adolescent Medicine, Occupational Medicine, Patient Safety and Substance Abuse.

ABIM Pass Rates

Do ITE Scores Indicate Board Exam Scores?

To a degree.  Your ITE scores provide more of a negative indicator of your potential boards exam score.  If you did poorly on ITE's, you have your work cut out for you.  If you did well on ITE's, it doesn't mean you'll score the same on the boards, but it is a positive indicator.

Start preparing early, pick a couple of good resources, and use them.  Frequent short study sessions, done in a methodical manner, are going to do a lot more for you than cramming.

Strategizing Your Preparation

Comprehensive Study Material

Choose study resources that are aligned with the ABIM Blueprint, ensuring that you cover every topic in depth. Resources like Med-Challenger Internal Medicine Review offer tailored preparation with a vast question bank of constantly updated content.

Mock Exams and Simulations

Simulated exams, such as Med-Challenger's Board Exam Simulator, part of the Internal Medicine Boards Prep Course, are instrumental in gauging your preparation level. They offer insights into your strong areas and those requiring improvement, enabling a focused preparation strategy.

Time Management

The ABIM exam evaluates candidates under timed conditions. Practice with timed mock exams to enhance your time management skills, ensuring that you can navigate through the questions effectively and efficiently during the actual exam.

See also: How To Prepare for Internal Medicine Boards - 8 Tips to Pass ABIM Exam

Navigating the Exam Day

Stay Calm

It’s natural to feel anxious. However, staying calm and composed is crucial to think clearly and make informed decisions during the exam. Knowing what to expect by checking out What to Expect on Exam Day can also help put your mind at ease.

Pace Yourself

The exam is structured to evaluate a broad spectrum of your skills and knowledge. Pacing yourself is crucial to ensure that every section of the exam is attempted with equal focus and concentration.

Review Your Work

If time permits, review your answers. Sometimes, a second look can offer new perspectives and insights.