The Complete Guide to the Internal Medicine Board Exam (2024)

Updated on 11/20/23

Key points:

  1. An ABIM Certification is a credential held by a physician who has met all the requirements to be certified to practice Internal Medicine by the American Board of Internal Medicine (ABIM).
  2. Board eligibility implies that you've completed all of the training (residency) necessary to be an Internist, you just haven't taken your internal medicine board certification exam yet. For Internal Medicine, board eligibility expires seven years after your residency training.
  3. The internal medicine board exam will take you approximately 10 hours (including breaks) to complete. It has a maximum of 240 questions. Over the past two years, the ABIM pass rate for first-time test takers has fallen from 93% to 88%.
  4. Focus your study sessions using the ABIM exam blueprint to see what material is represented on the certification exam, with the percentage assigned per content category.
  5. You should plan on at least 6–9 months of dedicated study time for your internal medicine board exam.

The ABIM exam is one of the most rigorous exams you’ll ever take. It requires months and months of preparation. Even the most meticulous doctors need to understand what is required for the ABIM exam before they start studying.

You need to understand how the exam is structured, what material is covered in the questions, how to create your study calendar, and what to expect on the day of the exam. Once you understand how to prepare, you can start studying (and you’ll be way ahead of your peers!)

What is ABIM certification?

An ABIM Certification is a credential held by a physician who has met all the requirements to be certified to practice Internal Medicine by the American Board of Internal Medicine (ABIM). The ABIM is an independent, not-for-profit organization that certifies physicians in Internal Medicine and its subspecialties.

How long does ABIM certification last?

ABIM certification lasts five years. After five years, you will need to participate in MOC activities to maintain your certification, which includes an exam to test your knowledge.

In order to maintain an ABIM Certification, a physician must participate in maintenance of certification (MOC) activities. Physicians need to earn 100 MOC credits every 5 years in order to remain eligible for certification.

When is this year's ABIM exam?

If you're taking the ABIM certification exam in 2024, you can choose from one of these dates to sit for your exam: Aug. 15, 20, 26, 28, 29, 2024.

You need to register for your certification exam between Dec. 1, 2023 and Apr. 15, 2024. If you register between April 16 through April 28, 2024, you'll incur a $400 late fee.

Once you're eligible, you can schedule your certification exam through your ABIM Physician Portal. Exam day slots are filled on a first-come, first-served basis by the test vendor.

What is the ABIM exam day schedule like?

The internal medicine certification exam takes approximately 10 hours. The exam day is broken into four two-hour sessions. Each session has up to 60 questions.

You have 100 minutes of available break time throughout your exam day, and you can choose how much break time to use from your total bank after each session.

It’s important to research your exam day scheduleso you understand what exam day will look like for you, and help you set expectations for that day.

What is covered in the internal medicine board exam?

Many people don’t know this pro tip! The ABIM exam blueprint details 16 content categories that Internal Medicine doctors should know completely. The blueprint shows you exactly what material is represented on the certification exam, with the percentage assigned per content category. You should use it to focus your study sessions. Spend the most time studying topics that are more difficult and more prevalent in the exam blueprint. You can spend a little less time studying topics that have a low percentage (1%).

There are a maximum of 240 questions on the internal medicine board exam. These case-based questions will require you to make a diagnosis, identify and issue necessary tests and interpret test results, recommended treatment, and understand the underlying pathophysiology of disease applicable to patient care.

How hard is the ABIM exam?

The ABIM exam is one of the most difficult exams a doctor will take throughout their career. There are 240 case-based, single-best-answer multiple-choice questions that cover a wide range of Internal Medicine topics.

The ABIM certification exam consists of single-best-answer questions only. On each question, you'll see a brief statement, case history, graph or picture followed by a question and list of possible options. You choose the one answer that is better than the others. Qbanks are a great study tool to help you prepare for the ABIM exam because they get you used to the exam question format.

What are the ABIM board certification eligibility requirements?

Board eligibility implies that you've completed all of the training (residency) necessary to be an Internist, you just haven't taken your internal medicine board certification exam yet.

How long can you be board eligible for internal medicine certification?

For Internal Medicine, you are board eligible for seven years after your residency training. After seven years there are additional steps that you'll need to take before being able to take the exam again. This is sometimes referred to as the ABIM "7 year" rule.

How long is the internal medicine board exam?

The internal medicine board exam will take you approximately 10 hours (including breaks) to complete. It has a maximum of 240 questions.

The ABIM exam format is modular, and there are up to 60 single best-answer multiple-choice questions per module.

Internal medicine board exam results

You will get your internal medicine board exam results within three months of the exam date. Once they're out, you'll receive email notification from the ABIM with instructions on how to access your Score Report through your Physician Portal.

The ABIM publishes internal medicine board exam pass rates during Q1 of the following year.

Internal medicine board exam pass rates

The internal medicine board exam is pass/fail based on your entire test performance.

Over the past two years, the ABIM pass rate for first-time test takers has fallen from 93% to 88%.

  • ABIM certification pass rates for 2022: 87%
  • ABIM certification pass rates for 2021: 88%
  • ABIM certification pass rates for 2020: 93%
  • ABIM certification pass rates for 2019: 91%
  • ABIM certification pass rates for 2018: 91%
  • ABIM certification pass rates for 2017: 90%

How many times can you take the internal medicine board exam?

You're able to take the ABIM exam 3 times. If there are 3 failed attempts, you must wait a full year before enrolling in the exam again.

But don't worry, after a solid board review and some Q&As you'll be well on your way to a passing ABIM exam score!

How to study for Internal Medicine board exam

The ABIM certification exam is designed to evaluate whether you possess the knowledge, diagnostic reasoning, and clinical judgment skills expected of a certified Internist.

The exam is composed of multiple-choice questions with one correct answer, most of which describe clinical scenarios. You need to get ~64% of the questions correct to pass.

  1. Use your ITE exam results as a reference. The internal medicine in-training exam uses the same blueprint and covers similar material to the ABIM certification exam. Were you weaker in a certain area, and stronger in others? Use your IM-ITE exam results as a gauge against the content categories on the blueprint.
  2. Understand the ABIM exam blueprint. It details the 16 internal medicine topics that will be covered on your exam, with percentages according to how much of the exam content is dedicated to that topic!
  3. Understand which study tools—and formats—are available to you. Most residents rely heavily on qbanks for test prep because that’s what they’re used to: repetition. However, qbanks aren’t the strongest test prep tool. There are internal medicine books, video board reviews, and courses that you can build a great foundational of knowledge with, and then test your knowledge with a qbank.
  4. Build a study plan. Now that you know which topics you’ll need to study the hardest, start to build out your study calendar accordingly. Plan to study the toughest material first so you have the longest amount of time dedicated to spaced repetition of that information. Your study plan should include comprehensive review as well as spaced repetition.
  5. Go through the vital facts 60 days before the exam. One or two months before the exam, you should for your review. Make sure you go through each topic several times and try to implement interleaving and spaced retrieval if you can. This will help you key in on areas where you need to focus your review right before the exam, and will also help dredge up knowledge from your long-term memory.

You should plan on at least 6–9 months of dedicated study time. Here are a few tips for how to study for the internal medicine board exam.

ABIM exam secrets study guide

Before you ever even open a book or qbank, download and read through StudyWise. Think of StudyWise as your ABIM exam secrets study guide! It's a quick read that will de-bunk the 6 learning myths that may be holding you back—and will reveal the 2 secrets to long-term learning.

When you're studying for the ABIM certification exam, space out your study sessions and review the content multiple times before your exam for the most effective review. No cram sessions or crash courses!

A simple formula: Go to the Table of Contents and look at the main topics (ex: Cardiology: Hypertension). Decide on how many of these you’ll go through each day. Knocking out 1 topic at a time, plan out your next 1-2 months of review by assigning dates next to each main topic to indicate when you’ll study that topic.

For the ABIM Certification exam, we recommend the Study Strong Essentials. It’s our 3 most essential Internal Medicine study tools designed to work together to be the most up-to-date, clear, and board-focused content available. You’ll get all the information you need to know for your exam—nothing more, nothing less.

We also offer free trials on all of our digital MedStudy tools. Even if you’re thinking you’d like the print products better, use the free trial to see the content before you buy.

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The Complete Guide to the Internal Medicine Board Exam (2024)
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