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What Does the Internal Medicine Board Examination Cover?

The examination in internal medicine has two goals. The first is to assure competence in the diagnosis and treatment of common conditions that have important consequences for patients. The second goal is to assure excellence in the broad domain of internal medicine.
Examination content is consistent with a pre-established blueprint or table of specifications. The blueprint is developed by the Board of Directors, and it is reviewed and revised annually to ensure that it is current. The foundation of the blueprint is published studies that describe the kinds of tasks internists actually perform in practice. These data on frequency then are modified to reflect both the breadth of medicine and the importance of various conditions.
Approximately 75% of the questions test knowledge in the traditional subspecialties of internal medicine (cardiology, endocrinology, gastroenterology, hematology, infectious disease, nephrology, oncology, pulmonary disease, and rheumatology). In recognition that the practice of internal medicine requires knowledge in other areas, the remaining 25% of the questions test in the following: allergy/ immunology, dermatology, gynecology, neurology, ophthalmology, and psychiatry. Independent of primary content, about 50% of the questions are chosen to guarantee coverage of content that spans these disciplines. Cross-content areas include: geriatric medicine, critical care medicine, adolescent medicine, clinical epidemiology, ethics, nutrition, occupational medicine, palliative/end-of-life care, prevention, substance abuse, and women's health. A blueprint representing content distribution in recent years follows.
The vast majority of questions (over 75%) are based on patient presentations. The settings of the encounters reflect current medical practice, so most take place in an outpatient or emergency department setting (roughly 75%); the remainder occur in inpatient settings, ranging from the intensive care unit to the nursing home. Questions requiring simple recall of medical facts are in the minority; the majority of items require integration of information from several sources, prioritization of alternatives, and/or utilization of clinical judgment in reaching a correct conclusion.

What's on the ABIM Certification Examination in Internal Medicine?
- Source: ABIM Website:

In answer to that question, the examination blueprint (Table 1) reveals that approximately 75% of the single-best answer, multiple-choice questions test knowledge in the traditional medical subspecialties. Recognizing that the practice of internal medicine requires knowledge in other areas, the remaining 25% of questions relate to allergy/immunology, dermatology, gynecology, neurology, ophthalmology, and psychiatry. Independent of primary content, some 40% of the questions are chosen to guarantee coverage of cross-content areas.

The vast majority, about 75%, of the exam questions are based on patient presentations. The settings of the encounters reflect current medical practice, so most take place in an outpatient or emergency room setting; the remainder occur in inpatient settings, ranging from the intensive care unit to the long-term care facility. The majority of items require integration of information from several sources, prioritization of alternatives, and/or utilization of clinical judgment in reaching a correct conclusion. Questions requiring simple recall of medical facts are in the minority.

The examination blueprint, the foundation of which is published studies that describe the kinds of tasks internists actually perform in practice, is reviewed and revised annually by the ABIM Board of Directors to ensure its currency.