The American Board of Internal Medicine (ABIM) is a non-profit organization established in 1936 to certify and recertify physicians of internal medicine and its subspecialties in a standardized format and process through the utilization of self-evaluation modules and secure examinations. The ABIM administers board examinations to members of the American College of Physicians. Their mission is to set standards for clinical competency, improve the quality of care delivered, and encourage continuing medical education for post-graduate practitioners of internal medicine. Beginning in 1990, ABIM granted certificates that were valid for 10 years. For physicians to maintain their certification status, they must participate in the Maintenance of Certification (MOC) program, which entails a self-evaluation component and a secure examination (shorter than the initial exam). The majority of the internal medicine community agrees that this process fosters a continued knowledge in up-to-date medical practices, procedures, and treatment regimens.
The purpose of the Internal Medicine Boards is to certify physicians who have demonstrated the competent level of knowledge, skill, and professionalism to maintain a high standard of health care delivery in the United States. To earn their admitting privileges, Internal Medicine physicians are required by most hospitals to attain an initial certification followed by recertification every ten years to satisfy the certification requirements of health care plans that classify physicians as "preferred" or "in network."
The exam takes place over the course of one day and covers a broad range of topics. The majority of the exam (approximately 75%) is based in an outpatient or emergency department setting; the remaining cases occur in an inpatient setting (ie, intensive care unit, nursing home, etc). Most of the exam will test the examinees' knowledge of traditional internal medicine and its subspecialties, with particular focus given to cardiology, pulmonology, and gastroenterology. However, the American Board of Internal Medicine (ABIM) also expects that test takers be well-rounded and prepared to identify and treat patients in departments such as allergy/immunology, dermatology, psychiatry, ophthalmology, nutrition, women's health, and ethics.
Most of the questions require that examinees integrate information from a variety of sources and use appropriate clinical judgment to attain the correct answers. A few of the questions may involve audio/visual aids. Examinees can also expect to see both long- and short-question stems and should be able to manage their testing time effectively.
The ABIM Initial Certification examination is offered only once per year and is administered on a predetermined test date. The ABIM recertification exam is offered twice per year, also on predetermined test dates. Examination dates and registration deadlines may change throughout the year. A list of current examination dates as well as other important registration deadlines for each of the tests can be found on the official ABIM website.
Taking this exam is costly. Utilizing the UWorld IM Qbank will help you maximize your chance of passing on the first try, sparing you the expense of re-examination fees. The cost of the examination for initial certification and recertification, refund policies on fees, as well as other discount-related information can be found on the official ABIM website.
The Initial Certification and Maintenance of Certification examinations are comprised of four sessions of up to sixty multiple choice questions each. Two hours are allotted for each session. Also included in the examination time is one hundred minutes worth of break time that can be divided between three predetermined break points (between each session). A candidate can expect to spend approximately ten hours taking the test on examination day.
The entire exam is made up of multiple choice questions with only one single best answer option. Some of the questions may require interpretation of radiographs, electrocardiograms, clinical photographs, photomicrographs, etc. There may also be questions that contain audio/video-related content meant for interpretation (eg, heart sounds, lung sounds, and clinical videos). Many of the questions will contain patient laboratory results; a list of normal laboratory values will also be provided.
Results of the examination are released within three months of the last examination date. Scoring is based on a pass/fail decision on the entire examination. The minimum passing score is based on a predetermined absolute standard. Scores are not based on the cumulative performance of any group of examinees; all scores reflect the independent performance of the candidate. Examinees are encouraged to answer all questions, as any unanswered question is scored as incorrect.
In the event that candidates are unsuccessful on the initial attempt at the Internal Medicine Examination, they may reapply as long as all licensure, professional standing, and procedural requirements are met.
IMPORTANT: Starting in 2011, if a candidate fails the initial certification examination for three consecutive years, the candidate must "sit out" one full examination year and will not be eligible to retake the exam during the following annual exam administration. (This new policy does not apply to recertification examinees). If the above requirements are met, there are no restrictions on the total number of opportunities for re-examination.
To be considered eligible to take the initial certification exam, candidates must meet all of the following criteria:
Research suggests that clinical skills and up-to-date medical knowledge diminish over time, even in the most experienced practicing physicians.
Technology is changing continuously.
Physicians certified by the ABIM, on average, deliver a higher quality of health care.
Employers and health plans require it, and patients prefer it.
Everybody is doing it.
2. Choudry, N.K., R.H. Fletcher, and S.B. Soumerai. "Systematic Review: The Relationship Between Clinical Experience and Quality of Health Care." Annals of Internal Medicine, 2005. 142(4): p. 260-W-30.
6. Turchin A, Shubina M, Chodos AH, Einbinder JS, Pendergrass ML. "Effect of board certification on antihypertensive treatment intensification in patients with diabetes mellitus." Circulation 117(5):623-8. (Feb 5, 2008)
8. Lipner Rebecca S; Bylsma Wayne H; Arnold Gerald K; Fortna Gregory S; Tooker John; Cassel Christine K. "Who is maintaining certification in internal medicine--and why? A national survey 10 years after initial certification." Annals of Internal Medicine, 2006. 144(1):29-36.
10. Grossman RS, Fincher RM, Layne RD, Seelig CB, Berkowitz LR, and Levine MA. "Validity of the in-training examination for predicting American Board of Internal Medicine certifying examination scores." Journal of General Internal Medicine, 1992. 7(1):63-7.
11. Rollins LK, Martindale JR, Edmond M, Manser T, and Scheld WM. "Predicting Pass Rates on the American Board of Internal Medicine Certifying Examination." Journal of General Internal Medicine, 1998. 13(6):414-6.
12. Lipner Rebecca, Song Hao, Biester Thomas, Rhodes Robert. "Factors that influence general internists' and surgeons' performance on maintenance of certification exams." Academic Medicine : Journal of the Association of American Medical Colleges, 2011. 86(1):53-8.