Internal Medicine Policies | ABIM.org (2023)

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Eligibility for Certification and Board Policies

The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, February 2022 (pdf), governs ABIM's decision about eligibility for certification. The February 2022 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).

General Requirements

To become certified in internal medicine, a physician must complete the requisite predoctoral medical education, meet the graduate medical education training requirements, demonstrate clinical competence in the care of patients, meet the licensure and procedural requirements, and pass the ABIM Internal Medicine Certification Examination.

Predoctoral Medical Education

Candidates who graduated from medical schools in the United States or Canada must have attended a school that was accredited at the date of graduation by the Liaison Committee on Medical Education (LCME), the Committee for Accreditation of Canadian Medical Schools or the American Osteopathic Association.

Graduates of international medical schools must have one of the following: (1) a standard certificate from the Educational Commission for Foreign Medical Graduates without expired examination dates; (2) comparable credentials from the Medical Council of Canada; or (3) documentation of training for those candidates who entered graduate medical education training in the United States via the Fifth Pathway, as proposed by the American Medical Association.

Graduate Medical Education (GME)

To be admitted to theABIM Internal Medicine Certification Examination, physicians must have satisfactorily completed, by August 31 of the year of examination, 36 calendar months, including vacation time, of U.S. or Canadian graduate medical education accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec. Residency or research experience occurring before completion of the requirements for the MD or DO degree cannot be credited toward the requirements for certification. The 36 months of residency training must include 12 months of accredited internal medicine training at each of three levels: R-1, R-2 and R-3. No credit is granted for training repeated at the same level or for administrative work as a chief medical resident. In addition, training as a subspecialty fellow cannot be credited toward fulfilling the internal medicine training requirements.

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Training and Procedure Requirements

The total months of training required, including specific clinical months, and requisite procedures are outlined below.

Minimum Months
of Training
Clinical Months
Required
Procedures

* For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.

36*30
  • Procedures are essential to internal medicine training; to be eligible for certification, all residents must perform procedures during training.
  • Not all residents need to perform all procedures.
  • Program directors must attest to general competence in procedures at end of training.
  • At the completion of training, residents must have demonstrated effective consent discussions, standard or universal precautions, establishment of a sterile field, and application of local anesthetic as applicable to most procedures a resident may perform.
  • Residents must have the opportunity to develop competence in procedures which will further their development as fellows in their chosen subspecialty, or as independent practitioners in their intended fields if entering practice after residency.

Content of Training

The 36 calendar months of full-time internal medicine residency education:

  1. Must include at least 30 months of training in general internal medicine, subspecialty internal medicine and emergency medicine. Up to 4 of the 30 months may include training in areas related to primary care, such as neurology, dermatology, office gynecology or office orthopedics.
  2. May include up to three months of other electives approved by the internal medicine program director.
  3. Includes up to three months of leave for vacation time. (See “Leave of Absence and Vacation Policy”)
  4. For deficits of less than one month in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.

In addition, the following requirements for direct patient responsibility must be met:

  1. At least 24 months of the 36 months of residency education must occur in settings where the resident personally provides or supervises less experienced residents who provide direct care to patients in inpatient or ambulatory settings.
  2. At least six months of the direct patient responsibility on internal medicine rotations must occur during the R-1 year.

Procedures Required for Internal Medicine

The exposure to the performance of, and the opportunity to develop competence in, invasive procedures by residents is essential for internal medicine residents’ preparation for their subsequent subspecialty fellowship or chosen career path.

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As of the 2019-2020 academic year, residents must meet the requirements outlined in the table above to be admitted to the Internal Medicine Certification Examination. Internal medicine graduates will likely perform some invasive procedures in the course of their future training or practice; however, the specific procedures will vary based on subsequent subspecialty, hospitalist or general career path taken. The performance of all invasive procedures requires the ability to facilitate an effective discussion with patients regarding risk and benefit of the procedure before obtaining consent, a critical task that all internists must effectively perform. Internists who perform any invasive procedures must be able to initiate a standardized preparation beforehand including hand washing, donning of sterile gloves, preparation of the procedural field, and application of some form of anesthetic. Procedural competence need not be determined solely by a minimum number of successfully completed procedures but may be customized as appropriate through simulation, direct observation, and other criteria determined by the program director and clinical competency committee.

Clinical Competence Requirements

ABIM requires documentation that candidates for certification in internal medicine are competent in: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.

Through its tracking process, FasTrack®, ABIM requires verification of residents' clinical competence from an ABIM certified program director (other ABMS Board and Canadian certification is acceptable, if applicable). Program directors must also complete clinical competence evaluations each year for internal medicine residents. A candidate may be excluded from an ABIM examination if the required components of clinical competence are not satisfactorily documented by the training program.

As outlined in the Program Director Ratings of Clinical Competence table below, all residents must receive satisfactory ratings in overall clinical competence. In addition, residents must receive satisfactory ratings in each of the six ACGME/ABMS Competencies during the final year of required training. It is the resident's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each of the six ACGME/ABMS Competencies and overall clinical competence.

Program Director Ratings of Clinical Competence

Six ACGME/ABMS Competencies:

The resident/fellow is demonstrating satisfactory development of the knowledge, skill and attitudes/behaviors needed to advance in training. S/he is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.

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Six ACGME/ABMS Competencies*
Components and RatingsResidents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training

* The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.

At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS competencies.

YesFull creditFull credit
Conditional on ImprovementFull creditNo credit; must achieve satisfactory rating before receiving credit
NoFull creditNo credit; must repeat year

Overall Clinical Competence

This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:

Overall Clinical Competence
Components and RatingsResidents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training
* At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies.
Satisfactory or SuperiorFull creditFull credit
Conditional on ImprovementFull creditNo credit; must achieve satisfactory rating before receiving credit*
UnsatisfactoryNo credit; must repeat yearNo credit; must repeat year

Credit in Lieu of Standard Training for Internal Medicine Candidates

Training Completed Prior to Entering Internal Medicine Residency

ABIM may grant credit for up to 12-months of the 36 month internal medicine trainingrequirement for training taken prior to entering training in internal medicine. The program director of an accredited internal medicine residency program must petition ABIM to grant credit in lieu of standard internal medicine training. Before being proposed, the candidate should have been observed by the proposer for a minimum of three months.

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  1. Month-for-month credit may be granted for satisfactory completion of internal medicine rotations taken during a U.S. or Canadian accredited non-internal medicine residency program if all of the following criteria are met:
    • The internal medicine training occurred under the direction of a program director of an accredited internal medicine program.
    • The training occurred in an institution accredited for training internal medicine residents.
    • The rotations were identical to the rotations of the residents enrolled in the accredited internal medicine residency program.
  2. For trainees who have satisfactorily completed some U.S. or Canadian accredited training in another specialty, ABIM may grant:
    • Month-for-month credit for the internal medicine rotations that meet the criteria listed under (1) above PLUS
    • Maximum of six months' credit for the training in a family medicine or a pediatrics program or
    • Maximum of three months' credit for training in a non-internal medicine specialty program.
  3. Up to 12 months' credit may be granted for at least three years of U.S. or Canadian accredited training in another clinical specialty, and certification by an ABMS member Board in that specialty.
    • Include a non-refundable Special Candidate fee of $300.
  4. Up to 12 months may be granted for three or more years of training completed abroad prior to entering accredited training in the United States or Canada.
    • Must demonstrate satisfactory overall clinical competence as an internist.
    • Must complete a minimum of 18 months of direct patient responsibility.
    • Must have either a standard certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) without expired examination dates or comparable credentials from the Medical Council of Canada at the time of application for admission to the Certification Examination in Internal Medicine.
    • Include a non-refundable Special Candidate fee of $300.

    Proposals for credit in lieu of standard training may be emailed toAcademicAffairs@abim.organd must:

    • Document the reasons the proposer feels the candidate merits special consideration.
    • Include letters from the program directors where prior training was completed documenting the training.
    • Exact from-to dates of training.
    • A brief description of the training.
    • Confirmation of the candidate's satisfactory clinical competence in the program. Please note that ABIM does not accept certificates of completion of training or certification by other certifying boards as fulfilling this requirement.
    • Include a copy of the candidate's curriculum vitae and bibliography.
    • If applicable, include documentation of certification by an ABMS member board in another clinical specialty.
    • Include the candidate's date of birth and Social Security/social insurance number.

    Training in Combined Programs

    ABIM recognizes internal medicine training combined with training in the following programs:

    • Anesthesiology
    • Dermatology
    • Emergency Medicine
    • Emergency Medicine/Critical Care Medicine
    • Family Medicine
    • Medical Genetics
    • Neurology
    • Nuclear Medicine
    • Pediatrics*
    • Physical Medicine and Rehabilitation
    • Preventive Medicine
    • Psychiatry

    Guidelines for the combined training programs and requirements for credit toward the ABIM Internal Medicine Certification Examination are availablefrom the links above.

    *Combined medicine/pediatrics training initiated July 1, 2007 or after must be undertaken in a combined medicine/pediatrics program accredited by the ACGME. SeeInternal Medicine/Pediatrics Policiesfor more details.

Certification Using the Research Pathway

The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. The value of the ABIM Research Pathway is that while it requires core clinical training, it concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.

Guidelines for certification using the research pathway are available inResearch Pathway.

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FAQs

Is Board Basics enough for ABIM? ›

Best Books for ABIM Prep

If you actually want to read something, similar to First Aid for Step 1, then you should try to get through the Board Basics book. This is an excellent and easy-to-read summary guide of everything on ABIM and includes excellent pictures.

Is Mksap enough for ABIM? ›

BOTTOM LINE: MKSAP is probably the gold standard of review materials for ABIM. It is a thorough review program with the added benefit of highlighting inpatient content for budding hospitalists.

What is the best question bank for internal medicine boards? ›

Let's state the obvious: we sell Rosh Review Qbanks for internal medicine board review, and a Rosh Review Qbank might not be the best fit for you. UWorld, MKSAP, MedStudy, or NEJM Knowledge+ might be a better fit.
...
Where the Rubber Meets the Road
  • BoardVitals.
  • MedStudy.
  • MKSAP.
  • NEJM Knowledge+
  • Rosh Review.
  • TrueLearn.
  • UWorld.
8 Jan 2022

How do you pass internal medicine? ›

Follow these steps to ensure you are prepared for the Internal Medicine Board Exam.
  1. Understand the Structure of the Exam. ...
  2. Know What to Expect on Exam Day. ...
  3. Plan Out a Study Strategy. ...
  4. Find a Smart ABIM Question Bank. ...
  5. Practice & Re-Practice. ...
  6. Identify & Attack Weak Areas. ...
  7. Treat Your Body Right. ...
  8. During the Exam.

Can you pass ABIM without studying? ›

Some people have studied throughout their residency and for a small percentage of those people doing only questions as review might be enough, but this is a tough exam and really requires studying.

What percentage of questions do you need to pass ABIM? ›

In order to get an ABIM passing score, you need to score at least a 366, which is 64% of questions correct on the ABIM exam. The 2021 ABIM certification pass rate was 88% and the maintenance of certification exam pass rate was 95%.

Is ABIM harder than UWorld? ›

Question Style and Format

Now let's get into the UWorld ABIM QBank's question difficulty, question length, and quality of explanations: UWorld questions are slightly more difficult than those on the boards.

Is Mksap harder than boards? ›

The American College of Physicians' MKSAP is another popular choice for ABIM board studying. MKSAP questions are slightly easier, with little to no reading between the lines.

How hard is it to pass ABIM? ›

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.

Is ABIM easier than Usmle? ›

On the hierarchy of medical exams, the difficulty of the ABIM exam lies somewhere in the middle, below the MCAT and USMLE Step 1, but above USMLE Steps 2 and 3.

What is the passing score for internal medicine boards? ›

Overall performance is reported on a standardized scale ranging from 200 to 800 points. Your performance on the entire exam determines the exam pass- fail decision. To pass the exam, your standardized score must equal or exceed the standardized passing score of 366.

Is MedStudy good for ABIM? ›

MedStudy helps you ace ABIM boards, earn CME credits and MOC points, and update your knowledge for practice.

What happens if you fail ABIM boards? ›

Applicants cannot take the ABIM internal medicine certification exam more than three times in a row. After three failed attempts, the applicant cannot register for an exam for one year.

What should you do the day before an ABIM? ›

A day or two before the exam, step back even further. Stop studying and do something that you find enjoyable and relaxing — and make sure to get a full night's sleep. Taking the ABIM certification exam is a rite of passage.

Can you use UpToDate on ABIM exam? ›

Physicians Can Now Use UpToDate for ABIM Maintenance of Certification | Wolters Kluwer.

When should I start studying for ABIM boards? ›

Amidst fellowship or job applications, your third year is the time to develop a detailed study schedule to prepare to take the boards in the summer following residency. If you are someone who struggled with USMLE exams, you may want to start intensive studying at the beginning of PGY3.

When should I start studying for ABIM? ›

Medical educators typically recommend making a plan that starts at least six months before your exam date, with dedicated study time set aside each week, and generally increasing the amount of time in the two months before the exam.

How do I study for an ABIM Internal Medicine exam? ›

Create timed “practice exams” through your question bank using questions from all content areas. You can do this at minimum every 3 weeks to simulate a timed environment and pace yourself. There are not practice tests for ABIM internal medicine boards like there are from NBME for Step 1, so this is a great substitute.

Are Internal Medicine Boards difficult? ›

The Internal Medicine Board Exam can be fairly difficult for first-time test takers. In 2018, the First-Time Taker Pass Rate for the ABIM Internal Medicine Certification Exam was 91%.

What is a good score on the medical boards? ›

between 230 and 245

How do you know if you passed ABIM? ›

Your results will be released within three months of the last date of the exam in that area. When your results are released, you will receive an e-mail notification with instructions on how to access your Score Report in PDF format in the My Assessments section of your ABIM Physician Portal.

How many questions are there on UWorld for ABIM? ›

There are currently over 1275 questions in the UWorld QBank. When you log in, there is a Performance page that acts as a dashboard. You can see your progress on how many questions you have completed. This page also features a bell curve of where your scores stand compared to others using the ABIM UWorld QBank.

How many blocks is the ABIM? ›

How many questions are on the ABIM board exam? There are 240 total questions administered in 4 blocks of 60 questions each. According to the ABIM website, you will have up to 2 hours to complete each block of questions.

Whats a good percentage on Mksap? ›

I've heard 60-70%. I would definitely recommend going through the MKSAP boards basics book as a nice review outline a few days/weeks before the test.

When should I start Mksap? ›

Full Member. My general advice to interns is to spend the first 6 months learning how to survive (studying how to treat the patients you currently have, learning to navigate the system, etc) then after about 6 months add MKSAP above and beyond that.

How much does Mksap cost? ›

MKSAP 19 Pricing and Formats
ProductsPricing
Resident/Fellow MemberNonmember
MKSAP 19 Digital$410$658
MKSAP 19 Complete Green$522$839
MKSAP 19 Complete$634$1,019
5 more rows

Are there practice ABIM exams? ›

In addition, NEJM Knowledge+ offers two practice exams that have been designed to help you prepare for your actual ABIM board exam experience. Each practice exam contains 60 case-based questions similar to the format of the NEJM Knowledge+ Question of the Week.

What percentage of doctors fail their boards? ›

If you studied for days, weeks and months and spent money on study aids and testing support only to fail the exam, you are not alone. It's reported that 35 percent of physicians fail the test, only to have to retake it.

How long does ABIM board certification last? ›

How long does ABIM certification last? Internists who pass the traditional MOC exam will be reported as certified for ten (10) years.

How many questions are on the ABIM exam? ›

The exams are given in modular format with a maximum of 60 multiple-choice questions per exam session.

Do ABIM scores matter? ›

ABIM-CE results are important for both the residents and their residency programs. In order for the residency programs to maintain their ACGME accreditation, ACGME requires a 80% pass rate in ABIM-CE from the first-time takers of the exam in the latest three-year period [3].

What should I study for ABIM? ›

The majority of the subspecialty questions on the Internal Medicine board exam will focus on cardiology, gastroenterology, and pulmonary care. However, do not neglect the other areas as the ABIM wants to ensure that internists have a broad base of medical knowledge.

Is UWorld enough for IM shelf? ›

UWorld should be the primary source for information (the question explanations). Only if you feel the explanation is not sufficient should you read Step Up To Medicine or another book to supplement your learning.

What percentage of physicians are board certified? ›

Approximately 90 percent of all practicing physicians in the U.S. are board-certified. Physicians may not be board-certified for any number of reasons.

What happens if you fail recertification ABIM? ›

Physicians who are unsuccessful on the traditional, 10-year MOC exam can re-take the exam during any future exam administration. There is no restriction on the total number of opportunities for re-examination. Physicians earn 20 Medical Knowledge MOC points for every attempt of the traditional, 10-year MOC exam.

How many hours should I study for boards? ›

For boards 6 to 8 hours is sufficient . Divide in two or three parts of 2 - 4 subjects. Read or learn two or more subjects in a day, it makes you free from boredom. Increase studying hours during last month of exam .

How long is Mksap 18 Good For? ›

If you have already purchased MKSAP 18, you will continue to have digital access through February 1, 2024. Consider purchasing the current edition of MKSAP to gain access to new questions and content. MKSAP 19 is filled with new features to help you easily update your knowledge and earn CME and MOC.

What is Mksap used for? ›

The American College of Physicians' (ACP) Medical Knowledge Self-Assessment Program (MKSAP) is a highly regarded and valuable CPD resource with multiple choice questions which enables physicians to measure their knowledge in the broad specialty of internal medicine.

How often is MedStudy updated? ›

To keep up, MedStudy releases a new, fully rewritten edition of the Core every 2 years.

How hard is it to pass ABIM? ›

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.

What should I study for ABIM? ›

The majority of the subspecialty questions on the Internal Medicine board exam will focus on cardiology, gastroenterology, and pulmonary care. However, do not neglect the other areas as the ABIM wants to ensure that internists have a broad base of medical knowledge.

When should I start studying for ABIM? ›

Medical educators typically recommend making a plan that starts at least six months before your exam date, with dedicated study time set aside each week, and generally increasing the amount of time in the two months before the exam.

What happens if I fail ABIM boards? ›

Applicants cannot take the ABIM internal medicine certification exam more than three times in a row. After three failed attempts, the applicant cannot register for an exam for one year. In 2019, the first-time test taker internal medicine certification exam pass rate was 91%.

What percentage of doctors fail their boards? ›

If you studied for days, weeks and months and spent money on study aids and testing support only to fail the exam, you are not alone. It's reported that 35 percent of physicians fail the test, only to have to retake it.

What is a good ABIM score? ›

Overall performance is reported on a standardized scale ranging from 200 to 800 points. Your performance on the entire exam determines the exam pass- fail decision. To pass the exam, your standardized score must equal or exceed the standardized passing score of 366.

Is ABIM easier than UWorld? ›

Question Style and Format

UWorld questions are slightly more difficult than those on the boards. On ABIM boards the information you need is generally given to you in the question, so there isn't a lot of filling in the blanks like there is in clinical practice.

How much should I study for ABIM? ›

This can be as little as 1 hour every evening starting February 1st to go through board study questions. Set weekly deadlines for yourself for questions and content. If you start your study plan in February, for example, a reasonable goal is to do 60 questions per week.

What is the best way to prepare for internal medicine boards? ›

Developing an Internal Medicine Board Preparation Strategy
  1. Supplement your lectures and clinical experience with reading. ...
  2. Read and study from a variety of sources that match your learning style. ...
  3. Practice answering questions. ...
  4. Form a study group. ...
  5. Consider taking a board review course.

How can I pass my board exam while working? ›

9 proven steps to pass a professional exam while working full...
  1. Step #1: Prepare the list of subjects to cover for the exam. ...
  2. Step #2: Apply for the exam. ...
  3. Step #3: Tell your boss and ask for time off. ...
  4. Step #4: Find a study partner or a study group. ...
  5. Step #6: Focus on your strengths.
1 Nov 2017

When should I start using Mksap? ›

Full Member. My general advice to interns is to spend the first 6 months learning how to survive (studying how to treat the patients you currently have, learning to navigate the system, etc) then after about 6 months add MKSAP above and beyond that.

How many questions are in ABIM? ›

The exams are given in modular format with up to 60 multiple-choice questions per exam session. Exam time: You will have up to two hours to complete each session.

How many questions are on the internal medicine board exam? ›

The examination is a secure examination administered in a dedicated testing center. It consists of a maximum of 240 questions and takes approximately 10 hours to complete (including breaks). Learn more about the certification examination.

Is ABIM harder than Step 3? ›

And you might be daunted by the pass rate: In 2013, the pass rate for the ABIM certification exam was 86% among first-time test-takers, considerably lower than the 96% pass rate for the USMLE Step 3 exam among first-timers from U.S. and Canadian schools.

How many times can take ABIM? ›

The ABIM Internal Medicine Certification Exam cannot be taken more than three times in a row (over 3 consecutive years). After three failed attempts, you must wait one year before being able to register for the exam again.

How long do you have to pass ABIM? ›

2022 ABIM Maintenance of Certification Requirements

Earn at least 100 MOC points every five (5) years. Twenty (20) of these points must be in the Medical Knowledge category. Pass the MOC Exam within ten (10) years of when you last passed.

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