ACP Internal Medicine In-Training Exam
The leading practice internal medicine exam for residents and other physicians preparing for certification.
Developed by the American College of Physicians and co-sponsored by the Association of Program Directors in Internal Medicine and the Association of Professors of Medicine, the Internal Medicine In-Training Examination® (IM-ITE®) is designed to:
- Give residents an opportunity for self-assessment.
- Give program directors the opportunity to evaluate their programs.
- Identify areas in which residents need extra assistance.
For information, call 215-351-2553 or 215-351-2567.
Frequently Asked Questions
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How is the IM-ITE Developed?
The IM-ITE is written by a committee of 11 expert physician-authors, including four representatives from the American College of Physicians and three representatives each from the Association of Professors of Medicine and the Association of Program Directors in Internal Medicine. The final committee member is a rotating representative from one of these three organizations.
Preparation for the internal medicine exam begins 18 months before administration. The committee creates the content blueprint and writes multiple-choice questions according to well-established principles of examination construction. The 340 questions are subjected to several reviews and revisions.
The internal medicine questions are written at the level of proficiency expected from second-year residents and cover a wide spectrum of knowledge in internal medicine, including acute and chronic care, in-patient and ambulatory problems, and essential clinical skills. The examination emphasizes a range of content areas considered important during the training of a general internist, including cardiology, gastroenterology, endocrinology, pulmonology/critical care medicine, rheumatology, nephrology, hematology/oncology, infectious disease, neurology, geriatric medicine, and general internal medicine (including, but not limited to, dermatology, ophthalmology, preventive medicine, psychiatry, geriatrics, women's health, nutrition, medical ethics, and biostatistics).
.What is the Blueprint for the IM-ITE?
The blueprint for the IM-ITE, shown below, is modeled after the blueprint for the American Board of Internal Medicine’s certification examination.
2013 Internal Medicine In-Training ExaminationBlueprint
| Content Areas | Percentage of Multiple-Choice Questions |
| Cardiology | 13.5% |
| Endocrinology | 6.5% |
| Gastroenterology | 9.5% |
| General Internal Medicine | 15% |
| Geriatric Medicine | 6% |
| Hematology/Oncology | 11.5% |
| Infectious Diseases | 9% |
| Nephrology | 6% |
| Neurology | 4% |
| Pulmonology/Critical Care Medicine | 10% |
| Rheumatology | 9% |
| Total | 100% |
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What is the Purpose of the IM-ITE?
Residents may use the results to identify areas of deficiency that require further learning, to compare their performance with that of their peers in training programs throughout the world, and to help in making career choices. Program directors may use the results to provide educational counseling to residents, develop curricula, and validate the need for planned curricular changes. Physicians may use the results to help them prepare for the maintenance of certification examination.
.Can the IM-ITE Be Used for Advancement?
The examination is neither a qualifying nor a certifying instrument. It should not be used for determining who should be promoted, who should be eligible to take the American Board of Internal Medicine certifying examination, or who may be qualified for post-residency fellowship training. It is designed only as a self-assessment tool.
However, program directors are encouraged to include IM-ITE results in semiannual reviews of resident performance and reporting on attributes of the Medical Knowledge competency. As part of the Internal Medicine Milestone Project, this activity may contribute to a residency program’s participation in the Next Accreditation System (NAS) to determine the overall progress of residents. However, the release of any score, either at an individual or aggregate level, to any person or organization outside the residency program is strictly prohibited.
.Who Should Take the IM-ITE?
ACP's practice internal medicine exam is designed for residents at the midpoint in their training, but residents at all postgraduate training years are encouraged to participate. In addition, faculty members, program directors, and other physicians with an interest in internal medicine may take the examination to test their medical knowledge against that of residents, or to prepare for the maintenance of certification examination.
The program director decides who will take the examination. The sponsoring organizations impose no requirements. More than 20,000 residents from all but a few residency programs in the United States participate in the examination. The IM-ITEis also taken by more than 2,000 participants in 14 countries.
.Should Residents Study for the IM-ITE?
The goal of the IM-ITEis to gauge progress in training, not to achieve a certain level of performance. Examinees, therefore, are advised not to study for the examination. Studying may result in an inaccurate self-assessment of the training experience and an inability to plan appropriately for correcting deficiencies.
.Are Second-Year Residents Required to Take the IM-ITEBefore Other Residents?
The IM-ITEis administered annually at each training site during a prescribed period at the end of October. Program directors select the day, within this period, that is most convenient for them. If the examination cannot be administered to all residents on the same day, programs are encouraged to administer it to second-year residents initially, although this is no longer a requirement.
The purpose of these guidelines is to ensure uniform, secure examination administration conditions, which are important if the examination is to provide accurate scores and norms for gauging resident and program performances.
.When will Future IM-ITE'sBe Administered?
The 2013 IM-ITE will be administered October 4-19, 2013, including Sunday, October 6 and Sunday, October 13, 2013. Testing centers should select the day or days, within this period, that would be most convenient for them.
.How is the IM-ITE Scored?
Independent scoring is conducted to identify flawed questions, which are not included in the final score. A final score is determined by the total number of questions that are answered correctly. There is no penalty for guessing. Answering all questions, even when there is doubt about the correct answers, maximizes the likelihood that the score reflects the breadth of the examinee's knowledge of the field.
A score is reported as a percentage of total questions answered correctly. Because the examination is an educational exercise, no specified level of performance is considered a passing level, and no one can fail the examination.
.When Are the Results of the IM-ITE Made Available?
A link to online score reports is made available about 8 weeks after the examination. The program director accesses a score report Web site and distributes the score reports to the examinees. The American College of Physicians, the Association of Professors of Medicine, and the Association of Program Directors in Internal Medicine consider the results to be confidential and do not release them to any agency, organization, or person other than the program director.
Each examinee receives a report that shows:
- The individual’s total percent correct score and percentile rank.
- Percent score and percentile rank for each of the 11 major content areas tested.
- A list of test questions answered incorrectly.
- A norm table and guidelines for interpreting the data for use in comparing his or her score with the scores of different resident groups.
- A booklet describing the educational objective for every test question.
The program director receives:
- A score report and list of questions missed for each resident.
- An overall program performance report.
- Mean percent correct scores and percentile ranks for each of the 11 major content areas tested, grouped by first-year residents (PGY-1), second-year residents (PGY-2), third-year residents (PGY-3), and all other residents.
- Examinee and program performance graphs.
- The norm table with guidelines for interpreting the data.
- The educational objective for every test question.
- Electronic results that can be downloaded into an Excel or similar software program, allowing program directors to keep track of their program's results over a period of years.
How Do You Register for the IM-ITE?
You can register your program by contacting Valerie Dangovetsky (vdangovetsky@acponline.org, 215-351-2553). After making this initial contact, you will be instructed on how to register your residents online. If you have used the examination within the past 2 years, you can access the registration site any time after July 5.
Registration costs $100 per examinee. A late fee of $30 is charged for registrations received after Aug. 22. Program directors must make payment to the American College of Physicians.
Examination materials and proctor instructions are mailed to program directors at the end of September, at least 2 weeks before the examination is administered.
Physicians wishing to take the examination may register as walk-ins on the day of examination administration at a particular center. (For an updated list of test centers administering the examination, please contact ACP Customer Service at 800-523-1546, extension 2600.)
Related Links
IM Board Review Courses: Review medical content and improve test-taking skills with ACP's expert clinician educators as you prepare for the ABIM certification exam.
MKSAP: ACP's comprehensive Medical Knowledge Self-Assessment Program provides residents and practicing physicians with an up-to-date study resource for ABIM certification and recertification.
MKSAP for Students: Supplement your learning and reinforce key concepts with the fully revised and updated MKSAP for Students 5!
IM Essentials for Students: The fully revised and updated Internal Medicine Essentials for Students is the authoritative educational resource to augment learning during the third-year internal medicine clerkship.
Virtual Dx(SM): An online-only program that uses images and studies to challenge your diagnostic ability in a way that no textbook can.
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