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The Board Certification Process

The American Board of Internal Medicine (ABIM) requires that five specific criteria be met in order to become certified:

1. Complete the requisite predoctoral medical education. Students in the United States and Canada must have graduated from a school accredited 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 either certification from the Educational Commission for Foreign Medical Graduates (ECFMG) or comparable credentials from the Medical Council of Canada.

2. Meet the graduate medical education training requirements. A total of 36 calendar months of training is required and must be completed in a U.S. or Canadian graduate medical education program accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada, or the Professional Corporation of Physicians of Quebec.

3. Demonstrate clinical competence in the care of patients. The ABIM requires that candidates for certification in internal medicine demonstrate adequate performance in the six core competencies defined by the American Board of Medical Specialties (ABMS)/ACGME for all physicians: patient care and procedural skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Residency program directors are required to complete clinical competence evaluations each year for internal medicine residents, and to be eligible for board certification, residents must achieve satisfactory ratings in each of the six competency areas during the final year of training. Additionally, the program director must attest that the trainee is competent to practice in an unsupervised manner at the end of training. You can learn more about the required evaluation process.

4. Meet the procedural and licensure requirements. The ABIM requires demonstration of competency and safe performance of a limited number of medical procedures to be eligible for initial certification. You can learn more about the procedural requirements. Candidates for board certification must also possess a permanent, valid, unrestricted, and unchallenged medical license in the United States or Canada.

Only when these requirements have been met will candidates be allowed to take the final step in initial board certification process:

5. Pass the ABIM Internal Medicine Certification Examination. 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.

"Board eligible" is a term applied to individuals who have met most of the requirements for board certification but have not fully completed the process of initial certification; this most commonly applies to physicians who have met the training and procedure/licensure requirements but have not yet passed the initial certification examination. In internal medicine, the period of board eligibility is limited to seven years from the completion of training, beyond which additional steps need to be taken to reinstitute board eligibility for the purposes of certification.