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ACP Internal Medicine In-Training Examination

The Web-based IM-ITE: 2016 Test Administration Window Extended by 3 Days!

The Internal Medicine In-Training Examination (IM-ITE), developed by the American College of Physicians in collaboration with the Alliance for Academic Internal MedicineTM (AAIMTM), will be administered from Thursday, August 25, 2016, to Wednesday, September 14, 2016, except Labor Day (Monday, September 5, 2016). We hope the addition of these three days will offer programs more flexibility in coordinating their scheduling during the hectic period involving fellowship interviews. The IM-ITE Administration Window has been extended from 13 to 20 days since 2010.

What Do I Need to Know to Prepare for Web-based Testing?

About the IM-ITE

The 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.
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 six representatives from the Alliance for Academic Internal Medicine (AAIM). The final committee member is a rotating representative from ACP or AAIM.

Preparation for the IM-ITE begins 18 months before administration. Each committee member reviews and writes questions in one or more of the 11 subspecialties listed on the content blueprint (see next three paragraphs) and according to well-established principles of exam construction. All questions used in any examination have undergone 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 exam emphasizes a range of content areas considered important during the training of a general internist, including cardiology, endocrinology, gastroenterology, general internal medicine (including, but not limited to, dermatology, ophthalmology, preventive medicine, psychiatry, geriatrics, women's health, nutrition, medical ethics, and biostatistics), geriatric medicine, hematology/oncology, infectious diseases, nephrology, neurology, pulmonary and critical care medicine, and rheumatology.

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 exam.

2015 Internal Medicine In-Training Exam Blueprint

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%
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 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 postresidency 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?

The IM-ITE 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 and health care professionals 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 exam.

The program director decides who will take the exam. The sponsoring organizations impose no requirements. More than 26,000 residents from 12 countries participate in the exam.

Should residents study for the IM-ITE?

The goal of the IM-ITE is to gauge progress in training, not to achieve a certain level of performance. Examinees, therefore, are advised not to study for the exam. 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-ITE before other residents?

The IM-ITE is administered annually at each training site during a prescribed period. The 2015 IM-ITE will be administered August 28-September 14, 2015, excluding Monday, September 7 (Labor Day) and including the weekend days of August 29-30, September 5-6, and September 12-13. 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 exam is to provide accurate scores and norms for gauging resident and program performance.

How many items will be in the 2015 IM-ITE?

The 2015 IM-ITE will consist of 300 items.

How is the IM-ITE scored?

Independent scoring is conducted to identify flawed questions, which are not included in the final score; this process is known as key validation. 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 will be made available approximately 4 to 5 weeks following the end of the exam window. The program director accesses a score report Web site and distributes the score reports to the examinees. The American College of Physicians and the Alliance for Academic 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 educational objectives of 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 listing of 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.
What are the dates for the 2016 IM-ITE?

The dates for the 2016 IM-ITE are August 25, 2016 to September 14, 2016, except Labor Day, Monday, September 5, 2016.

How do I obtain prior IM-ITE score reports?

You can obtain prior IM-ITE score reports by calling Kim Kerns at 215-351-2568, or by emailing Kim Kerns at kkerns@acponline.org.

Please note that effective with the 2015 exam there will be a $25 processing fee for obtaining prior year score reports.


More Questions? Contact ACP by phone or email.

For general information about the IM-ITE, call 215-351-2553 or 215-351-2568 or send us an email at IM-ITE@acponline.org.

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.

IM Essentials: Created by over 90 internal medicine clerkship directors, IM Essentials covers the key topics and concepts in the core medicine clerkship through textbook chapters and self-assessment questions.

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