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The ACP Internal Medicine In-Training Examination® is a web-based self-assessment exam for residents to assess their progress.

The exam is to be administered from Thursday, August 19, 2021, to Wednesday, September 8, 2021, except Labor Day (Monday, September 6, 2021).

The 2020 exam is now closed.

As of October 16, 2020, the 2020 score reports are now available to programs for distribution to examinees. All participating programs have been sent an email from with credentials to retrieve their scores and related information.

New to the IM-ITE? Learn about the registration process.

Important dates for the 2021 IM-ITE:

Registration: Registration will open late May 2021.

Test Administration Window: All programs are welcome to test one day or each day during the entire testing window*, Thursday, August 19, 2021, to Wednesday, September 8, 2021, except Labor Day (Monday, September 6, 2021).
*Although the registration process requires programs to identify a specific date or dates of testing, once registered, programs can schedule their residents to sit for the exam during any day of the test administration window, regardless of the date or dates identified during registration.

About the Exam

The IM-ITE® is developed by a committee of 11 expert physician-authors and is used by residents, program directors, and physicians alike. It is modeled after the American Board of Internal Medicine's certification exam. The exam is administered annually at each training site during a prescribed period. This year's exam will be administered from Thursday, August 19, 2021, to Wednesday, September 8, 2021, except Labor Day (Monday, September 6, 2021).

The exam 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

2021 Testing Window

IM-ITE August 2021 Calendar IM-ITE September 2021 Calendar

For Examinees

The goal of the IM-ITE® is to gauge progress in training. For the most accurate assessment, you are advised not to study.

Before the Exam

  • You are advised not to study for this exam.
  • Special accommodations for those who need them can be made ahead of time. Be sure to alert your program director of any special needs as soon as possible.
  • A few weeks prior to the testing window, you will be able to take the online practice exam to familiarize yourself with the online testing process.

Practice Exam

Exam Day

  • The total testing time will be 9 hours.
  • There will be 7 hours devoted to the exam itself, plus several 10 minute breaks and a lunch hour.
  • The exam will have roughly 300 questions.
  • There is no penalty for guessing an answer, and the exam cannot be failed. Only questions answered correctly are counted toward your score.
  • The exam will cover a number of specialties as well as general internal medicine.

After the Exam

  • Results will be made available online roughly 4 to 6 weeks after the exam window.
  • Programs will receive a report that shows the percent of questions correct for each examinee as well as each examinee's percentile rank.
  • Report will also include a list of educational objectives of questions answered incorrectly.

For Program Directors and Chief Proctors

Now Web Based

The IM-ITE will be administered online, offering examinees these great benefits:

  • Quicker access to score reports (4 to 6 weeks post-administration) with shorter turnaround of scores expected in the future
  • Examinees gain experience with computer-based testing format in anticipation of ABIM Certification Examination
  • Flexibility in configuring testing rooms because the exam can be administered on both institutional computers or residents' personal laptops
  • Optional scheduled breaks for examinees, allowing them to control the pace at which they complete the exam
  • Ability for examinees to mark questions for review during a testing session
  • Additional security measures possible through Chief Proctor's computer monitoring of examinees' progress and scrambling of individual exam questions (no two examinees will see the same questions at the same time)
  • Elimination of inconvenient and time-consuming manual processes for Chief Proctors, such as post-examination reporting and packaging of exams and related materials

Technical Requirements

Each testing room must have:
  • Bandwidth of 256 kbps per examinee to support the number of examinees to be tested in each room
  • A dedicated computer workstation or personal laptop for the Chief Proctor for the entire test session near the doorway to check in examinees more efficiently and monitor the test session
  • A dedicated computer station for each Assistant Proctor who will be monitoring the exam in a separate exam room
  • Other technical requirements, such as required operating system and computer configuration details, are available in PDF form.

Full Technical Requirements

Responsibilities of the Program Director

  • Fill out and return form in April to indicate interest in exam
  • Secure testing rooms as soon as testing dates and approximate number of examinees are known
  • Select Chief Proctors before registration opens in May, providing them with information about their responsibilities

Responsibilities of Chief Proctors - Before Test Day

  • Secure computer lab/testing room
  • Designate a Chief Proctor computer workstation in the lab or room
  • Arrange for IT staff at the test site to assist with any hardware/software problems before and during the exam
  • Assure system requirements are met on each examinee workstation and on Chief Proctor workstation
  • Select Assistant Proctors (one for every 20 to 25 examinees)
  • Assure appropriate number of Assistan Proctors and workstations for the number of examinees testing each day
  • Assure standard testing room arrangements
  • Review Chief Proctor's Manual and Chief Proctor Video Tutorial
  • Ensure the Workstation Certification utility is run on each fixed workstation and institution laptop
  • Practice monitoring a sample exam on the Chief Proctor Resource site using the user name and password provided

Responsibilities of Chief Proctors - On Test Day

  • Prepare examinee workstations and boot up workstation
  • Log into the Chief Proctor Resource site with username and password and enter test session information
  • Admit examinees to the testing room; distribute Examinee Instruction Sheets, which includes examinee login info
  • Provide examinees with Examinee Startup Code for launching the exam (code is generated from the Chief Proctor's workstation)
  • Monitor the testing session on the Chief Proctor workstation and report any incidents on the Test Administration Report
  • End the exam session and complete the Test Administration Report

Scoring and Results


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.


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 performance report
  • Mean percent correct scores and percentile ranks for each of the 11 major content areas tested
  • Examinee and program performance graphs
  • The norm table with guidelines for interpreting data
  • The educational objective for every test question



The Process

The registration process begins when ACP sends out a Program Information Form in April. This form will allow you, as a program director, to indicate your interest in the exam. It will ask for contact information so you can be granted access to the IM-ITE Registration Site in May. If your Program hasn’t participated in the IM-ITE before, sign up to receive a Program Information Form: email or call 215-351-2568 or 215-351-2553 (M-F, 9am-5pm ET) by April 1.

In May, programs who previously participated in the exam will be able to update their existing roster of residents with additions and deletions. Newly participating programs will be able to type in the names of their participating residents into the registration site. Payment will be due at that time. You will also be asked to provide your chosen Chief Proctors' contact information.

In early August, ACP will mail out Chief Proctors' login information as well as a link to the Chief Proctor's Manual.


Walk-in residents are previously unregistered individuals that request participation on the day of the exam. As long as workstations are available, they may be permitted to take the exam. Instructions for admitting walk-in registrants are included in the Chief Proctors Manual.

Still Have Questions?

For general information about the IM-ITE, call 215-351-2553 or 215-351-2568.
You can also send us an email at

Read the FAQ