IM-ITE FAQ

The ACP Internal Medicine In-Training Examination® is a web-based exam designed to assess the progress of residents as they prepare for their initial ABIM certification exam.

The IM-ITE is developed by a committee of 11 expert physicians and is used by residency programs to assess their residents’ strengths and areas in need of remediation during training and in preparation for their initial certification exam. It is modeled after the American Board of Internal Medicine's certification exam. The exam is administered annually by each training program during strictly monitored start and end dates.

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

The IM-ITE is designed for residents at the midpoint in their training, but nearly 37,000 PGY1, PGY2, and PGY3s participate each year. In addition, faculty members, program directors, and other physicians may take the examination. If you are unaffiliated with a program, but would like to take the IM-ITE, you must find a program that will permit you to take the exam along with their registrants.

• If your residency program hasn't participated in the IM-ITE before, complete the 2026 IM-ITE New Program form and e-mail it to IM-ITE@acponline.org before regular registration closes. The program director and coordinator will then be provided access to the MyNBME Services Portal and detailed registration instructions and will be asked to enter the roster of residents and administrative contacts for the first time.
• Be sure that the individual who will assist with the administration of the IM-ITE reads the information provided on ACP’s IM-ITE web page as well as all directions provided for the registration process.

The IM-ITE consists of 300 questions and is modeled after the blueprint for the American Board of Internal Medicine’s certification exam. Here is the breakdown of topics:

Progams will have the option for in-person testing or remote proctoring and testing, or a combination of both, using third-party software (Zoom, MS Teams, or Webex).

• Regular registration: April 29, 2026, through July 13, 2026 — $145 per registrant.
• Late registration: Starting July 14, 2026 — $145 per registrant plus a $30 late fee.

Programs with outstanding IM-ITE registration fee balances from the prior year will be unable to register their examinees until the fees owed are paid in full.

After programs verify and submit their roster, they can generate the Program Registration Confirmation form and pay by check, credit card, or electronic funds transfer (EFT). In addition, 5-7 business days after submission of your roster, an invoice is will be automatically sent via US mail to the Program Director listed in the MyNBME portal. Payment is due 14 business days after registering examinees. 

Programs with prior outstanding IM-ITE balances will be unable to register their examinees until the fees owed are paid in full. For questions related to invoices and payment, please contact ACP Member and Product Support at 1-800-ACP-1915 (1-215-351-2600 outside the USA/Canada) or by email at help@acponline.org. Staff are available Monday – Friday, 9am-5pm EST, excluding holidays. Please have your IM-ITE program number handy, which can be found in the MyNBME portal. 

*Please allow 2 business days after you submit your roster before contacting ACP Member and Product Support to allow time for your registration details to upload into ACP’s payment system from the MyNBME portal.

Please contact ACP Member and Product Support, Monday-Friday; 9am-5pm EST at 1-800-ACP-1915 (USA & Canada) or 1-215-351-2600 (outside of USA & Canada) or by email at help@acponline.org. Please have your IM-ITE program number handy, which can be found in the MyNBME portal.

*Please allow 2 business days after you submit your roster before contacting ACP Member and Product Support to allow time for your registration details to upload into ACP’s payment system from the MyNBME portal.

Programs with prior outstanding IM-ITE balances will be unable to register their examinees for the exam until the fees owed are paid in full.

For questions related to invoices and payment, please contact ACP Member and Product Support at 1-800-ACP-1915 (1-215-351-2600 outside the USA/Canada) or by email at help@acponline.org. Staff are available Monday – Friday, 9am-5pm EST, excluding holidays. Please have your IM-ITE program number handy.

The American College of Physicians has a strict no-refund policy for the IM-ITE. Once you have registered your examinees and paid, your payment cannot be refunded. However, if you registered examinees and they do not take the exam, you may apply the resulting credit to any unscheduled test-day examinees or substitutions.

If you have questions, please contact ACP Member and Product Support, Monday-Friday; 9am-5pm EST at 1-800-ACP-1915 (USA & Canada) or 1-215-351-2600 (outside of USA & Canada) or by email at help@acponline.org. Please have your IM-ITE program number handy.

Registration

• Regular registration: April 29, 2026 – July 13, 2026
• Late registration: Beginning July 14, 2026, a $30 late fee per registrant will apply

Test Administration Window

• Thursday, August 13 – Friday, September 4, 2026
  Programs may test on one or multiple days during the testing window.

Program Materials and Communications

• Chief Proctor Manual available in MyNBME portal: July 21, 2026
• Workstation Certification email: July 30, 2026
• Examinee Instruction Sheets available in MyNBME portal: July 30, 2026

Post Exam Activities

• Roster verification email: September 7, 2026
  Programs must verify and update registrant biographic information. This step is completed by the program, not NBME or ACP.
• Preliminary exam feedback sent to Program Directors (PGY1-5 only): September 14, 2026
• Score reports and feedback posted to the MyNBME portal: October 14, 2026.
  Note: Score reports are not released directly to residents affiliated with a program. Faculty and unaffiliated examinees (PGY 6 and PGY7) receive their score reports individually through the MyNBME portal.

Yes. Although the registration process requires programs to identify a specific date or dates of testing, once registered, programs can reschedule their residents during any day of the test administration window, regardless of the date or dates identified during registration, and without contacting ACP or the NBME.

No. It is a secure exam, and technical support staff are only available during the exam window. The exam is shut down after the last day of the exam window.

Programs select the day(s) that are convenient for all staff and examinees within the exam window. It is common for large programs to schedule testing for more than one day. We recommend that programs schedule early during the exam window to allow flexibility to choose an additional date if necessary. Programs may choose new or different dates for the exam within the exam window without contacting the NBME or ACP.  The goal is to have a uniform and secure test administration environment.

The total test session time is 9 hours. There are 6 sections consisting of 50 items each. Examinees will have 70 minutes of testing time for each section, with an optional 10-minute break after test sections 1, 2, 4, and 5, and an optional 60-minute lunch break at the end of test section 3. There is an optional 15-minute tutorial at the start of the exam, a 5-minute Biographic Information Survey following the Tutorial, and an untimed Resident Survey at the end of the examination.

Each site must have one Chief Proctor and may have an unlimited number of additional proctors depending on the needs of the Chief Proctor. The Chief Proctor is responsible for performing any actions that affect ALL examinees, such as starting the exam session, ending the exam session, and submitting the Test Administration report via the Chief Proctor Resource Site. The Chief Proctor is also responsible for recruiting Assistant Proctors for the test session.

An Assistant Proctor who is assisting a Chief Proctor in the same testing room does not require a dedicated computer station; however, an Assistant Proctor who is assigned to a separate testing room requires his or her own computer workstation to monitor the exam. Assistant Proctors may also relieve the Chief Proctors and other Assistant Proctors monitoring exam rooms to allow them to take breaks. Assistant Proctors who are being recruited to simply circulate and monitor examinee behavior do not need a separate login. Both Chief and Assistant Proctors should be identified during registration.

Programs Directors/Coordinators/Administrators should select Chief Proctors to monitor the exam, and are responsible for providing the Chief Proctors with information on general responsibilities, exam dates, and time commitment required. Providing this information to Chief Proctors is important so that they are prepared to receive the Chief Proctor's login information and can schedule time to monitor the exam.

In late July, ACP will email Chief Proctors login information and a link to the Chief Proctor's Manual, which will contain instructions on how to perform the workstation certification process, distribute examinee instruction sheets, and a link to the examinee practice exam. It is strongly recommended that the Chief Proctors read the comprehensive manual thoroughly. Approximately 14 days before the exam window opens, Chief Proctors will receive the ticket number and URL necessary for accessing the workstation certification utility. This utility will check workstations for compatibility with web-based testing and must be run on all institutional and student-owned laptops that will be used for the exam.

The Chief Proctor should schedule a meeting with all proctors prior to the test day. The following should be reviewed at the meeting:

• The examination time schedule and all administrative procedures
• The location of the test site and the time Assistant Proctors are to report to the test site
• The functionality of the computer testing system
• The tasks assigned to each Proctor or Assistant Proctor
• Procedures for identifying and admitting examinees into the examination
• Procedures for administering and proctoring the exam remotely (if applicable)
• Procedures for handling same-day examinees (any examinee that was not pre-registered)
• Handling late arrivals
• Procedures for the distribution and collection of Examinee Instruction Sheets
• Ensuring that examinees return to the same workstation after breaks
• Procedures to follow for an examinee that becomes sick or has an emergency during the exam

The Chief Proctor’s Manual is divided into four major sections. Each section includes a checklist that can be used as a quick guide to prepare for and administer the exam. For example, the Chief Proctor can use the “On Test Day” and “Using the Proctoring Software” checklist along with the Troubleshooting tips and reference materials in the Appendix as a quick start guide on test day.

Section 1: Prior to Test Day covers important pre-administrative tasks such as Workstation Certification that must be performed prior to test day.

Section 2: On Test Day covers the tasks that must be performed on test day prior to the start of the exam.

Section 3: Using the Proctoring Software explains how to use the Chief Proctor Resource site to administer the exam.

Section 4: Managing the Test Session provides general information on monitoring examinees on test day.

Appendix: the appendix includes troubleshooting tips and other important supplementary information for administering the exam.

Contact NBME Test Administration Services for questions concerning the MyNBME portal, workstation certification, the proctoring software, technical requirements, or the administration of the exam:

Prior to Test Day
215-243-3919
E-mail: nbmewebtest@nbme.org

On Test Day
215-243-3707

Call the NBME “On Test Day” phone number immediately: 1-215-243-3707. This technical assistance line is staffed 24 hours a day, every day, during the exam window. In addition, be sure to file an incident report using the Proctor site.

Do not call or email ACP staff unless directed by the NBME.

Do NOT Close the Examinee Session or End All Exams. Refer to the Chief Proctor Manual section “Examinee Leaves Due to Illness” for instructions, and call the NBME “On Test Day” phone number immediately: 1-215-243-3707. This technical assistance line is staffed 24 hours a day, every day, during the exam window. In addition, please file an incident report using the Proctor site.

Examinee instruction sheets can be printed up to and including on exam day using the MyNBME portal and will include blank sheets for this purpose. Examinee instruction sheets for registrants added after initial registration can also be printed from the MyNBME portal. Misspellings on the Examinee instruction sheets do not affect scores and can be corrected during the post-exam Roster Verification Process.

After the exam administration, an email will be sent to programs with Roster Verification instructions. Programs will have the opportunity to review, update, and verify the biographic information on their registration roster. This is a very important step for correcting of any inaccuracies, and the information provided on the verified roster is an exact representation of how it will appear on the score report. Changes cannot be made after the roster verification deadline.

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. The release of any score, either at an individual or aggregate level, to any person or organization outside the residency program, is strictly prohibited.

Yes. The MyNBME portal will only provide the reports for the prior 2 years, so we strongly recommend promptly retrieving and saving the score reports in a secure, known, and accessible location for reference by current and future administrative staff.

The prior 2 years’ score reports are in the MyNBME portal under Performance Feedback. Program Coordinators and Directors should have already been given access to this portal at the start of the registration period.

Requests for score reports that are beyond 2 prior test administrations are subject to a $50 administration fee per year and require 3-4 weeks for delivery. Direct requests to ACP at im-ite@acponline.org.

Score reports are only provided to a program’s verified administrative staff. Under no circumstances are they provided to a current or prior examinee.

Exam date(s): Inform residents of the date(s) on which the examination will be administered.

Practice test: Notify residents about the practice test and share the URL provided in the Chief Proctor Manual.

Personal items: Personal items are not permitted at the workstation, including electronic devices, smartphones, backpacks, coats, calculators, noise canceling headphones, and food.

• Scratch paper will be provided by the proctor and collected after the exam.
• Examinees must return to the same workstation after each break.

Additional policies: For a complete list of testing policies, refer to the Chief Proctor Manual, available on MyNBME approximately three weeks before the exam window opens.

Score reports: Score reports will be available to program directors by late October. Examinees should not contact ACP or NBME directly to request scores.

The Disability and Authorization Form is available in the MyNBME Services Portal with directions for its use, along with a list of permitted accommodations. Once you have logged in, you can find the form by clicking on the Manage Exams tile on the top navigation bar. All paperwork must be submitted before the deadline listed on the form. If you have additional questions concerning Special Accommodations, please contact Kim Kerns at kkerns@acponline.org or Toni Allen at tallen@acponline.org.

Residents who will be on rotation, on vacation, or out of town on the scheduled examination day should be encouraged to return to their parent institution for the examination.  If this is not possible, the program director is responsible for making arrangements at an alternative test site.

The program director of the parent institution should contact the program director of the alternative test site before the registration period closes and arrange for the resident to take the examination there.  Any resident testing at an alternate test site must be included on the Registration Roster of the parent institution with the appropriate alternate test site indicated. Please enter the correct residency program code number and program name in the Alternate Center column if an alternative test center is authorized. This will ensure that the Examinee Instruction Sheets for these residents are sent to the alternate testing location, and the scores are reported to the parent institution.

The parent institution is responsible for payment for residents who take the examination at an alternative test site. If appropriate arrangements are not made before the deadline, the resident may not be able to take the examination. For more information, refer to the registration instructions.

Yes. Your test center would be considered an Alternate Center. The program director of the parent institution should contact your program before the registration period closes and arrange for the resident to take the examination.  

The parent institution is responsible for including any resident who is testing at an alternate test site on the parent institution’s Registration Roster with the appropriate alternate test site indicated. This will ensure that the Examinee Instruction Sheets for these residents are sent to the alternate testing location, and the scores are reported to the parent institution.

The parent institution is responsible for payment for residents who take the examination at an alternative test site. If appropriate arrangements are not made before the deadline, the resident may not be able to take the examination. For more information, refer to the registration instructions.

Yes. Examinees may be registered after the regular registration period closes, including during the exam administration window, up to and including the exam day. Using the MyNBME Portal, add examinees to your roster and submit them just like your initial examinees. The program director will receive an emailed invoice for any additional examinee registration fees. After the regular registration period has ended, an additional $30 fee will be charged for each. If you would like to request or pay for an invoice, please contact ACP Member and Product Support, Monday – Friday, 9am – 5pm ET at 1-800-ACP-1915 (USA/Canada), 1-215-351-2600 (outside USA/Canada), or help@acponline.org. If you know your IMITE program ID, please have it handy to expedite the process. All invoices from prior years, including additional invoices for late registrants, must be paid prior to registration for the current year.

Test-day registration is discouraged. However, if previously unregistered individuals request participation on the day of the examination and computer workstations are available, they may be permitted to take the examination. 

Instructions for admitting test-day registrants are included in the Chief Proctors Manual.  A unique ID Number will be assigned to each registrant on the day of the examination when the proctor enters the examinee’s information on the Chief Proctor Resource Site.  A valid email address is required for all faculty and other nonresidents who are test-day registrants.

Any registrants who take the exam at an institution other than their parent institution must receive approval from their program director and ensure that the parent institution’s six-digit IM-ITE residency program code is entered correctly. The parent institution is financially responsible for test-day examinees, and the parent institution’s program director will be billed accordingly.

Fees paid during registration for pre-registrants who do not complete the examination are not refundable but can be applied to test-day examinees and examinees who are added after the registration deadline. An additional $30 will be charged for each applicant registered after the deadline, including test-day registrants. If you have questions on the day of the exam, please contact the NBME at 215-243-3707.

Before the Exam

Preparation: You are advised not to alter or intensify your usual study habits specifically for this exam.

Special accommodations: If you require testing accommodations, notify your program director as early as possible. Requests must be submitted by a strict deadline, approximately one month before the exam window opens.

Nursing mothers or timed medication breaks: Ask your program about the “Stop the Clock” option.

Practice exam: A few weeks before the testing window opens, you will have access to an online practice exam to familiarize yourself with the testing platform. Your program will provide access.

Questions: Direct all exam-related questions to your program director or coordinator. Do not contact ACP or NBME directly.

Exam Day

Total testing time: Approximately 9 hours

• 7 hours of exam time
• Scheduled 10 minute breaks and a lunch break

Exam format:

• 300 total questions: 260 scored, 40 unscored practice items

Scoring: There is no penalty for guessing; only correct answers count toward your score. 

Content: Questions cover general internal medicine and multiple medical specialties. 

Breaks: You must return to the same workstation after each break.

After the Exam

The score reports will be available to program directors and coordinators by mid-to-late October.

Programs will receive a report that shows the percentage of questions correct for each examinee as well as each examinee's percentile rank.

Residents will receive a report from their program listing the educational objectives of questions they answered incorrectly.

Residents should not contact the ACP or NBME directly to ask for their scores.

Click on the Manage Exams tile on the upper navigation ribbon within the MyNBME Service Portal and then click on Other Information. You’ll find the program list there. Please note that if your program is taking the IM-ITE for the first time, it might not be listed this year.

The Program ID is unique to your residency program and will assist NBME and ACP staff in identifying your program if you need assistance.

The MyNBME Services Portal is hosted by the National Board of Medical Examiners (NBME) and is used for the registration and administration of the IM-ITE.

The ACP’s Residency Program Portal is hosted by the American College of Physicians and is used by residency programs to purchase ACP memberships and ACP MKSAP subscriptions.

Send us an email (preferred) at IM-ITE@acponline.org, Monday – Friday; 9am – 5pm ET.

If you know your IM-ITE program ID, please provide it to expedite the process.