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Determining the Pass-Fail Standard for the Boards and Disclosing Examination Results

Patrick C. Alguire, MD, FACP
Director, Education and Career Development

How the Pass Standard is Set

Pass-fail decisions for the examination are determined by performance on the entire examination, and there is a single overall pass-fail standard. The approach used to set the standard is a multi-step process involving the ABIM Board of Directors. First, the directors define the characteristics of a minimally certifiable candidate, a hypothetical candidate who will just barely pass the Boards. Next, each director reviews each item on the examination, estimating the percentage of "borderline" candidates they think will answer the question correctly. After all the directors have reviewed a question and provided an estimate, the average estimate is calculated for each question. Then, the average percentage of correctly answered questions (estimated) for the entire examination is summed. This sum represents the percentage-correct minimum passing score for the examination. In summary, the passing standard is based upon the professional judgment of the ABIM Board of Directors, which estimates how many questions a minimally certifiable candidate must answer correctly to pass. This process is very reliable (1), and is the same process used to determine the pass-fail standard on other high-stakes examinations.

Disclosure and Length of Certification

The ABIM provides information to program directors regarding the certification status of examinees who trained in their program and the program's overall performance on the examination. This information can be used by the program director in reviewing and revising the educational components of the training program. It is also one of many factors taken into consideration when the residency program is reviewed to determine its accreditation status. The performance of each training program is published by the ABIM on its Web site. It is also possible for anyone to search the ABIM Web site to determine who is and is not certified in internal medicine.

The ABIM certificate is good for 10 years, and the dates of validity are noted on the certificate. Candidates who are unsuccessful on any certification examination may apply for reexamination. There is no restriction on the number of opportunities for reexamination.


1. Norcini JJ, Shea JA. The reproducibility of standards over groups and occasions. Applied Measure Educ. 1992;5:63-72.

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