How to Study for the American Board of Internal Medicine Exam

This blog was originally posted on February 26, 2020 and edited in November 2023 by Dr. James Boothe

How to Study for the American Board of Internal Medicine Exam (ABIM)

The American Board of Internal Medicine (ABIM) certification exam is a high-stakes standardized exam testing clinical reasoning, use of diagnostic tools, and treatment decisions. The exam tests your knowledge on common and rare diagnoses expected from a board-certified internist according to ABIM standards.

To set yourself up for success on the ABIM board certification exam, it is important to start early and practice often. In this post, we will discuss how best to study for your ABIM exam.

Set a Schedule

The American Board of Internal Medicine certification exam dates are in August every year. We recommend getting started with making a timeline. UWorld and MKSAP, two commonly used question banks, each contain over 1200 questions. You want to have time to do all the questions at least once. 

Start early! Many residents go on to fellowship or start working immediately after finishing residency in July, which undoubtedly is a busy time with moving and learning a new job. I recommend starting your studies in the January-February time frame. For the first three months, it is important to go through at least half of your question bank. This way, if you’re not getting the scores you need, you will still have time to look into other resources (tutors, online or live courses, alternate question banks, etc).

Below are some tips to building and sticking to a schedule: 

1. Block off time in your calendar for studying. This can be as little as 1 hour every evening starting February 1st to go through board study questions. 
2. Set weekly deadlines for yourself for questions and content. If you start your study plan in February, for example, a reasonable goal is to do 60 questions per week. At month-end, assess your progress, and adjust if you’re behind.

Familiarize Yourself With the American Board of Internal Medicine Website

The ABIM exam website has great resources. Review them before studying to understand the exam format and which content to focus on. This is publicly available information. For example, you can find the Internal Medicine Certification Exam Blueprint here, which outlines approximate content percentages along with specific topics within each disease category. There are also very useful tutorials on the ABIM website where you can familiarize yourself with the question interface and shortcuts, which can be found here.

What Study Tools Should I Be Using?

The most commonly used question banks are MKSAP and UWorld. They have different styles of questions and explanations but both hit on the content you need to study for ABIM.

MKSAP has books along with the question bank. Your local residency office or library may have a copy of the books, which have review questions in the back if you’d like to preview that format.

You can preview practice UWorld questions on their website to review the question format. UWorld’s questions are known for being somewhat more intricate and “tricky”. Ultimately, either resource will cover the sort of depth and breadth of information you need to study for the ABIM board certification exam. 

Here are some tips for getting the most out of your question bank:

Use Question Banks as a Study Tool

Each question has explanations as to why all answer choices are correct or incorrect. Read these even for the questions you get correct, as you may have gotten the question correct for the wrong reasons, or you might not be able to fully explain why the wrong answers are “wrong”. Do these question sessions in the untimed/tutor mode so you can learn from them at a careful and meticulous pace.

Subject-Specific vs. Randomized Practice Questions

Consider going through questions sequentially by subject area (e.g., infectious disease, cardiology, etc.). This can help you master each subject area one by one.

Some may prefer practicing questions in a randomized format to better simulate the test day experience and enhance preparation. It’s advisable to try both approaches as you begin your study regimen.

Strategic Approaches to Practice Questions

When you’re using practice questions, use test-taking strategies to help narrow down your answer choices. Take a quick, <5-second glance at the answer choices before reading the question. If you feel that looking at the answer choices first throws you off, an alternate strategy is to read through the question stem and answer it in your mind (without even knowing the answer options!), and look for that answer in the choices. It is important to read the question in its entirety for a hidden “not” or “unlikely” in the stem, or for that one pesky lab value or physical exam finding slipped in at the end of a long question body that truly changes everything diagnostically. 

Leveraging Resources for Continued Knowledge Growth

If you answer a question incorrectly, use resources like UpToDate, MKSAP books, PubMed, StatPearls, etc., to learn more. This broadens your ABIM exam knowledge and keeps you up to date for practical use in clinical practice.

Know Your Study Style

If you like reading content material to supplement your question bank, MKSAP’s accompanying books are a good resource. The MKSAP book set includes focused and detailed review books for each subfield. These can be useful for either targeted review of a given subfield (example: cardiology) if you are finding yourself particularly weak in that subject, or you could progress through all of the books if you find your overall knowledge foundation is just proving inadequate (though this would be QUITE the time and effort investment, so start early!). If you don’t prefer textbook-style reading, at least review the Board Basics book. It offers a concise outline of MKSAP content, providing a solid overview of the highly testable pathologies and processes in all internal medicine fields tested on ABIM.

The Importance of Timed Practice Exams in Your Study Routine

Create timed “practice exams” through your question bank using questions from all content areas. You can do this about every 3 weeks. Try your best to simulate a timed environment without distractions or interruptions and pace yourself like you would on the real test day. There are no formal practice tests for ABIM like there are from NBME for Step 1, so this is a great substitute. Always reach out for help if you aren’t seeing the scores or progress you need.  

Studying for the internal medicine board certification exam can be a nerve-wracking time, but if you start early and stick to a timeline, you’ll identify your weaker areas and be able to prepare better for them. If you need any help along the way to define a study strategy for your ABIM certification exam, or if you find yourself needing formal tutoring on certain subjects, contact or call us! Our ABIM tutors are happy to help your studying process.