Written Exam


The following requirements must be met in order to be eligible to apply for the Early Entry pathway to the Internal Medicine Certification exam:

    • Third-year Internal Medicine residents must have participated in the ACOI in-training exam during each of the first two years of internal medicine residency
    • An anticipated training completion date of Aug. 31, 2020 or earlier

The following training requirements must be completed before a candidate may sit for the Written Exam for primary certification in Internal Medicine:

  • Demonstrate clinical competence in the practice of internal medicine by submitting a copy of your residency Program Director’s Report form by Aug. 1 of the year you will take the exam.
    • Complete 12 months of a non-medicine track internship followed by 36 months of an internal medicine residency (not necessarily running 36 consecutive months). Candidates may receive advanced standing credit for training in the internship which has been granted by the ACOI, which may be applied towards the 36 months of internal medicine residency requirement.
    • 12 months of a medicine track internship followed by 24 months of an internal medicine residency or 36 months of an internal medicine residency.
    • 12 months of an AOA-recognized internship followed by 48 months of a combined emergency medicine/ internal medicine residency training program. The residency training must contain 24 months of emergency medicine and 24 months of internal medicine and meet the basic requirements for training as approved by the AOA.
    • 48 months of a combined internal medicine/pediatrics residency training program. The residency training must contain a minimum of 24 months of internal medicine training and 18 months of pediatrics training and meet the basic requirements for training as approved by the AOA.
  • Adhere to the AOA Code of Ethics.
  • Submit a Program Director’s Report Form that shows clinical competence.


Once training requirements for eligibility are met, candidates must submit the following:

  • A completed application.
  • Required fees.
  • Initial applicants and applicants who have not completed their training must submit a Program Director report verifying clinical competence and expected completion date of training.
  • If you completed your training in an ACGME residency program, you must submit a letter from the AOA stating that the ACGME residency training has been AOA-recognized.

Exam Fees

An exam fee of $800 must be submitted with your completed application. No application will be considered complete until all fees have been paid. Exam applications submitted after June 1 will incur a $200 non-refundable late fee. No applications will be accepted after July 1. All cancellations must be made in writing. No exam fees are refunded unless the candidate withdraws from the examination process, which will result in a loss of board eligibility. Otherwise, candidates’ fees are credited toward the next year’s examination, less the applicable cancellation fee, and will remain board eligible until June 1 of the following year. Cancellation fees are as follows:

  • Before June 1: $100 cancellation fee
  • Between June 1 and July 1: $400 cancellation fee
  • After July 1: $800 cancellation fee

Exam Dates and Deadlines

The early entry pathway to the Internal Medicine Certification exam is offered to third-year Internal Medicine residents March 30 – April 4, 2020. The application period is open now and will close March 13, 2020.

The Internal Medicine Written Exam is offered in September at Prometric testing sites around the country. The application period opens the previous year, starting in December. Candidates will receive information on how to register with Prometric once their application is deemed complete.

Exam Content Outline

The Internal Medicine Written Exam tests the knowledge and understanding of basic science and clinical knowledge, skills and principles critical to the practice of Internal Medicine. The seven-hour exam consists of 320 multiple choice questions in the below areas: Primary Certification

Primary Certification
  1. 1. Allergy/Immunology
  2. 2. Cardiovascular disease
  3. 3. Endocrinology
  4. 4. Hematology
  5. 5. Gastroenterology
  6. 6. Oncology
  7. 7. Nephrology/Hypertension
  8. 8. Rheumatology
  9. 9. Pulmonary diseases
  10. 10. Infectious disease
  11. 11. Dermatology
  12. 12. Otorhinolaryngology
  13. 13. Neurology
  14. 14. Obstetrics/Gynecology
  15. 15. Ophthalmology
  16. 16. Psychiatry
  17. 17. Miscellaneous
    • 1-5%
    • 10-14%
    • 7-11%
    • 4-8%
    • 9-13%
    • 6-10%
    • 8-12%
    • 6-10%
    • 9-13%
    • 8-12%
    • 1-4%
    • 1-4%
    • 2-6%
    • 1-4%
    • 1-4%
    • 1-4%
    • 1-4%
  1. 18. Adolescent medicine
  2. 19. Bioethics
  3. 20. Critical care medicine
  4. 21. Clinical epidemiology
  5. 22. Disease prevention
  6. 23. Geriatric medicine
  7. 24. Nutrition
  8. 25. Occupational medicine
  9. 26. Substance abuse
  10. 27. OMM/OMT
  • 1-4%
  • 1-4%
  • 1-4%
  • 6-10%
  • 1-4%
  • 2-6%
  • 3-7%
  • 1-4%
  • 1-4%
  • 1-4%

Exam Scoring

The AOBIM sets passing standards for the Written Exam using a measurement model known as “criterion-referenced standard setting.” Using this model, the board specifies the particular content and level of content difficulty necessary to be considered a passing candidate. All examination results will be reviewed by the board. Results will be released electronically through the AOBIM’s application portal. Candidates must be program-complete and maintain AOA membership in order to access electronic results.