ITE Study Guide 2026
Everything you need to pass the ITE exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.
ITE exam key facts
- The IM-ITE has 300 questions in six sections of 50 items each, and its blueprint is modeled on the ABIM Internal Medicine certification exam. Source
- The IM-ITE session lasts 9 hours in total, with 7 hours of testing time (six 70-minute sections) plus optional breaks and a 60-minute lunch. Source
- The IM-ITE has no passing score and cannot be failed; it reports percent-correct scores and percentile ranks for self-assessment. Source
- The 2026 IM-ITE regular registration fee is $145 per registrant, paid by the residency program, and a $30 late fee per registrant applies after July 13, 2026. Source
- The IM-ITE is given once a year by each residency program, within a fixed testing window. Source
📋 ITE Exam Format at a Glance
📚 ITE Topics to Study (79)
✍️ Sample ITE Questions & Answers
1. A patient with a mechanical mitral valve prosthesis becomes pregnant. Which anticoagulation strategy is associated with the lowest risk of valve thrombosis?
Warfarin throughout pregnancy offers the most reliable anticoagulation for mechanical valves and the lowest thrombosis risk, though it carries fetal risks (especially in the first trimester).
2. Which test is most useful in the diagnosis of primary hyperparathyroidism?
The most useful diagnostic test for primary hyperparathyroidism involves measuring both serum calcium and parathyroid hormone (PTH) levels. In primary hyperparathyroidism, there is typically hypercalcemia (high calcium) accompanied by inappropriately elevated or normal PTH levels. This combination confirms autonomous PTH secretion, which is characteristic of the condition.
3. Which of the following is the most common cause of hyperthyroidism?
Graves' disease is the most common cause of hyperthyroidism, an autoimmune disorder where the body produces antibodies that stimulate the thyroid gland to produce excessive thyroid hormones. This leads to symptoms such as weight loss, heat intolerance, and palpitations. It is characterized by diffuse thyroid enlargement and often ophthalmopathy.
4. A patient with Cushing's disease undergoes transsphenoidal surgery. Post-operatively, serum cortisol is 2 mcg/dL. What does this indicate?
Very low post-operative cortisol indicates successful tumor removal but requires exogenous glucocorticoid replacement until the HPA axis recovers.
5. A 65-year-old man with bicuspid aortic valve has severe AR with LVEF 55% and LVESD 52 mm but no symptoms. What is the most appropriate management?
In severe AR, surgery is indicated when LVESD ≥50 mm (Class IIa) or ≥55 mm (Class I) even in asymptomatic patients to prevent irreversible LV dysfunction.
6. A 55-year-old man with idiopathic pulmonary fibrosis (IPF) has FVC 65% predicted and DLCO 48% predicted. Honeycombing is present on HRCT. Which medication has been shown to slow FVC decline in IPF?
Nintedanib (and pirfenidone) are the only FDA-approved antifibrotic agents that slow FVC decline in IPF; corticosteroids and azathioprine increase mortality in IPF.
🎯 Free ITE Practice Tests
📖 ITE Guides & Articles
- Family Medicine ITE Scores: Complete Guide for Residents
- Internal Medicine ITE Reddit: What Residents Are Actually Saying (and What Works)
- How to Study for the Internal Medicine In-Training Exam: Complete Resident Guide
- Internal Medicine ITE Score: Complete Guide to Understanding, Interpreting, and Improving Your Results
- ITE Exam 2025: The Complete Internal Medicine In-Training Exam Study Guide
- ITE Practice Test: Prepare for the Internal Medicine In-Training Exam
- IM ITE 2025: The Complete Internal Medicine In-Training Exam Study Guide
- IM ITE Results: How to Interpret Your Score and Build a Smarter Study Plan
What Practice Test Geeks adds beyond an AI chat for ITE
An AI chatbot can quiz you, but it can't reproduce the exam conditions or keep your record. Here you get:
- A timed, full-length ITE mock exam — 300 questions in 360 minutes with a 60% pass mark, modeled on the official exam's question count and time limit, followed by a score report broken down by exam domain.
- A fixed ITE question bank: the same test every attempt, so your score is comparable from one try to the next instead of changing with every regenerated quiz.
- Progress saved on your device: completed tests, scores and missed questions stay in My Progress, so you can retake only what you got wrong.
- A printable ITE cheat sheet you can print or save as a PDF.
- ITE flashcards built from the same question bank.
- Free ITE practice tests with the correct answer shown after each question.
How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- acponline.org — Test delivery, eligibility, retake policy, time limit, fees, passing score, exam information · verified Nov 2026