The ABIM Internal Medicine Board Exam 2026 is one of the most difficult exams that a physician can take. It consists of 240 case-based questions that test a doctor's ability to make a diagnosis, identify and issue necessary tests, interpret results, recommend treatment, and understand the underlying pathophysiology of disease applicable to patient care.
Prepare for the Internal Medicine Exam exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
The Royal College internal medicine exam is a knowledge and clinical skill-centric examination that assesses candidates’ readiness to practice. It is a valuable qualification for doctors in the UK and around the world. For nursing exam prep, see our NCLEX practice test. For nursing exam prep, see our MCAT practice test.
The content of the exam is based on a blueprint that reflects the competencies in general internal medicine, to ensure that it reflects relevant clinical practice. The content is also balanced to ensure that it reflects the depth of knowledge required for the subspecialty.
All questions are developed and reviewed by the internal medicine examination board, which is made up of practicing Canadian physicians. They are recognized content experts in the field and are responsible for ensuring that the questions reflect the depth of knowledge required to qualify as a fellow.
In addition, the examination is subject to review by a quality reviewer and linguistic reviewer for translation accuracy. This ensures that the content reflects the standard terminology appropriate to the subspecialty.
In addition to the core knowledge, candidates will be asked to answer short-answer questions (SAQs). These are typically multiple-choice and require a small amount of time for the candidate to provide an answer. These questions are assigned a score by the examiners.