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He helped me prepare for my ABIM exam focusing on process and approach. We all know the information. Taking the test is a game, and Sean helped me figure out how to play it!
Kyle F.
The internal medicine ITE is the ACP Internal Medicine In-Training Examination, a roughly 300-question exam that residency programs give their residents once a year, inside a fixed late-summer window, to check progress toward the ABIM certification exam. It has no passing score and cannot be failed; programs get your percent correct, your percentile rank and the learning objectives behind the questions you missed (ACP IM-ITE).
That report is the most useful free diagnostic you will get before the boards. This page covers the format and dates, what the numbers mean, why ACP asks residents not to cram, and how to use your results to plan ABIM preparation.
Passing standard at a glance
| Topic | Official rule | Source |
|---|---|---|
| Pass or fail | None. ACP says the exam cannot be failed; it is used as an assessment only. | ACP: IM-ITE |
| Scoring | Only correct answers count and there is no penalty for guessing. Programs receive each resident's percent correct, percentile rank and a list of the educational objectives of questions answered incorrectly. | ACP: IM-ITE |
| Results | Preliminary reports go to program directors about 10 business days after the window closes; final reports roughly 4 to 6 weeks after. | ACP: IM-ITE |
| ABIM first-time pass rate | 86% of 10,743 first-time takers of the ABIM internal medicine certification exam passed in 2025. | ABIM: certification pass rates (pdf) |
IM-ITE format and the 2026 testing window
The testing day is 9 hours: 7 hours on the exam itself, several 10-minute breaks and a 1-hour lunch, with roughly 300 questions spread across the internal medicine subspecialties and general internal medicine (ACP). It is written by a committee of 11 physicians and modeled after the ABIM certification exam (ACP).
Your program, not you, registers and schedules it. The 2026 window ran from Thursday, Aug. 13 to Friday, Sep. 4, and programs could test on one day or several, in person or by remote proctoring (ACP 2026 information sheet). A few weeks before the window an online practice exam opens so you can see the interface (ACP); take it, because a new screen layout costs time you would rather spend on questions.
How IM-ITE scores work
Only correct answers count, so answer every question; there is no penalty for guessing (ACP). Programs receive a preliminary report about 10 business days after the window closes and the final report roughly 4 to 6 weeks after (ACP). Ask your program coordinator for your copy if it does not reach you.
The report gives two numbers and a list. Percent correct is your raw share of questions right. Percentile rank shows where that share puts you among the other residents who took the exam. The list of missed educational objectives is the part most residents skip, and it is the part that tells you what to study.
ACP does not publish an ITE score that predicts passing the ABIM, and it says the ITE should not be used as a qualification for that exam (ACP). Treat a low percentile as an early warning, not a forecast.
Should you study for the internal medicine ITE?
ACP's answer is no: for the most accurate assessment, it advises residents not to study for the exam or change their study habits for it (ACP). We agree. The ITE is worth most as an honest snapshot of what you know in the middle of training, and cramming for it gives you a flattering number that tells you less.
What you can do without distorting the result: take ACP's practice exam to learn the interface, sleep before test day, and treat the 7 hours as a stamina rehearsal for the ABIM, which runs about 10 hours. ACP also says the ITE should not be used in decisions on fellowship positions or in letters of recommendation (ACP), so there is little to gain from gaming it.
Using your ITE report to plan for the ABIM
The ITE report becomes useful the week it arrives. Sort the missed objectives by subspecialty, then set them beside the ABIM blueprint: cardiovascular disease is 14% of the certification exam, and endocrinology, gastroenterology, infectious disease, pulmonary disease and rheumatology/orthopedics are 9% each (ABIM blueprint). A weak area that is also heavily weighted goes first.
For a PGY-1 or PGY-2, the report shapes a light, steady plan: a small block of questions on most days, tied to the rotations you are on. For a PGY-3, it marks where the final months before the August ABIM exam should go. In 2025, 86% of first-time ABIM takers passed (ABIM pass rates); the ITE is the cheapest way to find out early whether you are on track to be in that group.
Read the report for patterns as well as topics. If your misses cluster late in the day, the fix is stamina and timing. If they are spread across every subspecialty, the fix is usually how you work a question rather than more content.
Where tutoring fits
We do not coach residents to cram for the ITE. We use it. Sean Moazezi, a board-certified internist, works with internal medicine residents on ITE results and ABIM preparation: you bring the report, and the first session turns the missed objectives into a weekly plan that survives a call schedule. Sessions are one-on-one by live video (Zoom or Google Meet), a scribe writes up each one, and the plan is adjusted as rotations change.
If you are closer to the boards, read about ABIM tutoring, or, if a past attempt did not go to plan, what to do after failing the ABIM.