Prepping for the ABIM Exam: An Internist’s Candid Perspective

To get to this point, you have successfully passed the MCAT, USM LE Step 1, USMLE Step 2 CK, USMLE Step 2 CS, and USMLE Step 3. You have poured blood and sweat into years of perpetual q3 or q4 call, surviving page-bombs by nurses, holding life-and-death conferences with overwhelmed family members, boosting the confidence of doe-eyed medical students and interns, and managing the inflated egos of attendings Security+ certification.

We go through all of this for the privilege of taking care of patients, to make a palpable difference in the lives of people who have entrusted their physical and emotional well-being to us. It’s certainly a heady task to take on. But before we can call ourselves truly independent, one last exam looms on the horizon: the American Board of Internal Medicine (ABIM) certification exam.

On the hierarchy of medical exams, the difficulty of the ABIM exam lies somewhere in the middle, below the MCAT and USMLE Step 1, but above USMLE Steps 2 and 3. And importantly, it is strictly pass-fail: either you get enough questions right and become board-certified, or you don’t and must retake the exam the following year. The percentile break-downs are for the egoists among us.

You’d think that a pass-fail test would endow test-takers with a sense of confidence. But if my colleagues from medical school and residency are any indication, then the ABIM test forces the re-emergence of the psychotic college pre-meds dormant in each of us. Sometimes panic ensues. Yet I’m here to tell you that at the end of the day, the vast majority of you will pass that the test, and become the newest members of a most exclusive guild: board-certified internal medicine physicians.

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