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The ACP Internal Medicine In-Training Examination® is a web-based self-assessment exam for residents to assess their progress.

The IM-ITE® is developed by a committee of 11 expert physicians and is used by residency programs to assess their residents’ strengths and areas in need of remediation during training and in preparation for their initial certification exam. It is modeled after the American Board of Internal Medicine's certification exam. The exam is administered annually by each training program during a strictly prescribed period.

The exam is designed to:

• Give residents an opportunity for self-assessment
• Give program directors the opportunity to evaluate their programs
• Identify areas in which residents need extra assistance

The IM-ITE is designed for residents at the midpoint in their training, but over 35,000 PGY1, PGY2, and PGY3s participate each year. In addition, faculty members, program directors, and other physicians may take the examination. If you are unaffiliated with a program, but would like to take the IM-ITE, you must find a program that will permit you to take the exam along with their registrants.

• If your Program hasn't participated in the IM-ITE before, contact ACP to receive a Program Information Form at IM-ITE@acponline.org before regular registration closes. The program director and coordinator will then be provided access to the registration portal, detailed registration instructions, and will be asked to enter the roster of residents and administrative contacts for the first time.
• Be sure that the individual who will assist with the administration of the IM-ITE reads the information provided on ACP’s IM-ITE web page as well as all the directions provided for the registration process.

The IM-ITE consists of 300 questions and is modeled after the blueprint for the American Board of Internal Medicine’s certification exam. Here is the breakdown of topics:

Progams will have the option for in-person testing or remote proctoring and testing or a combination of both, using third-party software (Zoom, MS Teams, or Webex).

Regular registration - May 1, 2024, through July 15, 2024: $135 per registrant
After July 16, 2024: additional $30 per registrant

After programs submit their roster, they can generate the Program Registration Confirmation to pay by check, credit card or pro-forma invoice. Also, 5-7 business days after submission of your roster, a formal emailed ACP invoice is automatically sent to the Program Director listed in the MyNBME portal. Payment is due 14 business days after registering examinees. For questions related to invoices and payment, please contact ACP Member and Product Support at 1-800-ACP-1915 (1-215-351-2600 outside the USA/Canada) or by email at help@acponline.org. They are available Monday – Friday, 9am-5pm EST, excluding holidays. Please allow for 2 business days after you submit your roster to call ACP Member and Product Support.

Please contact ACP Member and Product Support, Monday-Friday; 9am-5pm EST at 1-800-ACP-1915 (USA & Canada) or 1-215-351-2600 (outside of USA & Canada) or by email at help@acponline.org. If you know your IMITE program ID, please have it handy to expedite the process.

Score reports will be withheld for the current year’s examination until the arrears are paid. Please note that ACP makes every effort to contact programs that are in arrears prior to the release date of the current year’s test scores.

If you have questions concerning payments or invoices, please contact ACP Member and Product Support, Monday-Friday; 9am-5pm EST at 1-800-ACP-1915 (USA & Canada) or 1-215-351-2600 (outside of USA & Canada) or by email at help@acponline.org. If you know your IMITE program ID, please have it handy to expedite the process.

The �鶹ֱ��app has a strict no-refund policy for the IM-ITE. Once you have registered your examinees and paid, your payment cannot be refunded. However, if you registered examinees and they do not take the exam, you may apply the resulting credit to any walk-ins or substitutions.

If you have questions, please contact ACP Member and Product Support, Monday-Friday; 9am-5pm EST at 1-800-ACP-1915 (USA & Canada) or 1-215-351-2600 (outside of USA & Canada) or by email at help@acponline.org. If you know your IMITE program ID, please have it handy to expedite the process.

• Registration: Regular registration will open May 1, 2024 through July 15, 2024. Starting July 16, 2024, an additional $30 fee will be charged per registrant.
• Test Administration Window: All programs are welcome to test one day or each day during the entire testing window, Thursday, August 15, 2024 – Wednesday, September 4, 2024 (excluding Labor Day: Monday, September 2, 2024).
• Chief Proctor Manual release: July 23, 2024.
• Work Station Certification email: July 26, 2024.
• Examinee Instruction Sheets available: July 30, 2024.
• Post exam roster verification email: September 5, 2024. After the testing window closes, programs will receive an email reminding them to verify (and possibly update) the biographic information for each registrant. This will be performed by the program and not NBME or ACP.
• Preliminary exam feedback sent to Program Directors: September 11, 2024.
• Score reports and feedback posted to portal: October 14, 2024. Please note: score reports are not released directly to resident-examinees.

Although the registration process requires programs to identify a specific date or dates of testing, once registered, programs can reschedule their residents during any day of the test administration window, regardless of the date or dates identified during registration, and without contacting ACP or the NBME.

No. It is a secure exam and technical support staff are only available during the exam window. The exam is shut down after the last day of the exam window.

Programs select the day(s) that are convenient for all staff and examinees within the exam window. It is common for large programs to test on more than one day. Programs have the freedom to choose new or different dates for the exam – if they are within the exam window – without contacting the NBME or ACP. We suggest that programs schedule earlier during the exam window so there is flexibility to choose an additional date if necessary. The goal is for a uniform and secure test administration environment.

The total test session time is 9 hours. There are 6 sections consisting of 50 items each. Examinees will have 70 minutes of testing time for each section, with an optional 10-minute break after test sections 1, 2, 4, and 5, and an optional 60-minute lunch break at the end of test section 3. There is an optional 15-minute tutorial at the start of the exam, a 5-minute Biographic Information Survey following the Tutorial, and an untimed Resident Survey at the end of the examination.

Each site must have one Chief Proctor and may have an unlimited number of additional proctors depending on the needs of the Chief Proctor. The Chief Proctor is responsible for performing any actions that affect ALL examinees, such as starting the exam session, ending the exam session, and submitting the Test Administration report via the Chief Proctor Resource Site. The Chief Proctor is also responsible for recruiting Assistant Proctors for the test session.

An Assistant Proctor who is assisting a Chief Proctor in the same testing room does not require a dedicated computer station; however, an Assistant Proctor who is assigned to a separate testing room requires his or her own computer workstation to monitor the exam. Assistant Proctors may also relieve the Chief Proctors and other Assistant Proctors monitoring exam rooms to allow them to take breaks. Assistant Proctors who are being recruited to simply circulate and monitor examinee behavior do not need a separate login. Both Chief and Assistant Proctors should be identified during registration.

Programs Directors/Coordinators/Administrators should select Chief Proctors to monitor the exam and provide them information on their general responsibilities, exam dates, and time commitment required. Providing this information to Chief Proctors is important so that they are prepared to receive the Chief Proctor's login information and can schedule time to monitor the exam.

In late July, ACP will email Chief Proctors login information and a link to the Chief Proctor's Manual, which will contain instructions on how to perform the workstation certification process, distribute examinee instruction sheets, and a link to the examinee practice exam. It is strongly suggested that the Chief Proctors read the manual thoroughly. Approximately 14 days before the exam administration, Chief Proctors will receive the ticket number and URL necessary for accessing the workstation certification utility. This utility will check workstations for compatibility with web-based testing and must be run on all institutional and student-owned laptops that will be used for the exam.

The Chief Proctor should schedule a meeting with all proctors prior to test day. The following items should be reviewed at the meeting:

1. The examination time schedule and all administrative procedures
2. The location of the test site and the time Assistant Proctors are to report to the test site
3. The functionality of the computer testing system
4. The tasks assigned to each Proctor or Assistant Proctor
5. Procedures for identifying and admitting examinees into the examination
6. Procedures for handling walk-ins (any examinee that was not pre-registered)
7. Handling late arrivals
8. Procedures for the distribution and collection of Examinee Instruction Sheets
9. Ensure that examinees return to the same workstation after breaks

The Chief Proctor’s Manual is divided into four major sections: Prior to Test Day, On Test Day, Using the Proctoring Software, and Managing the Test Session. Each section includes a checklist that can be used as a quick guide to prepare and administer the exam. For example, the Chief Proctor can use the “On Test Day” and “Using the Proctoring Software” checklist along with the Troubleshooting tips and reference materials in the “Appendix” as a quick start guide on test day.

Section 1: Prior to Test Day covers important pre-administrative tasks such as Workstation Certification that must be performed prior to test day.

Section 2: On Test Day covers the tasks that must be performed on test day prior to the start of the exam.

Section 3: Using the Proctoring Software explains how to use the Chief Proctor Resource site to administer the exam.

Section 4: Managing the Test Session provides general information on monitoring examinees on test day.

Appendix: the appendix includes troubleshooting tips and other important supplementary information for administering the exam.

Contact NBME Test Administration Services as follows for questions concerning workstation certification, the proctoring software, or the administration of the exam:

Prior to Test Day
215-243-3919
E-mail: nbmewebtest@nbme.org

On Test Day
215-243-3707

Examinee instruction sheets can be printed out up to and including exam day using the MyNBME portal and should include blank sheets for this purpose. Examinee instruction sheets for registrants added after initial registration can also be printed from the MyNBME portal. Misspellings on the Examinee instruction sheets do not affect scores and can be corrected during the Roster Verification Process. Please contact ACP at IM-ITE@acponline.org with any additional questions.

After the exam administration, an email will be sent to programs as a reminder of the Roster Verification Process. Programs will have the opportunity to review, update and verify the biographic information on their registration roster. This is a very important opportunity for correction of any inaccuracies as the information provided on the verified roster is an exact representation of how it will appear on the score report. This information will also be used to compute examinee percentile ranks. Changes cannot be made after the roster verification deadline.

The examination is neither a qualifying nor a certifying instrument. It should not be used for determining who should be promoted, who should be eligible to take the American Board of Internal Medicine certifying examination, or who may be qualified for post residency fellowship training. It is designed only as a self-assessment tool.

However, program directors are encouraged to include IM-ITE results in semiannual reviews of resident performance and reporting on attributes of the Medical Knowledge competency. As part of the Internal Medicine Milestone Project, this activity may contribute to a residency program’s participation in the Next Accreditation System (NAS) to determine the overall progress of residents. The release of any score, either at an individual or aggregate level, to any person or organization outside the residency program, is strictly prohibited.

The MyNBME portal will only provide the reports for the prior 2 years, so we strongly suggest saving the score reports in a secure, known, and accessible location for reference by current and future administrative staff.

The prior 2 years’ score reports are in the MyNBME portal under Performance Feedback. Program Coordinators and Directors should have already been given access to this portal at the start of the registration period.

Requests for score reports that are beyond 2 prior test administrations are subject to a $50 administration fee per year and require 3-4 weeks for delivery.

Score reports are only provided to a program’s verified administrative staff. Under no circumstances are they provided to a current or prior examinee.

For further assistance, please contact Kim Kerns at 215-351-2568 (kkerns@acponline.org) or Chuck Graver at 215-351-2553 (cgraver@acponline.org).

• Be sure to communicate the date(s) the examination will be administered.
• Inform the examinees of the practice test; forward them the URL as found in the Chief Proctor Manual.
• Personal items will not be allowed at the computer workstation during the examination, including computer devices, smart phones, backpacks, coats, calculators, and food. Scratch paper will be provided by the proctor prior to the examination and collected afterwards. For a full listing, please refer to the Chief Proctor Manual.
• Examinees must return to the same workstation after each break.
• The score reports will be available to program directors by late October. Examinees should not contact the ACP or NBME directly to ask for their scores.

The Disability and Authorization Form will be available on the MyNBME registration site with directions for its use, along with a list of permitted special arrangements. Be sure that all paperwork is submitted before the deadline listed on the form. If you have additional questions concerning Special Accommodations, please contact Kim Kerns at kkerns@acponline.org.

Residents who will be on rotation, on vacation, or out of town on the scheduled examination day should be encouraged to return to their parent institution for the examination.  If this is not possible, the program director must take responsibility for making alternative arrangements at an alternative test site.

The program director of the parent institution should contact the program director of the alternative test site before the registration period closes and arrange for the resident to take the examination there.  Any resident testing at an alternate test site must be included on the Registration Roster of the parent institution with the appropriate alternate test site indicated. Please enter the correct residency program code number and program name in the Alternate Center column if an alternative test center is authorized. This will ensure that the Examinee Instruction Sheets for these residents are sent to the alternate testing location and the scores are reported to the parent institution.

The parent institution is responsible for payment for residents who take the examination at an alternative test site. If appropriate arrangements are not made before the deadline, the resident may not be able to take the examination.

Yes. Your test center would be considered an Alternate Center in the case of this examinee. The program director of the parent institution should contact your program before the registration period closes and arrange for the resident to take the examination.  Any resident testing at an alternate test site must be included on the Registration Roster of the parent institution with the appropriate alternate test site indicated. Please enter the correct residency program code number and program name in the Alternate Center column if an alternative test center is authorized. This will ensure that the Examinee Instruction Sheets for these residents are sent to the alternate testing location and the scores are reported to the parent institution.

The parent institution is responsible for payment for residents who take the examination at an alternative test site. If appropriate arrangements are not made before the deadline, the resident may not be able to take the examination.

You are welcome to register examinees after the early registration window has closed at any time during the exam administration window, up to and including exam day. Using the MyNBME Portal, add examinees to your roster and submit them just like your initial examinees. The program director will receive an emailed invoice for any additional examinee registration fees. After the early registration window has closed, each examinee will be charged an additional $30 fee (added to the regular registration fee). If you would like to request or pay for an invoice, please contact ACP Member and Product Support, Monday – Friday, 9am – 5pm ET at 1-800-ACP-1915 (USA/Canada), 1-215-351-2600 (outside USA/Canada), or help@acponline.org. If you know your IMITE program ID, please have it handy to expedite the process.

Walk-in registration is discouraged.  However, if previously unregistered individuals request participation on the day of the examination and computer workstations are available, they may be permitted to take the examination. Note: Instructions for admitting Walk-In Registrants are included in the Chief Proctors Manual.  A unique ID Number will be assigned to each Walk-In Registrant on the day of the examination when the proctor enters the examinee’s information on the Chief Proctor Resource Site.  Be sure to include the email address for all faculty, practitioners, and other nonresidents who are Walk-In Registrants, and verify that the parent institution’s six-digit IM-ITE residency program code is correct. The parent institution is responsible for payment for residents who take the examination as Walk-Ins.  The parent institution’s program director will be billed for their Walk‑In examinees.  Fees paid during registration for pre-registrants who do not complete the examination are not refundable but can be applied to Walk-In examinees and examinees who are added after the registration deadline. An additional $30 will be charged for each applicant registered after the deadline, as well as for Walk‑In registrants. If you have questions on the day of the exam, please contact the NBME at 215-243-3707.

Before the Exam

• You are advised not to augment your study habits for the purposes of taking this exam.
• Special accommodations for those who need them can be made ahead of time. Be sure to alert your program director of any special needs as soon as possible. There is a strict deadline for this process approximately one month before the exam window opens.
• Nursing mothers: ask your program about the “Stop the clock” option.
• If you require timed medication breaks:  ask your program about the “Stop the clock” option.
• A few weeks prior to the testing window, you will be able to take the online practice exam to familiarize yourself with the online testing process.
• Examinees should not contact the ACP or NBME directly, but direct their questions to their program directors or coordinators.

Exam Day

• The total testing time will be 9 hours.
• There will be 7 hours devoted to the exam itself, plus several 10-minute breaks and a lunch hour.
• The exam will consist of 300 questions, 260 of which are scored and 40 of which are unscored practice items.
• There is no penalty for guessing an answer. Only questions answered correctly are counted toward your score.
• The exam will cover a number of specialties as well as general internal medicine.
• Be sure to return to the same workstation after each break.

After the Exam

• The score reports will be available to program directors by late October.
• Programs will receive a report that shows the percentage of questions correct for each examinee as well as each examinee's percentile rank.
• Residents will also receive a report from their program listing the educational objectives of questions they answered incorrectly.
• Examinees should not contact the ACP or NBME directly to ask for their scores.

Click on the Manage Exams option on the on the upper navigation ribbon within the MyNBME portal and then click on Other Information. You’ll find the Program List there. Please note that if your program is taking the IM-ITE for the first time, it might not be listed this year.

The Program ID is unique to your residency program and will assist in locating your program promptly and accurately under a variety of circumstances.

• Send us an email (preferred) at IM-ITE@acponline.org, or
• Call 215-351-2553 or 215-351-2568 (Monday – Friday; 9am – 5pm ET.)

If you know your IM-ITE program ID, please provide it or have it handy to expedite the process.