IM-ITE® | Internal Medicine In-Training Examination® (2024)

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The ACP Internal Medicine In-Training Examination® is a web-based self-assessment exam designed for residency programs to assess the progress of their residents during training.

The 2024 regular registration period will begin on May 1, 2024.

The 2024 IM-ITE testing window datesare Thursday, August 15, 2024 through Wednesday, September 4, 2024, excluding Monday September 2, 2024 (Labor Day).

Programs will have the option for in-person testing or remote proctoring and testing or a combination of both, using third-party software.

The regular registration fee for the 2024 IM-ITE will be $135 per registrant through July 15, 2024. An additional $30 fee will be charged per registrant starting July 16, 2024.

For more details about the IM-ITE, please read the important information below, including FAQs:

Useful Information for the 2024 IM-ITE

New to the IM-ITE? Learn about the registration process.

Important dates for the 2024 IM-ITE:

Registration: begins May 1, 2024.

Test Administration Window: All programs are welcome to test one day or each day during the entire testing window*, August 15, 2024 – September 4, 2024, excluding Labor Day.
*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.

About the Exam

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 2024 exam will be administered from Thursday, August 15, 2024 – Wednesday, September 4, 2024 (excluding Labor Day: Monday, September 2, 2024).

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 an educational exercise. It should not be used in the following ways:

  • For decisions concerning residency or fellowship training positions
  • As a qualification to take the American Board of Internal Medicine Certification Examination
  • By outside regulatory agencies for the purpose of assessing resident knowledge or the quality of training programs
  • In letters of recommendation for residents

For Examinees

The goal of the IM-ITE® is to gauge progress in training. For the most accurate assessment, you are advised not to study for this exam.

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 or program coordinator of any special needs as soon as possible so they can request them for you. The strict deadline for special accommodation requests is July 26, 2024.
  • 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.

Practice Exam

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 have roughly 300 questions.
  • There is no penalty for guessing an answer, and the exam cannot be failed. Only questions answered correctly are counted toward your score.
  • The exam will cover a number of subspecialties, including General Internal Medicine.

After the Exam

  • Final score reports will be made available online to program directors and coordinators roughly 4 to 6 weeks after the exam window closes.
  • Programs will receive a report that shows the percentage of questions correct for each examinee as well as each examinee's percentile rank.
  • The report will also include a list of educational objectives of questions answered incorrectly.

For Program Directors and Chief Proctors

Technical Requirements

The following requirements are necessary to administer an NBME web-based examination. (Updated June 24, 2024)

Dedicated Technical support staff with administrative rights is required at the test site prior to and on test day(s).


Mac OS


  • Windows 10, Windows 11
  • 1GHz processor or higher
  • 17” or larger color monitor (Desktops)
  • 13” screen or larger (Laptops)
  • Minimum screen resolution of 1024x768 is required with 32-bit color setting
  • Virtual machines and applications are not allowed
  • iPad/tablets are not allowed
  • ASUS Laptops with touchpad/touchscreen are not allowed
  • Mac OS version 10.15, v11.0, v12.0, v13.0
  • 1GHz processor or higher
  • 17” or larger color monitor (Desktops)
  • 13” screen or larger (Laptops)
  • Minimum screen resolution of 1024x768 is required with 32-bit color setting
  • Virtual machines and applications are not allowed
  • iPads/tablets are not allowed


  • Edge1
  • Chrome1
  • Firefox1
  • Do not use beta versions. Other browsers are not supported.
  • Safari 13 or higher
  • Chrome1
  • Firefox1
  • Do not use beta versions. Other browsers are not supported.

Browser Settings

  • JavaScript Enabled
  • Cookies Enabled
  • CSS Enabled
  • Pop-ups Enabled
  • TLS 1.2 or higher
  • JavaScript Enabled
  • Cookies Enabled
  • CSS Enabled
  • Pop-ups Enabled
  • TLS 1.2 or higher

Internet Connection

  • Broadband Internet connection (DSL, Cable or T1)
  • Network bandwidth per workstation
    • 256Kbps or higher for onsite testing
    • 1 mbps or higher for remote testing
  • Disable Toolbars, Adware or Spyware programs. They may adversely affect the computer’s performance and cause delays in loading test questions.
  • Turn off Windows, virus scanner, and Citrix Workspace updates to avoid interruptions during testing.
  • 1Chrome, Edge, and Firefox support is limited to the current version plus one previous version due to forced automatic updates.
  • NBME does not support the use of other browsers and operating systems. Other browsers and operating systems have not been tested for their compatibility and some features may not work as expected. NBME is not responsible for any system issues that are related to the use of unsupported browsers or operating systems.

The Secure Browser

A secure browser is required to administer a web-based exam. It “locks down” the computer, preventing the examinee from accessing applications such as email or notepad. The secure browser application requires administrator rights to install for the first time and may be downloaded before or on test day from the examinee URL.

Workstation Certification for fixed Workstations or Institutional laptops

The NBME provides a utility that checks the computer for web-based testing compatibility and launches a sample test. This utility must be run on each computer in the testing room prior to test day. The Workstation Certification utility is sent via email from ACP to the Chief Proctor at 14, 7, and 3-day intervals prior to test day. Do not forward this email to examinees – it is for institutional use only.

Workstation Certification for Examinees with Personal Laptops

Examinees with personal laptops are required to run a separate Workstation Certification check. Prior to test day, Chief Proctors should forward the URL and Workstation Certification instructions from the ‘Prior to Test Day’ section of the Chief Proctor's Manual to examinees.

Examinees with personal laptops should also be advised to arrive early on exam day to re-run Workstation Certification to detect any problems with the local firewall.

Extra Workstations/ Laptops

Extra workstations/laptops should be available to replace computers that may malfunction during the test session. These spares should be enabled for wired and wireless LAN use.

If you have questions or concerns, please

Responsibilities of the Program Director

The program director is responsible for the following:

  • Ensuring compliance with the program schedule and for coordinating examination administration;
  • Completing registration in the MyNBME Services Portal and submitting the Program Registration Confirmation and payment;
  • Securing a computer lab/testing room for examination administration;
  • Securing appropriate number of proctors and workstations for examinees;
  • Assuring system requirements on each examinee workstation;
  • Arranging for IT staff at test sites to assist with any hardware/software problems before and during test administration; and
  • Maintaining examination security.

Responsibilities of Chief Proctors - Before Test Day

Prior to test day

  • Secure computer lab/testing room for exam administration if you are administering at your institution
  • Designate a Chief Proctor computer workstation in the computer lab or testing room
  • Arrange for IT staff at the test site to assist with any hardware/software problems before and during test administration
  • Assure System Requirements are met on each examinee workstation and on Chief Proctor workstation
  • Assure appropriate number of Assistant Proctors and workstations for the number of examinees testing each day
  • Select Assistant Proctors for the test session (one for every 20-25 examinees)
  • Assure standard testing room arrangements as outlined in Chief Proctor’s Manual or in a manner that best accommodates your testing room
  • Review Chief Proctor’s Manual and Instructions for Remote Administration provided by NBME
  • Ensure the Workstation Certification utility is run on each fixed workstation and institutional laptop
  • Forward a link to the examinee version of the Workstation Certification utility to any candidates who will be testing on their personal laptops
  • Practice monitoring a sample exam on the Chief Proctor Resource site using the username and password provided by NBME

Responsibilities of Chief Proctors - On Test Day

On Test Day

  • Prepare examinee workstations – boot up each workstation in the testing room
  • Log in to the Chief Proctor Resource site with username and password and enter test session information
  • Admit examinees to the testing room; distribute Examinee Instruction Sheets, which includes examinee login information
  • Provide examinees with Examinee Startup Code for launching the exam (this code is generated from the Chief Proctor’s workstation)
  • Monitor the testing session on the Chief Proctor’s workstation and report any incidents on the Test Administration Report (contact NBME if support is needed)
  • Ensure examinees return to the correct workstation after each break
  • End the exam session and complete the Test Administration Report

Scoring Reports

Examination Feedback and Appropriate Use

Examination results are made available to program directors only via the MyNBME Services Portal for distribution to examinees approximately 5 weeks after the examination is administered; each examinee should receive from their program director a print-out of an individual performance report that contains a percent correct score for the total test and for each content area, a percentile rank for the total test and for each content area, and educational objectives for questions answered incorrectly. Additionally, each examinee should receive from their program director the full listing of educational objectives and a Performance Interpretation Guidelines document describing the individual performance report.

In the MyNBME Service Portal, each program director will have access to a graph showing the distribution of average examinees’ scores for training programs (based on PGY 2 examinees); additional graphs showing the distribution of examinees’ scores at each PGY level (PGY 1, 2, 3, and 4); a program performance report listing average percent correct scores and percentile ranks for all programs and for the program director’s program for the total test and for each content area at each PGY level; for every item, the percentage of examinees who answered correctly in all programs and in the program director’s program at each PGY level; the full listing of educational objectives; an electronic downloadable scores roster of the program director’s examinees; and a Performance Interpretation Guidelines document that includes norm data at each PGY level by program type.

In addition to the scores and data provided to programs as described above, preliminary percent correct total test scores (i.e., percentage of correctly answered questions for the entire examination, but not for the content area subscores) for every examinee within the program will be provided to the program director 5 business days from the last day of the examination administration window. Please note that preliminary percent correct total test scores are subject to change upon provision of official score reports due to quality control analysis.

Program directors are urged to develop a broad-based evaluation process both for the examinees and the program. Examination scores can be a useful element in this evaluation as a measure of cognitive knowledge. Other important factors that should be evaluated include attitudes, relationships with patients, problem-solving skills in a clinical setting, technical skills, teaching skills, and the ability to interact effectively with other members of the health care team.

Individual examinee results may be helpful in identifying areas of deficiency and for planning improvements. In addition, the program director might find it helpful to review results to identify potential areas of program weakness and strength.

ACP or NBME will not provide individual score reports directly to examinees.

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.

Questions about Performance Feedback reports should be addressed to


The Process

The 2024 regular registration period will begin May 1, 2024. Regular registration will end July 15; an additional $30 fee per registrant will be charged starting July 16, 2024.

Programs that have previously participated in the IM-ITE: program directors and coordinators listed from the previous year will receive an email providing access to the registration portal. Program Directors and coordinators both have access to the MyNBME portal and will be able to update their existing roster of residents with additions and deletions themselves, along with updates to administrative contacts. If the program director or coordinator has changed since last year and have questions on how to update the contacts themselves, please contact ACP at to ensure you receive the initial registration email.

If your Program hasn't participated in the IM-ITE before, contact us to receive a Program Information Form at through July 14, 2024, when 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.

Still Have Questions?

For general information about the IM-ITE, call 215-351-2553 or 215-351-2568.
You can also send us an email at

Read the FAQ

IM-ITE® | Internal Medicine In-Training Examination® (2024)
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