2026 ABIM Exam Blueprint

You can’t predict which specific questions will appear on the ABIM Certification Exam and the Longitudinal Knowledge Assessment (LKA), but ABIM provides a content outline, or blueprint, of information you can expect to be covered on the exam.


AMBOSS Knowledge+ Internal Medicine Board Review content is designed to reflect the ABIM exam blueprint. Because our system adapts to you, our Knowledge+ will help you focus on the blueprint areas where you need the most review, providing efficient, effective preparation for the ABIM exam.


The following information was taken directly from the ABIM Certification Examination Blueprint, updated January 2026.

Purpose of the exam

The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified internist in the broad domain of the discipline. The ability to make appropriate diagnostic and management decisions that have important consequences for patients will be assessed. The exam may require recognition of common as well as rare clinical problems for which patients may consult a certified internist.

Exam Content

Exam content is determined by a pre-established blueprint, or table of specifications. The blueprint is developed by ABIM and is reviewed annually and updated as needed for currency. Trainees, training program directors, and certified practitioners in the discipline are surveyed periodically to provide feedback and inform the blueprinting process.

The primary medical content categories of the blueprint are shown below, with the percentage assigned to each for a typical exam:

Content Domain Exam Weight
Allergy and Immunology 2%
Cardiovascular Disease 14%
Dermatology 3%
Endocrinology, Diabetes, and Metabolism 9%
Gastroenterology 9%
Hematology 6%
Infectious Disease 9%
Miscellaneous 2%
Nephrology and Urology 6%
Neurology 4%
Obstetrics and Gynecology 3%
Medical Oncology 6%
Ophthalmology 1%
Otolaryngology and Dental Medicine 1%
Psychiatry 4%
Pulmonary Disease 9%
Rheumatology and Orthopedics 9%
Geriatric Syndromes 3%
Total 100%

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Exam questions in the content areas above may also include topics in Critical Care Medicine, Prevention, Clinical Epidemiology, Ethics, Nutrition, Palliative and End-of-Life Care, Adolescent Medicine, Occupational Medicine, Patient Safety and Substance Abuse.

Exam Format

The exam is composed of up to 240 single-best-answer multiple-choice questions, of which approximately 35 are new questions that do not count in the examinee’s score. Most questions describe patient scenarios and ask about the work done (that is, tasks performed) by physicians in the course of practice:

  • Making a diagnosis
  • Ordering and interpreting results of tests
  • Recommending treatment or other patient care
  • Assessing risk, determining prognosis, and applying principles from epidemiologic studies
  • Understanding the underlying pathophysiology of disease and basic science knowledge applicable to patient care

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For more information, visit the ABIM website.

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