Depending on your residency program, you may take the in-training exam (ITE) anywhere from one to three times during your training. The ITE is always given in August or September, and the results usually come back in October or November. What’s in your ITE score report and what should you do with it?

What’s Included in My ITE Score Report? 

• Total exam percent correct score
• Percentile rank by PGY Level
• PGY Level
• Percent Correct, Mean % Correct, Standard Deviation Around Mean, and Your Percentile for the 11 core exam content areas, plus High Value Care
• A list of topics within core content areas that you answered correctly. Objectives which are included in the High Value Care content area are indicated as well.

ITE Exam Core Content Areas:

• Cardiology
• Endocrinology
• Gastroenterology
• General Internal Medicine
• Geriatric Medicine
• Hematology/Oncology
• Infectious Diseases
• Nephrology
• Neurology
• Pulmonary and Critical Care Medicine
• Rheumatology

How Do I Use My ITE Score in Intern Year?

In your intern year, you should not expect to get a perfect score on the ITE. Otherwise, what would you be learning for the next 3 years of residency?

In your intern year, the ITE is merely a way to measure yourself in an objective way against your peers at this stage of training. Based on your percentile, you may want to approach the scores differently:

1. 75th or greater percentile: Congratulations! You have phenomenal clinical knowledge, and you are on track to do very well on your medicine boards. Whatever study method you are currently using is working for you, and you should continue to push yourself to expand your clinical knowledge in weaker content areas.
2. 25th to 75th percentile: You are amongst the middle 50% of interns. Your clinical knowledge is appropriate for your level of training, and you should feel good about your accomplishments. If you are on the lower end of that spectrum, you may want to plan to do a more focused review of the areas where you were weakest. You can use the list of educational objectives to go through and read about each topic you got wrong on the exam.
   1. For example, if you missed “diagnose atrial myxoma,” read the section of MKSAP on atrial myxomas and take detailed notes in a physical or virtual MKSAP notebook (see When Should I Start Studying for the ABIM Internal Medicine Boards?).
3. Below the 25th percentile, you may want to reach out to your program leadership for additional resources. You will likely need more in-depth content review of the material. Many programs have peer-mentoring programs or dedicated tutoring services. You can also reach out to our Advanced Boards Tutoring Team, who can develop a personalized learning schedule amidst your busy intern rotations.

PGY1 ITE Takeaway: Learn the Medicine and Acknowledge Red Flags

How to Interpret ITE Scores in Your Second Year of Residency

As a second year resident, you should be thinking more about preparing for the medicine boards. As such, you should use your ITE results to see what educational objectives you got wrong on the exam, review those concepts in the MKSAP books, and take notes for you to review when you get closer to your exam—regardless of your ITE score.

1. Above the 25th percentile: You should also start to work your way through the MKSAP questions. It may be helpful to line up the content areas of review from the ITE, while you do MKSAP questions in the same area to reinforce the content (i.e. cardiology questions while reviewing cardiology educational objectives).
2. Below the 25th percentile: You should speak with your program and/or MST about additional ways to start studying for the boards. This may involve dedicated tutoring sessions, more in depth reading of other review books (e.g. Johns Hopkins Board Review, First Aid), and/or other question banks to practice content.

PGY2 ITE Takeaway: Address Gaps in Knowledge

ITE Scores for Third Year Residents: Planning Your Dedicated Study Period for the Boards

Depending on your performance on the ITE in your third year of residency, you should plan to start a dedicated study period for the boards somewhere between the beginning of the year vs. the spring before graduation. Regardless of how you performed, you should plan to review the educational objectives on the ITE as above and complete the MKSAP question bank at least twice.

1. For those with lower scores or difficulty with standardized exams, you may want to purchase an additional question bank to practice the content (e.g. UWorld, NEJM).
2. You can also investigate online or in-person review courses offered by different residency programs, or you can consider individual tutoring if you are concerned about your performance on the exam.

PGY3 ITE Takeaway: Make a Study Plan for the Test

If at any point in this process, you feel like you need more guidance or individualized tutoring/mentoring, please reach out to Med School Tutors. We have multiple advanced boards tutors available to help guide you through the process of learning in residency, planning your fellowship and career path, and succeeding on the medicine boards.

Everything You Need to Know About the ABIM Internal Medicine Exam