ITE Practice Test
Updated for October 2026What changed for the ACP IM-ITE in 2026
- 2026 testing window: The 2026 ACP Internal Medicine In-Training Examination (IM-ITE) is administered by residency programs from Thursday, August 13 through Friday, September 4, 2026; programs may test on one or several days inside that window. (source)
- Delivery: The IM-ITE is a web-based exam delivered through the NBME platform; for 2026 programs choose in-person testing, remote proctoring (Zoom, MS Teams or Webex), or a mix of both. (source)
- Format and time: The exam has 300 questions; total testing time is 9 hours, with 7 hours of exam time plus several 10-minute breaks and a 1-hour lunch. There is no penalty for guessing and the exam cannot be failed. (source)
- Fee: The 2026 registration fee is $145 (USD) per registrant, paid by the program; regular registration ran April 29 to July 13, 2026, and a $30 per-registrant late fee applies from July 14, 2026. (source)
- Blueprint: The IM-ITE is modeled on the ABIM Internal Medicine Certification Exam blueprint: Cardiovascular Disease 14%; Endocrinology 9%; Gastroenterology 9%; Infectious Disease 9%; Pulmonary Disease 9%; Rheumatology/Orthopedics 9%; Hematology 6%; Medical Oncology 6%; Nephrology/Urology 6%; Neurology 4%; Psychiatry 4%; Dermatology, Geriatrics and Ob/Gyn 3% each; Allergy/Immunology 2%; Ophthalmology 1%; Otolaryngology/Dental 1%; Miscellaneous 2%. (source)
- Scoring: Score reports give each examinee's percent correct and percentile rank (by PGY level) for the total test and each content area, plus the educational objectives of questions answered incorrectly; there is no pass/fail cut score. (source)
- Results timing: Preliminary feedback goes to program directors (PGY1-5) on September 14, 2026, about 10 business days after the window closes; final score reports post to the MyNBME portal on October 14, 2026 for distribution by programs. Residents receive scores from their program, not from ACP or NBME. (source)
- Accommodations: Special-accommodation requests for the 2026 exam were due July 24, 2026 and must be submitted through the program director; a free online practice exam is opened a few weeks before the window. (source)
Last verified: September 17, 2026 against the American College of Physicians (ACP) IM-ITE program pages and the 2026 IM-ITE information sheet.
Did you know? Scoring well on the ITE exam is a strong predictor of passing your future board certification exam. Residents who score above the 50th percentile are significantly more likely to pass their boards on the first attempt.
ITE Practice Test Questions
Prepare for the ITE - Internal Medicine In-Training Exam exam with our free practice test modules. Each quiz covers key topics to help you pass on your first try.
ITE Cardiovascular Medicine
ITE Exam Questions covering Cardiovascular Medicine. Master ITE Test concepts for certification prep.
ITE Endocrinology
Free ITE Practice Test featuring Endocrinology. Improve your ITE Exam score with mock test prep.
ITE General Internal Medicine
ITE Mock Exam on General Internal Medicine. ITE Study Guide questions to pass on your first try.
ITE Allergy and Immunology
ITE Questions and Answers on Allergy and Immunology. Free ITE practice for exam readiness.
ITE Cardiovascular Disease
ITE Mock Test covering Cardiovascular Disease. Online ITE Test practice with instant feedback.
ITE Diabetic Ketoacidosis and HHS
ITE Practice Questions for Diabetic Ketoacidosis and HHS. Build confidence for your ITE certification exam.
ITE Endocrinology and Metabolism
ITE Test Online for Endocrinology and Metabolism. Free practice with instant results and feedback.
ITE Gastroenterology and Hepatology
ITE Study Material on Gastroenterology and Hepatology. Prepare effectively with real exam-style questions.
ITE Hematology and Oncology
Free ITE Test covering Hematology and Oncology. Practice and track your ITE exam readiness.
ITE Infectious Disease Management
ITE Exam Questions covering Infectious Disease Management. Master ITE Test concepts for certification prep.
ITE - Internal Medicine In-Training Diabet...
Free ITE Practice Test featuring - Internal Medicine In-Training Diabetic Ketoacidosis and HHS. Improve your ITE Exam score with mock test prep.
ITE - Internal Medicine In-Training Valvul...
ITE Mock Exam on - Internal Medicine In-Training Valvular Heart Disease Management. ITE Study Guide questions to pass on your first try.
ITE Nephrology and Hypertension
ITE Test Prep for Nephrology and Hypertension. Practice ITE Quiz questions and boost your score.
ITE Internal Medicine In-Training Exam Questions and Answers
Click to flip and test your knowledge on key medical concepts
🫀What is the first-line treatment for acute pericarditis?
NSAIDs and Colchicine are the standard first-line therapy for acute pericarditis.
START ITE PRACTICE TEST🩺Which murmur is associated with aortic stenosis?
A systolic crescendo-decrescendo murmur heard best at the right upper sternal border.
REVIEW ITE QUESTIONS🍬What is the diagnostic threshold for diabetes using A1C?
An HbA1c level of 6.5% or higher is diagnostic for diabetes mellitus.
TRY ITE MOCK EXAM🫁What is the most common cause of community-acquired pneumonia?
Streptococcus pneumoniae is the most frequent pathogen causing CAP.
GET ITE EXAM PREP🦠What is the treatment for latent TB infection?
Isoniazid for 9 months or Rifampin for 4 months are common regimens.
ACCESS ITE STUDY GUIDE🩸What does improved TSH with low Free T4 indicate?
This pattern is diagnostic of primary hypothyroidism.
PRACTICE ITE TEST NOWITE Internal Medicine In-Training Exam Questions and Answers
Prepare effectively for your residency in-service exam with our detailed ITE exam study guide. Whether you are taking the IM ITE exam or the Family Medicine ITE exam, understanding the basics is crucial for success.
ITE Internal Medicine In-Training Exam Questions and Answers
Total Scored Questions
150
105 out of 150 correct
70%
Required to Pass: ~70% (Estimated)
Your residency program invests significantly in the ITE exam to ensure your board success. Take advantage of this paid opportunity to assess your readiness.
ITE Internal Medicine In-Training Exam Questions and Answers
- ✓Valid Hospital ID / Photo ID
- ✓Program-assigned Login Credentials
- ✓Water and Snacks (if allowed)
- ✓Arrive 15 minutes early
- ✓Comfortable clothing (layers)
- ✓Turn off pager/cell phone
- ✓Review exam tutorial beforehand
- ✓Good night's sleep!
Ready to Ace the ITE Exam?
Start practicing with our free ITE exam questions today and boost your chances of scoring in the top percentile.
ITE Internal Medicine In-Training Exam Questions and Answers
Board Cycle
10 Years
CME Credits
Varies
Maintenance
of Certification (MOC)
After residency, you will transition from the ITE exam to board certification exams and subsequent Maintenance of Certification (MOC) requirements to keep your license active.
- +Industry-recognized credential boosts your resume
- +Higher earning potential (10-20% salary increase on average)
- +Demonstrates commitment to professional development
- +Opens doors to advanced career opportunities
- −Exam preparation requires significant time investment (4-8 weeks)
- −Registration costs $145 per resident in 2026 (paid by the program; $30 late fee after July 13)
- −May require continuing education to maintain
- −Some employers may not require certification
Sample ITE - Internal Medicine In-Training Exam Practice Questions
Try these questions from our free ITE - Internal Medicine In-Training Exam practice tests. The correct answer and an explanation follow each question.
Which physical exam finding is most characteristic of severe aortic regurgitation?
- A. Slow-rising carotid pulse (pulsus parvus et tardus)
- B. Wide pulse pressure with bounding/water-hammer pulse
- C. Fixed split S2
- D. Middiastolic rumble at the apex
Answer: B. Wide pulse pressure with bounding/water-hammer pulse
Severe AR causes volume overload of the LV, producing a wide pulse pressure (elevated systolic, low diastolic) and a bounding, collapsing (water-hammer) pulse.
A 55-year-old man presents with exertional syncope. Physical exam reveals a harsh mid-systolic crescendo-decrescendo murmur at the right upper sternal border radiating to the carotids. Carotid upstroke is diminished and delayed (pulsus parvus et tardus). What is the most likely diagnosis?
- A. Hypertrophic obstructive cardiomyopathy
- B. Severe aortic stenosis
- C. Pulmonary stenosis with right heart failure
- D. Aortic regurgitation with wide pulse pressure
Answer: B. Severe aortic stenosis
Pulsus parvus et tardus (small, slow-rising carotid pulse) with a calcific mid-systolic murmur radiating to carotids and exertional syncope are classic findings of severe calcific aortic stenosis.
A 40-year-old HIV-positive man (CD4 40) on antiretrovirals develops vision loss. Fundoscopic exam shows yellow-white perivascular exudates with hemorrhage ('pizza pie' appearance). What is the diagnosis and treatment?
- A. Toxoplasma retinitis; pyrimethamine plus sulfadiazine
- B. CMV retinitis; IV ganciclovir or oral valganciclovir
- C. Ocular histoplasmosis; itraconazole
- D. Cryptococcal chorioretinitis; fluconazole
Answer: B. CMV retinitis; IV ganciclovir or oral valganciclovir
CMV retinitis in advanced AIDS presents with the classic 'pizza pie' fundoscopic appearance and is treated with valganciclovir 900mg BID for induction followed by maintenance therapy.
A 48-year-old man with no cardiac history presents with syncope preceded by dizziness while standing. On exam, systolic BP drops from 140 to 95 mmHg after 3 minutes of standing. Heart rate does not compensate appropriately. The most likely diagnosis is:
- A. Autonomic dysfunction (orthostatic hypotension)
- B. Vasovagal syncope
- C. Cardiac arrhythmia
- D. Hypovolemia
Answer: A. Autonomic dysfunction (orthostatic hypotension)
Orthostatic hypotension with inadequate heart rate response suggests autonomic neuropathy; common causes include diabetes, Parkinson's disease, and certain medications.
Take the full ITE - Internal Medicine In-Training Exam practice test
ITE Questions and Answers
Official Resources
- American College of Physicians — IM-ITE Program: the official ACP page for the Internal Medicine In-Training Examination, with registration windows, score-report timing, and the current-year information sheet.
- American Board of Internal Medicine (ABIM): the certifying board whose blueprint the IM-ITE mirrors — use it to check certification requirements and the topics your ITE percentile is meant to predict.
- National Board of Medical Examiners (NBME): the testing organization that delivers the IM-ITE exam platform, including tutorials and technical requirements for exam day.
About the Author
Registered Nurse & Healthcare Educator
Johns Hopkins University School of NursingDr. Sarah Mitchell is a board-certified registered nurse with over 15 years of clinical and academic experience. She completed her PhD in Nursing Science at Johns Hopkins University and has taught NCLEX preparation and clinical skills courses for nursing students across the United States. Her research focuses on evidence-based exam preparation strategies for healthcare certification candidates.
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