First American Board of Internal Medicine critical care examination: process and results

On November 10, 1987, 2,712 diplomates of the American Board of Internal Medicine (ABIM) took the initial examination recognizing added qualifications in critical care medicine (CCM). The 1-day examination, made up of one-best-answer and multiple true/false questions, covered a broad range of topics from the internal medicine domain of CCM. Diplomates were admitted to the examination through four pathways requiring formal training in CCM and two practice pathways; 89% of the diplomates entered through the practice pathways. The absolute standard for the examination resulted in a total group pass rate of 64% (n = 1,725); the pass rate for diplomates with training in CCM was 84%. Examination performance was positively associated with months of critical care training, earlier ABIM examination scores, certification in pulmonary medicine, program directors' ratings of overall clinical competence, and several factors associated with the critical care work environment.