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Examination Content

Internal Medicine

The IM Examination (MCQ) is designed to evaluate the extent of the candidate's knowledge and clinical judgement in the areas in which an internist should demonstrate a high level of competence. Expertise in the broad domain of internal medicine, and the diagnosis and treatment of both common and rare conditions that have important consequences for patients will be assessed.

The examination content is consistent with a pre-established blueprint developed and used by the American Board of Internal MedicineABMS-S, in collaboration with the Ministry of Health Singapore, modified the blueprint to ensure that the content and relative percentages reflect practice of internal medicine in Singapore. The blueprint will be reviewed and revised annually to ensure that it is current.

The majority of questions are based on patient presentations occurring in settings that reflect current medical practice. Questions requiring simple recall of medical facts are in the minority; the majority of questions require integration of information from several sources, prioritisation of alternatives, and/or utilisation of clinical judgement in reaching a correct conclusion. Some questions require interpretation of pictorial material, such as ultrasound scans, magnetic resonance imaging scans, electrocardiograms, radiographs, computed tomograms, and photomicrographs (e.g. blood films, Gram stains).

The content areas covered and their relative proportions on the examinations are as follows:

Table 1 : Examination Content for Internal Medicine MCQ Examination

Medical-Content Category Percentage
Cardiovascular Disease 13%
Gastroenterology 10%
Neurology 10%
Pulmonary Disease 10%
Infectious Disease 9% (3% tropical diseases)
Endocrinology, Diabetes and Metabolism 8% (4% diabetes)
Medical Oncology 7%
Rheumatology 7%
Haematology 6%
Nephrology 6%
Dermatology 3%
Miscellaneous 3%
Psychiatry 3%
Allergy/Immunology 2%
Obstetric Medicine 1%
Ophthalmology 1%
Otorhinolaryngology 1%

Every question in the exam is classified into one of the primary medical-content categories shown above.  A subset of these items is also classified into one of the following “cross-content categories” shown in the table below.  The percentages below reflect the maximum number of items in cross-content categories that would be included on any exam.

Table 2 : Cross-Content Categories Maximum Percentages

Cross-Content Category Maximumu Percentage
Geriatric Medicine 10%
Critical Care Medicine 9%
Prevention (Public Health) 5%
Women's Health 5%
Clinical Epidemiology 3%
Ethics 3%
Nutrition 3%
Palliative/End-of-Life Care 3%
Occupational Medicine 2%
Patient Safety 2%
Substance Abuse 2%
Adolescent Medicine 1%