Does the IM-ITE Predict ABIM Boards? Research

Residents want to know whether their in-training exam (IM-ITE) score says anything about the ABIM certification exam. The research says yes, but imperfectly. This guide summarizes what published studies found and how to turn a score into a study plan.

The short answer

ITE scores predict ABIM results better than chance and often better than earlier USMLE scores, but no single score is fully predictive. Use it as a diagnostic that tells you where to work, not as a verdict.

What the studies found

A 2007 study re-examined the long-used rule of thumb that the 35th percentile at PGY-2 predicts passing, and found the percentile cut-points were significantly lower than earlier work suggested. Its model classified performance correctly about 75 to 79% of the time, with scores above about 65% predicting a pass and below about 49% predicting a fail.
A commentary noted pooled sensitivity of 0.83 and specificity of 0.75, which means frequent false positives and false negatives.
A 2020 study in BMC Medical Education found that third-year ITE scores predicted ABIM results better than USMLE Step 1 or Step 2 scores. A 5% increase in ITE percentage raised the odds of passing (odds ratio about 2.9, with a wide confidence interval).

Why raw score may beat percentile

A 2022 analysis argued that raw ITE score is a more robust way to identify residents at risk than percentile rank, because percentile depends on how the comparison group performed in a given year. If your program reports both, look at the raw percentage as well.

How to use your ITE result

Look at content-area breakdowns, not only the total.
Compare year over year. Your trend matters more than one result.
Treat a low score as a reason to start question practice earlier, not as a prediction of failure.

A plan if your score is low

List the three weakest content areas from your score report.
Do timed, mixed question blocks, plus focused sets in those areas.
Review every miss and log the concept.
Re-test those concepts after a few days and again before the exam.

MedPrep's adaptive engine automates the last two steps for ABIM-style vignettes: a miss flags the concept and variations return on a schedule. Try the free ABIM sample questions first, then the 7-day free trial. More: ABIM pass rate and format and the ABIM study guide.

Frequently asked questions

Does the IM-ITE predict ABIM certification exam results?

Yes, imperfectly. Studies find ITE scores predict pass or fail better than chance, with classification accuracy around 75 to 79% in one model.

What ITE percentile do I need to pass the ABIM exam?

The 35th percentile at PGY-2 was a common benchmark, but a 2007 study found the cut-points were lower. Raw score may be a more robust measure than percentile.

Is the ITE a better predictor than USMLE scores?

One 2020 study found third-year ITE scores predicted ABIM results better than USMLE Step 1 or Step 2 scores.

What should I do if my ITE score is low?

Use the content breakdown to find weak areas, start timed question practice earlier and re-test weak concepts on a schedule.

Can practice questions help for ABIM?

Yes. MedPrep has free ABIM sample questions and a 7-day free trial of the adaptive ABIM bank.

Sources and disclaimers

Figures in this guide come from the USMLE program's published notices and from third-party summaries that we could not check against the primary source, and we say so where that applies. Standards, policies and score data change, so confirm current details on USMLE.org, ECFMG and NRMP before you plan around them. MedPrep Institute is our own product, and is not affiliated with or endorsed by NBME, FSMB, USMLE, ECFMG, NRMP, UWorld or any other company named here. All trademarks belong to their owners. Study details come from published research, including The American Journal of Medicine (2007) and BMC Medical Education (2020).