NBME Internal Medicine Shelf Exam Review Questions and Practice Tests

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“BoardVitals is outstanding! Its Internal Medicine question bank for both the shelf exam and the boards is excellent... I had the opportunity to review both question banks, and as someone who has taken both the shelf exam and the boards, these questions are exactly what you need to pass! They will expose the areas in which you are weak, and the explanations will expand your medical knowledge. The questions are challenging and reflect current best practices. I strongly recommend BoardVitals IM exams!”

Sonya Lecuona
Internal Medicine Specialist, Baltimore MD

gold key Key Board Review Features


Internal Medicine Shelf Exam Board Review Topics Covered:

  • Infectious Disease
  • Oncology
  • Dermatology
  • Gastroenterology
  • General Medicine
  • Neurology
  • Allergy and Immunology
  • Hematology
  • Cardiology
  • Endocrinology
  • Pulmonary
  • Renal
  • Rheumatology

About the NBME Internal Medicine Shelf Exam (Subject Exam)

As outlined by the NBME, the Subject Exams are designed to provide institutions with effective evaluation tools and useful examinee performance data that can be compared with a large representative group of examinees at the same stage of training.

What content is covered on the Internal Medicine Shelf Exam?

According to the NBME Clinical Science: Medicine Modular content outline, the following topics are covered on the exam:

General Principles 1%–5%

Organ Systems

  • Immunologic Disorders 5%–10%
  • Diseases of the Blood and Blood-forming Organs 5%–10%
  • Diseases of the Nervous System and Special Senses 5%–10%
  • Cardiovascular Disorders 15%–20%
  • Diseases of the Respiratory System 15%–20%
  • Nutritional and Digestive Disorders 10%–15%
  • Gynecologic Disorders 1%–5%
  • Renal, Urinary, and Male Reproductive System 10%–15%
  • Disorders of the Skin and Subcutaneous Tissues 5%–10%
  • Diseases of the Musculoskeletal System and Connective Tissue 5%–10%
  • Endocrine and Metabolic Disorders 5%–10%

Physician Tasks

  • Promoting Health and Health Maintenance 10%–15%
  • Understanding Mechanisms of Disease 20%–25%
  • Establishing a Diagnosis 40%–45%
  • Applying Principles of Management 20%–25%

What question formats are on the Internal Medicine Shelf Exam?

As outlined in the NBME Guide to the Subject Examination Program, the following question formats will be on the exam:

Application of Knowledge

This exam will have an increased emphasis on the application of knowledge instead of the recall of isolated facts.


Questions are framed in the context of clinical vignettes.

Single-best-answer (A-type)

This is the most widely used MCQ format. Each question is comprised of a focused item stem (e.g., a clinical vignette) and a lead-in question, followed by a series of options with one correct answer for each item.

Extended Matching (R-type)

These questions are organized into sets that use one list of options for all items in the set. Examinees must select one best answer.

NBME Internal Medicine Shelf Exam Prep and Readiness

Internal Medicine is a really broad topic, especially for shelf exams. You won’t find any one single source that follows the exam directly. Most physicians that we talked to used 3+ sources during their prep time. Fortunately, though, the Internal Medicine content is not as ‘tricky’ as Family Medicine, you just need to have a broad knowledge base. First Aid is a good Internal Medicine companion to use hand in hand with BoardVitals to make sure that you’re covering all relevant topics.

NBME Internal Medicine Percentile Requirements

Internal Medicine requires a score at the 11th percentile to pass.

Since it is graded ‘on a curve’, it’s important to compare yourself to others. Use the ‘percent correct’ feature on our platform to know where you stand. Internal Medicine is not a rushed exam, generally speaking, but it is important to be aware of timing – we suggest using the time keeping feature on our platform.

Our platform also allows you to flag questions so you can go back and review at a later date. Good luck on the shelf exams! They do get easier!

If you need any help, feel free to reach out us

View all of our NBME Shelf Exam Prep Offerings.