Family Medicine ITE: Everything You Need to Know

The family medicine in-training exam (ITE) is administered every fall of the residency year. It is also known as the in-service exam. It’s a pretty long exam with a lot of questions (like most tests you’ve faced) and the questions span multiple subjects from primary care to surgery.

The exam usually occurs in October during your residency year. Like most tests administered today, it is computer-based. Your program usually takes care of registering you for the exam and there is no monetary cost to take the exam. You just need to show up.

How Long Does the ABFM ITE Take

The ITE is four hours long and has 240 questions. The subjects range from internal medicine, family medicine, and pediatrics to topics like general surgery, ophthalmology, and urology.

Purpose of the Exam

You’re probably wondering why the ITE is administered. Well… it is able to help gauge your performance to the real board exam. Both the ITE and the board certification exam are created by the American Board of Family Medicine (ABFM). The ITE has a predictor performance attached to it called the Bayseian Score Predictor. What does that mean? Basically, it takes your raw score from this current exam as well as your performance on previous in-training exams and board exams from medical school to predict how you will do in future ITEs and even the board certification exam.

Alright… so you know you need to take the exam. You also know the better you do here, the greater the chance of passing the actual exam is. At the end of the family medicine ITE is a predictor calculator. Watch the YouTube video (located in the bottom right corner of the video) to fully understand how to use it.

Understanding Your ITE Score

There isn’t a passing score for this exam, so it’s hard to say what constitutes a “good score” for the ABFM ITE. A good benchmark though is to compare your results to the national average, which was 534 in 2023. TheABFM.org posts how people have done in the ABFM board exam in the past at different residency programs. The odds are in your favor, but that should not be a reason not to study or prepare for the in-service exam or the boards.

Preparing for the Family Medicine ITE

Now… how do we go about studying for the exam. We’ve got a few different options but first:

The first step is to take the ITE from the previous year, approximately six months or more before the new one being administered in the fall (think February to April time frame). The score that you get will guide you to decide which of the following options is the best one for you.

A Study Schedule for New Interns

This prep work is done about 6 to 12 months before the ITE. This plan is recommended for all the newbies who have never taken a proctored ITE (looking at all the new interns out there), second year residents who scored below average on previous ITE/ board exams, and people with test anxiety. The goal here is to use review book(s) to review/learn material while doing weekly sets of 10 to 20 questions. The questions can be obtained from the American Academy of Family Practice (AAFP) website, the ABFM mobile app, and even the TrueLearn family medicine question bank. This longer time period will hopefully allow you to absorb new material and help solidify old material, which will hopefully result in a huge confidence booster.

A Study Schedule for Second-Year Residents

This prep work usually occurs about 3 to 6 months before the exam. This plan is recommended for second-year residents who have taken the ITE before and scored at or close to average, interns who have done well on previous board exams, or third year residents who scored below average on the previous ITE. Much like the previous plan, the goal here is to use board review material to help solidify all topics, while learning new material, and using questions to reinforce said material.

The main difference here, is that questions can either be done more frequently (such as 10 to 20 questions every other day) or on a weekly basis (such as 30 or 40 questions instead of 10 or 20).

An Advanced Schedule for Third Year Residents

This prep work is started about 2 to 3 months before the exam. This plan is recommended for 3rd year residents who scored at least average on previous ITEs and second-year residents who scored above average on previous exams. The goal here is to go through as many questions as possible to remember old information, clear up gray areas in high-yield topics, as well as learn some new material.

Some residents prefer to do 10 to 20 questions per day and go over the answers the same day, while others prefer to do 100 to 200 questions in one day and use the rest of the week to review those questions.

The Takeaway

Regardless of which option you decide to follow, you need to do questions and you need to go over those questions regardless of whether you got the question right or wrong. Remember, continue to learn all the time and try to do a little bit every day as opposed to cramming a few days before the exam.

I hope this post helped answer any questions that you may have had and helped to guide you to study for the ITE. While nothing is guaranteed, remember, you made it this far already! You overcame the MCAT, your rigorous medical school curriculum, and you passed your med school boards. YOU GOT THIS! Say it with me this time! YOU GOT THIS!

Decide on a study plan, stick with it, work hard, and just do your personal best!