100+ Free ABAI Practice Questions

The ABAI Certification Exam contains 225 one-best-answer multiple-choice items delivered across two sessions in approximately 7 hours at Pearson VUE test centers. Content is split 25% basic science and 75% clinical science, with blueprint weights covering hypersensitivity disorders (54%), immunological disorders (45%), and a small pharmacology/allergens component.

ABAI uses a criterion-referenced absolute minimum passing score set before each administration by the Conjoint Standards Committee (ABAI, ABIM, ABP representatives). There is no percentile curve — theoretically all candidates can pass or all can fail. The standard is based on the probability of an average competent allergist/immunologist answering each item correctly.

Candidates must have completed an ACGME-accredited fellowship in Allergy and Immunology and hold prior ABIM (internal medicine) or ABP (pediatrics) certification. Certification must be achieved within 7 years of fellowship completion; candidates who miss that window must complete an additional year of ACGME-approved A/I retraining. Dual pathways exist with pediatric pulmonology, adult rheumatology, and pediatric rheumatology.

The 2026 ABAI Certification Examination fee is $2,650. A $500 non-refundable late application fee applies after the deadline. If a candidate cancels before the deadline, $1,850 is refundable ($800 is retained as a non-refundable evaluation and processing fee). Rescore requests cost $100 and must be submitted within 30 days of the results letter via certified mail.

The ABAI Certification Examination is offered once per year. Dates and Pearson VUE locations are announced through ABAI newsletters, the ABAI website, and specialty journals. Because Pearson VUE administers many exams, ABAI cannot guarantee preferred date or site availability — register early.

Most successful candidates combine the AAAAI Review Course, Middleton's Allergy: Principles and Practice, Stiehm's Immunologic Disorders in Infants and Children, and a dedicated question bank. Focus heavily on immunodeficiencies (16% — the largest single section), GINA/NAEPP asthma updates, biologics indications, HAE management, and the Gell-Coombs framework. Use the In-Training Examination results to guide weak-area review.

There is no limit on the number of retake attempts, but the 7-year board eligibility window still applies. If the 7-year window closes without certification, candidates must complete one additional ACGME-approved fellowship year. Diplomates who already had multiple attempts before the 2019 policy change received a 2-year extension to complete certification.

The BLS reports median annual wages of $239,200 for Physicians, All Other (SOC 29-1229) and $236,000 for Internal Medicine Physicians (SOC 29-1216) as of May 2024, with total physician employment projected to grow 4% from 2023-2033. Approximately 5,000 US physicians hold active ABAI certification; the AAAAI estimates roughly 140-150 new A/I fellowship graduates enter the workforce each year, making allergy/immunology one of the smallest internal medicine subspecialties by workforce size.