Free Practice Questions for ABIM Critical Care

Candidates must hold active ABIM Internal Medicine certification at the time of application and must satisfactorily complete ACGME-accredited Critical Care Medicine training: 24 months with at least 12 clinical months in the stand-alone pathway, or 36 months with at least 18 clinical months in a combined Pulmonary Disease and Critical Care Medicine fellowship. Training must be complete by October 31 of the examination year, and the program director attests to clinical competence. Physicians from anesthesiology, emergency medicine, or surgery pursue Critical Care Medicine certification through their own parent boards (ABA, ABEM, ABS).

The Critical Care Medicine examination contains up to 240 single-best-answer multiple-choice questions in four sessions of up to 60 questions each, on a single exam day of roughly 10 hours that includes 100 minutes of total break time, at Pearson VUE test centers. The 2026 administration is scheduled for October 26 to 30, 2026. Questions are case-based and emphasize clinical application of current guidance (the 2026 Surviving Sepsis Campaign, ARDS definitions, KDIGO, post-arrest temperature control, and PADIS) rather than rote recall.

ABIM, ABA, ABEM, and ABS all recognize Critical Care Medicine as an ABMS subspecialty, and their blueprints cover much of the same core content. Each Member Board administers its own examination: the ABIM version is internal-medicine-weighted, with more medical ICU content such as sepsis, acute kidney injury, hepatic failure, and hematologic disease, while the ABA version includes more cardiothoracic and anesthesia-related critical care. Candidates apply through their primary certifying board.

ABIM uses an absolute standard set by its specialty board through a standard-setting process, reported as pass or fail, and the threshold is not published as a percentage. Unanswered questions are scored as incorrect, so there is no reason to leave an item blank. ABIM reported first-time pass rates of 92% in 2021, 89% in 2022, 85% in 2023, 89% in 2024, and 86% in 2025.

The initial certification examination fee is $2,325 (with an additional $400 fee if registering during the late registration window). Total preparation cost including the SCCM Comprehensive Critical Care Review, Marino's ICU Book, and a high-yield question bank typically ranges from $3,000 to $4,800.

The January 2026 blueprint, used from the fall 2026 examination, covers 12 categories: Pulmonary Disease (17%), Shock (15%), Renal, Endocrine and Metabolic Disorders (13%), Cardiovascular Disease (13%), Infectious Disease (10%), Neurology (9%), Gastrointestinal Disease (5%), Hematology and Oncology (5%), Surgical Critical Care (5%), Pharmacology and Toxicology (5%), Critical Care Ultrasound Scanning (2%), and Research, Administration and Ethics (1%). Half of the questions test treatment and care decisions and 40% test diagnosis and testing. The heaviest second-level topics are mechanical ventilation (6%), distributive shock (5%), and cardiogenic shock (4%).

ABIM diplomates maintain CCM certification through the Longitudinal Knowledge Assessment (LKA) — an open-book, quarterly question set delivered over a 5-year cycle — or through the traditional 10-year recertification exam. Diplomates must also meet MOC activity requirements and hold an active unrestricted medical license.

Most candidates study 250 to 400 hours over 6 to 12 months alongside fellowship. Preparation usually combines a comprehensive critical care review course, a standard ICU textbook, the current primary guidelines (including the 2026 Surviving Sepsis Campaign), board-style question banks, and case-based bedside learning. Clinical volume in the medical ICU is the strongest predictor of examination success.