100+ Free ABPM Public Health Practice Questions

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Question 1

Score: 0/0

In a steady-state population, prevalence can be approximated by which relationship?

Prevalence = Incidence / Average Duration

Prevalence = Incidence × Average Duration

Prevalence = Incidence × Population Size

Prevalence = Incidence + Mortality

to track

2026 Statistics

Key Facts: ABPM Public Health Exam

~275

Total MCQ Items

ABPM Public Health/GPM Primary Certification Exam

~8 hr

Total Exam Time

1-day computer-based test including breaks

~18-22%

Epidemiology Weight

Largest domain on 2026 ABPM content outline

$1,900

2026 Initial Cert Fee

ABPM Public Health/GPM primary certification

3 yr

Required Residency

ACGME Preventive Medicine residency with MPH

80-90%

First-Attempt Pass Rate

ACGME-trained candidates (ABPM summaries)

The ABPM Public Health/General Preventive Medicine exam is a 1-day computer-based test at Pearson VUE with approximately 275 single-best-answer MCQs across ~8 hours. The 2026 blueprint emphasizes epidemiology (~18-22%), public health systems/law/policy (~10-12%), communicable disease control (~10-12%), chronic disease prevention (~10%), biostatistics (~10-12%), quality/ethics/informatics (~6-8%), environmental/occupational health (~5-7%), vaccines (~5-7%), behavioral health (~5%), maternal-child (~5%), leadership/global health (~5-7%), and injury/social determinants (~4-5%). Initial certification fee is ~$1,900; a 3-year ACGME Preventive Medicine residency with MPH is required.

Sample ABPM Public Health Practice Questions

Try these sample questions to test your ABPM Public Health exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1In a steady-state population, prevalence can be approximated by which relationship?

A.Prevalence = Incidence / Average Duration

B.Prevalence = Incidence × Average Duration

C.Prevalence = Incidence × Population Size

D.Prevalence = Incidence + Mortality

Explanation: When incidence and duration are stable over time (steady state), P ≈ I × D. Interventions that shorten disease duration (e.g., effective treatment that cures or increases case-fatality) will LOWER prevalence even if incidence is unchanged.

2A case-control study of lung cancer and asbestos exposure finds 80 exposed cases, 20 unexposed cases, 40 exposed controls, and 60 unexposed controls. What is the odds ratio?

A.0.17

B.2.0

C.6.0

D.4.0

Explanation: OR = (a×d)/(b×c) = (80×60)/(20×40) = 4800/800 = 6.0. Case-control studies cannot directly calculate incidence or relative risk, so OR is the appropriate measure of association. Under the rare disease assumption, OR approximates RR.

3Which Bradford Hill criterion is considered essential (as opposed to merely supportive) for inferring causation?

A.Specificity

B.Temporality

C.Analogy

D.Coherence

Explanation: Temporality is the only Bradford Hill criterion regarded as essential — the cause must precede the effect. The remaining criteria (strength, consistency, specificity, biologic gradient, plausibility, coherence, experiment, analogy) support but cannot alone establish causation; specificity is the weakest.

4Nondifferential misclassification of a dichotomous exposure, independent of outcome status, generally biases the measure of association in which direction?

A.Away from the null

B.Toward the null

C.Unpredictable direction

D.No effect on the estimate

Explanation: Nondifferential (random) misclassification of a dichotomous exposure that is independent of outcome typically biases the RR or OR TOWARD the null (1.0). Differential misclassification (e.g., recall bias when cases recall exposures better than controls) can bias in either direction unpredictably.

5Which bias is most characteristic of hospital-based case-control studies, where the selection of cases and controls from a hospitalized population distorts the exposure-disease relationship?

A.Berkson bias

B.Neyman (prevalence-incidence) bias

C.Lead-time bias

D.Healthy worker effect

Explanation: Berkson bias occurs when cases and controls are drawn from hospitalized patients, because the probability of hospitalization depends on both exposure and disease — distorting the observed association. Neyman bias refers to survivorship in prevalent-case sampling; lead-time bias applies to screening.

6A screening test for a disease with prevalence 1% has sensitivity 99% and specificity 95%. Which statement best characterizes the positive predictive value (PPV)?

A.PPV will be high (>95%) due to high sensitivity

B.PPV will be low (~17%) because prevalence is low

C.PPV will equal the specificity

D.PPV is independent of prevalence

Explanation: Of 10,000 people: 100 have disease (99 TP, 1 FN), 9,900 do not (9,405 TN, 495 FP). PPV = 99/(99+495) ≈ 16.7%. PPV increases with prevalence; sensitivity and specificity are test properties independent of prevalence, but predictive values are NOT.

7Screening leads to an APPARENT increase in survival time simply because disease is detected earlier in its course, without any true prolongation of life. This is called:

A.Selection bias

B.Length-time bias

C.Lead-time bias

D.Healthy screenee effect

Explanation: Lead-time bias: earlier detection shifts the diagnosis date earlier, inflating measured survival from diagnosis without changing date of death. Length bias is a separate phenomenon where screening preferentially detects slower-growing, more indolent disease. Both can make screening appear beneficial when it is not.

8An outbreak of salmonellosis is suspected at a catered wedding. 120 of 300 attendees develop gastroenteritis within 48 hours. What is the attack rate?

A.20%

B.40%

C.60%

D.33%

Explanation: Attack rate = ill/total exposed = 120/300 = 40%. Attack rate is a cumulative incidence measure used in acute outbreaks with well-defined exposure windows. Food-specific attack rates by exposure status help identify the likely vehicle via attack rate ratios or relative risks.

9Which of the following is an ESSENTIAL early step in CDC's classic outbreak investigation framework, performed BEFORE hypothesis generation?

A.Establish a working case definition and perform descriptive epidemiology (time-person-place)

B.Implement control measures only after hypotheses are confirmed

C.Conduct a matched case-control study

D.Publish findings in MMWR

Explanation: CDC's 10-step framework requires establishing a case definition and performing descriptive epidemiology (epidemic curve by time, plus place and person) BEFORE generating and testing hypotheses. Control measures should actually be initiated as soon as practical — often in parallel with investigation — not withheld until hypotheses are proven.

10A cohort study finds 20% incidence of CHD in smokers and 5% in non-smokers over 10 years. What is the attributable risk (risk difference) among smokers?

A.15%

B.4.0

C.25%

D.75%

Explanation: Attributable risk (AR) = risk(exposed) - risk(unexposed) = 20% - 5% = 15%. Relative risk would be 20/5 = 4.0. AR represents the EXCESS risk in smokers attributable to smoking — more relevant for public health impact than RR alone because it incorporates baseline risk.

About the ABPM Public Health Exam

The ABPM Public Health and General Preventive Medicine primary certification validates physician expertise in population health and clinical preventive medicine — epidemiology, biostatistics, USPSTF-recommended screening and counseling, ACIP immunization policy, communicable disease control (TB, HIV, STI, hepatitis), chronic disease prevention (CVD, diabetes, cancer screening), environmental and occupational health, maternal-child health, behavioral health screening (depression, alcohol, drug use, IPV), injury prevention, social determinants of health, public health law and systems (10 Essential Services, CDC/FDA/HHS/HRSA), emergency preparedness and bioterrorism, quality/safety (IOM STEEEP, PDSA), research ethics (IRB, Belmont), and health informatics (EHR, FHIR, HIPAA). Requires a 3-year ACGME Preventive Medicine residency plus an MPH.

Questions

275 scored questions

Time Limit

1-day CBT (~8 hours including breaks)

Passing Score

Criterion-referenced scaled score set by ABPM (modified Angoff)

Exam Fee

~$1,900 initial certification fee (ABPM 2026) (American Board of Preventive Medicine (ABPM) / Pearson VUE)

ABPM Public Health Exam Content Outline

~18-22%

Epidemiology

Descriptive vs analytic study designs, incidence vs prevalence (P = I × D), measures of association (RR, OR, AR, PAF, NNT), bias (selection, information, recall, Berkson, Neyman, differential vs nondifferential misclassification), confounding (Mantel-Haenszel, multivariable adjustment), effect modification, Bradford Hill criteria, screening metrics (sensitivity, specificity, PPV/NPV, LR+/LR-, ROC, lead-time, length bias), outbreak investigation (CDC 10 steps), surveillance, R0 and effective R.

~10-12%

Biostatistics

Descriptive statistics, normal/binomial/Poisson distributions, hypothesis testing (type I α, type II β, power 1-β), parametric vs nonparametric tests (t-test, ANOVA, χ², Fisher, Mann-Whitney, log-rank), regression (linear, logistic, Cox PH, Poisson), Kaplan-Meier survival, 95% CI, multiple comparisons (Bonferroni), meta-analysis (fixed vs random effects, I², forest and funnel plots).

~10-12%

Communicable Disease Control

Tuberculosis (LTBI 3HP or 4R; active TB RIPE 6 mo; IGRA vs TST; contact tracing), STIs (GC/CT screen women <25; syphilis RPR/VDRL → treponemal confirmation; CDC 2024 doxy PEP for MSM/TW), HIV (PrEP TDF/FTC or cabotegravir LA; 28-day PEP; U=U), hepatitis (HCV universal 18-79 screening), antimicrobial stewardship, healthcare-associated infection bundles (CLABSI, CAUTI, SSI, VAP, CDI), vector-borne disease.

~10%

Chronic Disease Prevention & USPSTF

CVD (ASCVD calculator; 2021 AHA/ACC statin; 2017 ACC BP <130/80), diabetes (USPSTF 2021 35-70 overweight/obese), cancer screening 2026: breast 40-74 biennial mammogram, cervical 21-65 cyto/HPV q3-5 yr, CRC 45-75 colonoscopy q10 or annual FIT, lung LDCT 50-80 with ≥20 pack-years current or quit within 15, prostate 55-69 shared decision, AAA one-time 65-75 ever-smoked men. Tobacco (5A's, varenicline/bupropion/NRT), obesity (BMI; behavioral + semaglutide/tirzepatide; bariatric).

~10-12%

Public Health Systems, Law & Policy

10 Essential Public Health Services, federalism (CDC, FDA, HHS, HRSA, IHS; state and local health departments), MMWR, community health assessment, emergency preparedness (NIMS, PHEIC), safety-net programs (WIC, SNAP, Medicaid, Medicare A/B/C/D, ACA), value-based care (ACOs, bundled payments, MIPS), population health management.

~6-8%

Quality, Safety, Ethics & Informatics

IOM 6 aims (STEEEP), PDSA cycles, LEAN/Six Sigma, RCA, human factors, never events, CUSP, IRB and Belmont Report (respect for persons, beneficence, justice), Tuskegee and Henrietta Lacks, EHR and clinical decision support, HL7 FHIR, PHR, HIPAA.

~5-7%

Environmental & Occupational Health

Air pollution (PM2.5, ozone, NO2, SO2; EPA NAAQS; cardiopulmonary effects), water (SDWA, lead, PFAS, disinfection byproducts), radon (second leading cause of lung cancer), climate change health impacts, Superfund/CERCLA, occupational health (NIOSH, OSHA, healthy worker effect, hierarchy of controls).

~5-7%

Vaccines & Immunization Policy

Live vs inactivated, contraindications (severe allergy to prior dose/component; live vaccines contraindicated in immunocompromise and pregnancy — MMR, varicella), ACIP 2026 schedule, VIS, VAERS, VFC, measles herd immunity 93-95%, HPV 9-valent 9-45 yr, shingles RZV ≥50, pneumococcal PCV15/20 + PPSV23, RSV (≥75 universal, 60-74 shared decision; maternal 32-36 wk; nirsevimab infants), COVID-19 2026.

~5-7%

Leadership, Global Health & Preparedness

Program planning (MAPP, PRECEDE-PROCEED), logic models, process vs outcome evaluation, budgeting, workforce, SDGs, WHO, global HIV/TB/malaria, maternal mortality, CDC Category A bioterror agents (smallpox, anthrax, botulism, plague, tularemia, VHF), pandemic preparedness (H1N1 2009, COVID-19), risk communication.

~5%

Maternal-Child & Reproductive Health

Prenatal care, WIC, preconception folate 400 µg, vaccines in pregnancy (Tdap 27-36 wk, influenza, COVID, RSV), MAT for OUD in pregnancy (buprenorphine or methadone), infant mortality determinants, SIDS prevention (back to sleep, firm surface, no soft bedding or bed sharing, pacifier, avoid smoke).

~5%

Behavioral Health & Substance Use

USPSTF screening: depression PHQ-2/9 (adults and adolescents), anxiety GAD-7, alcohol AUDIT-C + SBIRT, unhealthy drug use, IPV screening in women of reproductive age. Opioid response (naloxone distribution, MAT — buprenorphine/methadone/naltrexone), fentanyl and xylazine, tobacco cessation 5A's (Ask, Advise, Assess, Assist, Arrange).

~4-5%

Injury Prevention & Social Determinants

Motor vehicle (seat belts, child restraints, graduated driver licensing), firearms (safe storage, extreme risk protection orders), falls in older adults (Tai Chi, vitamin D, PT), social determinants (income, education, housing, food security), adverse childhood experiences (ACEs), racism as a public health issue.

How to Pass the ABPM Public Health Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPM (modified Angoff)
Exam length: 275 questions
Time limit: 1-day CBT (~8 hours including breaks)
Exam fee: ~$1,900 initial certification fee (ABPM 2026)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPM Public Health Study Tips from Top Performers

1Memorize the epidemiology calculation framework cold: from a 2x2 table, Sensitivity = TP/(TP+FN), Specificity = TN/(TN+FP), PPV = TP/(TP+FP), NPV = TN/(TN+FN) — PPV and NPV depend on prevalence, sens/spec do not. Case-control → Odds Ratio = (a×d)/(b×c). Cohort/RCT → Relative Risk = [a/(a+b)] / [c/(c+d)]. Attributable Risk = risk(exposed) - risk(unexposed). NNT = 1/ARR. In steady state, Prevalence ≈ Incidence × Duration.

2Know the Bradford Hill criteria and that TEMPORALITY is the only one that is truly essential — cause must precede effect. The others (strength, consistency, specificity, biologic gradient/dose-response, plausibility, coherence, experiment, analogy) support but do not prove causation. Specificity is the weakest of the nine.

3Differential vs nondifferential misclassification: nondifferential misclassification of exposure or outcome (random, independent of the other variable) typically biases effect estimates TOWARD the null. Differential misclassification (e.g., recall bias in case-control where cases remember exposures better) can bias AWAY from or toward the null unpredictably.

4Master the 2026 USPSTF Grade A/B highlights: breast mammogram biennially age 40-74 (Grade B), cervical 21-65 cytology/HPV q3-5 yr, colorectal 45-75 (colonoscopy q10 or annual FIT), lung LDCT 50-80 with ≥20 pack-years currently smoking or quit within 15 years, AAA one-time ultrasound 65-75 ever-smoked men, diabetes 35-70 overweight/obese, statin for ASCVD primary prevention 40-75 with ≥1 risk factor and ≥10% 10-year risk (Grade B). Prostate PSA 55-69 is shared decision (Grade C).

5Know the 10 steps of outbreak investigation from CDC: 1) prepare for fieldwork, 2) establish existence of outbreak, 3) verify diagnosis, 4) construct working case definition, 5) find cases systematically and record information, 6) perform descriptive epidemiology (time-person-place → epidemic curve), 7) develop hypotheses, 8) evaluate hypotheses (often case-control with OR), 9) refine hypotheses and carry out additional studies, 10) implement control and prevention measures, communicate findings.

Frequently Asked Questions

What is the ABPM Public Health and General Preventive Medicine certification?

The ABPM Public Health and General Preventive Medicine (PH/GPM) primary certification is awarded by the American Board of Preventive Medicine to physicians who demonstrate expert-level knowledge in population health and clinical preventive medicine. Scope includes epidemiology, biostatistics, USPSTF-recommended screening, ACIP immunization, communicable and chronic disease control, environmental and occupational health, maternal-child health, behavioral health screening, injury prevention, public health law and systems, emergency preparedness, quality/ethics/informatics, and health policy. The certification qualifies physicians for independent practice in local, state, or federal public health leadership roles, academic preventive medicine, and population health management.

Who is eligible to take the ABPM Public Health exam?

Candidates must hold an MD, DO, or equivalent doctoral medical degree with an unrestricted medical license and must complete a 3-year ACGME-accredited Preventive Medicine residency in Public Health/General Preventive Medicine. Training consists of a PGY-1 clinical year plus 2 practicum years that include a graduate public health degree (typically MPH) and supervised population-health practicum rotations. Program director attestation of satisfactory training completion is required for application.

What is the format of the ABPM Public Health exam?

The exam is a 1-day computer-based test administered at Pearson VUE test centers, comprising approximately 275 single-best-answer multiple-choice questions over roughly 8 hours including breaks. Items include vignettes requiring interpretation of 2x2 tables, Kaplan-Meier curves, forest plots, ROC curves, screening test calculations, outbreak investigation scenarios, USPSTF grade-level recommendations, ACIP schedules, and public health law vignettes. Question stems are aligned to the ABPM content outline.

How much does the 2026 ABPM Public Health exam cost?

The 2026 ABPM Public Health/GPM initial certification fee is approximately $1,900 (verify current figure on the ABPM site). Cancellation and refund policies follow ABPM's posted schedule with decreasing refunds as the exam date approaches. Continuing Certification fees apply during the 10-year cycle (ABPM is transitioning to a longitudinal assessment model). Retakes within the eligibility window require re-registration and full fee payment.

When is the 2026 exam administered?

ABPM typically administers the Public Health/GPM exam during a summer or fall testing window at Pearson VUE. Application windows generally open in the spring with a submission deadline in late spring/early summer. After application approval, candidates schedule a specific appointment with Pearson VUE. Exact 2026 dates should be confirmed on the ABPM exam information page.

How is the exam scored?

ABPM uses criterion-referenced scoring with the passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports include subdomain performance breakdown to guide future learning. Results are typically released several weeks after the testing window closes.

What are the highest-yield topics?

Highest-yield topics include: epidemiologic measures (incidence vs prevalence, RR/OR/AR/PAF/NNT), study designs and their biases (recall, selection, Berkson, healthy worker), confounding control, Bradford Hill criteria, screening test characteristics (sens/spec, PPV/NPV, LR, lead-time and length bias, ROC), outbreak investigation CDC steps, the 2026 USPSTF grade A/B screening recommendations, the 2026 ACIP adult and childhood immunization schedules, TB control, HIV PrEP/PEP, the 10 Essential Public Health Services, Medicare/Medicaid/ACA structure, IOM STEEEP and PDSA quality methods, and the Belmont Report principles.

How should I study for this exam?

Use a 9-15 month structured plan during and after residency. Lead with epidemiology and biostatistics (Gordis, Rothman, or CDC Principles of Epidemiology). Layer in USPSTF and ACIP current recommendations, then population-health content (TB, HIV, STIs, vaccines, environmental/occupational, MCH, behavioral health). Add public health systems, law, ethics (Belmont, IRB), quality improvement (IOM STEEEP, PDSA), and informatics (FHIR, HIPAA). Integrate MPH coursework, MMWR readings, and a structured board review course. Complete high-volume MCQs with timed practice and 2-3 full-length mock exams.