100+ Free ABPS Hospital Medicine Practice Questions

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Question 1

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A 68-year-old man with HFrEF (EF 28%), type 2 diabetes, and CKD stage 3 (eGFR 42) is being discharged after an acute HF exacerbation. Per the 2022 AHA/ACC/HFSA HF guidelines and 2023 focused update, which regimen reflects complete guideline-directed quadruple therapy?

Lisinopril + metoprolol tartrate + furosemide

Sacubitril/valsartan + carvedilol + spironolactone + dapagliflozin

Losartan + atenolol + hydrochlorothiazide + sitagliptin

Digoxin + amiodarone + spironolactone + empagliflozin

to track

2026 Statistics

Key Facts: ABPS Hospital Medicine Exam

~200

Total MCQ Items

ABPS Hospital Medicine Certification Examination

~4 hr

Total Exam Time

Computer-based test including breaks

~15%

Cardiovascular Weight

Largest single domain aligned to SHM core competencies

~$2,500

2026 Certification Fee

ABPS (verify current schedule)

140-180

ADA 2026 Inpatient Glucose

ADA Standards of Care — non-ICU and ICU target mg/dL

24 hr

Stroke Thrombectomy Window

DAWN / DEFUSE-3 with advanced imaging for LVO

The ABPS Hospital Medicine Certification Examination is a computer-based test from the American Board of Physician Specialties' Board of Certification in Hospital Medicine, comprising approximately 200 single-best-answer MCQs over roughly 4 hours. Content aligns to SHM core competencies: cardiovascular (~15%), infectious diseases (~11%), GI/hepatology (~10%), renal (~8%), endocrine (~8%), pulmonary/critical care (~8%), heme/onc (~7%), perioperative (~6%), neurology (~6%), patient safety (~6%), geriatrics/transitions (~5%), procedures (~4%), and palliative/ethics (~4%). Certification fee is approximately $2,500; requires MD/DO with unrestricted license and substantial hospital practice.

Sample ABPS Hospital Medicine Practice Questions

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

1A 68-year-old man with HFrEF (EF 28%), type 2 diabetes, and CKD stage 3 (eGFR 42) is being discharged after an acute HF exacerbation. Per the 2022 AHA/ACC/HFSA HF guidelines and 2023 focused update, which regimen reflects complete guideline-directed quadruple therapy?

A.Lisinopril + metoprolol tartrate + furosemide

B.Sacubitril/valsartan + carvedilol + spironolactone + dapagliflozin

C.Losartan + atenolol + hydrochlorothiazide + sitagliptin

D.Digoxin + amiodarone + spironolactone + empagliflozin

Explanation: The 2022 AHA/ACC/HFSA HFrEF guideline (reinforced by the 2023 focused update) recommends quadruple therapy: an ARNI (sacubitril/valsartan, preferred over ACEi/ARB), an evidence-based beta-blocker (carvedilol, metoprolol succinate, or bisoprolol), an MRA (spironolactone/eplerenone), and an SGLT2 inhibitor (dapagliflozin or empagliflozin) — regardless of diabetes status, down to eGFR 20-25. Metoprolol tartrate is not the correct beta-blocker formulation.

2A 74-year-old woman with paroxysmal atrial fibrillation has CHA2DS2-VASc of 4. She has CKD with CrCl 45 mL/min. Which anticoagulation strategy is most appropriate for stroke prevention?

A.Aspirin 81 mg daily

B.Apixaban 5 mg twice daily

C.Warfarin with INR goal 2.5-3.5

D.Clopidogrel plus aspirin

Explanation: In non-valvular AF with CHA2DS2-VASc ≥2 (men) or ≥3 (women), DOACs are first-line. Apixaban 5 mg BID is the standard dose; dose reduction to 2.5 mg BID requires ≥2 of: age ≥80, weight ≤60 kg, or creatinine ≥1.5 mg/dL. At CrCl 45, no dose reduction is triggered. Aspirin is not effective stroke prophylaxis. Warfarin INR goal is 2-3 for non-valvular AF.

3A 58-year-old man presents with crushing chest pain. ECG shows 3-mm ST elevation in leads II, III, aVF. Troponin is pending. Door-to-balloon capable PCI center is 30 minutes away. What is the most appropriate management?

A.Administer tenecteplase and transfer after 24 hours

B.Aspirin 325 mg, heparin, and transfer for primary PCI with goal device time ≤120 minutes

C.Obtain stress echocardiogram before intervention

D.CT coronary angiography first

Explanation: Inferior STEMI requires emergent reperfusion. Primary PCI is preferred when first-medical-contact to device time is ≤120 minutes. The patient should receive dual antiplatelet loading (ASA + P2Y12), anticoagulation, and prompt transfer. Fibrinolytics are reserved when PCI cannot be achieved within 120 minutes.

4A 55-year-old man with NSTEMI (TIMI 4) is admitted. He is hemodynamically stable. Troponin I is elevated. Per 2023 ACC/AHA NSTE-ACS guidelines, optimal timing of coronary angiography is:

A.Within 2 hours (immediate invasive)

B.Within 24 hours (early invasive) given intermediate-high risk

C.Within 72 hours after medical optimization only

D.Deferred — ischemia-guided strategy only

Explanation: For intermediate-to-high risk NSTE-ACS (TIMI ≥3, GRACE >140, dynamic troponin), early invasive strategy with angiography within 24 hours improves outcomes. Immediate (<2 hr) is for very high-risk features: hemodynamic/electrical instability, refractory angina, mechanical complications, acute HF. Low-risk patients can undergo ischemia-guided testing.

5Which clinical feature most strongly supports a diagnosis of pulmonary embolism per the Wells criteria?

A.Fever >38.5°C

B.Clinical signs of DVT (leg swelling and pain with palpation)

C.Productive cough

D.Pleuritic chest pain

Explanation: Wells criteria (3 points each): clinical signs of DVT AND PE most likely diagnosis. Other items worth fewer points: tachycardia >100 (1.5), immobilization/surgery within 4 weeks (1.5), prior VTE (1.5), hemoptysis (1), malignancy (1). Wells >4 = PE likely; ≤4 = PE unlikely (use D-dimer).

6A hemodynamically stable 62-year-old with submassive PE has RV strain on echo and elevated troponin. Systolic BP is 118/72. Per 2019 ESC and 2023 AHA guidance, which therapy is most appropriate?

A.Systemic thrombolysis with alteplase 100 mg

B.Therapeutic anticoagulation with close monitoring; reserve rescue thrombolysis for decompensation

C.IVC filter placement

D.Observation without anticoagulation

Explanation: Intermediate-high-risk PE (normotensive but with RV dysfunction and positive troponin) is managed with therapeutic anticoagulation and close hemodynamic monitoring. Systemic thrombolytics are reserved for hemodynamic decompensation (massive/high-risk PE) because of bleeding risk. Catheter-directed therapy is an emerging option for select patients.

7A 70-year-old with AF (CHA2DS2-VASc 5) on warfarin is scheduled for elective colonoscopy with biopsy. Based on the BRIDGE trial, optimal periprocedural management is:

A.Hold warfarin 5 days; bridge with therapeutic enoxaparin

B.Hold warfarin 5 days without bridging

C.Continue warfarin throughout the procedure

D.Switch to aspirin for 2 weeks

Explanation: The BRIDGE trial demonstrated that in patients with AF (without mechanical valves or recent stroke/VTE), bridging with LMWH did not reduce thromboembolic events but significantly increased bleeding. For patients with CHA2DS2-VASc <7 and no recent stroke, simply holding warfarin 5 days is preferred. Bridging is reserved for mechanical mitral valves, recent (<3 mo) stroke/TIA, or high-risk VTE.

8A 45-year-old febrile IV drug user has a new murmur, splinter hemorrhages, and three positive blood cultures for S. aureus. TEE shows a 1.2 cm tricuspid vegetation. Per modified Duke criteria (2023 revision), this represents:

A.Possible infective endocarditis

B.Rejected endocarditis

C.Definite infective endocarditis

D.Culture-negative endocarditis

Explanation: Definite IE by modified Duke/2023 Duke-ISCVID: 2 major criteria, OR 1 major + 3 minor, OR 5 minor. Major criteria: typical organism in ≥2 blood cultures (S. aureus, viridans strep, S. gallolyticus, HACEK, enterococci without primary focus); evidence of endocardial involvement (vegetation on echo). This patient meets 2 major criteria.

9A 62-year-old with COPD (FEV1 45% predicted) presents with increased dyspnea, purulent sputum, and increased sputum volume. Per GOLD 2026, which triad defines an Anthonisen 'Type 1' exacerbation warranting antibiotics?

A.Cough, wheeze, fever

B.Increased dyspnea, increased sputum volume, increased sputum purulence

C.Hemoptysis, chest pain, dyspnea

D.Orthopnea, pedal edema, JVD

Explanation: The Anthonisen criteria define COPD exacerbation severity. Type 1 (all three cardinal symptoms: increased dyspnea, sputum volume, sputum purulence) benefits most from antibiotics. GOLD 2026 recommends antibiotics in patients with all three symptoms, two symptoms if one is increased purulence, or those requiring mechanical ventilation.

10A 55-year-old admitted with CAP has a PaO2/FiO2 ratio of 180 on PEEP 10 cm H2O, bilateral infiltrates on CXR, and no evidence of cardiogenic edema. Per the Berlin definition, ARDS severity is:

A.Mild ARDS

B.Moderate ARDS

C.Severe ARDS

D.Does not meet ARDS criteria

Explanation: Berlin ARDS criteria: acute onset (≤1 week), bilateral opacities, not fully explained by cardiac failure, and PaO2/FiO2 on PEEP ≥5: mild (200-300), moderate (100-200), severe (≤100). This patient's ratio of 180 falls in the moderate range.

About the ABPS Hospital Medicine Exam

The ABPS Hospital Medicine Certification Examination validates core knowledge for independent hospitalist practice aligned to the Society of Hospital Medicine (SHM) core competencies. Content spans cardiovascular (ACS, AHA 2022/2023 HF quadruple therapy, AF, VTE), infectious diseases (Surviving Sepsis 2021 Hour-1 bundle, IDSA/ATS 2019 CAP, ATS/IDSA HAP/VAP 2016, IDSA CDI 2021 fidaxomicin), GI/hepatology (UGIB, pancreatitis, cirrhosis, AASLD HRS-AKI), renal (KDIGO AKI, hyponatremia, hyperkalemia), endocrine (ADA 2026 inpatient glycemia 140-180, DKA/HHS, thyroid storm), pulmonary/critical care (GOLD 2026, GINA 2026, ARDS, PE), hematology/oncology (DOAC reversal — andexanet alfa/idarucizumab, BRIDGE trial, HIT 4T score, TTP, oncologic emergencies), perioperative co-management (RCRI, 2024 ACC/AHA), neurology (acute stroke — DAWN/DEFUSE-3 thrombectomy, ICH, status epilepticus), patient safety (CMS HACs, TJC NPSG, I-PASS handoff, ABCDEF bundle), geriatrics and transitions (Beers Criteria, 4Ms), procedures (POCUS, central lines, paracentesis), and palliative care/ethics (WHO pain ladder, SPIKES, capacity). Requires MD/DO with unrestricted license and substantial hospital practice.

Questions

200 scored questions

Time Limit

CBT (~4 hours including breaks)

Passing Score

Criterion-referenced scaled score set by ABPS Board of Certification in Hospital Medicine (modified Angoff standard)

Exam Fee

~$2,500 certification examination fee (ABPS 2026 — verify current schedule) (American Board of Physician Specialties (ABPS) — Board of Certification in Hospital Medicine)

ABPS Hospital Medicine Exam Content Outline

~15%

Cardiovascular

Acute coronary syndromes (2021 ACC/AHA chest pain, 2023 non-ST ACS, door-to-balloon <90 min, DAPT, high-intensity statin), heart failure (AHA/ACC 2022 + 2023 focused update — quadruple therapy ARNI/ACEi + evidence-based BB + MRA + SGLT2i; diuresis), atrial fibrillation (CHA2DS2-VASc, HAS-BLED; DOAC preferred except mechanical valves/mitral stenosis), VTE (Wells, PERC, YEARS, PESI; DOAC first-line; thrombolysis for massive PE), hypertensive emergency (labetalol, nicardipine, clevidipine), endocarditis (Duke), pericarditis/tamponade.

~11%

Infectious Diseases

Sepsis and septic shock (Surviving Sepsis 2021 Hour-1 bundle — lactate, cultures before antibiotics, broad-spectrum antibiotics within 1 hour, 30 mL/kg crystalloid, norepinephrine first-line), CAP (IDSA/ATS 2019), HAP/VAP (ATS/IDSA 2016), C. difficile (IDSA 2021 — fidaxomicin preferred; bezlotoxumab for recurrence), UTI/CAUTI, SSTI and necrotizing fasciitis (LRINEC), meningitis (ceftriaxone + vancomycin ± ampicillin; dexamethasone for pneumococcal), SBP, IE, febrile neutropenia, HIV OIs, COVID-19 2026, influenza.

~10%

Gastroenterology & Hepatology

UGIB (Glasgow-Blatchford, Rockall; PPI, Hgb 7 transfusion threshold; terlipressin/octreotide + ceftriaxone for variceal; TIPS for refractory), lower GIB, acute pancreatitis (revised Atlanta, BISAP; aggressive LR; early enteral nutrition), cirrhosis decompensation (SBP prophylaxis, HE — lactulose + rifaximin), AASLD HRS-AKI (albumin + terlipressin or norepinephrine with midodrine/octreotide), acute liver failure (NAC for APAP; King's College transplant criteria), IBD flare, mesenteric ischemia, bowel obstruction, diverticulitis.

~8%

Renal & Electrolytes

AKI (KDIGO staging; pre-renal vs intrinsic vs post-renal; FeNa/FeUrea; contrast-associated AKI), hemodialysis indications (AEIOU), hyponatremia (SIADH; correction ≤8-10 mEq/L/24 hr to avoid osmotic demyelination), hypernatremia, hyper/hypokalemia (calcium gluconate, insulin/D50, beta-agonists, kayexalate/patiromer, HD), hyper/hypocalcemia, hyper/hypomagnesemia, acid-base (anion gap, Winter's, delta-delta), rhabdomyolysis, tumor lysis syndrome.

~8%

Endocrine

Inpatient hyperglycemia (ADA 2026 Standards — basal-bolus insulin preferred; target 140-180 mg/dL for non-ICU and ICU; avoid sliding scale alone), DKA/HHS (fluids, insulin infusion, K replacement before insulin if K<3.3, bicarbonate only if pH<6.9), thyroid storm (beta-blocker, PTU, iodine after thionamide, steroids), myxedema coma, adrenal crisis (hydrocortisone 100 mg IV q8h), SIADH/DI, hypercalcemia of malignancy.

~8%

Pulmonary & Critical Care

COPD exacerbation (GOLD 2026 — bronchodilators, 5-day steroids, antibiotics for purulence; NIV for hypercapnic failure), asthma exacerbation (GINA 2026), ARDS (Berlin; low tidal volume 6 mL/kg PBW, plateau ≤30, driving pressure ≤15, permissive hypercapnia, PEEP tables, proning for P/F <150, NMB), PE (hemodynamic stratification; systemic thrombolysis for massive; catheter-directed for submassive with decompensation), pleural effusion (Light's), ventilator weaning (SBT, RSBI <105), shock classification.

~7%

Hematology/Oncology

DOAC management and reversal (idarucizumab for dabigatran, andexanet alfa for Xa inhibitors, 4-factor PCC for warfarin), BRIDGE trial (no bridging for most non-valvular AF on warfarin), HIT (4T score; stop heparin, start argatroban/bivalirudin/fondaparinux; confirm SRA), DIC, TTP/HUS (PLASMIC, ADAMTS13; plasma exchange, caplacizumab), sickle cell crisis and acute chest, oncologic emergencies (TLS, SVC syndrome, spinal cord compression — dexamethasone + MRI, febrile neutropenia), transfusion medicine.

~6%

Perioperative & Co-Management

Perioperative risk assessment (RCRI, ACS NSQIP, Gupta MICA; functional capacity ≥4 METs), 2024 ACC/AHA perioperative cardiovascular guidance (no routine stress testing if adequate METs; stent/DAPT management), beta-blocker continuation, BRIDGE trial anticoagulant bridging, DOAC hold 24-48 hr by CrCl and bleeding risk, VTE prophylaxis (Caprini/Padua; LMWH vs UFH vs mechanical), perioperative diabetes, hip fracture to OR <48 hr, postoperative delirium.

~6%

Neurology

Acute ischemic stroke (IV alteplase ≤4.5 hr; tenecteplase; mechanical thrombectomy for LVO up to 24 hr — DAWN and DEFUSE-3 with advanced imaging), ICH (SBP 140; andexanet for Xa reversal; 4-factor PCC for warfarin), SAH (nimodipine, Hunt-Hess, Fisher), status epilepticus (benzodiazepine → fosphenytoin/levetiracetam/valproate; refractory — midazolam/propofol/ketamine infusion), delirium (CAM/CAM-ICU; ABCDEF bundle; avoid antipsychotics unless safety risk), GBS, myasthenic crisis.

~6%

Patient Safety & Quality

CMS Hospital-Acquired Conditions (HACs) and never events, TJC National Patient Safety Goals (NPSG) 2026, medication safety and reconciliation (admission/transfer/discharge), CLABSI and CAUTI prevention bundles, pressure injury and fall prevention, rapid response systems, root cause analysis and just culture, I-PASS handoff (Illness severity, Patient summary, Action list, Situation awareness, Synthesis by receiver), disclosure of adverse events, readmission reduction (Project RED, BOOST).

~5%

Geriatrics & Transitions of Care

Beers Criteria (AGS 2023) — potentially inappropriate medications (benzodiazepines, anticholinergics, NSAIDs with CKD, long-acting sulfonylureas), frailty (Clinical Frailty Scale, Fried), deprescribing (STOPP/START), falls and delirium prevention, functional status (ADL/IADL), goals of care and advance care planning, 4Ms Age-Friendly framework (Medications, Mentation, Mobility, what Matters), transitions of care (Project RED, BOOST, Care Transitions Intervention), medication reconciliation at discharge.

~4%

Procedures & Bedside Ultrasound

Central venous catheter placement (ultrasound-guided IJ; verify position; pneumothorax check), arterial line, paracentesis (albumin 8 g/L removed when >5 L), thoracentesis (Light's criteria, post-procedure imaging), lumbar puncture (contraindications, CSF analysis), bedside POCUS (FAST, cardiac, lung, vascular access), incision and drainage, shared decision-making and informed consent for procedures.

~4%

Palliative Care & Ethics

Pain management (WHO ladder, opioid equianalgesic conversion, opioid rotation, neuropathic adjuvants — gabapentin/duloxetine), symptom management (dyspnea — opioids; nausea — haloperidol/ondansetron/metoclopramide; constipation), hospice and palliative referral criteria, goals-of-care conversations (SPIKES, Ask-Tell-Ask, REMAP), advance directives and POLST, surrogate decision-making, capacity vs competency, withdrawal of life-sustaining treatment, principle of double effect, ethics consultation.

How to Pass the ABPS Hospital Medicine Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPS Board of Certification in Hospital Medicine (modified Angoff standard)
Exam length: 200 questions
Time limit: CBT (~4 hours including breaks)
Exam fee: ~$2,500 certification examination fee (ABPS 2026 — verify current schedule)

Keys to Passing

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

ABPS Hospital Medicine Study Tips from Top Performers

1AHA/ACC 2022 + 2023 focused update — heart failure with reduced ejection fraction (HFrEF) requires quadruple therapy: (1) ARNI (sacubitril/valsartan; or ACEi/ARB if ARNI not tolerated); (2) evidence-based beta-blocker (carvedilol, metoprolol succinate, or bisoprolol); (3) MRA (spironolactone or eplerenone); (4) SGLT2 inhibitor (dapagliflozin or empagliflozin). SGLT2i is now indicated across the EF spectrum including HFpEF. Initiate and titrate all four pillars rapidly — sequence matters less than achieving all four.

2Surviving Sepsis Campaign 2021 Hour-1 bundle: (1) measure lactate; (2) obtain blood cultures before antibiotics; (3) administer broad-spectrum antibiotics within 1 hour; (4) begin rapid 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L; (5) start vasopressors (norepinephrine first-line) to maintain MAP ≥65 if hypotensive during or after fluid resuscitation. Re-measure lactate if elevated. qSOFA is no longer recommended as a single screening tool — use clinical judgment supplemented by SIRS, NEWS, or MEWS.

3Inpatient hyperglycemia (ADA 2026 Standards of Care): preferred regimen is scheduled basal-bolus insulin (basal + prandial + correction) — NOT sliding-scale-alone. Target glucose 140-180 mg/dL for both non-ICU and most ICU patients; avoid <110 due to hypoglycemia risk. In DKA/HHS — start isotonic fluids first, check K+ before insulin (if K<3.3, replace potassium before starting insulin), give insulin infusion 0.1 units/kg/hr, add dextrose when glucose reaches 200 (DKA) or 300 (HHS), bicarbonate only if arterial pH <6.9.

4Acute stroke thrombectomy windows — know DAWN and DEFUSE-3 cold. Mechanical thrombectomy for large vessel occlusion (ICA, M1) is indicated up to 24 hours from last known well when imaging (CT perfusion or MRI DWI/PWI) shows a favorable penumbra-to-core mismatch. DAWN enrolled 6-24 hours based on clinical-core mismatch; DEFUSE-3 enrolled 6-16 hours based on perfusion-core mismatch. IV alteplase ≤4.5 hours remains standard; tenecteplase is an accepted alternative. Always check glucose and exclude hemorrhage before thrombolysis.

5BRIDGE trial (2015) — changed perioperative anticoagulation practice. For patients with non-valvular atrial fibrillation on warfarin undergoing elective procedures, NO BRIDGING with LMWH is non-inferior to bridging for arterial thromboembolism AND results in significantly less major bleeding. Bridging should be reserved for highest-risk patients (mechanical mitral valve, recent stroke/TIA within 3 months, CHA2DS2-VASc ≥7, or recent VTE <3 months). For DOACs, simply hold 24-48 hours preoperatively based on CrCl and bleeding risk — no bridging needed.

Frequently Asked Questions

What is the ABPS Hospital Medicine Certification Examination?

The ABPS Hospital Medicine Certification Examination is administered by the American Board of Physician Specialties through its Board of Certification in Hospital Medicine (BCHM). It validates breadth of knowledge for independent hospitalist practice aligned to the Society of Hospital Medicine (SHM) core competencies, covering cardiovascular, infectious diseases, GI/hepatology, renal, endocrine, pulmonary/critical care, hematology/oncology, perioperative co-management, neurology, patient safety, geriatrics/transitions, procedures, and palliative care/ethics.

Who is eligible to take the ABPS Hospital Medicine exam?

Candidates must hold an MD, DO, or equivalent degree with a valid unrestricted medical license and have completed an ACGME/AOA-accredited residency in Internal Medicine, Family Medicine, or Pediatrics. Eligibility also requires substantial hospital-based practice aligned to SHM core competencies, typically documented full-time or majority hospitalist practice with professional references attesting to clinical competence and ethics.

What is the format of the ABPS Hospital Medicine exam?

The ABPS Hospital Medicine certification exam is a computer-based examination of approximately 200 single-best-answer multiple-choice items administered over roughly 4 hours. Items commonly include clinical vignettes, imaging, ECGs, and laboratory data. The exam is blueprinted to the SHM core competencies with emphasis on cardiovascular, infectious diseases, GI/hepatology, renal, endocrine, pulmonary/critical care, perioperative co-management, and patient safety.

How much does the 2026 ABPS Hospital Medicine exam cost?

The 2026 ABPS Hospital Medicine certification fee is approximately $2,500 — always verify the current schedule on the ABPS website. Refund and cancellation policies follow the ABPS schedule with decreasing refund as the exam date approaches. Retakes require re-registration and full fee payment within the allowed qualification window. Continuing Certification involves additional CME and periodic assessment fees after initial certification.

When is the 2026 exam administered?

The ABPS Hospital Medicine exam is offered on scheduled dates per the BCHM calendar. Applications generally open several months before each testing window, with specific appointments scheduled at authorized CBT centers after application approval. Exact 2026 dates and registration deadlines should be confirmed on the ABPS Hospital Medicine page.

How is the exam scored?

ABPS uses criterion-referenced scaled scoring with a 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 domain-level feedback to guide future study and continuing certification activities.

What are the highest-yield topics?

Highest-yield topics include AHA/ACC 2022 + 2023 heart failure quadruple therapy (ARNI/BB/MRA/SGLT2i), Surviving Sepsis 2021 Hour-1 bundle, IDSA/ATS 2019 CAP, ATS/IDSA 2016 HAP/VAP, IDSA 2021 C. difficile with fidaxomicin, ADA 2026 inpatient glycemia target 140-180, DAWN and DEFUSE-3 thrombectomy windows, BRIDGE trial anticoagulant management, HIT 4T score with argatroban/bivalirudin, DOAC reversal (idarucizumab, andexanet alfa), AASLD HRS-AKI, ARDS low tidal volume and proning, CAM/ABCDEF bundle, I-PASS handoff, Beers Criteria, and 4Ms Age-Friendly framework.

How should I study for this exam?

Use a structured 6-12 month plan layered on active hospitalist practice. Map to SHM core competencies: begin with cardiovascular, infectious diseases, GI/hepatology, renal, and endocrine (foundational bread-and-butter), then pulmonary/critical care, heme/onc, and neurology; follow with perioperative co-management, geriatrics and transitions; finish with patient safety, procedures, and palliative care. Integrate current AHA/ACC, IDSA, ATS/IDSA, KDIGO, AASLD, GOLD, GINA, ADA, and SHM guidelines. Use UpToDate, MKSAP-HM or SHM Spark, Journal of Hospital Medicine, and high-volume MCQ practice. Complete 2-3 full-length timed mock exams.