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Date Updated: September 29, 2017

International Foundations of Medicine (IFOM)

The IFOM Basic Science Exam

The International Foundations of Medicine® (IFOM®) Basic Science Exam (BSE) is a comprehensive examination designed to assess examinees’ knowledge of the basic medical sciences. Schools that use a traditional curriculum (in which students are taught basic sciences first and then progress to clinical training) often administer the IFOM BSE prior to the start of clinical training, but the exam is also used for other purposes.

For What Purposes Is the IFOM BSE Used?

Schools and other organizations use the exam in the following ways:

  • End-of-course, end-of-year, or end-of-training assessment
  • Part of admission requirements (with the IFOM Clinical Science Exam or other exams) for an internship or residency program
  • Curriculum or assessment benchmarking, eg, comparing the IFOM BSE scores to scores on a local assessment or comparing the IFOM BSE scores of students experiencing different types of curricula

The IFOM BSE is also used by individual students and graduates for personal benchmarking, for applying to residency programs, and for preparation to take the United States Medical Licensing Exam® (USMLE®) Step 1.

The exam comprises 160 multiple-choice questions, most of which are presented in clinical vignette style, in order to assess examinees’ ability to not just recall but also apply basic medical science knowledge. The following content areas are covered:

  • Anatomy
  • Biochemistry
  • Histology and Cell Biology
  • Microbiology
  • Organ Systems
  • Pathology
  • Pharmacology
  • Physiology

BSE Content Blueprint

The BSE is built to the following specifications; you can also download a PDF of the content blueprint here.

General Principles: 30%-35%

Biochemistry and molecular biology

  • gene expression: DNA structure, replication, and exchange
  • gene expression: transcription, including defects
  • gene expression: translation, including defects
  • structure and function of proteins
  • energy metabolism, including metabolic sequences and regulation
  • metabolic pathways of small molecules and associated diseases
  • biosynthesis and degradation of other macromolecules and associated abnormalities, complex carbohydrates, glycoproteins, and proteoglycans

Biology of cells

  • structure and function of cell components
  • signal transduction
  • cell-cell and cell-matrix adhesion
  • cell motility
  • intracellular sorting
  • cellular homeostasis
  • cell cycle
  • structure and function of basic tissue components
  • adaptive cell response to injury
  • intracellular accumulations
  • mechanisms of injury and necrosis
  • apoptosis

Human development and genetics

  • embryogenesis: programmed gene expression, tissue differentiation and morphogenesis, homeotic genes; developmental regulation of gene expression
  • congenital abnormalities: principles, patterns of anomalies, dysmorphogenesis
  • principles of pedigree analysis
  • population genetics: Hardy-Weinberg law, founder effects, mutation-selection equilibrium
  • genetic mechanisms
  • clinical genetics

Biology of tissue response to disease

  • inflammation, including cells and mediators
  • reparative processes
  • neoplasia

Gender, ethnic, and behavioral considerations affecting disease treatment and prevention

  • progression through the life cycle, including birth through senescence
  • psychologic and social factors influencing patient behavior
  • patient interviewing, consultation, and interactions with the family
  • medical ethics, jurisprudence, and professional behavior

Multisystem processes

  • nutrition
  • temperature regulation
  • adaptation to environmental extremes
  • fluid, electrolyte, and acid-base balance and disorders

Pharmacodynamic and pharmacokinetic processes

  • general principles
  • general properties of antimicrobials
  • general properties of antineoplastic agents and immunosuppressants
  • Microbial biology and infection
  • microbial classification and its basis
  • bacteria and bacterial diseases
  • viruses and viral diseases
  • fungi and fungal infections
  • parasites and parasitic diseases
  • principles of sterilization and pure culture technique

Immune responses

  • production and function of granulocytes, natural killer cells, and macrophages
  • production and function of T lymphocytes, T-lymphocyte receptors
  • production and function of B lymphocytes and plasma cells; immunoglobulin and antibodies: structure and biologic properties
  • antigenicity and immunogenicity; antigen presentation; cell activation/regulation; tolerance/clonal deletion
  • immunologic mediators: chemistry, function, molecular biology, classic and alternative complement pathways, cytokines, chemokines
  • immunogenetics; MHC structure and function, class I, II molecules; erythrocyte antigens
  • immunizations: vaccines, protective immunity
  • alterations in immunologic function
  • immunologically mediated disorders
  • immunologic principles underlying diagnostic laboratory tests
  • innate immunity

Quantitative methods

  • fundamental concepts of measurement
  • fundamental concepts of study design
  • fundamental concepts of hypothesis testing and statistical inference

Organ Systems: 65%-70%

Hematopeoietic and Lymphoreticular System: 2%-5%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical injury
  • neoplastic disorders
  • metabolic and regulatory disorders
  • vascular and endothelial disorders
  • systemic disorders affecting the hematopoietic and lymphoreticular system
  • idiopathic disorders

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the hematopoietic system
  • other therapeutic modalities (eg, splenectomy, chelating agents, radiation therapy for lymphomas, plasmapheresis)

Central and Peripheral Nervous System: 10%-15%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • acquired metabolic and regulatory disorders
  • vascular disorders
  • systemic disorders affecting the nervous system
  • idiopathic disorders affecting the nervous system
  • congenital disorders, including metabolic
  • degenerative disorders
  • paroxysmal disorders
  • disorders of special senses
  • psychopathologic disorders, processes and their evaluation

Principles of Therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the nervous
  • other therapeutic modalities (eg, radiation, CFS shunting, surgery)

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function, including barrier functions, thermal regulation, eccrine function
  • repair, regeneration, and changes associated with stage of life or ethnicity
  • skin defense mechanisms and normal flora

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic, regulatory, and structural disorders
  • vascular disorders
  • systemic disorders affecting the skin

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the skin/connective tissue
  • other therapeutic modalities (eg, laser, tattoo removal, cryotherapy)

Musculosekeletal System: 4%–7%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic, regulatory, and structural disorders
  • vascular disorders
  • systemic disorders affecting the musculoskeletal system
  • idiopathic disorders
  • degenerative disorders

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the musculoskeletal system
  • other therapeutic modalities (eg, radiation, surgery, casts, rehabilitation)

Respiratory System: 8%–10%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function, including surfactant formation, alveolar structure
  • repair, regeneration, and changes associated with stage of life
  • pulmonary defense mechanisms and normal flora

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic, regulatory, and structural disorders
  • vascular and circulatory disorders
  • systemic disorders affecting the respiratory system

Principles of Therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the respiratory system
  • other therapeutic modalities (eg, oxygen therapy, nasal CPAP, mechanical ventilation, physical therapy, surgical procedures, including transplantation)

Cardiovascular System: 11%–13%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic and regulatory disorders
  • vascular disorders
  • systemic diseases affecting the cardiovascular system
  • congenital disorders of the heart and central vessels

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the cardiovascular system
  • other therapeutic modalities (eg, pacemakers, angioplasty, valves, grafts, other surgical procedures)

Gastrointestinal System: 7%–9%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life
  • gastrointestinal defense mechanisms and normal flora

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic and regulatory disorders
  • vascular disorders
  • systemic disorders affecting the gastrointestinal system

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the gastrointestinal system
  • other therapeutic modalities (eg, surgical procedures, stents, feeding tubes)

Renal/Urinary System: 6%–9%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic and regulatory disorders
  • vascular disorders
  • systemic diseases affecting the renal system

Principles of Therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the renal and urinary system
  • other therapeutic modalities (eg, dialysis, renal transplantation)

Reproductive System: 4%–7%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function
  • reproductive system defense mechanisms and normal flora

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic and regulatory processes
  • systemic disorders affecting reproductive function
  • disorders relating to pregnancy, the puerperium, and the postpartum period

Principles of Therapeutics

  • mechanisms of action, use, adverse effects of drugs for treatment of disorders of the reproductive system and management of normal reproductive function
  • other therapeutic modalities affecting the reproductive system (eg, tampons)

Endocrine System: 4%–7%

Normal

  • embryonic development, fetal maturation, and perinatal changes
  • organ structure and function
  • cell/tissue structure and function, including hormone synthesis, secretion, action, and metabolism
  • repair, regeneration, and changes associated with stage of life

Abnormal

  • infectious, inflammatory, and immunologic disorders
  • traumatic and mechanical disorders
  • neoplastic disorders
  • metabolic and regulatory processes
  • vascular disorders
  • systemic disorders affecting the endocrine system
  • idiopathic disorders

Principles of Therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the endocrine system
  • other therapeutic modalities (eg, surgery, radiation)

Organ System Processes

Normal: 20%-25%

Abnormal: 50%-55%

Principles of Therapeutics: 20%-25%

Test Administration Options

The IFOM BSE can be ordered by schools and other institutions for administration at their sites to cohorts of students that they deem eligible. Institutions can administer the IFOM BSE either on paper or as a web-based test, using desktop or laptop computers on-site. See our For institutions page for information about the steps that schools and other organizations must take to be eligible to use the IFOM exams at their sites.

Individuals can take the IFOM BSE separately from their schools or training programs; individual administrations are offered at Prometric Test Centers twice a year, once in the spring and once in the fall. See the Test Administrations for Individuals page for information about applying to take the IFOM BSE as an individual and for registration and testing schedules.

Language Availability

The IFOM BSE is available in English, but a Spanish version will be available in early 2018. We can also translate the IFOM exams into other languages in certain circumstances. Contact the IFOM team if you are interested in administering IFOM exams in a language other than those listed above.

Take the IFOM BSE Practice Exam

Examinees can familiarize themselves with the IFOM BSE web-based format by using the free 20-question online practice exam, in either timed or untimed test administration conditions. Access the IFOM BSE Practice Exam.

Note: The practice exam is NOT intended to assist examinees in preparing for the content of the exam; it is only intended to familiarize examinees with the style and format of test questions they are likely to see on the IFOM exams if administered over the web.

Exam Security

Please visit this page for important information about NBME’s rules for examination security and conduct.

 

 

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