The International Foundations of Medicine (IFOM®) Program provides high-quality exams to medical schools and other organizations around the world.

Information for Examinees

Measure Your Students Against an International Standard

The International Foundations of Medicine Program enables medical schools and other organizations around the world to assess students’ knowledge and compare their performance against international benchmarks.

The exams are used for a variety of purposes, including evaluating student knowledge at key points in their education, selecting candidates for training programs, granting national certifications, and personal or curricular benchmarking.

    Exam Content

    Exam content is intended to represent global health care trends and needs, and to target the types of health problems and issues facing patients and physicians outside the United States and Canada.

    We rely on a committee of international medical school faculty to write and review exam items.

    The program is comprised of three exams. Click below to learn more and visit the resources section to view full content outlines.

      The IFOM Basic Science Exam 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 Basic Science Exam prior to the start of clinical training, but the exam is also used for other purposes.

      For What Purposes Is the IFOM Basic Science Exam 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, such as comparing the IFOM Basic Science Exam scores to scores on a local assessment or to scores of students experiencing different types of curricula

      The IFOM Basic Science Exam is also used by individual students and graduates for personal benchmarking, for applying to residency programs, and for preparation to take the 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

      View the full content outline here.

      The International Foundations of Medicine Clinical Science Exam assesses the medical knowledge and understanding of clinical science considered essential for the provision of safe and effective patient care.

      For What Purpose Is the IFOM Clinical Science Exam Used?

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

      • Curriculum/assessment benchmarking/quality control
      • Testing students prior to or after clinical training
      • Medical school exit exam
      • Intern/residency selection
      • Preparation for the United States Medical Licensing Exam® (USMLE®) Step 2 Clinical Knowledge

      IFOM Clinical Science Exam is also used by individual students and graduates for personal benchmarking, to apply to residency programs, and for preparation to take USMLE Step 2 Clinical Knowledge.

      The exam comprises 160 multiple-choice questions presented in clinical vignette style to assess examinees’ ability to not just recall but also apply their knowledge in clinical contexts.

      The following content areas are covered:

      • Family Medicine
      • Medicine
      • Obstetrics and Gynecology
      • Pediatrics
      • Psychiatry
      • Surgery

      View the full content outline here.

      The IFOM Clinical Science Self-Assessment can help to assess an individual’s knowledge of the clinical sciences in advance of taking the IFOM Clinical Science Exam.

      It's built to the same content specifications as the IFOM Clinical Science Exam and covers the same topics and physician tasks, but includes only 80 items. Examinees can choose to take the IFOM Clinical Science Self-Assessment untimed or timed (to practice how quickly they need to move from item to item to complete the exam). Scores are provided immediately.

      Individuals can order the IFOM Clinical Science Self-Assessment for themselves, or schools and other institutions can use the NBME Self-Assessment Services Voucher Program to order it for their examinees. When institutions order the self-assessment for their students, both the students and the institution receive the scores.


      Interested in ordering an International Foundations of Medicine exam?

      The IFOM Basic and Clinical Science exams can be ordered by schools and other institutions for administration at their sites to cohorts of students that they deem eligible.

      You can contact us directly at and we’ll set up a call to discuss bringing the exam to your organization. 

      Exams are available in both web-based and paper format. If you select the web-based option, NBME staff will provide a 90-minute training session for your chief proctors to learn how to use NBME’s web-based test ordering, rostering, and testing systems.


      Language Availability

      Both the IFOM Basic Science Exam and Clinical Science Self-Assessment are available in English and Spanish.

      IFOM Clinical Science Exam is available in English, Spanish and Portuguese.

      We can also translate IFOM exams into other languages in certain circumstances. Contact the IFOM team if you are interested in administering IFOM in a language other than those listed above.


      Exam Security

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


      Scoring is included in the cost of all three IFOM examinations and standard score reports are provided at no additional charge.

      To learn more about the score reports offered for the IFOM Clinical Science Self-Assessment, visit the Taking a Self-Assessment page.

      Equated percent correct scores are the primary scores for the IFOM Basic Science Exam and the IFOM Clinical Science Exam. Equated percent correct scores provide a consistent way to measure examinees’ performance on multiple exam forms administered at the same or different times.

      These scores are statistically equated across exam administrations. Equating practices ensure that all scores have the same meaning on different forms of the same exam, despite potential differences in overall exam difficulty.

      Scores are scaled to a reference group of examinees from international medical schools (the “International Comparison Group”) who took the exam for the first time under standardized conditions.

      NBME provides a variety of performance feedback on the IFOM exams in relation to an international comparison group of examinees.

      The current International Comparison Groups for the IFOM Basic Science Exam and Clinical Science Exam include examinees from the Americas, Asia (including the Middle East), Europe, and Oceania who sat for the IFOM exams for the first time, under standardized conditions, from 2018 through 2022.

      Schools and other organizations that administer IFOM exams receive the following reports:

      • An Examinee Performance Report for each examinee, which includes the examinee’s total test score and performance profiles outlining areas of strength and weakness, as compared to the International Comparison Group (ICG), in each content area measured by the exam.
        • This report links to a Score Interpretation Guide that helps examinees understand all aspects of their score and allows them to compare their performance on the IFOM Basic Science Exam or Clinical Science Exam to the USMLE® Step 1 or Step 2 Clinical Knowledge.
      • A Certification in Basic/Clinical Science Knowledge is provided for any IFOM examinee whose score is at or greater than the corresponding approximate USMLE Step examination passing score (Step 1 for IFOM Basic Science Exam, Step 2 CK for IFOM Clinical Science Exam).
      • A Score Roster in Excel Format listing each examinee and their total test score.
      • A Score Roster in PDF Format listing each examinee’s total test score, along with information on the examinee group’s mean, standard deviation, minimum, and maximum performance.
      • Score Interpretation Guidelines that assist organizations in interpreting all aspects of their examinees’ scores and that provide a table enabling comparisons of examinees’ scores to analogous scores on Step 1 (IFOM Basic Science Exam) or Step 2 Clinical Knowledge (IFOM Clinical Science Exam).
      • In addition, organizations that have administered IFOM exams to 15 or more examinees will receive Group Summary Reports. These detailed reports compare the performance of the examinee group with the International Comparison Group and help highlight areas of strength and weakness in medical school curricula.
        • The Group Summary Reports include:
          • Group Norm Table Report, which provides information on both the examinee group and the International Comparison Group; this can be used to compare total test performance of individual examinees in your group with scores of the International Comparison Group.
          • Group Performance Report, which provides a visual comparison of the total test performance of the examinee group and the International Comparison Group.
          • Performance Summary Profile Report, which provides box plots to show the examinee group’s performance in all major subject areas covered in the examination.
          • It may also be possible for NBME to provide comparisons to groups other than the International Comparison Group, for example, a regional comparison group or a countrywide group.


      The standard prices listed below include the following:

      • The IFOM exam 
      • Instruction on using the NBME’s web-based testing system 
      • Proctor manuals for both paper and web-based exams  
      • Standard score reports, which are distributed via the MyNBME Services Portal.
        Fee (Per Exam)
      IFOM Basic Science Exam $50
      IFOM Clinical Science Exam  $75
      IFOM Clinical Science Self-Assessment $35


      Additional fees may be charged for other services related to the IFOM examinations, including but not limited to shipping of paper examinations, translation services, or other special services.

      Your organization can purchase vouchers for the IFOM Clinical Science Self-Assessment for distribution to students or other examinees using the Self-Assessment Voucher Program.