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Date Updated: December 13, 2018

International Foundations of Medicine (IFOM)

The IFOM Clinical Science Exam

The International Foundations of Medicine® (IFOM®) Clinical Science Exam (CSE) 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 CSE 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 (CK)

IFOM CSE is also used by individual students and graduates for personal benchmarking, to apply to residency programs, and for preparation to take USMLE Step 2 CK.

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

IFOM CSE Content Blueprint

The CSE is built to the following specifications; you can also download a PDF of the content blueprint here.
(The content outline for IFOM CSE exams taken up until December 31, 2018 is represented here).

CONTENT OUTLINE

  • Infancy and Childhood (0 to 12 years)
  • Adolescence (13-17 years)
  • Adulthood (18-64 years)
  • Senescence (65 years and older)

Immune System: 2%-4%

  • Disorders associated with immunodeficiency
  • HIV/AIDS
  • Immunologically mediated disorders
  • Adverse effects of drugs on the immune system

Blood and Lymphoreticular System: 4%-6%

  • Infectious and immunologic
  • Neoplasms
  • Anemia, cytopenias, and polycythemia
  • Coagulation disorders (hypocoagulable and hypercoagulable conditions)
  • Traumatic, mechanical, and vascular disorders
  • Congenital disorders
  • Adverse effects of drugs on the hematologic and lymphoreticular systems

Behavioral Health: 3.5%-5.5%

  • Psychotic disorders
  • Anxiety disorders
  • Mood disorders
  • Somatoform disorders
  • Factitious disorders
  • Eating disorders and impulse control disorders
  • Disorders originating in infancy/childhood
  • Personality disorders
  • Psychosocial disorders/behaviors
  • Substance use disorders
  • Adverse effects of drugs

Nervous System and Special Senses: 8.5%-10.5%

  • Infectious, immunologic, inflammatory disorders
  • Neoplasms (cerebral, spinal, and peripheral)
  • Cerebrovascular disease
  • Disorders relating to the spine, spinal cord, and spinal nerve roots
  • Cranial and peripheral nerve disorders
  • Neurologic pain syndromes
  • Degenerative disorders/amnestic syndromes
  • Global cerebral dysfunction
  • Neuromuscular disorders
  • Movement disorders
  • Metabolic disorders
  • Paroxysmal disorders
  • Sleep disorders
  • Traumatic and mechanical disorders and disorders of increased intracranial pressure
  • Congenital disorders
  • Adverse effects of drugs on the nervous system
  • Disorders of the eye and the eyelid
  • Disorders of the ear

Skin and Subcutaneous Tissue: 3.5%-5.5%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Adnexal disorders (hair and hair follicles, nails, sweat gland, sebaceous glands, oral mucous membranes)
  • Oral disease
  • Disorders of pigmentation
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on skin and subcutaneous tissue

Musculoskeletal System: 6%-8%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Degenerative and metabolic disorders
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the musculoskeletal system

Cardiovascular System: 8%-10%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Dysrhythmias
  • Heart failure
  • Ischemic heart disease
  • Diseases of the myocardium
  • Diseases of the pericardium
  • Valvular heart disease
  • Hypotension
  • Hypertension
  • Dyslipidemia
  • Vascular disorders
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the cardiovascular system

Respiratory System: 8.5%-10.5%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Obstructive airway disease
  • Pneumoconiosis/fibrosing/restrictive pulmonary disorders/interstitial lung disease
  • Respiratory failure/respiratory arrest and pulmonary vascular disorders
  • Metabolic, regulatory, and structural disorders
  • Disorders of the pleura, mediastinum, and chest wall
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the respiratory system

Gastrointestinal System: 8%-10%

  • Infectious, immunological, and inflammatory disorders
  • Neoplasms
  • Signs, symptoms, and ill-defined disorders
  • Disorders of the oral cavity, salivary glands, and esophagus
  • Disorders of the stomach, small intestine, colon, rectum, and anus
  • Disorders of the liver and biliary system, noninfectious
  • Disorders of the pancreas
  • Disorders of the peritoneal cavity
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the gastrointestinal system

Renal and Urinary System: 4.5%-6.5%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Signs, symptoms, and ill-defined disorders
  • Metabolic and regulatory disorders
  • Vascular disorders
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the renal and urinary system

Pregnancy, Childbirth, and the Puerperium: 4%-6%

  • Prenatal care
  • Obstetric complications
  • Labor and delivery
  • Puerperium, including complications
  • Newborn (birth to 4 weeks of age)
  • Congenital disorders, neonatal
  • Adverse effects of drugs on pregnancy, childbirth, and the puerperium
  • Systemic disorders affecting pregnancy, labor and delivery, and puerperium

Female Reproductive System & Breast: 6%-8%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms of the breast, cervix, ovary, uterus, vagina, and vulva
  • Fertility and infertility
  • Menopause
  • Menstrual and endocrine disorders
  • Sexual dysfunction
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the female reproductive system and breast

Male Reproductive System: 1%-3%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Metabolic and regulatory disorders, including sexual dysfunction
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the male reproductive system

Endocrine System: 6%-8%

  • Diabetes mellitus and other disorders of the endocrine pancreas
  • Thyroid disorders
  • Parathyroid disorders
  • Adrenal disorders
  • Pituitary disorders
  • Hypothalamic endocrine disorders
  • Multiple endocrine neoplasia (MEN1, MEN2)
  • Congenital disorders
  • Adverse effects of drugs on the endocrine system

Multisystem Processes & Disorders: 6%-8%

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms and related disorders
  • Signs, symptoms, and ill-defined disorders
  • Nutrition
  • Toxins and environmental extremes
  • Venomous bites and stings
  • Fluid, electrolyte, and acid-base balance disorders
  • Abuse
  • Multiple trauma (e.g., prioritization, blast injury)
  • Shock, cardiogenic, hypovolemic, neurogenic, septic; sepsis, bacteremia, systemic inflammatory response syndrome (SIRS), refractory, multi-organ dysfunction syndrome
  • Genetic metabolic and developmental disorders
  • Adverse effects of drugs on multisystem disorders

Biostatistics, Epidemiology, and Public/Population Health: 3%-5%

Epidemiology and public/population health

  • Epidemiology and public/population health
  • Measures of disease frequency: incidence/prevalence
  • Measures of health status
  • Population pyramids and impact of demographic changes
  • Disease surveillance and outbreak investigation
  • Communicable disease transmission
  • Points of intervention

Study design, types and selection of studies

Measures of association (e.g.; relative risk, odds ratio, other)

Principles of testing and screening (e.g.; sensitivity and specificity, predictive value,probability)

Study interpretation (e.g.; causation, validity, statistical vs. clinical significance)

Research ethics (e.g.; informed consent, privacy of patient data, regulatory issues)

Social Sciences: 1%-3%

Medical ethics and jurisprudence

  • Consent to treatment/decision-making capacity
  • Death and dying and palliative care
  • Physician-patient relationship
  • Professional conduct/integrity

Patient safety (including basic concepts and terminology)

PHYSICIAN TASKS/COMPETENCIES

Medical Knowledge/Scientific Concepts: 13%-18%

  • Applying foundational science concepts

Patient Care – Diagnosis: 43%-48%

  • History and physical examination
  • Laboratory and diagnostic studies
  • Diagnosis
  • Prognosis/outcome

Patient Care – Management: 32%-37%

  • Health maintenance and disease prevention
  • Pharmacotherapy
  • Clinical interventions
  • Mixed management
  • Surveillance for disease recurrence

Professionalism: 1%-2%

  • Professionalism/legal/ethical issues in interaction with patients and families
  • Professionalism/legal/ethical issues in interactions with patients and families related to death and dying
  • Professionalism/legal/ethical issues in interactions with other health professionals

Patient Safety: 1%-2%

Practice-based Learning: 2%-4%

  • Understanding and application of principles of biostatistics, public health, and epidemiology
  • Understanding of the principles of research ethics and regulatory issues

Test Administration Options

The IFOM CSE can be ordered by schools and other institutions for administrations at their sites to cohorts of students that they deem eligible. Institutions can administer the IFOM CSE 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 IFOM exams at their sites.

Individuals can take the IFOM CSE 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 CSE as an individual and for testing schedules.

Language Availability

The IFOM CSE is available in English, Spanish and Portuguese. 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.

Preparing to Take the IFOM CSE

The National Board of Medical Examiners makes two methods available to help examinees prepare to take the IFOM CSE: a self-assessment and a practice exam.

The IFOM Clinical Science Self-Assessment Examination is an 80-question web-based exam built to the same content blueprint as the IFOM CSE; learn more on the IFOM Clinical Science Self-Assessment Exam web page.

The IFOM CSE Practice Exam is a free 20-question web-based exam that allows examinees to familiarize themselves with the IFOM CSE format, in either timed or untimed test administration conditions. Access the IFOM CSE 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 on the web.

Exam Security

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

 

 

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