1.1 ABPMR Part I Exam Overview & Format

ABPMR Physical Medicine and Rehabilitation Board Exam Study Guide Exam

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1 Chapter 1: Introduction & Exam Overview

1.1 ABPMR Part I Exam Overview & Format 1.2 Board Review Strategy & Content Blueprint Breakdown

2 Chapter 2: Musculoskeletal Medicine

2.1 Shoulder & Upper Extremity Diagnostics 2.2 Knee, Hip & Lower Extremity Conditions 2.3 Spine Pathology, Radiculopathy & Myelopathy 2.4 Inflammatory Arthritis, Tendinopathies & Concussion 2.5 Bone Health, Osteoporosis & Metabolic Bone Disease 2.6 Thoracic Outlet Syndrome & Peripheral Nerve Entrapment 2.7 Fracture Rehabilitation & Immobilization Complications 2.8 Overuse Tendinopathies & Regenerative Medicine 2.9 Gait Analysis & Abnormal Gait Patterns

3 Chapter 3: Spinal Cord Injury Rehabilitation

3.1 ASIA Examination & Impairment Scale 3.2 Spinal Cord Injury Syndromes 3.3 Autonomic Dysreflexia & Acute Complications 3.4 Neurogenic Bladder, Bowel & Secondary Complications

4 Chapter 4: Stroke & Neuromuscular Rehabilitation

4.1 Stroke Vascular Syndromes & Acute Assessment 4.2 Stroke Motor Recovery & Hemiplegic Complications 4.3 Spasticity Assessment & Multimodal Management 4.4 ALS, GBS, CIDP & Neuromuscular Disease Rehab 4.5 Multiple Sclerosis & Demyelinating Disease Rehabilitation 4.6 Parkinsonism, Movement Disorders & Functional Neurologic Disorder

5 Chapter 5: Electrodiagnostics (EMG/NCS)

5.1 Nerve Conduction Studies Principles & Physics 5.2 Needle Electromyography & MUAP Analysis 5.3 Mononeuropathies & Radiculopathy Patterns 5.4 Neuromuscular Junction Disorders & Myopathies

6 Chapter 6: Traumatic Brain Injury

6.1 TBI Severity Classification, Glasgow Coma Scale, and Pathophysiology 6.2 Rancho Los Amigos Levels of Cognitive Functioning and Disability Rating Scale 6.3 Neurobehavioral Sequelae and Agitation Management 6.4 Concussion Evaluation, Vestibular-Ocular Dysfunction, and Return-to-Play/Work Protocols

7 Chapter 7: Chronic Pain & Interventional Spine

7.1 Fluoroscopic Spine Interventions 7.2 Opioid Stewardship & Controlled Substance Compliance 7.3 Complex Regional Pain Syndrome, Fibromyalgia & Myofascial Pain 7.4 Spinal Cord Stimulation & Intrathecal Therapy

8 Chapter 8: Amputee Rehabilitation & Prosthetics

8.1 Amputation Surgical Levels & Medicare K-Levels 8.2 Socket Designs & Suspension Systems 8.3 Prosthetic Feet & Microprocessor Knee Mechanisms 8.4 Post-Amputation Care, Residual Limb & Phantom Pain

9 Chapter 9: Pediatric Rehabilitation

9.1 Cerebral Palsy Classification & GMFCS 9.2 Spina Bifida & Myelomeningocele Management 9.3 Muscular Dystrophies & Neuromuscular Disease in Children 9.4 Pediatric Brachial Plexopathy & Congenital Disorders

10 Chapter 10: Prosthetics, Orthotics & Assistive Technology

10.1 Lower Limb Orthoses — AFOs & KAFOs 10.2 Spinal & Upper Extremity Orthoses 10.3 Upper Limb Prosthetics — Body-Powered vs Myoelectric 10.4 Wheelchairs, Seating Systems & Pressure Mapping

11 Chapter 11: Medical Rehabilitation & Outcomes

11.1 Dysphagia Assessment & Management 11.2 Neurogenic Bladder & Bowel Management 11.3 Pressure Injuries & Wound Management 11.4 Outcome Measures & Medical Complications 11.5 Cancer Rehabilitation & Oncologic Rehabilitation 11.6 Burns, Endocrine/Metabolic & Medical Complications Rehabilitation

12 Chapter 12: Cardiopulmonary Rehabilitation

12.1 Cardiac Rehabilitation Phases & Metabolic Equivalents 12.2 Pulmonary Rehabilitation & COPD Management

13 Chapter 13: Foundational Rehabilitation Concepts

13.1 Kinesiology, Biomechanics & Functional Anatomy 13.2 Rehabilitation Pharmacology & Medication Management 13.3 Research Methodology, Biostatistics & Evidence-Based Practice 13.4 Nutrition, Metabolism & Energy Expenditure in Rehabilitation 13.5 Diagnostic Procedures: Imaging, MSK Ultrasound, Urodynamics & Neuropsych Assessment

1.1 ABPMR Part I Exam Overview & Format

Key Takeaways Explain This Topic AI

The ABPMR Part I Examination is a 1-day computer-based test at Pearson VUE comprising 325 single-best-answer multiple-choice questions (a subset are pretest/unscored), delivered in two 3-hour sections separated by a 60-minute break.

Passing scores are determined using a criterion-referenced modified Angoff standard set by expert physiatrists rather than a curved grade distribution; results are released 6-8 weeks after the August administration.

The 2026 on-time application fee is $1,395 ($795 fee + $600 processing) and the late fee is $1,895 (plus a $500 late fee); the exam is administered on a single date (August 4, 2026).

Eligible candidates have a defined Board-Eligible window following ACGME residency completion to pass both Part I and Part II examinations.

Last updated: July 2026

Executive Summary & Purpose of Part I Certification

The American Board of Physical Medicine and Rehabilitation (ABPMR) Part I Examination serves as the primary computer-based assessment for physicians seeking primary board certification in Physical Medicine and Rehabilitation (PM&R). Designed to evaluate broad-based clinical knowledge, diagnostic reasoning, functional assessment capability, and patient management strategies across the entire spectrum of rehabilitation medicine, passing Part I is the mandatory prerequisite for advancing to the Part II Oral Examination and achieving diplomate status. The examination tests not only core PM&R subspecialty knowledge—such as stroke, spinal cord injury, electrodiagnosis, and musculoskeletal care—but also underlying basic sciences, kinesiology, pharmacology, and interdisciplinary team leadership.

Exam Architecture and Pearson VUE Administration

The ABPMR Part I examination contains 325 single-best-answer multiple-choice questions (MCQs) , a subset of which are pretest (unscored) items that do not contribute to the candidate's score. It is administered in a single day at Pearson VUE professional testing centers across the United States and Canada. Testing consists of two 3-hour sections separated by a scheduled 60-minute break , giving 6 hours of active testing plus tutorial and break time. Candidates average roughly 66 seconds per question across the 6 hours of testing.

Exam Component Duration Item Count Format & Operational Details

Pre-Exam Tutorial & NDA ~15 minutes N/A Interface orientation, functionality check, and Non-Disclosure Agreement execution.

Section 1 3 hours (180 min) ~163 MCQs Single-best-answer clinical vignettes and direct factual items; media exhibits (imaging, EMG tracings) in a minority of items.

Scheduled Midday Break 60 minutes N/A Optional pooled break time between the two testing blocks.

Section 2 3 hours (180 min) ~162 MCQs Single-best-answer items covering remaining blueprint domains.

Post-Exam Survey ~15 minutes N/A Candidate feedback on testing environment, hardware, and item clarity.

Questions are presented in a single-best-answer format with four option choices. Navigation within an active section allows candidates to flag items, review responses, strike through options, and modify answers prior to submitting the section block. Once a section is submitted or time expires, candidates cannot return to previous questions.

Test Center Protocols & Biometric Check-In

On examination day, candidates must report to the assigned Pearson VUE center at least 30 minutes prior to their scheduled appointment. Security protocols are strict:

Identification Requirements : Candidates must present two forms of valid, unexpired identification (one primary government-issued ID with photo and signature, such as a driver's license or passport).

Biometric Authentication : Fingerprint or palm-vein scanning, digital signature capture, and a photograph are obtained upon arrival and prior to re-entering the testing room after breaks.

Testing Environment & Materials : No personal belongings, watches, mobile phones, or reference materials are permitted in the testing area. Pearson VUE provides candidates with erasable note boards or scratch paper and markers for calculations.

Americans with Disabilities Act (ADA) Accommodations : Candidates requiring testing accommodations (e.g., extended time, additional breaks, private testing rooms, or specialized medical equipment) must submit formal documentation to the ABPMR during the application window for pre-approval.

Psychometric Scoring Methodology: The Modified Angoff Standard

The ABPMR Part I examination employs a criterion-referenced scoring system rather than a norm-referenced (curved) grade distribution. Passing performance is established using the modified Angoff method , a rigorous psychometric standard-setting process:

Expert Panel Rating : A panel of practicing board-certified PM&R physicians evaluates every exam question individually.

Minimally Competent Candidate Estimation : Panelists estimate the probability that a "minimally competent candidate" (a borderline passing resident at graduation) will answer the question correctly.

Cut Score Determination : The individual question ratings are aggregated to establish an absolute passing threshold (the raw cut score) required to demonstrate clinical competence.

Scaled Score Conversion : Raw scores are mathematically converted to a standardized score scale to maintain equivalence across different examination forms administered in different test cycles.

Because the passing standard is fixed prior to exam administration, a candidate's pass/fail outcome is determined solely by their ability to meet the predefined competency threshold, independent of the performance of peer examinees. There is no predetermined percentage of candidates who fail. Raw Correct Answers ──► Psychometric Item Calibration ──► Scaled Score Calculation ──► Pass/Fail Result (vs Angoff Threshold)

Score Release & Candidate Performance Reports

Score results are released via the online ABPMR candidate portal approximately 6 to 8 weeks following the August examination window. Candidates receive an official score report indicating their overall Pass/Fail status . For candidates who do not pass, the report provides a detailed breakdown of performance across individual content domains, expressed relative to the passing threshold, allowing targeted remediation for subsequent attempts.

Eligibility Criteria and Application Procedures

To establish eligibility for the ABPMR Part I examination, applicants must fulfill specific educational and training prerequisites prior to registration:

ACGME-Accredited Residency : Successful completion of a 4-year categorical PM&R residency program or a 3-year advanced PM&R residency following an ACGME-accredited preliminary clinical year (or Royal College of Physicians and Surgeons of Canada equivalent).

Program Director Attestation : Formal verification by the residency program director confirming satisfactory completion of all clinical rotations, procedural competencies, electrodiagnostic requirements, and ethical standards.

Medical Licensure : Possession of a valid, unrestricted license to practice medicine in a U.S. state, commonwealth, territory, or Canadian province (or meeting specific resident physician permit criteria for newly graduated candidates).

The 2026 on-time application window runs November 1, 2025 through January 31, 2026 , with a late window February 1-28, 2026 . The on-time fee is $1,395 ($795 exam fee + $600 processing fee); the late fee is $1,895 (adds a $500 late fee). The examination is administered on August 4, 2026 . Candidates who miss the final registration cutoff cannot participate in that year's examination cycle.

Retake Policies and Board Eligibility

Graduates who complete residency enter Board-Eligible status , which confers a limited window to achieve primary board certification by passing both Part I and Part II examinations. Residency Completion (PGY-4) ──► Part I Exam (August) ──► Part II Oral Exam ──► ABPMR Diplomate Status

• │ │
• └─── Board-Eligibility Window ◄── One Attempt Per Year (August)

Key policy parameters governing retake attempts include:

Annual Cycle : Part I is administered only once per year, typically in August. Candidates who do not achieve a passing score must wait until the following August test cycle to retake the examination.

Attempt Limits : Candidates may re-examine annually within their board-eligibility window, provided registration and fee requirements are met.

Re-entry Pathway : Candidates whose board eligibility expires without achieving certification must complete a formal re-entry pathway designated by the ABPMR, which may involve additional accredited training, continuing medical education (CME) credits, professional peer reviews, and structured remediation prior to re-application.

Continuing Certification : After certification, diplomates maintain credentials through the ABPMR Longitudinal Assessment for PM&R (LA-PM&R) over 5-year Continuing Certification cycles—there is no longer a 10-year recertification examination.