NBME ®

INTERNATIONAL
FOUNDATIONS OF MEDICINE ®
PROGRAM GUIDE FOR INSTITUTIONS

Measure Student Knowledge and

Compare to an International Standard
CONTENTS

04 Overview and Policies for Use of International Foundations of Medicine (IFOM®) Examinations

04 Mission of the Program

04 Background

04 IFOM Program Goals

05 Policy on Use of IFOM Examinations

05 Legal Compliance

05 Research/Publications

06 Security of Examinations

07 Test Delivery Options

08 IFOM Examination Content

08 Content Outlines and Sample Items

09 Ordering and Test Administration

09 NBME Ordering Systems

Online Ordering of Examinations

11 Scheduling Web-based Exams at Prometric Test Centers

11 Payment Policies and Procedures

12 Administering IFOM Examinations

12 Test Administration Support

13 Test Accommodations

13 Examinees with Disabilities

Copyright © 2021, 2023 NBME. All rights reserved.

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CONTENTS

14 Scoring Feedback

14 Scoring, Scaling, and Equating of IFOM Examinations

15 Accessing Scores

15 Accessing Score Reports on the MyNBME℠ Services Portal

15 Additional Information

15 Score Recheck Service

15 Additional Resources

16 Contact Us

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OVERVIEW AND POLICIES FOR USE OF
INTERNATIONAL FOUNDATIONS
OF MEDICINE EXAMINATIONS

This guide provides general information about the International Foundations of

Medicine (IFOM®) program offered by NBME.

Mission of the Program „ Items are included on exams only after extensive
review and pretesting.
The primary mission of the NBME International
Foundations of Medicine program is to serve „ Item formats are similar to those used in Step 1
global medical education by providing high-quality and Step 2 CK.
assessment tools suitable for use potentially
„ The exams concentrate heavily on application and
anywhere in the world and for a variety of purposes.
integration of knowledge rather than on recall of
isolated facts. Many items are framed in the
context of clinical vignettes.

Background „ Multiple forms of each exam are available.

NBME offers a portfolio of standardized, discipline- IFOM exams are intended to complement other
based exams for use in assessment throughout the sources of information to evaluate the educational
medical school curriculum. These exams provide progress of medical students and others who take
institutions with effective evaluation tools and useful these exams and should be interpreted in addition to
examinee performance data that can be compared other available information. The quality of teaching
with a large representative group of examinees at can and should be evaluated by frequent peer
the same stage of training. IFOM exams are available observation and personal feedback, not inferred
globally in English, Spanish and Portuguese and solely from test scores.
provide faculty with valuable feedback on the
performance of their examinees.

The IFOM exams are developed and reviewed by

IFOM Program Goals
committees and task forces comprising faculty from
around the world. These committees follow the same Our multifaceted program goals are to provide:
rigorous protocol used to build Step 1 and Step 2
„ high-quality assessments that are efficient and
Clinical Knowledge (CK) of the United States Medical
cost-effective
Licensing Examination® (USMLE®). The IFOM exams
offer many benefits in the assessment of student „ opportunities to conduct and disseminate research
achievement: that informs faculty and policy makers and
promotes their understanding of assessment
„ Performance feedback provides comparisons of
individual examinee and cohort performance „ information on student educational
against the IFOM International Comparison Group, accomplishments to help advance educational
which includes examinees from the Americas, Asia, improvement and equity
the Middle East, Africa, Europe, and Oceania.
„ support services for a range of assessment and
educational programs

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Policy on Use of IFOM Examinations destinations, including countries subject to United
States comprehensive sanctions (e.g., Iran, Syria,
NBME provides IFOM exams in the basic and clinical the Crimea Region of Ukraine/Russia, Cuba or North
sciences for the purpose of assessing the educational Korea); (iii) to any individuals or entities that are
achievement of individuals in specific content areas. presently themselves on, or owned or controlled by
These exams may be provided to medical schools an entity that is on any Denied Party Lists; or (iv) that
and other institutions with a legitimate interest in the would, if exported or re-exported by NBME, violate
education of physicians or other health professionals. U.S. export control or economic sanctions laws or
All institutions using these exams must comply with require the issuance of a U.S. export license by one
test administration standards, including security or more U.S. government agencies.
protocols. Institutions using these exams must not engage, use
IFOM exams are designed primarily for use as or otherwise involve any individuals or entities that
summative exams after courses, clerkships, or are presently themselves on, or owned or controlled
other units of instruction. They may also be used by an entity that is on any Denied Party Lists, in
formatively but should not be used as practice paying any monies or fees to NBME.
exams. IFOM scores do not satisfy medical licensure
requirements in the USA.

Research/Publications
NBME analyzes IFOM exam-related data to ensure the
Legal Compliance integrity, security, fairness, and effectiveness of the
Any institution using these exams must comply in assessment. NBME may also use examination data for
all respects with all applicable laws, regulations, research and other purposes consistent with NBME’s
and orders to which it may be subject. Institutions Privacy Notice. Institutions that administer the IFOM
using these exams must not be (a) located in a examinations, as well as NBME itself, may also use
country that is subject to comprehensive sanctions exam-related data to conduct and publish research
by the United States; or (b) listed on, or owned or as long as neither individual performance results nor
controlled by a person listed on, or acting on behalf individual examinees are identified.
of a person listed on, any of the U.S. government Examinees may opt out from their IFOM examination
denied parties lists, including without limitation, the data being used by NBME for research intended
BIS Denied Persons, Entity or Unverified Lists; the for publication by indicating their preference in
OFAC Specially Designated National and Blocked their account at MyNBME.org or by emailing at
Person List; or the U.S. State Department Directorate [email protected].
of Defense Trade Controls (“DDTC”) Debarred Parties
List (collectively the “Denied Party Lists”). Learn more about NBME’s privacy practices by
reviewing our Privacy Notice, available at: https://
Institutions shall not, without first obtaining prior www.nbme.org/privacy.
express written approval of NBME and any necessary
export or re-export licenses, sell, export, re-export, For additional information, please contact NBME at
transfer or otherwise transmit the NBME exam [email protected].
materials or related services directly or indirectly:
(i) for any prohibited end uses; (ii) to any prohibited

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Security of Examinations Prometric testing may be preferred for students
serving on clinical rotations in a distributed hospital
To ensure the integrity of the NBME exams and network or for those located at a site without web-
the validity of the scores reported, it is essential based test delivery capability. It may also be useful
to always maintain the security and confidentiality for makeup tests.
of test materials. All items used in IFOM exams
are owned and copyrighted by NBME and/or its This option requires advance planning to allow
licensors. In addition, any unauthorized reproduction students sufficient time to schedule testing
or dissemination of test materials or any part of appointments.
them through any means, including but not limited
Note as well that medical students and graduates
to copying, printing, photographing or downloading
may register to take IFOM exams at Prometric
of electronic files, or reconstruction through
centers, independently of their medical schools or
memorization and/or dictation, is strictly prohibited.
training programs.
Institutions must notify NBME immediately upon
Scheduling Web-based Exams at Prometric Test
discovery or reasonable suspicion of a security
Centers
breach. The Institution must cooperate with any
NBME investigation of any actual or suspected After the test administration roster has been
security breach, and/or will conduct its own created for a web-based exam at a Prometric test
investigation at NBME’s request, including but not center, NBME generates a scheduling permit for
limited to interviewing examinees and proctors, and each examinee in approximately 2-3 business days.
will promptly provide the NBME with the outcome of There are exceptions if the examinee requires test
its own investigation, if any. accommodations (see page 11). Each examinee will
receive an e-mail from NBME with a URL to access
NBME reserves the right to pursue its rights and
and print or download their scheduling permit.
remedies to the fullest extent permitted by law
Information printed on the scheduling permit is
without further notice, including taking legal
required to schedule a testing appointment through
action. NBME also reserves the right to discontinue
Prometric’s website. The permit also has information
examination services in the event of a breach or
about admission to the test center, cancelling/
suspected breach in the security of test materials.
rescheduling appointments, and other policies and
procedures.

Test Delivery Options

Paper Examinations at Your Institution

Web-Based Examinations at Your Institution

As with our web-based tests, IFOM paper exams

must be administered in strict compliance with the
Web-based exams must be administered in a secure,
IFOM Test Administration Manual. For paper exams,
proctored setting. The Chief Proctor (CP) will have
orders must be placed and student rosters submitted
access to a centralized Chief Proctor Resource Site,
at least 30 days in advance of the test date.
which houses all the system applications in support
of test administration. The CP must conduct the
exam in strict compliance with the procedures
Language Options
outlined in the Chief Proctor’s Manual.

The IFOM Clinical Science Examination is available

Web-Based Examinations at Prometric Test Centers
in English, Spanish, and Portuguese. The IFOM
Basic Science Examination is available in English
and Spanish. IFOM examinations at Prometric Test
IFOM exams are available for administration at
Centers are only available in English.
Prometric’s worldwide network of secure test
centers.

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IFOM CONTENT

The IFOM program consists of two comprehensive Content Outlines and Sample Items
exams, the IFOM Basic Science Examination and the
IFOM Clinical Science Examination. IFOM content outlines developed by NBME
committees of international content experts are used
These are achievement tests covering material to construct each test. Items are selected based
typically learned during basic science education on content and performance statistics. The final
and core clinical clerkships. They reflect content form of each exam is reviewed and approved by
similar to that of the USMLE Step 1 and Step 2 CK the appropriate committee prior to release. Multiple
exams, respectively, and are typically used to identify forms of each exam are typically available at any time
areas of strength and weakness at key points during so that alternate forms may be used for successive
medical training. courses and clerkships or for makeup exams. Content
outlines and sample items for the IFOM exams
NBME also offers an IFOM Clinical Science Self-
are available on the IFOM webpage, on the Exam
Assessment for examinees preparing to take the
Content and Resources tabs.
IFOM Clinical Science Examination.

IFOM content
outlines are
developed by
committees of
content experts; the
items are selected
based on content
and performance
statistics.

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ORDERING AND TEST ADMINISTRATION

Online Ordering Systems

IFOM web-based and paper exams are ordered
through the NBME Online Ordering System in the
MyNBME℠ Services Portal.

Detailed information, test-location options, and

instructions for ordering web-based and paper
exams are available inthe MyNBME Services Portal.
All exams must be ordered in a time frame that is
sufficient to allow for processing and scheduling
administrative or technical support:

Web-Based Orders may be placed up to and including the 2nd calendar day prior to
Administrations the test date.
Through Your Institution Orders lock* 2 calendar days before the test date.

Web-Based Prometric A testing window of 7-14 calendar days is required.

Administrations Orders must be placed no later than 28 days prior to the start of the
testing window.

Orders lock* 21 calendar days prior to the start of the testing window.

Paper Examinations Orders must be placed and complete and accurate student rosters must
be received no less than 30 days prior to the test date. Any delays in
receipt of a final student roster may require a delay in the test date.

* All web-based exam orders can be revised or cancelled any time prior to the lock
date. After the lock date, NBME must be contacted to make order changes.

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Payment Policies and Procedures Test Administration Support

Exam Fees Web and Paper Examinations at Your Institution

Current IFOM exam fees are listed on the Fees tab of NBME staff will be available for test administration
the IFOM webpage. support on your test date to respond to technical or
procedural issues that may arise.

NBME staff are available 24 hours a day, 7 days a

Payment Terms
week by calling 215-590-9298 (exclusive of NBME
holidays).

NBME policies for payment are as follows: 2024 Holidays

„ Payment must be in US currency only and in the Monday, January 1

payment forms specified in the Payment Options Monday, January 15
section above. Monday, May 27
Wednesday, June 19
„ Payments, regardless of form, from examinees Thursday, July 4
are not accepted. Monday, September 2
„ No refunds are provided, but credits that can Thursday and Friday, November 28, and 29
be used for future orders may be applied in certain Wednesday, December 25
cases.

Web Administrations at Prometric Test Centers

Administering IFOM Examinations

Prometric test center staff will administer NBME
The ECP has overall responsibility for management
examinations in a secure setting and respond to
and planning of test administration events. The
any technical or procedural issues. Information
ECP is also required to recruit chief proctors and
about Prometric test centers is available at
other support staff, as needed, to perform the tasks
www.Prometric.com.
necessary to ensure a successful and secure test
administration.

NBME expects all proctors to be prepared to

administer NBME exams according to our policies
and procedures.

Detailed instructions for ECPs, chief proctors,

and proctors are available in the ECP Manual, the
Chief Proctor Manual (for web-based tests) and
the Test Administration Manual (for paper tests).
These manuals and other technical instructions for
administering NBME exams are available on the
MyNBME Services Portal.

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TEST ACCOMMODATIONS

Examinees with Disabilities

Individuals with disabilities may be entitled to accommodations under applicable law
in your location. The school or other ordering organization will determine whether
any accommodations are warranted, decide what specific accommodations may be
reasonable for a particular examinee, and bear all costs associated with any such
accommodation. NBME will make a good faith effort to provide such reasonable test
accommodations that the school determines are warranted for the examinee.

You must notify NBME of any examinees who have been approved for
accommodations at the time the order is placed. For additional information,
contact us at [email protected] or (215) 590-9258.

Extra Testing Time and Text Enlargement for Accommodations at

Local Administration of Web Examinations Prometric Test Centers

NBME has several pacing options (1.25x, 1.5x or It is possible to arrange for examinees to take an
2x) for examinees needing extra testing time. The examination with test accommodations (e.g., extra
pacing is set in the examinee’s record on the test testing time) at a Prometric test center.
administration roster, which alerts the system to
Orders should be placed as far in advance as possible
create an extra-time form. Examinees with visual
because generating these scheduling permits could
impairments may use their own screen magnification
take up to two weeks.
software or use the browser’s text size feature to
enlarge the font.

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SCORING FEEDBACK

Score and Analytical Reports

NBME provides a variety of performance feedback. Sample score reports for the
IFOM exams can be found on the Scoring tab of the IFOM webpage.

Scoring, Scaling, and Equating much notice as possible to help ensure organizations
and examinees are prepared for the changes.
of IFOM Examinations
Detailed information about scoring, scaling, equating,
and the make-up of comparison groups for the IFOM New Exam Forms
exams is available, along with sample score reports,
on the Scoring tab of the IFOM webpage.

Standard score reports for web-based IFOM exams When NBME introduces new exams, equated score
are normally delivered within a week of the test date; reporting may be delayed until sufficient data
standard score reports for paper exams are normally have been collected to enable score reporting.
delivered within 2 weeks of receipt of answer sheets. Any organization whose test administration could
experience delayed score reporting will be notified
NBME reserves the right to change its score scales, and will normally have the option to reschedule the
score reports, and other aspects of its score reporting exam or request that a different form of the same
for IFOM at any time, but we will always provide as exam be administered instead.

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ACCESSING SCORES

Accessing Score Reports on the NBME will not otherwise transmit or report scores,
including by fax, telephone, or e-mail. Score reports
MyNBME Services Portal
may be withheld for nonpayment of invoices.
Scores and related performance reports are available
Score reports for a specific academic year remain
through the portal after each test administration.
on the portal for approximately four academic years
Access to scores and score reports can be assigned
for all exams. Users will be notified about a month in
to your staff by your institution’s User Account
advance of information being removed, to allow time
Administrator.
for final download of reports if necessary.

ADDITIONAL INFORMATION

Score Recheck Service It should be noted that the sole purpose of the score
recheck service is to verify that the score originally
NBME is confident that each reported score is an reported is correct. Score recheck requests may be
accurate reflection of the responses that an examinee made up to six months after the test date. Score
recorded in the testing interface for web-based recheck requests received after that time cannot be
exams or on the paper answer sheet for paper accommodated.
exams. This is based on reliable scoring and reporting
techniques backed by a variety of quality control and
verification procedures.

However, if a score is believed to be in error, a score

Additional Resources
recheck can be requested. Additional information and resources are available at
www.nbme.org and on the MyNBME Services Portal
Requests for score rechecks must be initiated by the
(accessible only after a school or organization is
institution, either by the ECP or appropriate staff
authorized to use the NBME exams).
(e.g., course or clerkship director) in the department
administering the test. A Score Recheck Request
Form is available to download from the MyNBME
Services portal. It is located in both the Score
Reports page and on the ECP Page Services and
Documents. NBME will only accept checks or money
orders from the institution. Requests will not be
processed if the check or money order is provided
by the examinee. Results are provided approximately
two weeks after receipt of the request.

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CONTACT US

Please contact us if you have any questions. NBME staff can provide the information
you need or help solve a problem.

NBME Contact List

NBME Billing Accounts and Invoice Questions [email protected]

Operational Support for Web-Based Subject Exams [email protected]

including IFOM 215-590-9258
(questions about ordering exams, faculty review, test
accommodations, Prometric administrations, proctoring,
exam security, scoring issues, test administration, etc.)

Operational Support for Paper IFOM Exams [email protected]

All Other Inquiries [email protected]

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