The American Board of Internal Medicine has come under scrutiny in recent years for what some call an “alarming” drop in board pass rates. For example, overall ABIM pass rates for candidates seeking recertification fell from 90% in 2009 to just 78% in 2013. The ABIM maintains that neither the difficulty of the exam nor the strictness of the scoring process has changed. It points out that though pass rates for first attempts have fallen, the ultimate pass rate has remained stable. What’s more, the pass rate for first-time test-takers seeking initial certification has remained relatively steady over the last five