Pass rates for candidates taking the Nephrology board exam have fallen slightly over the last five years. This is true for both first-time test-takers and candidates seeking re-certification. The field of Internal Medicine as a whole has seen a significant drop in pass rates over the last decade; the American Board of Internal Medicine responded by citing the fact that while first-attempt pass rates had dropped, ultimate pass rates (meaning the candidate took multiple exam attempts to pass) remained high, between 95 and 98%.