This document provides an overview of preparation strategies for the ABAI Certification and Recertification exams. It describes the exam format, content, scoring, and resources for preparation. Key points include that the Certification exam consists of 225 multiple choice questions over 7 hours testing basic science and clinical knowledge, while the Recertification exam focuses only on recent clinical advances. Suggested preparation includes reviewing provided study guides and textbooks, practicing questions from prior exams, and focusing on high yield topics such as immunology, pharmacology, and common clinical presentations.

1. Curtain Page
Preparation Strategies for the
ABAI Cert/Recert Exams
Tao Le, MD, MHS
Associate Clinical Professor
Chief, Section of Allergy & Immunology
Department of Medicine
University of Louisville

2. www.slideshare.net/taolemd

3. Disclosures
• Editor, ACAAI Review for the Allergy and
Immunology Boards
• Senior Editor, First Aid for the Boards
review series (McGraw-Hill)
• Executive Editor, USMLE-Rx.com

4. Disclaimers
• No affiliation with the ABAI
• ABAI makes no recommendations
regarding test preparation resources or
guidance

5. Learning Objectives
• To describe the ABAI certification and
recertification examination
• To identify and select study and testing
strategies for the ABAI examinations
• To identify and select appropriate study
resources for the ABAI examinations

6. Brief History of the ABAI
• First administered in 1974
• First recertification administered 1977
• 10-yr certificates first awarded in 1989
• Offered annually starting 2005
• Certified roughly 120 allergists each year
• Roughly 85% of diplomates recertify

7. ABAI Exam Overview
www.abai.org
Certification MOC
Recent
Advances
Items 225 200 30
Time 7hrs (2 sessions) 4hrs (1 session) 6 weeks
Location test center test center ABAI Web Portal
Method computer-based computer-based computer-based
Passing Score
absolute
minimum
absolute
minimum
80% correct
Basic Science ~35% 0% 0%
Clinical Science ~65% 100% 100%

8. Anatomy of an MCQ
Stem A patient who is HIV+ (peripheral blood
CD4+ count ≤ 200/µl) develops acute
maxillary sinusitis.
Lead-In Which of the following organisms is most
likely to be causative?
Options A. Pseudomonas aeruginosa
B. Listeria monocytogenes
C. Aspergillus fumigatus
D. Streptococcus pneumoniae

9. Question Structure
• Best single answer
• No negatively phrased
• 4 response options
• Some questions have images
• Trends towards:
– Short vignettes
– Basic science and clinical integration
– Multi-step questions – eg, clinical presentation  dx
 molecular defect?

10. Certification Exam Content
2010-11
Basic Science 32%
--Immune mechanisms 6
--Cells involved in immune
responses
5
--Specific immune responses 7
--Laboratory tests 9
--Anatomy/physiology/pathology 3
--Research principles 2

11. Certification Exam Content
2010-11
Clinical Science 68%
--Hypersensitivity disorders 27
--Immunological disorders 13
--Pharmacology/therapeutics 12
--Specific diagnostic modalities 9
--Allergens/antigens 7

12. Certification vs. ITE
• No relationship between ABAI and AAAAI’s ITE
• Similar style and construction
• Similar content blueprint
• No evidence of correlation between ITE & Cert
• Differences
– Different computer interface
– ITE – 200 Q’s in 3.25 hrs
– ABAI – 225 Q’s in 7 hrs

13. Recertification Exam Content
ABAI Clinical Items 2009-10
Hypersensitivity disorders 41%
Immunological disorders 18%
Pharmacology/therapeutics 16%
Specific diagnostic
modalities
13%
Allergens/antigens 12%

14. Recert vs. Recent
Advances
• Style and construction of test items are identical
• Both with 100% clinical science coverage
• Exams share no questions
• Differences?
– Questions: 200 vs. 30 items
– Content: established literature vs. clinical advances
– Test situation: secure exam vs. open book/multiple attempts
– Passing: 400 scaled score vs. 80%

15. Pass/Fail Criteria
• Norm reference standard
– Until 2001
– A fixed percentage always fails
– Competent candidates could fail in a strong year
• Criterion reference standard
– Implemented in 2003
– Competency threshold predetermined
– Theoretically, 100% can pass

16. Certification Pass Rates
Group 2013 5 Yr Avg*
Overall 82% 86%
First-time 89% 93%
Repeater 29% 36%
U.S./Canadian Grad 86% 89%
IMG 67% 65%
www.abai.org
* Means are approximate

17. Recertification Pass Rates
www.abai.org
Group 2013 5 Yr Avg*
Overall 98% 97%
First-time 98% 97%
Repeater 50% 55%
* Means are approximate

18. Score Report
• 3-digit scaled scores
– Overall
– By category
– Range: 300’s – 600’s
• Overall passing threshold = 400
• Percentiles not reported

21. Text Resources
• ACAAI Review for the
Allergy and Immunology
Boards
– Written by fellows, recent
graduates
– Based on the ABAI outline
– Revised Fall 2013
– FREE
• JACI Primer – revised
2010, online, 120
questions

22. Text Resources
• Allergy texts
– Middleton’s Allergy: Principles and Practice – source for many
questions
– Patterson’s Allergic Diseases – more clinically relevant
– Pediatric Allergy: Principles and Practice
– UpToDate – clinically relevant
• Immunology texts
– Abbas – Cellular and Molecular Immunobiology
– Janeway – Immunobiology
– Bellanti – Immunology IV
– Choose one and stick with it

23. Journal Reviews
• Annals Allergy, Asthma and Immunology
• JACI
• JACI: In Practice
• Allergy
• Allergy and Asthma Proceedings
• Journal of Clinical Immunology

24. Question Resources
• ABAI Recent Advances exam
• ACAAI FIT Corner practice questions
• ACAAI/AAAAI board review course
• JACI Primer practice questions
• Past ABAI Home Study exams

25. Other Resources
• AAAAI/ACAAI Live Review
– Good framework
– Not enough for cert/recert
– Basic portion
• High-yield for cert
• Low-yield for recert
• Review Online/DVD -- great for catching the
details in context
• ACAAI Conferences On-Line Allergy (COLA)

26. Preparation Tips
• Many ways to prepare
• Review ABAI exam blueprint
• Incorporate materials from training
• Use ITE/Recent Advances exam to
pinpoint areas of weakness
• Establish a study schedule and stick with it
• Alternate study methods for variety

27. Preparation Tips
• Focus on:
– Dogma
– Nuances of management
– Common dz  uncommon/complicated presentations
– Uncommon dz  common presentations
• Focus on understanding vs. memorization early
• Tie basic concepts to clinical correlations
• Save crammable stuff for the end

28. ABAI “Tendencies”
• No mouse-specific immunology
• FDA-approved treatments only for therapeutics
• Off label indications unlikely
• MOA possible for investigational drugs

29. Test-taking Tips
• Know the CBT tutorial
• Pacing should not be an issue
• If long question, read lead in first and scan
choices before returning to stem
• OK to second guess
• Low quality questions should be
challenged

30. High-Yield Topic Areas
• Basic immunology
– Cytokines
– Chemokines
– CD molecules
– Immune cells
– Signal transduction
• Biostatistics and research principles
• Immunodeficiency
• Food/inhalant allergens
• Asthma/allergy meds and disease management during pregnancy
• Drug AEs and interactions
• Images – pollens, molds, flow-volume loops, tympanogram

31. ABAI Exam Registration
• Primary deadline – April 30
• Late deadline – May 31 with $500 penalty
• Adds 10 years of certification to end of
current cycle

32. • ABAI website – www.abai.org
– Exam description – www.abai.org/exam.asp
– Exam blueprint – www.abai.org/Outline.asp
– Email – abai@abai.org
• AAAAI JACI Primer – www.aaaai.org >> JACI >> 2010
Primer
• ACAAI Review for the A/I Boards – www.acaai.org
• ACAAI FIT Corner Questions – www.acaai.org >>
Fellows in Training >> FIT Corner Questions
• ACAAI COLA – www.youtube.com/user/ACAAICOLA
• Copy of this presentation – slideshare.net/taolemd
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