Internal Medicine & Subspecialty Policies
ABIM Certification Exams
Make a selection below to learn more about one of ABIM's certification exams. ABIM diplomates may also be eligible for additional certifications through other ABMS Boards.
To become certified in hematology, physicians must meet specific requirements set by the American Board of Internal Medicine. This page provides an overview of eligibility criteria, required training, clinical competence standards and the certification exam process—everything needed to understand the path to certification.
The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, December 2025 (pdf), governs ABIM's decision about eligibility for certification. The December 2025 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).
The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, December 2025 (pdf), governs ABIM's decision about eligibility for certification. The December 2025 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).
To become certified in the subspecialty of hematology, physicians must:
- At the time of application, be previously certified in internal medicine by ABIM;
- Satisfactorily complete the requisite graduate medical education fellowship training;
- Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting;
- Hold a valid, unrestricted and unchallenged license to practice medicine; and
- Pass the Hematology Certification Examination.
Hematology fellowship training must be accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec.
No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.
Fellowship training undertaken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.
To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31 of the year of examination.
Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic during nonclinical training is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double-counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.
To become certified in the subspecialty of hematology, physicians must:
- At the time of application, be previously certified in internal medicine by ABIM;
- Satisfactorily complete the requisite graduate medical education fellowship training;
- Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting;
- Hold a valid, unrestricted and unchallenged license to practice medicine; and
- Pass the Hematology Certification Examination.
Hematology fellowship training must be accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec.
No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.
Fellowship training undertaken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.
To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31 of the year of examination.
Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic during nonclinical training is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double-counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.
Training and Procedure Requirements Before Academic Year 2017-18
The total months of training required for fellows who began their hematology fellowship before Academic Year 2017-18, including specific clinical months, and requisite procedures are outlined below:
Minimum Months of Training
Clinical Months Required
Procedures
24
12
- Bone marrow aspiration and biopsy, including preparation, examination and interpretation of bone marrow aspirates and touch preparations of bone marrow biopsies.
- Interpretation of peripheral blood smears, including manual white blood cell and platelet counts.
- Administration of chemotherapeutic agents and biological products through all therapeutic routes.
- Management and care of indwelling venous access catheters and management of methods of apheresis.
For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.
Training and Procedure Requirements in or After Academic Year 2018-19
The total months of training required for fellows who began their hematology fellowship in or after Academic Year 2018-19, including specific clinical months, and requisite procedures are outlined below:
Minimum Months of Training
Clinical Months Required
Procedures
24
12
Must demonstrate competence in:
- Performance of bone marrow biopsies and aspirations
- Assessment and interpretation of complete blood counts
- Interpretation of peripheral blood smears
- Use of systemic therapies through all therapeutic routes
Must demonstrate knowledge of and experience in:
- Interpretation of bone marrow biopsies and aspirations
- How to make bone marrow aspirate smears and/or touch
- The indications, risks and process of performing therapeutic phlebotomy
- How to prepare peripheral blood smears
- The functional characteristics, indications, risks and process of using indwelling venous access devices
- Indications, contraindications, risks and management of complications related to methods of apheresis
For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.
Training programs are strongly encouraged to make additional training and experiences available for their trainees who anticipate the need to perform specified procedures in their post‐training careers (e.g., training to achieve competence in: interpretation of bone marrow biopsies and/or aspirates; lumbar punctures for diagnosis and/or administration of intrathecal chemotherapy; administering therapeutics through Ommaya reservoirs, etc.).
Training and Procedure Requirements Before Academic Year 2017-18
The total months of training required for fellows who began their hematology fellowship before Academic Year 2017-18, including specific clinical months, and requisite procedures are outlined below:
|
Minimum Months of Training |
Clinical Months Required |
Procedures |
|---|---|---|
|
24 |
12 |
|
|
For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf. |
||
Training and Procedure Requirements in or After Academic Year 2018-19
The total months of training required for fellows who began their hematology fellowship in or after Academic Year 2018-19, including specific clinical months, and requisite procedures are outlined below:
|
Minimum Months of Training |
Clinical Months Required |
Procedures |
|---|---|---|
|
24 |
12 |
Must demonstrate competence in:
Must demonstrate knowledge of and experience in:
|
|
For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf. |
||
Training programs are strongly encouraged to make additional training and experiences available for their trainees who anticipate the need to perform specified procedures in their post‐training careers (e.g., training to achieve competence in: interpretation of bone marrow biopsies and/or aspirates; lumbar punctures for diagnosis and/or administration of intrathecal chemotherapy; administering therapeutics through Ommaya reservoirs, etc.).
ABIM requires documentation that candidates for certification are competent in:
- Patient care and procedural skills
- Medical knowledge
- Practice-based learning and improvement
- Interpersonal and communication skills
- Professionalism
- Systems-based practice
Through its tracking process, FasTrack®, ABIM requires verification of fellows' clinical competence to come from a program director who is certified by ABIM in the discipline for which they are program director (other ABMS Member Board or Canadian certification is acceptable, if applicable).
As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence. In addition, fellows must receive satisfactory ratings in each of the six ACGME/ABMS Competencies and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each of the six ACGME/ABMS Competencies and overall clinical competence.
Program Director Ratings of Clinical Competence
Six ACGME/ABMS Competencies*
The resident/fellow must demonstrate satisfactory development of the knowledge, skills and attitudes/behaviors needed to advance in training. The trainee must also demonstrate a learning trajectory that anticipates the achievement of competency for unsupervised practice, which includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.
Components and Ratings
Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training
Yes
Full credit
Full credit
Conditional on Improvement
Full credit
No credit; must achieve satisfactory rating before receiving credit†
No
Full credit
No credit; must repeat year
*The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.
†At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS Competencies.
Overall Clinical Competence
This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:
Components and Ratings
Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training
Satisfactory or Superior
Full credit
Full credit
Conditional on Improvement
Full credit
No credit; must achieve satisfactory rating before receiving credit*
Unsatisfactory
No credit; must repeat year
No credit; must repeat year
*At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies.
ABIM requires documentation that candidates for certification are competent in:
- Patient care and procedural skills
- Medical knowledge
- Practice-based learning and improvement
- Interpersonal and communication skills
- Professionalism
- Systems-based practice
Through its tracking process, FasTrack®, ABIM requires verification of fellows' clinical competence to come from a program director who is certified by ABIM in the discipline for which they are program director (other ABMS Member Board or Canadian certification is acceptable, if applicable).
As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence. In addition, fellows must receive satisfactory ratings in each of the six ACGME/ABMS Competencies and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each of the six ACGME/ABMS Competencies and overall clinical competence.
Program Director Ratings of Clinical Competence
Six ACGME/ABMS Competencies*
The resident/fellow must demonstrate satisfactory development of the knowledge, skills and attitudes/behaviors needed to advance in training. The trainee must also demonstrate a learning trajectory that anticipates the achievement of competency for unsupervised practice, which includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.
|
Components and Ratings |
Residents/Fellows: |
Residents/Fellows: |
|---|---|---|
|
Yes |
Full credit |
Full credit |
|
Conditional on Improvement |
Full credit |
No credit; must achieve satisfactory rating before receiving credit† |
|
No |
Full credit |
No credit; must repeat year |
|
*The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice. †At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS Competencies. |
||
Overall Clinical Competence
This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:
|
Components and Ratings |
Residents/Fellows: |
Residents/Fellows: |
|---|---|---|
|
Satisfactory or Superior |
Full credit |
Full credit |
|
Conditional on Improvement |
Full credit |
No credit; must achieve satisfactory rating before receiving credit* |
|
Unsatisfactory |
No credit; must repeat year |
No credit; must repeat year |
| *At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies. | ||
Dual certification in hematology and medical oncology requires satisfactory completion of three years of accredited combined training, which must include: a minimum of 18 months of full-time clinical training, at least 12 months of which focus on the diagnosis and management of a broad spectrum of neoplastic diseases, including hematological malignancies, and six months of which center on the diagnosis and management of a broad spectrum of non-neoplastic hematological disorders. If the combined training must be undertaken in two different programs, 24 continuous months must be completed in one institution, and both institutions must be accredited in both hematology and medical oncology.
During the entire three years, the fellow must maintain a continuity outpatient clinic structured in a way that is consistent with ACGME requirements for continuity clinic in the discipline. Time spent in continuity outpatient clinic during nonclinical training is in addition to the requirement for full-time clinical training.
Candidates may complete all three years of combined training before applying for an examination in either subspecialty; however, those who elect to take an examination in one subspecialty following two years of combined training may also apply for the other examination after the third year of combined training is satisfactorily completed.
Dual certification in hematology and medical oncology requires satisfactory completion of three years of accredited combined training, which must include: a minimum of 18 months of full-time clinical training, at least 12 months of which focus on the diagnosis and management of a broad spectrum of neoplastic diseases, including hematological malignancies, and six months of which center on the diagnosis and management of a broad spectrum of non-neoplastic hematological disorders. If the combined training must be undertaken in two different programs, 24 continuous months must be completed in one institution, and both institutions must be accredited in both hematology and medical oncology.
During the entire three years, the fellow must maintain a continuity outpatient clinic structured in a way that is consistent with ACGME requirements for continuity clinic in the discipline. Time spent in continuity outpatient clinic during nonclinical training is in addition to the requirement for full-time clinical training.
Candidates may complete all three years of combined training before applying for an examination in either subspecialty; however, those who elect to take an examination in one subspecialty following two years of combined training may also apply for the other examination after the third year of combined training is satisfactorily completed.
ABIM diplomates in Internal Medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program.
Guidelines for proposals are available in Proposing Candidates for Special Consideration.
ABIM diplomates in Internal Medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program.
Guidelines for proposals are available in Proposing Candidates for Special Consideration.
The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. While the ABIM Research Pathway requires core clinical training, it mainly concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.
The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. While the ABIM Research Pathway requires core clinical training, it mainly concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.