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International In-Training Examination

Assessment for Pediatric Residents in Training

The International In-Training Examination (I-ITE) offered by the American Board of Pediatrics (ABP) can help both pediatric residents outside of the United States and Canada and those responsible for their training to assess trainee knowledge of general pediatrics. The I-ITE mirrors the ABP’s In-Training Examination (ITE) that is offered to pediatric residents in the United States and Canada at the beginning of their academic year.

Why Register for the I-ITE

The primary goal of all ABP in-training exams is self-assessment at either the individual resident or program level. Participation in the exam in no way provides access to or credit toward the ABP certification process.

Residents can:

  • Photo by Julien Harneis, CC BY-SA 2.0Assess their areas of strength as well as any areas needing improvement in general pediatric knowledge at the time of the examination; and
  • Assess their progress from year to year.

Program directors and coordinators can:

  • Compare residents’ performance with other peer groups;
  • Use the results obtained from the ITE to assist them in addressing any deficits in individual residents’ knowledge and to counsel and remediate them appropriately; and
  • Accumulate and analyze results over several years to evaluate the training quality of their programs.

Who Registers for the I-ITE

The program director or administrator is responsible for registering all pediatric residents within their program who plan to take the examination. The exam is restricted to those who are currently enrolled in a pediatric residency program. Please continue to read the sections below before registering your program to take the exam.

What to Expect on Exam Day

The I-ITE is a proctored exam delivered via the internet using a secure browser. The exam consists of up to 150 single-best answer multiple-choice questions. It is delivered in the English language. Exam takers are allotted 3.5 hours to complete the exam, plus an additional 30 minutes of break time. An English dictionary may be used by residents during the exam.

Although the ABP encourages collegial collaboration in daily practice, it is prohibited on this exam and is counter-productive because the purpose of the exam is to assist residents and their mentors in identifying areas of strengths and areas needing additional training in a resident’s core knowledge of general pediatrics. Therefore, sharing information or collaborating with mentors or peers before, during, or after the exam, or any other form of cheating, are not only prohibited by ABP policies but are counterproductive and renders the exam ineffective as an individual assessment tool.

Click Check Readiness in the Exam Tutorial/Demo to run a system check and see a sample of the test (Test Delivery Check).


Exam Security

Potential security issues with the exam can be minimized when both training program directors and the trainees taking the exam understand its purpose, which is self-assessment at both the resident and program level and the identification of strengths and any weaknesses or deficits that may exist in core knowledge of general pediatrics. Therefore, sharing information, collaboration between peers, or any other form of cheating are not only prohibited by ABP policies but are counterproductive and hinder the examination’s intended use.

To address potential instances of information sharing among trainees, data forensic analyses of the test response data are conducted to identify pairs of trainees whose response patterns have statistically unlikely similarities, as well as trainees whose scores are unusually high for their training level. If such trainees are identified, the training program will receive an incident report with specific information included in the exam results package. Program directors and administrators are strongly encouraged to handle these types of incidents, if any, as part of the trainee’s mentoring in professionalism. Incidents that compromise the integrity of the testing process may result in the exam scores being withheld.

Exam Reporting

Exam results are typically released within six weeks of the exam’s administration directly to the program director or administrator who will receive:

  • A memorandum with instructions on how to interpret and distribute the reports;
  • A result roster report that provides trainee scores by training level;
  • A performance comparison report that provides mean scores for each training level in the program compared with similar programs in that country (if applicable) and in the United States so that you can compare the performance of your pediatric trainees with that of U.S. pediatric trainees;
  • An item analysis report that provides information on how program trainees performed on each examination item;
  • Category performance reports that provide feedback to individual trainees on how they performed on items within major categories of pediatric knowledge; and
  • Trainee score and item feedback reports that provide individual trainees with their overall examination scores as well as specific feedback on individual items that were answered incorrectly. Content feedback statements will be provided and should be distributed to trainees with these reports for reference purposes.

Choosing the Exam Date(s)

For the performance comparison report (see the third bullet in above section) to be valid, pediatric trainees in international programs, residents must take the exam near the beginning of the academic year because U.S. residents sit for the exam just a few weeks after the academic year has commenced. If international pediatric trainees take the exam more than one month from the beginning of the academic year, the results will not be comparable.

The exam year begins July 1 and ends June 30, and the exam is offered almost every day of the year, except for some U.S. holidays (New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas Day). Please contact the ABP directly if there is any question about a desired testing date(s).

Fees and Payment

The ABP has adopted a differential pricing plan based on World Bank Gross National Income per capita data. To find your tier level (below), look up your individual country’s World Bank income group.

World Bank Tier Levels I-ITE Exam Fees
1 — Low $40 per person
2 — Low Middle $50 per person
3 — High Middle $60 per person
4 — High $85 per person

After you register your program, an invoice for the exam fee will be sent to you.

All exam fees must be paid to the ABP in U.S. dollars (USD). The ABP accepts payment by wire transfer, credit card, money order, or cashier’s check.

The deadline for submitting a payment will depend upon the payment method used.

  • To pay by wire transfer or credit card: Submit your payment no less than two weeks prior to the scheduled or desired testing date(s). Please contact the ABP directly for instructions.
  • To pay by money order or cashier’s check: Send your payment no less than six weeks prior to the scheduled testing date(s).

Additional Dates

  • Two weeks prior to testing: Each person responsible for monitoring and proctoring this exam must complete our online proctor agreement form
  • Two weeks prior to testing: Send a trainee roster to A roster form will be sent to you after you have registered and paid for the I-ITE. Please note that trainee names will appear on all exam reports exactly as entered on the trainee roster. 

Contact Us

Please contact us by e-mail, telephone, or post at:

The American Board of Pediatrics
111 Silver Cedar Court
Chapel Hill, NC 27514

Telephone: 919-929-0461
Business Hours: 8:30 a.m.–5 p.m. ET, Monday–Friday
Fax: 919-929-9255
Sending a fax? Use our fax cover letter.
Support Center Hours: 8:30 a.m.–5:30 p.m. ET, Monday–Friday