skip to Main Content


All examination questions are written and reviewed by an Exam Committee of academicians and practitioners whose goal is to make sure that each examination covers all sections of the exam content.

Question Review Process

New items are written by our content experts and assigned to members of our Exam Committee for additional review. During this process, each question is reviewed to ensure the accuracy and standardization of questions (style, format, terminology, and correct grammar). This process reduces ambiguity and technical flaws.

Once the Exam Committee approves a question, it is made available for selection in future examinations.

Question Format

Examination questions are written in a single-best-answer multiple-choice format. This question format is the most widely used format in the certification exam industry. Most examination questions are preceded by a clinical stem that provides information about a patient (including laboratory results and/or diagnostic findings). Each question is always followed by 4 answer options where only one option is the correct answer. The question review process ensures that the designated answer is uncontroversial, evidence-based, and the best choice. The other options (“distracters”) are designed to reflect plausible responses likely to be selected by less knowledgeable candidates.

Selection Process

Each examination is based on an exam content outline. The outline defines the percentage of questions from each content category. The exam selection process incorporates new questions as well as questions that have performed well on prior exams. Special attention is also provided to ensure that multiple versions of an exam are balanced with regard to difficulty and content.

More Information

Back To Top