How to Prepare for the American Board of Physical Medicine and Rehabilitation Exam

Introduction: Why the ABPMR Exam Matters

Passing the ABPMR (American Board of Physical Medicine and Rehabilitation) Exam is a major milestone for physiatrists. It represents the culmination of years of education, clinical training, and specialty focus in restoring function and quality of life for patients with musculoskeletal, neurological, and mobility impairments. This certification not only confirms your expertise but also opens doors to hospital privileges, professional credibility, and future fellowship opportunities.

But the ABPMR exam is more than just a knowledge test—it’s a strategic challenge that assesses your clinical decision-making, pattern recognition, and understanding of rehabilitation medicine from a systems-based perspective. In this article, we’ll break down everything you need to know to not just pass—but ace—this crucial board exam.

Understanding the ABPMR Exam Structure

The ABPMR board certification process includes two main parts:

1. Part I (Written Exam)

• Multiple-choice questions
• Covers fundamental knowledge in PM&R
• Administered annually at Pearson VUE testing centers
• Focus areas: anatomy, neurology, musculoskeletal medicine, pain, electrodiagnosis, spinal cord injury, brain injury, pediatrics, ethics, and rehabilitation modalities

2. Part II (Oral Exam)

• Conducted after passing Part I
• Based on clinical scenarios
• Candidates are expected to make real-time decisions about patient care
• Tests communication, judgment, clinical reasoning, and professionalism

Step-by-Step Guide to Preparing for the ABPMR Exam

1. Start Early, Stay Steady

Waiting until the last minute is a surefire way to increase anxiety and decrease retention. Ideally, you should begin at least 6–9 months before the exam.

• Create a study calendar that includes:
  • Core topic reviews
  • Practice question days
  • Flashcard sessions
  • Weekly mock tests
• Use a spiral learning approach, revisiting each topic multiple times.

2. Know the Core Topics Inside Out

The ABPMR doesn't just test rote facts—it wants to see how well you understand and apply key PM&R principles.

High-Yield Topics:

• Neurorehabilitation: Stroke, spinal cord injury, TBI
• Musculoskeletal medicine: Shoulder injuries, low back pain, joint disorders
• Electrodiagnosis: EMG/NCS patterns and indications
• Pediatric rehab: Cerebral palsy, developmental milestones
• Pain management: Interventional and conservative approaches
• Prosthetics & orthotics: Prescription principles and biomechanics
• Functional outcomes: Disability scoring, quality of life
• Ethics and professionalism

3. Choose the Right Study Resources

Your resources will make or break your preparation. Here are the top recommended tools:

Textbooks:

• Physical Medicine and Rehabilitation Board Review by Sara Cuccurullo (The “Cuccurullo Bible”)
• Braddom’s Physical Medicine and Rehabilitation
• PM&R Secrets for quick facts

Question Banks:

• AAPMR SAE-R questions
• TrueLearn PM&R SmartBank
• Cuccurullo question companion

For Part II:

• ABPMR's sample oral cases
• Mock oral boards with senior residents or attendings
• Use Zoom or in-person group practice sessions

4. Active Recall and Spaced Repetition

Instead of passively re-reading textbooks, use evidence-based study strategies:

• Anki or Quizlet for flashcards
• Use spaced repetition to retain difficult topics
• Practice active recall by answering questions without looking at notes

5. Practice Questions Daily

Aim for 20–40 questions per day during the bulk of your studying, then increase to 50–100/day in the final two months. Don't just read explanations—understand the why behind each correct and incorrect answer.

• Track your weak areas and review them weekly.
• Mix question topics to simulate test-day randomness.

6. Create Summary Sheets and One-Pagers

Summarize difficult topics in your own words:

• Electrodiagnostic criteria
• Stroke localization syndromes
• Botox dosages and side effects
• Nerve root vs peripheral nerve patterns
• Disability scales and rehab prognosticators

These one-pagers become golden quick-reference materials during your final review weeks.

7. Simulate Real Exam Conditions

• Take at least 3 full-length practice exams under timed conditions.
• Review your performance in detail: Did you run out of time? Miss distractor traps?
• Wear the same clothes, eliminate distractions, and time breaks as if it’s test day.

8. Mastering the Oral Boards (Part II)

This is often where anxiety peaks. But with preparation, you can dominate this section too.

Key tips:

• Practice aloud. Don’t just “think” your answers.
• Develop a systematic approach: HPI → DDx → Investigations → Plan
• Practice with simulated patients or colleagues.
• Record yourself. Listen to how clearly and confidently you speak.
• Work on your verbal organization: Think clarity over verbosity.
• Always explain your rationale—even if you’re unsure.

9. Take Care of Your Brain and Body

You are your most important resource.

• Sleep: Aim for 7–9 hours per night
• Exercise: Light cardio or strength training improves focus
• Nutrition: Brain foods like salmon, eggs, berries, and green leafy vegetables help cognition
• Hydration and breaks: Prevent burnout by taking intentional rest

10. Exam Day Survival Tips

• Get to the site early to avoid any delays
• Bring necessary ID and confirmation emails
• Stay calm—if you encounter a tough question, mark it and move on
• Use deep breathing to reset during stress spikes
• Keep a steady rhythm: don’t rush or linger

Common Mistakes to Avoid

1. Ignoring weaker topics – Avoiding them now only hurts later.
2. Overconfidence with review books – Complement quick reviews with deeper reads.
3. Neglecting the oral board format – It’s a different muscle; train it intentionally.
4. Cramming – This leads to superficial understanding and fatigue.

Encouragement from the Trenches

Every board-certified physiatrist has sat where you are now. The exam is challenging, yes—but it’s also passable with the right mindset and methods. Each study session, each mock case, and each review note builds toward a successful outcome.

Remember: You’re not just passing a test. You’re proving you’re ready to carry the responsibility of caring for patients with some of the most complex challenges in medicine. That’s a noble and powerful goal.

Final Words: You’ve Got This

Whether you're fresh out of residency or a few years into practice, preparing for the ABPMR exam is a transformative experience. Focus, commit, and trust your training. When it’s all over, the sense of achievement—and the title of board-certified physiatrist—will be well worth the grind.