Analysis of Candidate Performance in the Brain Injury Medicine Subspecialty Certification Examination

The Brain Injury Medicine (BIM) subspecialty certification examination has been administered by the American Board of Physical Medicine and Rehabilitation (ABPMR) since 2014. This retrospective review is the first publication on the administration of the BIM examination and candidate performance. Data were gathered from de-identified records in the ABPMR database on the characteristics and performance of candidates who took the 2014-2024 examinations. A total of 1197 candidates, including 74.4% ABPMR and 25.1% American Board of Psychiatry and Neurology (ABPN) diplomates, took the BIM exam during the study period. The overall pass rate was 97.2%. About 96% of first-time exam takers passed. A trend emerged indicating a decline in performance as the number of attempts increased. Generally, the mean scaled subscores of ABPMR diplomates were higher across all exam item categories except for “other neurologic disorders.” While over 90% of candidates agreed that the exam was relevant to BIM, only 77% believed the content reflected the scope of the training. The exam’s item reliability is high, ranging from 0.83 to 0.97. The study provides information that may guide prospective BIM Examination candidates and the examination developers.