ABIM Med Oncology study guide
ABIM Med Oncology · Work through your exam, one topic at a time.
The American Board of Internal Medicine (ABIM) Medical Oncology Certification Examination is the assessment physicians complete to earn board certification in medical oncology, typically after finishing an accredited hematology/oncology fellowship. It is aimed at internists who have trained in the diagnosis and management of solid tumors and hematologic malignancies and who want to demonstrate competence to patients, hospitals, and credentialing bodies. The ABIM Med Oncology study guide has 10 sections and about 2,401 words.
01Breast Cancer
Know receptor biology as the decision tree: ER/PR status drives endocrine therapy, HER2 status drives trastuzumab/pertuzumab and antibody-drug conjugates, and triple-negative disease pivots to chemotherapy, immunotherapy (PD-L1–positive), and germline BRCA-directed PARP inhibitors or sacituzumab govitecan. Stage-based logic: early-stage disease is about local control plus adjuvant systemic therapy guided by anatomic stage, tumor grade, genomic assays (e.g., 21-gene recurrence score), and menopausal status; metastatic disease is about palliating and prolonging life with sequential lines chosen by biomarker and prior exposure.
314 words, about 2 min02Thoracic and Head/Neck Cancers
For non–small cell lung cancer, stage determines intent: surgery or stereotactic radiotherapy for early stage, chemoradiation plus consolidation immunotherapy for unresectable stage III, and biomarker-directed therapy for advanced disease. Biomarkers to know: EGFR sensitizing mutations (osimertinib), ALK and ROS1 rearrangements, BRAF V600E, MET exon 14 skipping, RET and NTRK fusions, KRAS G12C, and PD-L1 expression guiding first-line immunotherapy.
265 words, about 1 min03Gastrointestinal Cancers
Colorectal cancer: know the adenoma-carcinoma sequence, mismatch repair/MSI testing for both prognosis and immunotherapy eligibility, and RAS/BRAF testing before anti-EGFR antibodies (panitumumab, cetuximab) in metastatic disease. Adjuvant chemotherapy duration and regimen depend on stage and risk.
241 words, about 1 min04Genitourinary Cancers
Prostate cancer: understand PSA screening controversy, Gleason grading/Grade Group, risk stratification, and treatment by stage-active surveillance for low risk, surgery or radiation for localized, androgen deprivation therapy (ADT) backbone for metastatic disease, with escalation using docetaxel, abiraterone, enzalutamide, or apalutamide. Know castration-resistant definitions and the role of PARP inhibitors in HRR-mutant disease and PSMA-targeted therapy.
246 words, about 1 min05Gynecologic and Other Solid Tumors
Ovarian cancer: epithelial histology, germline BRCA/HRD testing for PARP inhibitor maintenance, debulking surgery plus platinum-taxane chemotherapy, and CA-125 for monitoring (not screening). Endometrial cancer: type I versus type II, molecular classification (POLE, MSI, p53), and immunotherapy for MSI-high or advanced disease.
232 words, about 1 min06Hematologic Malignancies
Know the diagnostic framework: CBC and smear, flow cytometry, cytogenetics/FISH, and molecular testing (e.g., BCR-ABL, JAK2, FLT3, NPM1). Leukemias: AML induction with cytarabine/anthracycline and risk-adapted consolidation; APL is a medical emergency treated with ATRA plus arsenic.
229 words, about 1 min07Cancer Biology, Genetics, and Precision Oncology
Understand oncogenes versus tumor suppressors, the hallmarks of cancer, and the two-hit hypothesis. Know hereditary syndromes: BRCA1/2 (breast/ovarian/pancreatic/prostate), Lynch syndrome (MSI, colorectal/endometrial), Li-Fraumeni (TP53), APC (FAP), and MEN.
202 words, about 1 min08Diagnostic Oncology and Pathology
Know how tissue is obtained (core biopsy, FNA, excisional), when it is adequate, and the role of immunohistochemistry in determining origin (e.g., cytokeratin, TTF-1, CDX2, PAX8, GATA3). Understand grading and staging systems (TNM, Gleason, Nottingham), margin status, and the difference between grading and staging.
236 words, about 1 min09Antineoplastic Therapy and Supportive Care
Know drug classes and their signature toxicities: anthracyclines (cardiotoxicity), platinum (nephro/neuro/ototoxicity), taxanes (neuropathy, hypersensitivity), vinca alkaloids (vesicant, neurotoxicity), bleomycin (pulmonary fibrosis), methotrexate (mucositis, renal), and checkpoint inhibitors (immune-related adverse events). Understand antiemetic prophylaxis by emetogenicity (5-HT3 antagonist, NK1 antagonist, dexamethasone, olanzapine), growth factor use for febrile neutropenia risk, and tumor lysis syndrome prophylaxis.
204 words, about 1 min10Survivorship, Palliative Care, and Ethics
Survivorship: surveillance schedules by cancer type, late effects of therapy (cardiotoxicity, secondary malignancies, infertility, neuropathy, lymphedema), psychosocial screening, and health maintenance (vaccines, bone health, exercise). Palliative care: symptom management (pain, dyspnea, nausea, constipation), opioid principles, goals-of-care conversations, and the evidence that early palliative care improves quality of life.
232 words, about 1 min