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Date Updated: December 13, 2018

International Foundations of Medicine (IFOM)

The IFOM Basic Science Exam

The International Foundations of Medicine® (IFOM®) Basic Science Exam (BSE) is a comprehensive examination designed to assess examinees’ knowledge of the basic medical sciences. Schools that use a traditional curriculum (in which students are taught basic sciences first and then progress to clinical training) often administer the IFOM BSE prior to the start of clinical training, but the exam is also used for other purposes.

For What Purposes Is the IFOM BSE Used?

Schools and other organizations use the exam in the following ways:

  • End-of-course, end-of-year, or end-of-training assessment
  • Part of admission requirements (with the IFOM Clinical Science Exam or other exams) for an internship or residency program
  • Curriculum or assessment benchmarking, eg, comparing the IFOM BSE scores to scores on a local assessment or comparing the IFOM BSE scores of students experiencing different types of curricula

The IFOM BSE is also used by individual students and graduates for personal benchmarking, for applying to residency programs, and for preparation to take the United States Medical Licensing Exam® (USMLE®) Step 1.

The exam comprises 160 multiple-choice questions, most of which are presented in clinical vignette style, in order to assess examinees’ ability to not just recall but also apply basic medical science knowledge. The following content areas are covered:

  • Anatomy
  • Biochemistry
  • Histology and Cell Biology
  • Microbiology
  • Organ Systems
  • Pathology
  • Pharmacology
  • Physiology

IFOM BSE Content Outline

The BSE is built to the following specifications; you can also download a PDF of the content blueprint here.
(The content outline for IFOM BSE exams taken up until December 31, 2018 is represented here).

CONTENT OUTLINE

General Principles of Foundational Science: 12%-14%

Biochemistry and molecular biology

  • Gene expression: DNA structure, replication, exchange, and epigenetics
  • Gene expression: transcription
  • Gene expression: translation, post-translational processing, modifications, and disposition of proteins (degradation)
  • Structure and function of proteins and enzymes
  • Energy metabolism

Biology of cells

  • Adaptive cell responses and cellular homeostasis
  • Mechanisms of injury and necrosis, including pathologic processes
  • Apoptosis
  • Cell cycle and cell cycle regulation
  • Mechanisms of dysregulation
  • Cell/tissue structure, regulation, and function

Human Development and genetics

  • Principles of pedigree analysis
  • Population genetics: Hardy-Weinberg law, founder effects, mutation-selection equilibrium
  • Principles of gene therapy
  • Genetic testing and counseling
  • Genetic mechanisms
  • Biology of tissue response to disease
  • Acute inflammatory responses (patterns of response)
  • Chronic inflammatory responses
  • Reparative processes

Pharmacodynamic and pharmacokinetic processes

  • Pharmacokinetics: absorption, distribution, metabolism, excretion, dosage intervals
  • Mechanisms of drug action, structure-activity relationships
  • Concentration and dose-effect relationships, types of agonists, and antagonists and their actions
  • Individual factors altering pharmacokinetics and pharmacodynamics
  • Mechanisms of drug adverse effects, overdosage, toxicology
  • Mechanisms of drug interactions
  • Signal transduction, including structure/function of all components of signal transduction pathways such as receptors, ligands

Microbial biology

  • Microbial identification and classification
  • Bacteria
  • Viruses
  • Fungi
  • Parasites
  • Prions

Immune System: 3%-5%

Normal Processes

  • Development of cells of the adaptive immune response
  • Structure, production, and function
  • Cellular basis of the immune response and immunologic mediators
  • Basis of immunologic protection
  • Effect of age on the function of components of the immune system

Abnormal Processes

  • Disorders associated with immunodeficiency
  • HIV/AIDS
  • Immunologically mediated disorders
  • Adverse effects of drugs on the immune system

Blood and Lymphoreticular System: 3%-5%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Infectious and immunologic
  • Neoplasms
  • Anemia, cytopenias, and polycythemia
  • Coagulation disorders (hypocoagulable and hypercoagulable conditions)
  • Traumatic, mechanical, and vascular disorders
  • Congenital disorders
  • Adverse effects of drugs on the hematologic and lymphoreticular systems

Nervous System and Special Senses: 9%-11%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function, including neuronal cellular and molecular biology
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms (cerebral, spinal, and peripheral)
  • Cerebrovascular disease
  • Disorders relating to the spine, spinal cord, and spinal nerve roots
  • Cranial and peripheral nerve disorders
  • Neurologic pain syndromes
  • Degenerative disorders/amnestic syndromes
  • Global cerebral dysfunction
  • Neuromuscular disorders
  • Movement disorders
  • Metabolic disorders
  • Paroxysmal disorders
  • Sleep disorders
  • Traumatic and mechanical disorders and disorders of increase intracranial pressure
  • Congenital disorders
  • Adverse effects of drugs on the nervous system
  • Disorders of the eye and eyelid
  • Disorders of the ear

Normal Processes

  • Embryonic development, fetal maturation, and neonatal changes
  • Organ structure and function, including barrier function, thermal regulation
  • Cell/tissue structure and function, eccrine function
  • Repair, regeneration, and changes associated with stage of life
  • Skin defense mechanisms and normal flora

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Adnexal disorders (hair and hair follicles, nails, sweat glands, sebaceous glands, oral mucous membranes)
  • Oral disease
  • Disorders of pigmentation
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on skin and subcutaneous tissue

Musculoskeletal System: 5%-7%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Infectious, inflammatory, and immunologic disorders
  • Neoplasms
  • Degenerative and metabolic disorders
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the musculoskeletal system

Cardiovascular System: 11%–13%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal transitional changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Dysrhythmias
  • Heart failure
  • Ischemic heart disease
  • Diseases of the myocardium
  • Disease of the pericardium
  • Valvular heart disease
  • Hypotension
  • Hypertension
  • Dyslipidemia
  • Vascular disorders
  • Traumatic and mechanical disorders
  • Congenital disorders, including disease in adults
  • Adverse effects of drugs on the cardiovascular system

Respiratory System: 7%–9%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function, including surfactant formation, and alveolar structure
  • Repair, regeneration, and changes associated with stage of life
  • Pulmonary defense mechanisms and normal flora

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Obstructive airway disease
  • Pneumoconiosis/fibrosing/restrictive pulmonary disorders/interstitial lung disease
  • Respiratory failure/respiratory arrest and pulmonary vascular disorders
  • Metabolic, regulatory, and structural disorders
  • Disorders of the pleura, mediastinum, and chest wall
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the respiratory system

Gastrointestinal System: 8%–10%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Repair, regeneration, and changes associated with stage of life
  • Gastrointestinal defense mechanisms and normal flora

Abnormal Processes

  • Infectious, immunological, and inflammatory disorders
  • Neoplasms
  • Signs, symptoms, and ill-defined disorders
  • Disorders of the oral cavity, salivary glands, and esophagus
  • Disorders of the stomach, small intestine, colon, rectum, and anus
  • Disorders of the liver and biliary system, noninfectious
  • Disorders of the pancreas
  • Disorders of the peritoneal cavity
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the gastrointestinal system

Renal and Urinary Systems: 5%-7%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Signs, symptoms, and ill-defined disorders
  • Metabolic and regulatory disorders
  • Vascular disorders
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the renal and urinary system

Pregnancy, Childbirth, and the Puerperium: 2%-4%

Normal Processes

  • Organ structure and function: pregnancy

Abnormal Processes

  • Prenatal care
  • Obstetric complications
  • Labor and delivery
  • Puerperium, including complications
  • Newborn (birth to 4 weeks of age)
  • Congenital disorders, neonatal
  • Adverse effects of drugs on pregnancy, childbirth, and the puerperium
  • Systemic disorders affecting pregnancy, labor and delivery, and puerperium

Female Reproductive System & Breast: 2%-4%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Reproductive system defense mechanisms and normal flora

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms of the breast, cervix, ovary, uterus, vagina, and vulva
  • Fertility and infertility
  • Menopause
  • Menstrual and endocrine disorders
  • Sexual dysfunction
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the female reproductive system and breast

Male Reproductive System: 1%-3%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue structure and function
  • Reproductive system defense mechanisms and normal flora

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms
  • Metabolic and regulatory disorders, including sexual dysfunction
  • Traumatic and mechanical disorders
  • Congenital disorders
  • Adverse effects of drugs on the male reproductive system

Endocrine System: 5%–7%

Normal Processes

  • Embryonic development, fetal maturation, and perinatal changes
  • Organ structure and function
  • Cell/tissue/structure and function
  • Repair, regeneration, and changes associated with stage of life

Abnormal Processes

  • Diabetes mellitus and other disorders of the endocrine pancreas
  • Thyroid disorders
  • Parathyroid disorders
  • Adrenal disorders
  • Pituitary disorders
  • Hypothalamic endocrine disorders
  • Multiple endocrine neoplasia (MEN1, MEN2)
  • Congenital disorders
  • Adverse effects of drugs on the endocrine system

Multisystem Processes & Disorders: 8%-10%

Normal Processes

  • Principles of nutrition
  • Electrolyte and water metabolisms
  • Intracellular accumulations

Abnormal Processes

  • Infectious, immunologic, and inflammatory disorders
  • Neoplasms and related disorders
  • Signs, symptoms, and ill-defined disorders
  • Nutrition
  • Toxins and environmental extremes
  • Venomous bites and stings
  • Fluid, electrolyte, and acid-base balance disorders
  • Abuse
  • Multiple trauma (e.g., prioritization, blast injury)
  • Shock, cardiogenic, hypovolemic, neurogenic, septic; sepsis, bacteremia, systemic inflammatory response syndrome (SIRS), refractory, multiorgan dysfunction syndrome
  • Genetic metabolic and developmental disorders
  • Adverse effects of drugs on multisystem disorders

Biostatistics, Epidemiology/Population Health, and Interpretation of the Medical Literature: 2%-4%

Epidemiology and public/population health

Study design, types and selection of studies

Measures of association (e.g., relative risk, odds ratio, other)

Distributions of data (e.g., normal distribution, regression to mean)

Correlation and regression, uses and interpretation

Principles of testing and screening (e.g., sensitivity and specificity, predictive value, probability)

Study interpretation (e.g., causation, validity, statistical vs. clinical significance)

Social Sciences: 1%-3%

Communication and interpersonal skills, including patient interviewing, consultation, and interactions with the family (patient-centered communication skills)

Medical ethics and jurisprudence

  • Consent to treatment/decision-making capacity
  • Death and dying and palliative care
  • Physician-patient relationship
  • Professional conduct/integrity

ORGAN SYSTEM PROCESSES

Normal: 20%-30%

Abnormal: 70%-80%

PHYSICIAN TASKS/COMPETENCIES

Medical Knowledge/Scientific Concepts: 62%-68%

Patient Care: Diagnosis: 21%-28%

  • History and physical examination
  • Laboratory and diagnostic studies
  • Diagnosis
  • Prognosis/outcome

Patient Care: Management: 6%-8%

  • Health maintenance and disease prevention
  • Pharmacotherapy
  • Clinical interventions

Communication, Interpersonal Skills, & Professionalism: 1%-3%

Practice-based Learning: 2%-4%

  • Application of principles of biostatistics
  • Population health
  • Epidemiology

Test Administration Options

The IFOM BSE can be ordered by schools and other institutions for administration at their sites to cohorts of students that they deem eligible. Institutions can administer the IFOM BSE either on paper or as a web-based test, using desktop or laptop computers on-site. See our For institutions page for information about the steps that schools and other organizations must take to be eligible to use the IFOM exams at their sites.

Individuals can take the IFOM BSE separately from their schools or training programs; individual administrations are offered at Prometric Test Centers twice a year, once in the spring and once in the fall. See the Test Administrations for Individuals page for information about applying to take the IFOM BSE as an individual and for registration and testing schedules.

Language Availability

The IFOM BSE is available in English and Spanish. We can also translate the IFOM exams into other languages in certain circumstances. Contact the IFOM team if you are interested in administering IFOM exams in a language other than those listed above.

Take the IFOM BSE Practice Exam

Examinees can familiarize themselves with the IFOM BSE web-based format by using the free 20-question online practice exam, in either timed or untimed test administration conditions. Access the IFOM BSE Practice Exam.

Note: The practice exam is NOT intended to assist examinees in preparing for the content of the exam; it is only intended to familiarize examinees with the style and format of test questions they are likely to see on the IFOM exams if administered over the web.

Exam Security

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