About three in four candidates pass the Clinical Informatics board exam. In October 2025, 343 of 472 examinees passed, a pass rate of 73%. That is the lowest figure since the exam began, tied with 2022, and it came in the year with the most examinees ever.
The American Board of Preventive Medicine (ABPM) publishes these numbers itself. Below is the full table, what the trend tells you, and what it means for how you prepare.
Clinical Informatics pass rates, 2017 to 2025
| Exam | Examinees | Passed | Pass rate |
|---|---|---|---|
| October 2017 | 249 | 192 | 77% |
| October 2018 | 206 | 180 | 87% |
| October 2019 | 208 | 167 | 80% |
| October 2020 | 273 | 229 | 84% |
| October 2021 | 401 | 308 | 77% |
| October 2022 | 312 | 228 | 73% |
| October 2023 | 282 | 214 | 76% |
| October 2024 | 378 | 283 | 75% |
| October 2025 | 472 | 343 | 73% |
Source: ABPM exam pass rates. ABPM notes that the figures include all examinees certifying through either ABPM or the American Board of Pathology (ABPath), since both boards use the same exam.
ABPM does not publish separate rates for first-time takers, repeat takers, or fellowship versus practice pathway candidates. Any number you see quoted for those groups did not come from this table.
What the trend shows
The pass rate has settled in the mid 70s. From 2017 to 2020 the rate swung between 77% and 87%. Since 2021 it has stayed in a narrow band: 77, 73, 76, 75, 73. Five straight years in that range suggests this is the new normal, not a bad year.
2021 was a turning point. That was the first year the exam used the current five-domain content outline, built from a 2019 practice analysis of working clinical informaticians (Silverman et al., JAMIA 2019). The new outline added a full domain on data governance and analytics, including machine learning and AI. It was also the year the candidate pool jumped from 273 to 401.
Bigger cohorts, lower rates. The two largest cohorts, 2021 and 2025, coincide with the end of the practice pathway era. ABPM stopped accepting new practice pathway applications after the 2025 cycle, and many experienced physicians rushed to qualify before it closed. Practice-pathway candidates studied around full-time clinical and operational jobs rather than finishing a structured fellowship. ABPM has not published a breakdown, so treat this as a likely contributor, not a proven cause.
What a 73-75% pass rate means for you
One in four failing is high for a subspecialty board taken mostly by experienced, motivated physicians. A few patterns explain why strong clinicians still miss:
- The exam is broad. 200 questions span five domains, from HL7 messaging and database design to capital budgeting and change management models. Most candidates are strong in one or two of those areas from their own job and thin in the rest. See our domain-by-domain guide to the content outline.
- Leadership and Professionalism is 20% of the exam. Physicians often underestimate it. It covers project management, accounting principles, negotiation, and adult learning theory, topics few clinicians have formal training in.
- Standards questions punish vague familiarity. Knowing that LOINC exists is not enough. You need to know that LOINC codes lab tests and observations, RxNorm normalizes clinical drug names, and ANSI X12 carries claims transactions.
- Recall is not enough. Many questions describe a scenario (a failed CDS rollout, a downtime event, a data quality problem) and ask what an informaticist should do first.
How to land on the passing side
- Start four to six months out. Map your weak domains early so you can spend most of your time where you are thinnest. Our study plan for the Clinical Informatics boards breaks this down month by month.
- Study to the official outline, not your job. The ABPM content outline lists every testable topic. Weight your time by the domain percentages: 30% for Improving Care Delivery and Outcomes, 20% each for Fundamentals and Leadership, 15% each for Enterprise Systems and Data Governance.
- Do a lot of scenario questions. Practice questions show you how a topic is tested, not just what it is. Read the explanation for every option, including the ones you got right.
- Simulate the format. The real exam is 200 questions in four one-hour blocks of 50, with a 15-minute tutorial and a 15-minute break, 4 hours 30 minutes in total (ABPM exam format). Do at least one timed 50-question block before test day.
If you do not pass
Failing is common enough that you should know the rules before you sit. If you qualified through the practice pathway, your approval window matters: candidates approved in the 2025 cycle can test in 2025, 2026, or 2027 (ABPM support). After that, the only route back is an ACGME-accredited fellowship, so a practice-pathway candidate who fails in 2026 has one more attempt. Plan your retake for the next October window and confirm your eligibility with ABPM before you reapply.
Practice with questions built for this exam
CliniQuiz has a large Clinical Informatics bank covering all five domains, written as clinical and operational scenarios, with an explanation for every option and an AI tutor that can walk you through any concept. In October 2026 the whole bank was reviewed against board item-writing standards.
Try five free ABPM Clinical Informatics questions, no account needed, and see which domains you need to work on.
