- What "CIME Training" Actually Covers
- Training Hours vs. the Examination Itself
- The Seven Preparation Areas Behind AMA6 Training
- Format, Fees, and Registration Mechanics
- Eligibility Details That Need Confirmation
- Sequencing Your Preparation Around the Seven Areas
- Medicolegal Skills the Course Does Not Replace
- Staying Certified: The Five-Year Cycle
- Frequently Asked Questions
- CIME means Certified Independent Medical Examiner, awarded through the American Board of Independent Medical Examiners (ABIME).
- The dated 2026 brochure specifies at least 16 ABIME-sponsored training hours, though official documents conflict between 15 and 16.
- The 2026 physician exam fee is US$995; required training is billed separately.
- The exam is online with a verified four-hour sitting time; no numerical passing score is published.
What "CIME Training" Actually Covers
When physicians search for CIME training, they usually mean one of two things: the ABIME-sponsored coursework that qualifies them to sit for the credential, or the independent study they do to prepare for the examination itself. These are related but not identical. The course teaches you how to perform impairment evaluations using the AMA Guides; the exam then tests whether you can apply that knowledge and the surrounding medicolegal framework competently.
The credential is the Certified Independent Medical Examiner, issued by the American Board of Independent Medical Examiners. If you are still orienting yourself to the credential, our overview articles What Is CIME Certification? and What Does CIME Stand For? cover the basics before you commit to a training path.
Training Hours vs. the Examination Itself
ABIME treats training as a prerequisite, not a substitute for the exam. The dated 2026 brochure specifies at least 16 ABIME-sponsored training hours. Older or alternate official documents cite 15 hours, so confirm the current figure directly with ABIME before you register for a course.
The exam fee and the training cost are separate line items. The dated 2026 physician exam fee is US$995, and no member versus non-member split was found in the reviewed materials. Because required training is extra, your total outlay depends on which course you select. For a fuller accounting, see our CIME certification cost breakdown.
| Element | What the reviewed materials show |
|---|---|
| Credentialing body | American Board of Independent Medical Examiners (ABIME) |
| Training requirement | At least 16 ABIME-sponsored hours per the dated 2026 brochure (15 appears in other documents) |
| Physician exam fee (2026) | US$995; training is additional |
| Delivery | Online examination; proctor/testing vendor not identified |
| Verified sitting time | Four hours |
| Passing score | Numerical score not published in reviewed current materials |
The Seven Preparation Areas Behind AMA6 Training
The August 2026 ABIME AMA Guides sixth-edition course is organized around seven topic areas. These are issuer-course preparation topics. They are unweighted, and they are not an official or exhaustive blueprint of the examination. Treat them as the spine of your AMA6 preparation, then broaden from there. Our complete guide to the CIME content areas expands on how each one is typically approached.
Area 1: Key Concepts and Methodology of AMA Guides Chapters 1 and 2
This is the foundation everything else rests on. Chapters 1 and 2 establish how the Guides define impairment, how ratings are meant to be derived, and the rules that govern their use.
- Distinguish impairment from disability and understand why the distinction matters in reports
- Learn the sixth-edition's approach to diagnosis-based rating rather than relying on habits from earlier editions
- Master the general rules for applying grids, modifiers, and adjustments consistently
Area 2: Spine Impairment Rating
Spine cases are common in independent medical examination work, which makes this a high-leverage area for practical competence.
- Identify the correct diagnosis-based region and class for the clinical picture
- Apply modifiers accurately and explain why each was or was not used
- Recognize how documentation gaps limit what you can defensibly rate
Area 3: Upper and Lower Limb Impairment Rating
Limb ratings require careful navigation of region-specific grids and the interaction between regional and whole-person values.
- Select the proper diagnosis grid for the affected structure
- Convert regional impairment to whole-person impairment where the method requires it
- Handle multiple impairments in the same limb without double counting
Area 4: Nervous System Impairment Rating
Neurologic ratings often combine several functional domains, so the challenge is organization as much as recall.
- Work through the relevant functional assessments systematically
- Understand how central and peripheral conditions are rated differently
- Know when to combine versus when to rate separately
Area 5: Psychiatric Impairment Rating
Psychiatric evaluation is where clinical judgment and the structured rating method meet most visibly.
- Apply the Guides' structured approach to behavioral and mental conditions
- Separate diagnosis, symptom severity, and functional limitation in your reasoning
- Document the basis for ratings in language a reader outside medicine can follow
Area 6: Internal Medicine, Pulmonary, Cardiology, Eye and ENT Impairment
This is the broadest area in the course because it spans several organ systems, each with its own testing-based criteria.
- Know which objective tests anchor ratings in each system
- Recognize the thresholds and classes tied to those test results
- Budget extra study time here because the breadth is wide
Area 7: AMA6 Complex Case Studies
Case studies integrate the other six areas. They reward candidates who can move from history and findings to a defensible rating without losing the thread.
- Practice multi-system scenarios where more than one rating applies
- Show your calculation path, not just the final number
- Learn from errors in worked examples, since they reveal common methodological slips
Format, Fees, and Registration Mechanics
The examination is delivered online. The reviewed sources do not identify a third-party proctoring or testing vendor, so check ABIME's current candidate instructions for the technical and identity-verification steps before exam day. The verified sitting time is four hours. Availability-window language varies between 24 hours and one week across materials, which is exactly the type of detail to confirm directly; our guide to CIME exam dates and scheduling tracks that question.
Current question counts, scored versus unscored items, and the complete item-format specification are not verified for 2026. One archival booklet mentions 120 multiple-choice questions, but that figure is not confirmed as current, so do not plan around it. Likewise, detailed rules on calculators, reference books, and the number of permitted references need confirmation from ABIME. If your preparation assumes open-book access to the Guides, verify that assumption rather than relying on it.
The numerical passing score is not published in the reviewed current materials, and the pass rate is not publicly disclosed. We explore what can and cannot be known in our passing-score article and our pass-rate analysis.
Key Takeaway
Because question count, item formats, and passing score are unconfirmed for 2026, build your preparation around mastery of AMA6 methodology rather than around a guessed test format. Methodology competence transfers to any item style.
Eligibility Details That Need Confirmation
Eligibility requires qualifying medical licensure, practice or specialty credentials, and a clean conduct record. Two points in official documents conflict and should be resolved with ABIME before you invest in training:
- Years of practice: documents variously state five years or ten years.
- Training hours: documents variously state 15 or 16 hours, with the dated 2026 brochure specifying at least 16 ABIME-sponsored hours.
The safest approach is to plan for the stricter reading until ABIME confirms otherwise, then email or call to settle the question in writing. Our CIME requirements guide lays out the prerequisite categories in more detail.
Sequencing Your Preparation Around the Seven Areas
Generic study advice matters less than ordering the material sensibly. The one scheduling principle worth applying here is to front-load the shared methodology and back-load integration, because the later areas depend on the earlier ones. Here is one reasonable sequence; adjust the pacing to your own calendar and experience. For a broader plan, see the CIME study guide.
Methodology first
- Work through AMA Guides Chapters 1 and 2 slowly
- Write out the general rules in your own words
Musculoskeletal regions
- Spine rating, then upper and lower limbs
- These share grid-and-modifier mechanics, so learning them together reinforces the method
Nervous system and psychiatric
- Practice structured functional assessments
- Draft sample rating rationales
Multi-system breadth
- Internal medicine, pulmonary, cardiology, eye, and ENT
- Allow extra time because of the range of organ systems
Integration
- Complex case studies spanning several areas
- Timed practice that approximates a four-hour sitting
You can test your retention along the way with the practice questions on the main CIME Exam Prep practice site. Our question allocations across topics are editorial choices for study balance, not official weightings. For a quick refresher before exam day, the CIME cheat sheet condenses the highest-yield facts.
Medicolegal Skills the Course Does Not Replace
The AMA6 course teaches the rating method. It does not make you a competent independent medical examiner on its own. The seven course topics are not a complete CIME examination blueprint, so broader medicolegal preparation is also necessary. That generally means understanding the examiner's role as distinct from a treating physician, the importance of impartiality, how to structure a report that a lawyer, adjuster, or judge can read, and how to respond to challenges on methodology.
- Practice writing a rating rationale that states findings, the grid used, each modifier, and the result
- Learn how to explain why you rated at a particular class rather than the adjacent one
- Understand the limits of your opinion when records are incomplete
Physicians who think about the career side of the credential may also want to read our pieces on CIME jobs, the CIME salary guide, and whether the certification is worth it. Independent medical examination work is typically commissioned by insurers, employers, attorneys, and similar parties, so the training you choose should reflect the kinds of evaluations you expect to perform.
Staying Certified: The Five-Year Cycle
Certification and maintenance of certification run on a five-year cycle requiring 100 points. Sixty points come from recent CME or CPD earned within the last three years, and the remaining 40 come from either a recertification exam or the ACIME MAPP route. Current renewal and registry charges are unverified, so confirm them with ABIME when your cycle approaches.
Frequently Asked Questions
The dated 2026 ABIME brochure specifies at least 16 ABIME-sponsored hours. Some official documents cite 15, so confirm the current requirement with ABIME before enrolling in a course.
No. The dated 2026 physician exam fee of US$995 does not include the required training, which is billed separately. No member versus non-member split was found in the reviewed materials.
No. They are unweighted preparation topics from the August 2026 ABIME course. The current weighted exam outline has not been verified, so use the topics as a study framework and also prepare broadly in medicolegal practice.
The verified sitting time is four hours, delivered online. The testing vendor is not identified in reviewed sources, and availability-window language varies between 24 hours and one week, so confirm scheduling details with ABIME.
A numerical passing score is not published in the reviewed current materials, and the pass rate is not publicly disclosed. Focus on thorough command of AMA6 methodology rather than targeting a specific number.