Purpose of App Review

Medical providers often live for the challenge of a difficult diagnosis. Combine that with high quality photos of rare and not-so-rare diseases and you have the New England Journal of Medicine (NEJM) Image Challenge App.

I reviewed this app from the perspective of a medical resident to determine whether it was suitable to quiz myself with.


The NEJM Image Challenge App–most recently updated in December 2010 and available on the iPad and iPhone–is provided by the NEJM publishers.

The app randomly selects  various dermatologic, radiologic and other pictures from the weekly published NEJM. The image is accompanied in the app with a multiple choice question, usually asking for diagnosis or presenting symptoms.

User Interface

The main menu shows a collection of images and provides you with a few options – the image challenge, about, and settings. The settings section allows you to to change various aspects of the challenge such as when available images are refreshed, what images are downloaded (random versus newest), when the image selection is refreshed, and how many images to display at once.

Once you are happy with your settings, it is time to enjoy the challenge! Selecting “Take the Challenge”  brings you to a grid of images. You can choose any of the images displayed there or press the “Refresh” radio button to get new ones.

Upon selecting an image, you are taken to a new screen that offers one question—diagnosis, presenting symptoms, etc.—and five answers.

You can expand the image if the 2 centimeter by 2 centimeter image is too small. The resolution is not always perfect with the iPad 3, but clear enough to get the gist. Even with the smaller size, you are usually able to see the most pertinent findings.

If you choose the correct answer, you are provided with an explanation of why that selection is correct.

If you choose the wrong answer, you receive a message that this is not the preferred response and to try again.

No explanation is provided as to what that particular answer would look like (if you are talking about a diagnosis). No hyperlinks are provided for additional information on a particular answer choice, nor are references provided as to why the correct answer is the correct answer.

If you want to see how other people chose among the options, you can select “how others chose” to see the breakdown per answer choice. Did I mention medical providers love a good competition?

Once you have found the right answer, you can choose to go to the next image by selecting the “next” radio button at the bottom of the correct answer message.


  • $2.99


  • Breadth and variety of images available
  • High-quality images
  • Explanations provided for correct answers


  • No ability to highlight or save a particular image for later review
  • No explanation of wrong choices
  • No personalized statistics
  • Lack of links to additional information for a particular image or answer choices

Healthcare providers that would benefit from the app

  • Residents, nurse practitioners, medical/nursing students, MD/DOs


  • The NEJM Image Challenge app provides a great forum to keep one’s diagnostic skills sharp, but has limitations in lack of robustness of explanations and inability to save particular images for later review.
  • It’s a geek medical practitioner’s dream come true to have the NEJM Image Challenge app available, but has limited day-to-day application.

iMedicalApps recommended?

  • Yes

iTunes Link

Rating: 3.57
1. User Interface – 4
2. Multimedia usage – 3.75
3. Price – 3.5
4. Real world applicability – 3


This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.