The reputable New England Journal of Medicine (NEJM) currently offers a board review prep system for Internal Medicine and Family Medicine, accessible via web, iPhone, and Android. ($399 for trainees, and $650 for physicians).


Going beyond the standard question bank format of alternative systems like UWorld and MKSAP, the NEJM Knowledge+ Board Reviews feature “Adaptive Learning,” which promises to optimize time spent studying by focusing more on weaker subjects. But don’t worry, the NEJM Knowledge+ Board Review still has a lot of questions: >1500, including 2 timed, practice exams.

Having recently completed Internal Medicine residency and board certification, I test-drove the Internal Medicine offering. We have reviewed other Internal Medicine Board Review apps in the past and have compiled a list of the best Internal Medicine apps to download for iPhone and Android as well.

What Makes NEJM Knowledge+ Different?

If you are shopping for an Internal Medicine boards review course, you’re fairly well-versed when it comes to online question banks. So let’s focus on the unique features of the Knowledge+ Board Review.

As part of their “Adaptive Learning” system, in addition to selecting an answer to each question, you also indicate how confident you are in your answer. (See Picture).


By combining your accuracy, confidence, and time it took to answer, the system hopes to identify in which topics you are weaker or stronger. Utilizing these variables, the system offers several reports, including an interesting correlation between your confidence level and accuracy. (See Picture).


In addition, most of their >1500 questions are written in 3 formats: short answer, long-form, and fill-in-the-blank. The program utilizes various formats of each question to reinforce learning points without presenting the same exact question over again.

Furthermore, these variables are factored into a separate “Recharge” portion of the system, where certain weaker topics are reinforced at a later time.

Simply put, these bonus features (adaptive learning with reinforcement of weaker topics using multiple formats of questions) are quite promising, and seek to resolve some of the complaints of the more traditional question banks.

What We Liked
For the purpose of this review, I completed about 100 questions. I felt that the general difficulty level and quality of teaching points were on par with the actual board exam. This is likely due to the fact that the covered topics were taken from the official ABIM-published topic outline for the actual exam.

In addition to having high-yield questions, the explanations provided are succinct, but thorough. After answering each question, you are initially provided with the right answer and a short “key learning point.” Clicking on “More Details” will provide a more lengthy rationale, which also explains the incorrect answers.


I also was quite impressed by the fact that most questions are written in 3 forms: long-form, short-form, and fill in the blank. I like this because it allows you to be quizzed again on the same topic over again, without allowing for rote memorization of the right answer. While I was unable to test the “Refuel” feature due to my short time with the service, I imagine that it works by identifying questions you answered incorrectly, and presents it in an alternative form.

What We Didn’t Like

Given the name of our website, we hold medical apps to a high standard, even when it comes to board review question banks. While the NEJM Knowledge+ web-based dashboard was quite impressive, the iPhone and iPad app was less polished than I would have expected.


First off, the app adopts a non-standard UI, that seems especially out of place on iOS devices. Vertical scrolling through the app (such as reading question stems) is very rigid and stops immediately when you stop dragging your finger, ignoring any momentum.