Also curious is the fact that the question stem and the question/answer choices are on two separate screens, although this might be a matter of preference because there likely is not enough screen real estate to include the entire question anyways.

However, a clear misstep with the app is that text in tables can go off the screen and can’t be shifted onto the screen. (See the reference table in the above screenshot)

Beyond the app, I also take some issue with the Adaptive Learning system’s black box approach. While I applaud the intentions to help make studying more efficient and intelligent, obscuring the logic of the Adaptive Learning system provides uncertainty as to what exactly will happen later on down the line when I answer a question incorrectly, and how my “confidence level” affects the learning process.

At least with a traditional, non-adaptive learning system, the user can create a systematic approach of their own by highlighting incorrect questions/topics to be repeated later. With NEJM Knowledge+’s system, the user has to somewhat trust that the Adaptive Learning system works and will properly identify the weak topics/questions. I’m not fully convinced that this is the case.

Lastly, the lack of an offline mode will prove to be frustrating for those hoping to study while flying cross-country or otherwise lack internet connectivity.


As most savvy medical trainees and physicians can attest to, the ultimate utility of a question bank lies in two main issues: the quality of the questions and the quality of the answers. With respect to these categories, the NEJM Knowledge+ Board Review for Internal Medicine passes the test.

Especially for Internal Medicine boards, the gold standard board review material is the MKSAP question bank. Given its history and widespread use, I would strongly recommend MKSAP as the first-line board review material for the internal medicine boards.

If you are interested in a supplemental question bank or board review, the NEJM Knowledge+ Board Review would be a worthy addition to MKSAP.

The system’s strengths include the size of questions (>1500 questions, including 2 practice tests) and the potential benefits of its “Adaptive Learning System,” which hopes to make your studying more efficient by identifying weak subjects. Its primary weakness is in its mobile app, which is only serviceable in its execution.

  • Price
    • $399 for trainees; $650 for physicians
    • Large number of questions
    • Multiple formats of questions to reinforce topics
    • “Adaptive Learning System” offers potential for time-saving
    • High yield questions
  • Dislikes
    • No offline mode
    • Poor design on iPhone app
    • “Adaptive Learning System” is a black box
  • Overall

    While it doesn’t replace the MKSAP Internal Medicine board review prep, the NEJM Knowledge+ Board Review system serves as an excellent supplement for those preparing for the ABIM Internal Medicine board exam.

  • Overall Score
  • User Interface
  • Multimedia Usage
  • Price
  • Real World Applicability
  • Device Used For Review

    Web Browser, iPhone 6 Plus

  • Available for DownloadiPhone