- The exam is 200 questions total, split into two 100-question, two-hour sections with an optional 15-minute break.
- Musculoskeletal conditions (Domain 4) carry the single heaviest weight at 35 percent of the exam.
- ABEM candidates pay $470 plus $1,745 for 2026; ABFM candidates pay $1,300 initially or $650 to re-attempt.
- 2026 testing windows are July 7-11 and November 9-18, with ABEM application windows Feb 17-May 25 and Jul 1-Oct 5.
Exam Snapshot: The Numbers You Must Memorize
Before you touch a single practice question, lock in the logistics. These numbers show up constantly in scheduling decisions, budget planning, and last-minute panic-checking the week before your test date. This page is designed as a fast-reference companion to the deeper breakdowns in the SM Study Guide 2026 - use this cheat sheet for recall, and use that guide for strategy.
- Format: Two sections of 100 multiple-choice questions each, two hours per section, 200 items and four hours of total testing time.
- Break: One optional 15-minute break between sections.
- Delivery: Computer-based via Prometric, roughly 340 U.S. sites, 13 Canadian sites, plus select international centers.
- International fee: An additional $200 applies at international testing centers.
- 2026 windows: July 7-11 and November 9-18.
- Frequency: Twice per year.
Domain Breakdown at a Glance
The blueprint effective January 1, 2026 is the first content update since 2004, built from a national clinical activities survey. That means the weighting below reflects what practicing sports medicine physicians actually see, not a theoretical curriculum. For the full explanation of each area, see the SM Exam Domains 2026 Complete Guide.
Domain 1: Foundations of Practice (5%)
The smallest slice, but do not skip it - foundational principles anchor how questions in every other domain are framed.
- Core concepts underlying sports medicine practice patterns
Domain 2: Preventive Aspects of Sports Medicine (10%)
Screening, conditioning, and injury-prevention reasoning show up as scenario-based items rather than pure recall.
- Pre-participation evaluation logic and risk stratification
Domain 3: Care of Emergency Conditions (20%)
A full fifth of the exam. Expect sideline and acute-care decision trees that test rapid triage judgment.
- Time-sensitive recognition and management scenarios
Domain 4: Diagnosis, Management, and Epidemiology of Sports- and Exercise-Related Musculoskeletal Conditions (35%)
The single largest domain and the one that should anchor your entire review schedule. It spans knee, shoulder, spine, hand and wrist, leg, ankle and foot, pelvis and hip, muscle conditions, pain management, pediatrics, and procedures.
- Knee and shoulder pathology across the lifespan
- Spine, hand/wrist, and pelvis/hip presentations
- Procedural knowledge and pediatric-specific nuances
Domain 5: Diagnosis, Management, and Epidemiology of Sports- and Exercise-Related Medical Conditions (30%)
Nearly a third of the exam. Together, Domains 4 and 5 - the two clinical diagnosis and management domains - account for 65 percent of the total exam.
- Systemic and exercise-related medical conditions outside the musculoskeletal system
Key Takeaway
Domains 4 and 5 combine for 65 percent of your score. If your study time isn't roughly proportional to that weighting, you're studying the wrong things - regardless of how comfortable you feel with foundational or preventive material.
Registration, Fees, and Deadlines
Fee structures differ depending on which board credentials you. Get this wrong and you either overpay or miss a window entirely. A full walkthrough lives at SM Certification Cost 2026: Complete Pricing Breakdown, but here's the quick version.
| Item | ABEM Pathway | ABFM Pathway |
|---|---|---|
| Application fee | $470 (non-refundable) | Included in exam fee below |
| Examination fee | $1,745 (2026) | $1,300 (initial attempt) |
| Re-attempt fee | Combined with above | $650 per re-attempt |
| International fee | +$200 | +$200 |
| Application window | Feb 17 - May 25 or Jul 1 - Oct 5 | Varies by ABFM process |
For the full 2026 calendar, including how the application windows line up against the July and November testing periods, check SM Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Eligibility Checklist
Before you register, confirm every box below is checked. Missing one of these isn't a minor paperwork delay - it can knock you out of an entire testing cycle. A deeper walkthrough of each requirement is in SM Requirements 2026: Eligibility, Prerequisites & How to Qualify.
- Current certification by ABEM, AOBEM, or ABIM
- Active participation in continuing certification
- Successful completion of an ACGME-accredited Sports Medicine fellowship of at least one year
- Compliance with the ABEM Policy on Medical Licensure
Note that recertification operates on its own separate track: Emergency Medicine and Internal Medicine diplomates recertify by passing the Sports Medicine Recertification Examination every ten years, and that exam may be taken in years six through ten of the certification cycle. If you're weighing whether to pursue the credential at all, Is the SM Certification Worth It? Complete ROI Analysis 2026 covers the career case in more depth, and SM Jobs outlines where certified physicians typically practice.
Scoring, Rescore, and Results Timeline
Plan your post-exam expectations around these fixed points:
- Results are released approximately six to eight weeks from the close of the exam window - not from your individual test date.
- Rescore requests cost $200 and must be submitted within 14 days of results release.
- All candidates, regardless of sponsoring board, are held to an identical passing standard on the same exam.
If you want to understand exactly what "passing" requires and how the standard is set, see SM Passing Score 2026: Exactly What You Need to Pass. And if you're still calibrating how difficult this exam is relative to your comfort level with the material, How Hard Is the SM Exam? Complete Difficulty Guide 2026 and SM Pass Rate 2026: What the Data Shows are worth reading before you finalize a study timeline.
Last-Mile Review Plan
In the final weeks before your July or November sitting, structure review sessions around domain weight rather than personal comfort. Heavier domains deserve more repetitions, even if they feel less exciting to review.
Musculoskeletal Deep Dive (Domain 4)
- Cycle through knee, shoulder, spine, and hand/wrist presentations
- Drill pediatric-specific musculoskeletal variations and common procedures
Medical Conditions (Domain 5)
- Review exercise-related systemic and medical conditions
- Pair with Domain 4 topics where overlap exists (e.g., pain management)
Emergency and Preventive Content (Domains 3 & 2)
- Rehearse acute/sideline decision scenarios under time pressure
- Review pre-participation and screening frameworks
Foundations and Full Timed Runs
- Close the gap on Foundations of Practice content
- Simulate the two-section, four-hour format including the break
This kind of proportional scheduling is one of the few generic study techniques worth borrowing directly - spend your limited hours where the blueprint tells you the questions actually live. For a more detailed week-by-week build-out, the SM Study Guide 2026: How to Pass on Your First Attempt expands on this exact framework.
If you're building or refreshing your practice-question routine, running full-length timed sets on our practice test platform is one of the fastest ways to confirm your pacing matches the real two-section format before you sit for the actual exam.
Frequently Asked Questions
The exam totals 200 multiple-choice questions across two sections of 100 questions each, with two hours allotted per section and an optional 15-minute break between them, for four hours of total testing time.
Domain 4, Diagnosis, Management, and Epidemiology of Sports- and Exercise-Related Musculoskeletal Conditions, carries the heaviest weight at 35 percent, followed by Domain 5's medical conditions at 30 percent. Together these two domains make up 65 percent of the exam.
ABEM candidates pay a $470 non-refundable application fee plus a $1,745 examination fee, submitted together with the application. ABFM candidates pay $1,300 for an initial attempt and $650 for each re-attempt. International testing centers add a $200 fee.
The exam is offered twice in 2026: July 7-11 and November 9-18. ABEM application windows run February 17 to May 25 and July 1 to October 5 through the MyABEM portal.
Results take approximately six to eight weeks from the close of the exam window. Rescore requests can be submitted within 14 days of results release for a $200 fee.