End-of-Rotation Exam Prep

Internal Medicine EOR exam prep

Internal Medicine rewards depth in adult inpatient medicine — workup, interpretation of labs and imaging, and stepwise management of complex disease.

2026 blueprint update

PAEA's updated End of Rotation exams are effective as of July 27, 2026 (legacy versions run through July 2027). The Internal Medicine exam adds Professional Practice (7%), shifts weight into endocrine, neurologic, and renal content, and drops the standalone Critical Care topic.

See the full Internal Medicine EOR blueprint changes →

What topics does the Internal Medicine EOR exam cover?

Cardiology

ACS, heart failure (HFrEF/HFpEF), arrhythmias and rate vs rhythm control, valvular disease.

Pulmonology

COPD/asthma exacerbations, pneumonia, PE, pleural effusions, and ABG interpretation.

Nephrology & electrolytes

AKI vs CKD, hyponatremia/hyperkalemia workup, acid–base disorders.

Endocrinology

DKA/HHS, thyroid disease, adrenal disorders, and inpatient glucose management.

Gastroenterology & hepatology

GI bleed, cirrhosis and its complications, pancreatitis, IBD.

Hematology/oncology

Anemias by MCV, thrombocytopenia, anticoagulation, common malignancy presentations.

Infectious disease

Sepsis, endocarditis, cellulitis, and antibiotic selection principles.

Rheumatology

Crystal arthropathies, autoimmune screening serologies, vasculitis basics.

Which topics show up most on the Internal Medicine EOR?

  • Anemia workup by MCV (micro/normo/macrocytic)
  • Acid–base: anion-gap vs non-gap and compensation
  • Heart failure guideline-directed therapy
  • AKI: pre-renal vs intrinsic vs post-renal (FENa)
  • Hyponatremia algorithm by volume status
  • DKA management priorities (fluids, insulin, K+)
  • PE diagnosis pathway (Wells, D-dimer, CTPA)
  • Cirrhosis complications (varices, SBP, HE)

How should you study for the Internal Medicine EOR?

  • Go deep. IM questions are multi-step: interpret the labs and imaging, then pick the next best step — practice reasoning, not recall.
  • Master lab interpretation cold: anemia by MCV, acid–base with compensation, AKI by FENa, and hyponatremia by volume status.
  • Expect inpatient complexity — heart failure, COPD/PE, GI bleed, cirrhosis, DKA — and know the stepwise workup plus first-line therapy.
  • Then run it on FirstPassPA. Work the Internal Medicine question set by topic, read every explanation, and let spaced repetition resurface your misses as your exam date nears — then simulate with timed, mixed blocks in the final week.

What are common Internal Medicine EOR mistakes?

  • Skipping the volume-status step in hyponatremia
  • Giving insulin before fixing potassium in DKA
  • Forgetting compensation rules in acid–base questions
  • Confusing HFrEF vs HFpEF therapy
  • Not risk-stratifying before imaging in suspected PE

Study Internal Medicine on FirstPassPA

EOR rotation mode gives you a focused Internal Medicine question set with an AI tutor on every answer, spaced repetition, and analytics that show your weak spots. Free to start — no credit card.

Start studying free → Try free Internal Medicine questions →

Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA or PAEA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants; End of Rotation™ is a program of the Physician Assistant Education Association.