- The exam has 225 multiple-choice questions across seven hours in two sessions, delivered via Pearson VUE/DRC test centers.
- Allergy and Hypersensitivity Principles and Disorders carries 54% of the blueprint; Immunological Disorders carries 45%.
- Immunodeficiencies is the single largest named subdomain at 16% of the whole exam.
- The 2026 fee is $2,650, with a $500 late-application surcharge; the testing window runs September 28-October 2, 2026.
Exam Basics at a Glance
Before diving into content weightings, anchor yourself in the mechanics. The American Board of Allergy and Immunology (ABAI) administers this as the initial certification examination - a distinct credential from the fellows' In-Training Examination and from any Maintenance of Certification (MOC) assessment. If you're building a mental model of how this exam fits into a career timeline, the Allergy & Immunology Certification overview and What Is Allergy & Immunology Certification? pages both walk through the bigger picture.
- Format: 225 multiple-choice questions
- Duration: seven hours, split into two sessions
- Delivery: Pearson VUE test centers, coordinated with Data Recognition Corporation (DRC)
- 2026 window: September 28-October 2
- 2026 fee: $2,650 (plus $500 if you apply late)
For a deeper dive into scheduling logistics and deadlines, see the dedicated Allergy & Immunology Exam Dates 2026 guide.
Blueprint Breakdown: The Three Domains
The certification blueprint, last updated in November 2021, organizes content into three top-level categories that sum to 100%. Every question you see on test day maps back to one of these three buckets.
Domain 1: Allergy and Hypersensitivity Principles and Disorders (54%)
This is the largest domain by far, covering the mechanistic and clinical foundation of allergic disease.
- Roughly half of the entire exam lives here - prioritize accordingly
Domain 2: Immunological Disorders (45%)
Nearly as heavily weighted as Domain 1, this covers primary and secondary immune dysfunction across the lifespan.
- Contains Immunodeficiencies, the single largest named subdomain at 16%
Domain 3: Emerging Health Priorities (1%)
A small slice of the blueprint, but don't ignore it entirely - a single point can matter against an absolute passing standard.
- Low time investment relative to the other two domains
For the full subdomain-by-subdomain treatment, the Allergy & Immunology Exam Domains 2026 guide breaks apart each of these three categories in depth.
High-Yield Subdomains You Can't Skip
Because Domain 1 and Domain 2 together account for 99% of the blueprint, your subdomain-level triage matters more than domain-level triage. A few specifics worth memorizing exactly:
These boundary lines are exactly the kind of nuance that generic flashcard decks miss. If you want a structured walkthrough of how question-writers frame these distinctions, pair your review with the Allergy & Immunology Study Guide 2026.
Fees, Dates, and Registration Mechanics
Money and deadlines trip up otherwise well-prepared candidates. Lock in these numbers now:
| Item | 2026 Detail |
|---|---|
| Standard application fee | $2,650 |
| Late application fee | Additional $500 |
| Testing window | September 28 - October 2, 2026 |
| Test delivery | Pearson VUE, coordinated with DRC |
| Format | 225 questions, 7 hours, 2 sessions |
A complete cost breakdown, including how the late fee stacks with the base fee, lives on the Allergy & Immunology Certification Cost 2026 page.
Eligibility Snapshot
ABAI gates entry to the exam with three concrete requirements:
- Prior board certification: ABIM and/or ABP certification by the examination date
- Fellowship training: at least 24 consecutive months of full-time qualifying allergy/immunology fellowship training
- Licensure: valid, current, unrestricted medical licensure
If any of these is unresolved, resolve it well before registering - none are waived. Full detail on documentation and edge cases is covered in the Allergy & Immunology Requirements 2026 article.
How Passing Actually Works
Unlike exams that publish a flat "70% to pass" rule, ABAI evaluates performance against an absolute minimum standard rather than a stated percentage-correct threshold. That distinction matters for how you interpret practice-test scores: a raw percentage on a mock exam does not translate directly into a pass/fail prediction the way it might for other credentials.
Key Takeaway
Don't chase an arbitrary percentage target while studying. Focus on mastering Domain 1 and Domain 2 content comprehensively, since the standard is fixed against content mastery, not a moving curve. For a full explanation of how this standard is determined, see the Allergy & Immunology Passing Score 2026 breakdown.
After the Exam: MOC and CAP
Passing earns a certificate with a ten-year term - but staying certified is an ongoing commitment, not a one-time event. Maintenance of Certification requires:
- Annual license attestation
- 25 relevant AMA PRA Category I CME credits every year
- A patient-safety module once every ten years
- A practice-assessment/quality-improvement module once every five years
- Continuous Assessment Program (CAP) participation
- A $400 annual fee
CAP itself is open-resource and delivers 80 questions annually, split into two blocks, at ten minutes per question. The passing standard is an aggregate 80% over a five-year cycle after the two lowest-scoring blocks are dropped. These are renewal-phase rules - they do not apply to the initial certification exam's format or standard, but knowing them now helps you understand the full lifecycle of the credential before you commit to the process.
One-Week Review Sprint
If you're in the final stretch before your test date, allocate review time proportionally to blueprint weight rather than evenly across topics. This isn't generic time-blocking advice - it's mapped directly to the 54/45/1 split.
Domain 1 Deep Review
- Allergy and Hypersensitivity Principles and Disorders (54% of exam)
- Cross-check Food and Drug Allergy/Hypersensitivity boundaries against Eosinophilic and GI Disorders content
Domain 2 Deep Review
- Immunological Disorders (45% of exam)
- Spend extra time on Immunodeficiencies - the largest single named subdomain at 16%
Light Pass + Domain 3
- Quick review of Emerging Health Priorities (1%)
- Run timed practice blocks matching the two-session, seven-hour format
Practicing under realistic timed conditions matters more here than for exams with looser pacing - with 225 questions across seven hours, endurance is part of the skill being tested. Run full-length timed sets on our practice test platform to build that stamina before test day, and revisit the How Hard Is the Allergy & Immunology Exam? guide to calibrate expectations honestly.
Frequently Asked Questions
The exam contains 225 multiple-choice questions, administered across seven hours in two sessions at Pearson VUE test centers coordinated with DRC.
Allergy and Hypersensitivity Principles and Disorders is 54%, Immunological Disorders is 45%, and Emerging Health Priorities is 1%, totaling 100% per the November 2021 blueprint.
No. ABAI uses an absolute minimum standard rather than a stated percentage-correct threshold, so passing is judged against fixed content mastery criteria, not a published cutoff percentage.
The 2026 fee is $2,650, with a $500 surcharge for late applications. The 2026 testing window runs September 28 through October 2.
No. That content is explicitly excluded from Food and Drug Allergy/Hypersensitivity Reactions and instead belongs to the Eosinophilic and Gastrointestinal Disorders subdomain.