ABMLI Exam Information


The ABMLI is phasing out its certification exam; the last exam will be administered in August 2017. 


The objective is to measure the candidate’s knowledge, problem-solving abilities, and clinical judgment in subject areas considered necessary for the effective directorship of a laboratory engaged in the practice of medical laboratory immunology.



The exam consists of 200 multiple-choice questions.

It is computer-based and administered at testing centers worldwide.

Candidates can move forward and back through the questions while examining.

Candidates are allowed six hours to complete the exam.  The time allotted is considered to be much greater than required for answering the questions, but the Board does not wish time constraints to be a factor in performance.



  • Each question is multiple-choice with only one correct answer.
  • Questions have a stem and four possible responses.
  • Two types of questions are incorporated in the exam:
    1. Questions designed to test basic recall knowledge, direct interpretation of data, or simple synthesis of information
    2. Questions that require a higher level of thought process, reasoning skills, or interpretation of data to arrive at the correct answer.
  • In some cases, questions may require calculations. Examples of such questions include assessment of sensitivity, specificity, dilution factors, and cost-accounting results.
  • Questions are updated and reevaluated annually. Candidates should expect to see questions on technical advances or issues that occurred during the past year.

Learn more about how a question is developed.

Responsibilities of the Exam Development Committees and rosters of the current members.



The certification exams of the American College of Microbiology use a criterion-referenced scoring system. This method sets a standard of performance in absolute, not relative, terms. Candidates are not graded on a curve and do not compete against each other. Instead, each candidate’s performance is measured solely against established criteria and standards. Candidates must demonstrate that they have mastered these criteria in order to pass the exam. Candidates who perform at or above the established performance standard pass the exam and are certified. Each candidate’s score is based only on the number of correct answers; there is no penalty for guessing.

Learn more about criterion-referencing, discrimination, and scoring.



The ABMLI pass rate is available for 2010-2015.



Candidates not passing the exam on their initial attempt will have two additional opportunities to reexamine; thereafter, a new application will be required. Additionally, candidates must successfully reexamine within three consecutive exam cycles or their application will be withdrawn. The reexam fee is the same as the initial exam fee (i.e., $400).



The exam contains 30 questions associated with case studies. Case studies are presented in the form of a case history, clinical situation, or other problem similar to one that may be faced by a medical immunology laboratory director. Case study are associated with questions based on major topics involved in medical laboratory immunology. The remaining 170 questions are stand-alone questions.

Questions are distributed among four broad areas and 24 specific categories that are described below:


Domain I: Basic Immunologic Mechanisms.
This domain comprises approximately 20% of the exam. Five categories are included under this domain. Suggested topics to study include, but are not limited to, the following:

    • Antigens and antibodies. The classes of antibodies, structure and function of antibodies, chemistry of antigen-antibody interactions, determination of affinity and avidity, epitope mapping, generation of diversity and immunogenicity
    • Cells and tissues involved in the immune system. Lymphocytes, monocytes, macrophages, neutrophils, eosinophils, basophils; cell subpopulations; cell markers; functional differentiation and maturation; role in the immune response; lymph node, spleen, thymus, mucosal-associated lymphoid tissue, bone marrow structure and function, antigen presenting cells (dendritic cells and lymphocytes), and CD proteins
    • Cell cooperation and immune regulation. Cellular interactions among the various cells involved in immune responsiveness; cellular activation, signal transduction; apoptosis; immunization and adjuvants; major histocompatibility complex (MHC) restriction; mechanisms of action of immunosuppressive and immunomodulatory drugs; T regulatory cells, T cell excision circles; cytokines, such as interleukins, interferons, adhesion molecules, chemokines, and growth factors; toll-like receptors (TLR) and killer-cell immunoglobulin-like receptors (KIR)
    • Effector mechanisms. Protective and destructive effects of immunologic reactions on the host, microbial and tumor immunity, autoimmunity, transplantation immunity, immunotherapy, the process of inflammation and the cells involved in inflammation, and the structure and function of complement proteins
    • Mediators. Cytokines, such as interleukins, interferons, chemokines, adhesion molecules and growth factors involved in the immune response, and other soluble mediators


Domain II: Methodology.
This domain comprises approximately 30% of the exam. Six categories are included under this domain. Suggested topics to study include, but are not limited to:

    • Assays involving antigen/antibody reactions. Precipitation, agglutination, flocculation, hemolysis, radioimmunoassay (RIA), enzyme immunoassay (EIA), immunoblots, chemiluminescence, immunofluorescence assays, multiplex bead assays; select methods to use in given circumstances
    • Complement assays. Various procedures to measure concentration and activity of complement components, and specimen collection
    • Phagocyte assays. Types of procedures, appropriate use, specimen collection, controls, calculations, and interpretation of results
    • Cell-mediated immunity assays. In vitro and in vivo assays, including skin tests, proliferation, cytotoxicity, and mediator release assays; advantages and disadvantages of procedures; controls; interpretation of results
    • Molecular biology-based techniques. Principles and performance of blotting techniques, amplication technologies, various DNA- and RNA-based analyses; fluorescent in situ hybridization (FISH); microarray technology; advantages and disadvantages
    • Instrumentation. Microscopy, flow cytometry, automated immunoassay systems, and other instruments and equipment used in a clinical immunology laboratory; the use of these instruments, basic understanding of the principles of operation, controls, calibration, and quality assurance related to the procedures


Domain III: Immunodiagnosis and Clinical Laboratory Correlation.
This domain comprises approximately 40% of the exam. Seven categories are included under this domain. Suggested topics to study include, but are not limited to:

    • Infectious diseases. Diagnostic strategies based on disease processes, appropriate selection of tests, timing and analysis of appropriate specimen for disease staging based on immunologic analysis, differential diagnosis/algorithms
    • Autoimmune diseases. Immunologic causes or parameters of various systemic autoimmune diseases (including hemolytic and collagen-vascular diseases) and diseases of various organs; advantages and disadvantages of available diagnostic tests; interpretation of test results, differential diagnosis/algorithms
    • Immunodeficiency disorders. Tests for differential diagnosis of immunodeficiencies, primary and secondary; monitoring and prognostic tests; interpretation of results, differential diagnosis/algorithms
    • Leukemias, lymphomas, multiple myeloma, and other immunoproliferative disorders. Tests for differential diagnosis of immunoproliferative disorders, monitoring and prognostic tests, interpretation of results, differential diagnosis/algorithms
    • Allergic diseases. Allergen identification, evaluation of therapy
    • Transplantation. HLA system, HLA matching and detection of humoral sensitization, ABO-Rh compatibility, analysis of rejection or tolerance, stem cell enumeration, posttransplant complications and monitoring
    • Tumor markers. Prognosis, staging, monitoring effects of therapy
    • Mediators. Cytokines, such as interleukins, interferons, chemokines, adhesion molecules and growth factors involved in the immune response, and other soluble mediators


Domain IV: Laboratory Management.
This domain comprises approximately 10% of the exam. Six categories are included under this domain. Suggested topics to study include, but are not limited to, the following:

    • Assay validation, including cost/benefit analysis
    • Quality assurance and quality control
    • Regulatory and legal issues. Federal laws and agencies (e.g., Clinical Laboratories Improvement Amendments [CLIA], Occupational Safety and Health Administration [OSHA], Centers for Disease Control and Prevention [CDC], Food and Drug Administration [FDA]; other agencies (e.g., College of American Pathologists [CAP], Joint Commission on Accreditation of Healthcare Organizations [JCAHO], American Society for Histocompatibility and Immunogenetics [ASHI], Clinical and Laboratory Standards Institute [formerly NCCLS])
    • Proficiency testing
    • Laboratory safety. Use of personal protective equipment., hazadarous material handling, disaster preparedness, MSDS sheets
    • Personnel management, including credentialing, training, and competency assessment.



Please click here to download preparation suggestions and the suggested resources list.



Please click here to download sample questions for the ABMLI exam.