MKSAP vs UWorld for ABIM with price per question and which to buy first

MKSAP vs UWorld is the most common money question an internal medicine resident asks before boards, and the honest answer is that they are not the same kind of product. ACP MKSAP is a full internal medicine syllabus with about 2,000 questions, CME and a pass guarantee, sold by the year: $415 for a resident member, $849 for a nonmember. UWorld's ABIM Qbank is 1,200+ board-style questions with no textbook, sold by access window: $499 for 90 days up to $749 for two years. Those are the prices on each vendor's own page in September 2026.

So the choice is less "which one is better" and more "which one fits the months you have left and the money you want to spend." Here is the side by side, the math on buying both, and what each one is actually worth for the initial ABIM exam and for MOC.

MKSAP vs UWorld price, side by side

Per question is a rough yardstick, not the whole story, and it is computed on the launch count of MKSAP's bank. Adding UWorld's Medical Library, 1,300+ reference articles, costs another $50 on every window ($549 to $799). MKSAP ships with its syllabus in every tier, so there is nothing to add.

The resident MKSAP price only applies to paid ACP Resident/Fellow members. Our MKSAP 20 price page has the full ACP rate card and the dues math for attendings, where joining ACP to get the member price does not always pay.

Is MKSAP or UWorld better for the ABIM exam?

For learning internal medicine, MKSAP. For rehearsing the exam, UWorld. MKSAP's syllabus covers 16 subspecialty areas and links every wrong answer back to the text that explains it, which is why ACP says more than 90% of internal medicine residents use it. UWorld's vignettes are longer and harder, and residents who used both often report UWorld felt closer to the real test.

Put another way: if you are a PGY1 who will read around your patients for three years, MKSAP is the core. If you are a PGY3 four months out who already knows the medicine and needs to get faster at multi-step stems, UWorld does more per hour. Reviewers of both, including a Society of Hospital Medicine blog comparing IM question banks, land in the same place: MKSAP to build knowledge, UWorld to sharpen test-taking.

Should I do MKSAP or UWorld first?

MKSAP first, UWorld last. The timing follows from how each is sold. A 3 year MKSAP subscription at $495 bought early in residency covers training, the exam and the first year after, and the questions count toward the pass guarantee. UWorld charges by window, so buying it in PGY1 means paying for access you will not use for a year. Most residents buy the 90 or 180 day UWorld window roughly three to six months before their test date.

If you have only one budget line, the order still holds for a PGY1 or PGY2. For a PGY3 who never used MKSAP and has four months, the 180 day UWorld window at $549 is the better single purchase, with ACP's Board Basics (included in MKSAP) as the thing you would miss most.

Is it worth buying both MKSAP and UWorld?

For most residents, yes, and it is cheaper than it looks. A resident member pays $640 for 3 years of MKSAP including dues, then $549 for 180 days of UWorld near the exam: $1,189 across all of residency. That is less than a nonmember attending pays for MKSAP's 3 year term alone. Many programs also buy MKSAP for residents through ACP's Residency Program Portal, with 10% off orders of 10 or more, so check before paying yourself.

For an attending preparing for MOC or working through the Longitudinal Knowledge Assessment, the case for both is weaker. The LKA rewards steady breadth, which is MKSAP's strength, and MKSAP's CME covers much of the recertification cycle. UWorld is mainly worth adding before a traditional 10 year exam.

MKSAP vs UWorld for CME and MOC

This is where the two differ most, and where attendings should look first. Every ACP MKSAP question earns 0.25 AMA PRA Category 1 credit and ABIM MOC points once you answer it correctly within two tries, so the bank holds several hundred possible credits over a subscription. Credits reset on January 1 and must be claimed by December 31. UWorld's ABIM product page sells access and questions and does not list CME in the pricing table; if credit matters to you, confirm it with UWorld before buying.

There is a trap in MKSAP's refund rule that hits people who buy it for CME. Refunds are allowed within 3 days, but not after you log into the app, answer more than five questions or claim any credit. Decide on the 1 or 3 year term before you start.

What about MedStudy and Knowledge+?

They are the other two paid banks worth pricing. MedStudy's IM Qbank+ is $449 a year for 1,700+ questions and up to 120 CME and MOC credits. NEJM Knowledge+ now lives inside AMBOSS, sold as a yearly membership at $298 with one month of unlimited Qbank, $378 with six months or $448 with twelve, with a 30 day refund. Knowledge+ is adaptive, which some residents like as a last pass after MKSAP. Neither replaces MKSAP's syllabus, and neither has UWorld's reputation for exam-like stems.

Which one to buy, by where you are

• PGY1 or PGY2: ACP resident membership plus the 3 year MKSAP ($640). Add UWorld later.
• PGY3 with MKSAP already: UWorld 180 days ($549) about four to six months before the exam, plus one self-assessment form ($50) three weeks out.
• PGY3 with nothing yet and a tight budget: UWorld 180 days ($549). If money allows, add resident membership and 1 year of MKSAP ($560).
• Attending on MOC or the LKA: MKSAP alone, and run the member vs nonmember numbers first. UWorld only before a 10 year exam.
• Former MKSAP 19 user: that access ended August 31, 2026 with no upgrade price, so you are buying ACP MKSAP at the regular rate either way.

One more budget line most PGY3s forget: the attending contract you sign right after boards. A few hundred dollars of board prep is small next to the gap between a first offer and a negotiated one, and a salary negotiation coach that reviews the offer line by line is worth an evening before you sign.

Where exam prep ends and prescribing starts

Both banks will drill you on drug interactions, renal dosing and contraindications, because the exam tests them. On the wards the question is narrower and harder: does this drug fit this patient's full medication list, kidney function and liver function right now? That is what Prescriber.io is built for. You enter the prescribing scenario once and it checks interactions across every medication, flags contraindications and allergy blockers, and surfaces renal and hepatic dose adjustments with cited sources, for $24 to $37 per clinician a month billed annually. You review every flag and sign. Our drug interaction checker page shows how it works, and if you are also pricing a point-of-care reference for residency, the UpToDate vs Epocrates comparison covers the two apps most residents end up paying for, with the UpToDate CME credits guide showing how the searches you already run can earn Category 1 credit.