Board review buyer's guide
MKSAP 20 price and cost of ACP MKSAP for residents, members and nonmembers
ACP MKSAP, the edition that replaced MKSAP 19, costs $415 a year for resident members, $590 for ACP members and $849 for nonmembers. MKSAP 19 access ended on August 31, 2026.
Below is every price, when paying ACP dues saves money and when it does not, and how it stacks up against UWorld.
Press Run check for the interaction, contraindication, dosing and alternatives on this pair.
Not matched, so not checked: .
Nothing on this pair matched a row in the reference tables behind this check. That is not a clearance: it means these references do not name this combination.
Guideline-based alternatives
That was your demo check, run on the same references the desk uses. The desk adds renal dosing against an estimated clearance, hepatic review, unlimited checks, saved history and your sign-off on every card.
The on-page check covers five prescribing scenarios and never invents clinical output, so it will not produce a card for this pair.
The full Prescriber.io desk checks any regimen against interactions, contraindications, and renal or hepatic dosing, with cited sources for you to verify.
Interaction
Contraindication / allergy check
Dosing guidance (renal / hepatic)
Guideline-based alternatives
Decision support. You verify against official sources and sign.
Clinician in the loopDecision support for licensed clinicians. Prescriber.io does not diagnose or prescribe and is not a substitute for professional clinical judgment.
The short answer
How much does MKSAP 20 cost?
There is no numbered MKSAP 20. ACP replaced MKSAP 19 with ACP MKSAP, a digital subscription launched in February 2025. It costs $415 for 1 year or $495 for 3 years for resident members, $590 or $749 for ACP members, and $849 or $1,275 for nonmembers. Resident rates need paid ACP membership at $145 a year, so a resident's real 1 year cost is $560.
Prices read on ACP's product, FAQ and membership pages and on each competitor's own pricing page. No reseller estimates.
ACP MKSAP rate card
MKSAP 20 cost by membership and term
Two terms, three buyer types. The 3 year term costs less per year for everyone.
Resident members
1 year
$415
3 years
$495
3 year term works out to $165 a year.
Needs paid ACP Resident/Fellow membership, $145 a year.
ACP members
1 year
$590
3 years
$749
3 year term works out to $250 a year.
Physician dues are $324 or $565 a year, depending on years since medical school.
Nonmembers
1 year
$849
3 years
$1,275
3 year term works out to $425 a year.
No membership needed. The price most attendings outside ACP pay.
ACP list prices in USD, read in September 2026. Buying inside the iPhone app costs more.
Dues plus subscription
Should you join ACP to get the MKSAP member price?
What you pay at purchase with dues included, against the nonmember price. Shorter bar wins.
Resident, 1 year
Join. Saves $289.Resident, 3 years
Join. Saves $635 on the purchase.Physician, 7 years or less out, 1 year
Buy as a nonmember unless you want the membership.Physician, 7 years or less out, 3 years
Join. Saves $202 on the purchase.Physician, 8+ years out, 1 year
Buy as a nonmember.Physician, 8+ years out, 3 years
Nearly even. Nonmember is $39 cheaper.Residents should join, full stop. Resident dues are $145, and the member discount on MKSAP alone is $434 for 1 year and $780 for 3 years. The membership also includes online access to Annals of Internal Medicine.
Attendings need to do the math. ACP charges physicians $324 a year if they are seven years or less beyond medical school and $565 after that, and dues vary by chapter at renewal. For a 1 year subscription, dues plus the $590 member price beat the $849 nonmember price for nobody. For a 3 year subscription, a physician early in practice saves about $200 by joining; a physician eight or more years out is $39 better off as a nonmember. If you would pay ACP dues anyway, ignore all of this and take the member price.
From numbered editions to a subscription
Print and digital, one edition every 3 years
Digital only, 1 or 3 year subscription
Legacy product page now says no longer available
The only MKSAP ACP sells
When was MKSAP 20 released?
The edition that would have been MKSAP 20 launched on February 3, 2025 as ACP MKSAP. ACP dropped the number because the product no longer ships in fixed editions: the syllabus is revised several times a year and new questions are added annually, so there is no MKSAP 21 to wait for.
If you owned MKSAP 19, its access window closed on August 31, 2026. ACP offers no upgrade price for former MKSAP 19 buyers. You pay the same rate card as anyone else, which makes the member vs nonmember decision above the one that actually moves your cost.
What the subscription includes
What you get for the ACP MKSAP price
Everything is in every tier. Residents and nonmembers get the same product.
About 2,000 questions at launch
Learning questions, Virtual Dx image questions and Quick Qs in one bank, with new questions added each year.
16 subspecialty content areas
The syllabus text sits next to the questions, so a wrong answer links straight to the section that explains it.
0.25 CME and MOC per question
Each question answered correctly at least once in two tries earns 0.25 AMA PRA Category 1 credit and ABIM MOC points.
Board Basics and flashcards
The condensed board review and digital flashcards are included for every subscriber, not sold as add-ons.
Free app with offline use
iOS and Android apps plus Windows and Mac desktop apps. Answers sync when you reconnect.
Pass guarantee
Answer at least 1,200 questions and claim CME for them before your ABIM exam; if you fail, ACP gives you a free year.
Before you pay
Five MKSAP purchase rules that cost people money
From ACP's own FAQ. The first two are the ones buyers miss.
The refund window is 3 days
And it closes early. Log into the app, answer more than five questions or claim any CME and the refund is off, even inside the 3 days.
Upgrade to 3 years inside 30 days
A 1 year buyer can switch to the 3 year term within 30 days of purchase and pay only the difference at current rates. After 30 days that option is gone.
Auto-renewal uses the price at renewal
Not the price you paid. ACP emails a reminder before charging, and you can turn auto-renewal off in your ACP account at any time.
Do not buy it inside the iPhone app
An in-app purchase through Apple is charged at the nonmember 1 year rate plus Apple's fee. Buy at acponline.org, then sign into the free app.
Residents need paid membership
The $415 and $495 rates require an active paid ACP Resident/Fellow membership. Programs buying for 10 or more residents get 10% off, 100 or more another 5%.
The wider market
MKSAP price vs UWorld, MedStudy and Knowledge+
Paid ABIM prep an internist weighs, with the price each vendor publishes.
| Product | What it is | Published US price | Access |
|---|---|---|---|
| ACP MKSAP | Syllabus plus about 2,000 questions, CME and MOC | $415 to $849 a year, $495 to $1,275 for 3 years | 1 or 3 years |
| UWorld ABIM Qbank | 1,200+ board-style questions, no syllabus | $499 (90 days) to $749 (730 days) | 90 to 730 days |
| UWorld ABIM with Medical Library | Same bank plus 1,300+ reference articles | $549 to $799 | 90 to 730 days |
| MedStudy IM Qbank+ | 1,700+ questions, up to 120 CME and MOC a year | $449 | 1 year |
| AMBOSS with NEJM Knowledge+ | Board review Qbank inside the AMBOSS library | $298 to $448 | 1 year membership, 1 to 12 months of Qbank |
| Prescriber.io | Checks a real prescription, not an exam prep tool | $24 to $37 per clinician a month billed annually | Monthly or annual |
MKSAP is the only product here that is a full textbook as well as a question bank, and the only one with a pass guarantee. UWorld is the one residents most often pair with it: 1,200+ questions written closer to exam difficulty, sold by access window rather than by year. We compare the two question by question and dollar by dollar in MKSAP vs UWorld for ABIM.
If what you really need is CME rather than board prep, MKSAP is an expensive way to get it. Our UpToDate CME credits guide and the Medical Letter subscription cost page cover cheaper routes to Category 1 credit.
Where board prep stops and a prescription check starts
MKSAP teaches you the interactions and renal dose rules that the exam tests. At 2 a.m. on a ward, the question is narrower: does this new drug fit this patient's full list, creatinine clearance and liver function? Prescriber.io answers that at the point of prescribing. You enter the 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.
Which term to buy
The right MKSAP purchase by career stage
The cheapest path changes between PGY1 and attending.
PGY1 or PGY2 resident
Join ACP as a resident ($145) and buy the 3 year subscription ($495). $640 covers you through residency and the certification exam, and a 3 year term is what the pass guarantee rewards, since it needs 1,200 answered questions.
PGY3 sitting boards next summer
Resident membership plus 1 year ($560) if MKSAP is your main text. If you already know the material and want exam-style practice, a 180 day UWorld bank ($549) is the other common choice, and many residents buy both.
Attending doing MOC or the LKA
Check your years since medical school first. Seven or fewer: the 3 year member route ($1,073) beats nonmember pricing. Eight or more: buy as a nonmember unless you want Annals and the rest of ACP membership anyway.
You had MKSAP 19
Access ended on August 31, 2026, and there is no upgrade price. You buy ACP MKSAP at the rates above.
Straight answers
Questions people search about MKSAP 20 pricing
How much does MKSAP 20 cost?
There is no numbered MKSAP 20. The current edition is ACP MKSAP, sold as a subscription: $415 for 1 year or $495 for 3 years for resident members, $590 or $749 for ACP members, and $849 or $1,275 for nonmembers. Resident pricing requires paid ACP membership, which is $145 a year.
When was MKSAP 20 released?
The edition people call MKSAP 20 launched as ACP MKSAP on February 3, 2025. ACP dropped the edition number and moved to a 1 or 3 year digital subscription that is updated several times a year instead of a new numbered edition every three years.
Can I still use MKSAP 19?
No. ACP ended access to MKSAP 19 on August 31, 2026, and its product page now reads "MKSAP 19 is No Longer Available". There is no discounted upgrade from MKSAP 19; former users buy ACP MKSAP at the standard member or nonmember rate.
Is MKSAP cheaper with ACP membership?
For residents, clearly: $145 dues plus $415 is $560, against $849 as a nonmember. For attendings it depends. A physician eight or more years out pays $565 in dues, so dues plus the member price costs more than the $849 nonmember rate for a 1 year subscription.
How many CME credits does MKSAP give?
Each question earns 0.25 AMA PRA Category 1 credit and ABIM MOC points when you answer it correctly within two tries. With about 2,000 questions at launch, that is several hundred possible credits over a subscription. Credits reset every January 1 and must be claimed by December 31.
Does MKSAP come in print?
No. ACP MKSAP is digital only, on the web and in free iOS, Android, Windows and Mac apps that work offline. The printed books ended with MKSAP 19. ACP says print dates too quickly, so the digital syllabus is revised several times a year.
What is the MKSAP refund policy?
Refunds are allowed within 3 days of purchase only, and not at all once you have logged into the mobile app, answered more than five questions or claimed CME. Treat the purchase as final and decide on the 1 or 3 year term before you start studying.
Is MKSAP or UWorld better for the ABIM exam?
They do different jobs. MKSAP is a full internal medicine syllabus with questions, CME and a pass guarantee; UWorld is a 1,200+ question bank whose vignettes are closer to exam difficulty. Residents who can afford it usually read MKSAP during training and do UWorld in the final months.
Can a residency program buy MKSAP for residents?
Yes. Since May 2025 programs order membership and ACP MKSAP through ACP's Residency Program Portal. Orders of 10 or more subscriptions get 10% off and orders of 100 or more an extra 5%, and faculty can be included in the same order.
Go deeper
Other internal medicine subscriptions, priced
MKSAP vs UWorld for ABIM
Which bank to buy, and when to buy both.
CMEUpToDate CME credits
Category 1 credit from the searches you already run.
CostJAMA subscription cost
$238 online, and the JAMA Internal Medicine rate.
CostNEJM subscription cost
$189 a year, $89 for residents.
AppHarrison's app price
Four versions of the internal medicine text, priced.
ToolDrug interaction checker
Checks the whole medication list at the point of prescribing.
MKSAP gets you through the boards. We check the prescription after.
Prescriber.io checks interactions, flags contraindications, surfaces renal and hepatic dosing and suggests guideline-based alternatives, with cited sources. You review, verify, and sign.
Decision-support for licensed clinicians. Prescriber.io does not diagnose or prescribe autonomously and is not a substitute for professional clinical judgment. MKSAP and Board Basics are trademarks of the American College of Physicians. UWorld, MedStudy and AMBOSS are trademarks of their owners. Prescriber.io is not affiliated with ACP, ABIM, UWorld, MedStudy, AMBOSS or NEJM Group.