The ABPMR Part II domains A to E, explained

By The MockOral.ai team. Updated October 2026. Last reviewed October 22, 2026.

Every Part II vignette moves through the same five domains, and each one is scored on its own. Knowing exactly what the ABPMR says each domain measures tells you what to say, and just as important, what not to spend time on.

How the domains work

Each Part II vignette is led through five domains in order, A to E. The ABPMR says each domain is administered and scored independently: how you do in Domain A has no bearing on your Domain B score. At the start of each domain the examiner gives you the information you need for that domain, so a miss in one does not carry forward.

The ABPMR's prep tips compare this to golf: each hole is scored by itself, and at the next tee you get the yardage and layout you need. Practically, that means two things:

• Do not try to answer the whole case in Domain A. Answer the domain you are in.
• If a domain goes badly, let it go. The next one starts fresh.

There are eight vignettes across two 50-minute sessions, so each vignette, with all five domains, gets roughly 12 minutes. The examiners keep time. See the 2027 exam format.

Domain A: Data Acquisition

What the ABPMR scores: the history, the physical examination, the functional evaluation, and your response to psychosocial aspects of illness and functional limitations. The question it asks is whether you identified the data required to diagnose and manage the patient correctly.

How to answer: be specific and targeted. Name the history items and examination findings that would change your thinking, and say why when it is not obvious. Include function (mobility, transfers, self-care, communication, swallowing as relevant), home setup and support, and how the patient is coping.

Domain B: Problem Solving

What the ABPMR scores: integrating medical knowledge with clinical data, prioritizing rehabilitation goals and medical issues, generating a differential diagnosis, and using evidence-based medicine, research methods and information technology. The question it asks is whether you organized your thinking to choose among reasonable diagnoses while keeping the patient stable and anticipating future problems.

How to answer: prioritize. Give the most likely diagnosis, the differential that matters, the test that would distinguish them, and what you are watching for next. State what needs attention first.

Domain C: Patient Management

What the ABPMR scores: medication prescriptions, exercise and modality prescriptions, durable medical equipment, therapeutic and diagnostic injections, use of evidence-based medicine, a comprehensive care plan with monitoring and follow-up, health promotion and prevention, and management of complex medical problems. The question it asks is whether you directed the right treatments at the right times and reached an informed plan efficiently.

How to answer: be prescriptive. Name the drug, the therapy and its goals, the equipment and the follow-up. "Physical therapy" scores less than "PT three times a week for gait training with a rolling walker, progressing to a cane, with a home exercise program."

Domain D: Systems-Based Practice

What the ABPMR scores: knowledge of practice and delivery systems; risks, benefits, limitations and costs of available resources; resource use and justification; outcomes; referrals; and team management. The question it asks is whether your plan includes the right referral at the right time, with risks and benefits weighed.

How to answer: think about the level of care (acute rehabilitation, skilled nursing, home health, outpatient), who else needs to be involved, what insurance or resources allow, and how you will measure progress. This is where candidates who practise only clinical content lose points.

Domain E: Interpersonal and Communication Skills

What the ABPMR scores: communication with patients, families and other health professionals; listening; compassion, sensitivity and respect; sensitivity to diversity; and ethics and professionalism. The question it asks is whether you can explain things appropriately and respond ethically and sensitively to the patient, the family and colleagues.

How to answer: speak the actual words you would use, not a description of them. Acknowledge the emotion, give honest information in plain language, and close with a plan. This domain has its own guide: Domain E: communication and role play.

Habits that help in every domain

The ABPMR's own exam-day advice comes down to a few habits:

• Be systematic and specific about what you are asking for and what you will do.
• Speak precisely and at a moderate pace. Examiners take notes as you talk.
• Listen to the examiner's cues. The ABPMR says there are no trick questions, and everything the examiner says is meant to help you manage the patient.
• If information is unavailable, move on. The ABPMR says unavailable information is not needed to manage the case.
• Be ready to explain why. Examiners will ask, to understand your reasoning.
• Do not read silence as failure. Examiners are trained not to give feedback, verbal or otherwise.
• Follow redirection. If an examiner steers you, they are usually trying to get you back on track.

Practise all five, every time

The ABPMR recommends taking cases through all five domains with a mentor or study partner and giving the reasoning behind each decision. Our spinal cord injury sample vignette shows what that looks like from A to E.