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Exam Information
Official specifications published by ACSM
Exam Format
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Skills this practice test covers
- Explain how Exercise is Medicine moves patients from clinical care to community exercise.
- Write FITT-VP exercise prescriptions for hypertension, dyslipidemia, obesity and metabolic syndrome.
- Adjust a diabetes exercise plan for anti-hyperglycemic agents and the risk of hypoglycemia.
- Modify training for frail older adults, with balance work and fall risk in mind.
- Use motivational interviewing to draw out change talk and set SMART goals with clients.
- Plan a small group medical fitness program and a safe virtual training session.
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ACSM-EIM exam content
5 domains · 21 topics · 135 questions
Health Care Basics21 questions
This module explains how health care works and where an exercise professional fits in it. It covers models of care, the Exercise is Medicine clinical-to-community approach, health care terms and documentation, HIPAA privacy and the limits of scope of practice.
Skills tested
- Compare fee-for-service care with Accountable Care Organizations and Patient-Centered Medical Homes.
- Describe how a clinical referral leads a patient to a qualified exercise professional in the community.
- Write progress notes, such as SOAP notes, that a referring provider can act on.
- Handle client health data under the HIPAA Privacy Rule and Security Rule.
- Recognize requests outside scope of practice and refer the client back to a provider.
Questions by topic
- Privacy/HIPAA and Scope of Practice6
- EIM Clinical-to-Community Integration5
- Models of Care and Health Systems5
- Terminology, Documentation and Communication5
Exercise Prescription for Common Chronic Medical Conditions55 questions
The longest module applies the ACSM and PAGA guidelines to nine conditions, from hypertension and dyslipidemia to NAFLD, osteoarthritis, low back pain and cancer. It also covers how common medicines change the exercise response and when to send a client back to a provider.
Skills tested
- Apply FITT-VP to hypertension, watch for post-exercise hypotension and avoid the Valsalva maneuver.
- Set exercise volume for dyslipidemia, obesity and metabolic syndrome.
- Explain how exercise lowers liver fat in NAFLD even without weight loss.
- Time exercise around meals and insulin, and manage hypoglycemia in type 2 diabetes.
- Adapt programs for osteoarthritis, low back pain and clients during or after cancer treatment.
Questions by topic
- Hypertension Exercise Prescription7
- Dyslipidemia Exercise Prescription5
- Obesity Exercise Prescription6
- Metabolic Syndrome Exercise Prescription7
- NAFLD Exercise Prescription6
- Prediabetes and Type 2 Diabetes Exercise Prescription10
- Osteoarthritis4
- Low Back Pain6
- Cancer4
Exercise Prescription for Older Adults19 questions
This module covers the physical changes of aging and how they shape a program. Candidates apply the ACSM and PAGA guidelines for older adults, including frail older adults, and modify exercises to keep them safe.
Skills tested
- Describe how strength, balance and fitness change with age.
- Screen for frailty and fall risk before choosing exercises.
- Build multicomponent programs with balance, flexibility and chair-based exercises.
Questions by topic
- Aging and Physical Activity6
- Working with Frail Older Adults5
- Training Tips and Modifications8
Facilitating Behavior Change - The Coach Approach27 questions
A sound prescription helps only if the client follows it. This module teaches a client-centered coach approach built on behavior change theories, cognitive-behavioral support techniques and motivational interviewing.
Skills tested
- Apply theories such as the Health Belief Model to a client's readiness for change.
- Support adherence with cognitive restructuring and SMART goals.
- Elicit and strengthen change talk, and respond to sustain talk without arguing.
- Coach rather than instruct, using active listening and empathy.
Questions by topic
- Behavior Change Theories8
- Motivational Interviewing10
- Behavioral Support Techniques9
Exercise Prescription in Special Settings13 questions
The last module takes exercise beyond one-to-one sessions. It covers small group medical fitness programs for clients who share a condition, and technology and virtual training, with their safety, privacy and liability questions.
Skills tested
- Design one group program for clients who need a similar prescription.
- Individualize exercise for each member of a group.
- Plan emergency procedures and data security for virtual sessions.
Questions by topic
- Technology and Virtual Training8
- Facilitating Small Group Medical Fitness Programs5
Requirements
- Required: at least a bachelor's degree in exercise science, exercise physiology or kinesiology.
- Required: a current ACSM certification or another NCCA-accredited or ISO/IEC 17024 fitness certification.
- Required: completion of every module of ACSM's EIM online course, with each module quiz passed.
- Recommended: experience with clients who have chronic conditions and familiarity with ACSM's Guidelines for Exercise Testing and Prescription.
About the ACSM-EIM exam
With ACSM-EIM, a certified exercise professional shows the skills to plan safe exercise for clients with chronic medical conditions and to work alongside the providers who refer them. ACSM awards this Exercise is Medicine Credential to candidates who complete its self-paced EIM online course and pass the module quizzes. The course covers health care basics, exercise for conditions such as hypertension, type 2 diabetes and low back pain, older adults, behavior change coaching, and group and virtual settings. The credential stays active as long as the holder's NCCA-accredited fitness certification does.
Chronic conditions take the largest share of the PlanetCert practice test, led by prediabetes and type 2 diabetes, hypertension and metabolic syndrome. Each explanation ties the answer to FITT-VP and to the guidelines behind it, from ACSM and the Physical Activity Guidelines for Americans (PAGA). Flashcard Mode helps with first-module terms such as SOAP notes, HIPAA and scope of practice. Brainy AI Assistant can compare how two diabetes medicines affect exercise, or show how a reflective reply differs from advice in motivational interviewing.
How to earn the certification
- Earns
- Exercise is Medicine CredentialSpecialty Credential
The credential stays active for as long as the holder's NCCA-accredited fitness certification stays active.
- Before
- ACSM-CPT ACSM Certified Personal Trainer
One of the ACSM certifications that meets the credential's fitness-certification requirement.
- ACSM-CPT ACSM Certified Personal Trainer
- After
- ACSM-EP ACSM Certified Exercise Physiologist
A next step for credential holders whose fitness certification is at personal trainer level.
- ACSM-CEP ACSM Certified Clinical Exercise Physiologist
ACSM's clinical certification for work with patients in medical settings.
- ACSM-EP ACSM Certified Exercise Physiologist
How to prepare for ACSM-EIM
- 1
Keep both guideline sources at hand
The course draws on ACSM's Guidelines for Exercise Testing and Prescription and the Physical Activity Guidelines for Americans. Check each condition's advice against both while studying.
- 2
Make one sheet per condition
For each of the nine conditions, write the FITT-VP targets, the main precautions and the medicines that change the exercise response. These conditions make up the biggest block of practice questions.
- 3
Rehearse a coaching conversation
Practise a short motivational interviewing exchange with a colleague: ask open questions, reflect what is heard and listen for change talk. Behavior change is the second-largest area of the practice test.
- 4
Draft a sample SOAP note
Write a SOAP note for an imagined referred client, then check it for HIPAA privacy and scope of practice. This covers the documentation questions in Health Care Basics.
- 5
Study by module, then mix
Read every explanation in Study Mode, module by module, before mixing all five in a Timed Mode run of the ACSM-EIM practice test. Ask Brainy AI Assistant about the precaution or drug effect behind any missed question.
Start a timed ACSM-EIMrun
The credential is earned through ACSM's EIM Online Course, a self-paced course with interactive activities, video clips, handouts and module quizzes.
Who ACSM-EIM is for
- Personal trainers and exercise physiologists with a degree whose clients live with chronic conditions.
- Exercise professionals who want physicians and other providers to refer patients to them.
- Staff of medical fitness centers and community programs that receive referred patients.
Typical job titles: Exercise physiologist · Medical fitness specialist · Personal trainer · Health and wellness coach
ACSM-EIM glossary
19 terms from the exam objectives and the vendor's official material, each defined in a sentence.
- Accountable Care Organizations (ACOs)
- Groups of providers that share responsibility for the cost and quality of care for a group of patients.
- Change talk
- What a client says in favor of change, such as reasons, needs or plans to be more active.
- Clinical-to-Community Integration
- The Exercise is Medicine approach in which health care providers refer patients to qualified exercise professionals in the community.
- Decisional balance
- A tool that weighs the pros and cons of changing a behavior against those of staying the same.
- FITT-VP
- The parts of an exercise prescription: frequency, intensity, time, type, volume and progression.
- Frailty phenotype criteria
- Signs such as weight loss, weakness, exhaustion, slow walking and low activity, used to identify frailty in older adults.
- GLP-1 receptor agonists
- A class of diabetes medicines that lower blood glucose and reduce appetite.
- Health Belief Model
- A theory that links action to how serious a person thinks a health threat is and how much they expect action to help.
- Health Insurance Portability and Accountability Act (HIPAA)
- The US law that protects patients' health information and limits how it can be shared.
- Hypoglycemia
- Blood glucose that falls too low, a risk during exercise for clients who take insulin or some other diabetes medicines.
- Lymphedema
- Swelling, often in an arm or leg, caused by a build-up of lymph fluid after some cancer treatments.
- Metabolic Syndrome (MetSyn)
- A cluster of risk factors, such as a large waist, high blood pressure and high fasting glucose, that raises the risk of heart disease and diabetes.
- Motivational Interviewing
- A client-centered way of talking that helps people find and strengthen their own reasons to change.
- Non-Alcoholic Fatty Liver Disease (NAFLD)
- A build-up of fat in the liver that alcohol does not cause, which can progress to inflammation and scarring.
- Physical activity as a vital sign
- The practice of asking about and recording a patient's physical activity at each health care visit.
- Post-exercise hypotension
- A drop in blood pressure that lasts for some hours after a session of exercise.
- Scope of practice
- The limits of what an exercise professional is trained and allowed to do, which rule out giving medical advice.
- SOAP notes
- A note format with four parts: subjective, objective, assessment and plan.
- Valsalva maneuver
- Holding the breath while straining, which raises blood pressure sharply and is avoided by clients with hypertension.