Exams · AMA Guides 6th Edition

6th Edition CIRS™
Certification Exam.

50 questions  ·  4 hours  ·  Single sitting  ·  Open book  ·  75% to pass

The CIRS 6th Edition™ exam is the AMA Guides 6th Edition national credential for physicians producing impairment ratings in jurisdictions that have adopted the 6th Edition. It is open to any physician; no AAEME course is required for registration.

Exam Specifications
FormatOnline, self-scheduled
Duration4 hours, one sitting
Passing score75%
Questions50, mixed format
MaterialsOpen book + calculator
Access window90 days from purchase
ResultDigital certificate
Exam Fee $895

Who Is the CIRS 6th Edition Exam For?

The CIRS 6th Edition exam is for physicians who produce permanent impairment ratings under the AMA Guides to the Evaluation of Permanent Impairment, 6th Edition, in jurisdictions that have adopted that edition. Passing the exam earns the CIRS 6th Edition credential, AAEME's national AMA Guides 6th Edition certification.

National & International · 6th Edition
Workers' Compensation Physicians
MDs and DOs performing impairment ratings in workers' compensation jurisdictions that use the AMA Guides 6th Edition. The CIRS 6th Edition credential gives your reports a recognized AAEME certification matched to the edition you actually use in practice.
IME & Liability
Independent Medical Examiners
Physicians performing IMEs, motor vehicle case evaluations, and other liability case work where the 6th Edition is the controlling methodology. Useful for examiners practicing across jurisdictions where some cases require 6th Edition documentation standards.
DCs & Allied Practitioners
Chiropractors and Allied Providers
DCs and allied providers whose state practice act and case scope include impairment determination under the AMA Guides 6th Edition. The exam tests applied 6th Edition methodology, not the older 5th Edition framework.
One Sitting: Plan Accordingly
The exam must be completed in a single sitting. You cannot save your progress and resume later. Once you begin, the 4-hour timer runs continuously. Schedule a block of uninterrupted time before launching the exam.

How Is the CIRS 6th Edition Exam Structured?

The CIRS 6th Edition exam is delivered online and self-scheduled. It contains 50 questions in mixed formats (multiple choice, calculation, and case-based) drawn from the methodology and clinical scenarios covered by the AMA Guides 6th Edition. Candidates have 4 hours to complete the exam in a single sitting and must achieve 75% to pass.

The Exam
  • 50 questions in mixed formats: multiple choice, case-based scenarios, and impairment calculations
  • 4 hours total time, one sitting; the timer runs continuously
  • One question at a time; you cannot return to a previous question after answering
  • 75% passing score required; result is calculated and displayed at the end of the exam
  • Online, self-scheduled; sit when you are ready, from your own location
  • 90-day window from purchase to sit the exam
What You May Use
  • The AMA Guides 6th Edition; the exam is open book, physical or digital copy permitted
  • A calculator; physical, on-screen, or web-based
  • Personal notes from your independent preparation
  • Any reference materials you find helpful; there is no restricted-resource list
  • What is tracked: IP address, exam start and end times, time spent, session activity, and answer pattern. Video proctoring is not used at this time
  • What is not allowed: assistance from another person. The exam tests your competency, not collective

What Does the CIRS 6th Edition Exam Cover?

The CIRS 6th Edition exam tests applied knowledge of AMA Guides 6th Edition impairment rating methodology across all major specialties and body systems. The 6th Edition introduced a different organizing framework than the 5th, including diagnosis-based impairment grids, functional history adjustment, and the ICF model. The exam reflects that framework directly.

01
6th Edition Framework & ICF Model
The diagnosis-based impairment (DBI) approach, the ICF model that underlies the 6th Edition, and how the framework departs from the 5th Edition methodology.
02
Spine & Pelvis
Spinal impairment under the 6th Edition's diagnosis-based grid, functional history adjustment, and the documentation required to support each rating.
03
Upper & Lower Extremities
Joint, peripheral nerve, and amputation impairment under the 6th Edition methodology, including converting regional impairment to whole person values.
04
Cardiovascular & Respiratory
Functional class assessment, objective testing requirements, and impairment classification under the 6th Edition.
05
Neurological & Sensory
Central and peripheral nervous system impairment, vision, hearing, and the documentation needed to support each rating under the 6th Edition.
06
Reporting & Defensibility
Producing written evaluations under the 6th Edition that hold up in workers' compensation hearings, depositions, motor vehicle cases, and other liability proceedings.

The exam emphasizes applied methodology (case scenarios, calculations, and judgment under the Guides) over rote memorization. Candidates should be comfortable navigating the AMA Guides 6th Edition while answering. The exam is shorter than its 5th Edition counterpart but covers the same breadth of content.

How Should I Prepare for the CIRS 6th Edition Exam?

AAEME does not currently offer a 6th Edition preparation course or study guide. Candidates should prepare independently using the AMA Guides 6th Edition itself, peer-reviewed materials, and their own clinical experience with 6th Edition methodology. A 6th Edition Advanced course is in development at AAEME but not yet available.

Required Reference
AMA Guides 6th Edition
Available through the American Medical Association
The AMA Guides to the Evaluation of Permanent Impairment, 6th Edition is the primary preparation resource and is permitted as an open-book reference during the exam itself. Candidates without ready access to the Guides should obtain a copy before sitting.

A 6th Edition Advanced course is in development at AAEME. When it becomes available it will be announced through our newsletter and listed on the courses page. Until then, the exam is open to any physician confident in their applied knowledge of the AMA Guides 6th Edition.

What Happens After I Take the Exam?

Your score is calculated automatically and displayed at the end of the exam. If you achieve 75% or higher, your CIRS 6th Edition certificate is issued on AAEME's twice-monthly schedule. If you do not pass, you will need to re-register to sit again. Exam fees are non-refundable regardless of result.

If You Pass
CIRS 6th Edition Credential Issued
  • Digital certificate emailed to you on AAEME's twice-monthly schedule
  • Physical certificate available by mail for an additional fee
  • E-Eval Provider Network access: optional listing in AAEME's certified provider referral network. You choose whether to be listed; it is not automatic
  • Recognized credential for use in workers' compensation hearings, depositions, motor vehicle cases, and other liability proceedings under the AMA Guides 6th Edition
  • CME credit for the 6th Edition exam is pending
If You Don't Pass
Re-Register to Sit Again

Your score is displayed at the end of the exam. If you do not achieve 75%, you will need to re-register to sit again. There is no free retake. Use the time to prepare: review the AMA Guides 6th Edition directly, focusing on the methodology areas you found most challenging. The original exam fee is non-refundable regardless of result.

Frequently Asked Questions

Common questions about the CIRS 6th Edition certification exam, including how it differs from the 5th Edition exam and what preparation is available.

Do I need to take a course before sitting the CIRS 6th Edition exam?

No. The CIRS 6th Edition exam is open to any physician confident in their AMA Guides 6th Edition methodology. AAEME does not currently offer a 6th Edition preparation course; one is in development.

If I pass the CIRS 6th Edition, do I also get the CIRS 5th Edition?

No. The 5th and 6th Edition exams test different methodologies and issue separate credentials. Physicians who need both must sit both exams. Only NIRSAT carries a dual-credential outcome (NIRSAT + CIRS 5th Edition).

Why does the 6th Edition exam have fewer questions than the 5th Edition?

Because the 6th Edition uses a more compact diagnosis-based framework than the 5th Edition, it is more complex and its questions take longer to answer. 50 questions are sufficient to test applied competency across the major body systems and the new framework's diagnostic grids. Both exams allocate the same 4-hour window, so candidates have ample time per question on the 6th Edition exam.

Is the exam open book?

Yes. You may use the AMA Guides 6th Edition (physical or digital), a calculator, and any personal reference notes during the exam. The exam tests applied methodology, not memorization. Assistance from another person is not permitted; your competency is what is being assessed.

How long do I have to sit the exam after purchasing?

You have 90 days from the date of purchase to sit the exam. Because the window is fixed, AAEME recommends purchasing the exam when you are ready to take it rather than registering far in advance.

What happens if I fail the exam?

If you do not pass, you will need to re-register to sit again. There is no free retake. The retake follows the same format: 50 questions, 4 hours, single sitting, 75% to pass. The original exam fee is non-refundable regardless of result.

When will I receive my certificate?

AAEME processes certificates twice monthly, and your certificate is emailed to the address we have on file for you. A printed physical certificate is available by mail for an additional fee.

What is the refund policy?

All exam fees are non-refundable, regardless of result, change of mind, or failure to sit within the 90-day window. If you have questions before registering, please use our contact form.

Ready to Earn Your CIRS 6th Edition Credential?

Register when you are ready to sit. The 90-day window begins at purchase. Certificates are issued twice monthly after you pass.