CTH® FAQs

Registration is currently open for the exam.

✓ International recognition of your expertise and commitment to
the field of travel health
✓ Enhanced professional credibility with continued professional development
✓ Increased patient referrals
✓ Tools to promote your travel clinic
✓ Listing on the ISTM Global Travel Clinic Directory (ISTM Members Only)

Applications are welcome from licensed healthcare professionals who provide travel health–related services, including physicians, nurses, pharmacists, physician assistants and other licensed healthcare professionals.

While not required, ISTM strongly recommends that candidates have at least three (3) years of experience in travel medicine and/or formal education or training in the field.

Applications can be completed online. Applications must be submitted no later than 30 days before the exam date and require:

  • Completion of the application questionnaire
  • Agreement to terms and confidentiality policies
  • Upload of a valid government-issued photo ID, such as a passport, or state or country issued ID or driver’s license

After your application is approved, you will receive a confirmation email from ISTM and an email from Meazure Learning 3-4 weeks before the exam with instructions on scheduling your exam and what to expect on exam day.

Candidates have two options through ISTM’s testing partner, Meazure Learning:

  • Online ProctorU (remote, live-proctored exam)
  • Testing Center (over 1,400 sites in 110 countries; additional fee applies)

Online ProctorU

  • ISTM Member (Doctoral Level):
    • Early Bird: USD $500
    • Regular: USD $600
  • ISTM Member (Non-Doctoral Level):
    • Early Bird: USD $370
    • Regular: USD $470
  • Non-Member:
    • Early Bird: USD $725
    • Regular: USD $825

Testing Center

  • ISTM Member (Doctoral Level):
    • Early Bird: USD $575
    • Regular: USD $675
  • ISTM Member (Non-Doctoral Level):
    • Early Bird: USD $445
    • Regular: USD $545
  • Non-Member:
    • Early Bird: USD $800
    • Regular: USD $900

Fees are payable only in U.S. Dollars and payment must be made by VISA, MasterCard, Discover, or American Express.

All credit card payments will be charged in U.S. Dollars and currency conversions will be handled through the credit card company’s billing arrangement with the cardholder.

Candidates may request accommodations due to disability or other qualifying conditions. Requests must be submitted at least 30 days before the exam with appropriate medical documentation. ISTM will make reasonable accommodations where possible.

  • Cancellations or deferrals are allowed up to 45 days before the exam start date by emailing ISTM.
  • A refund will be issued minus a USD $75 application fee.
  • Candidates have the option of one deferral at no extra cost and only for the next available examination date. If the one-time deferral to the next scheduled examination date cannot be met by the candidate, they must submit a new application and application fee.
  • If a candidate has a health or family emergency after 45 days preventing them from taking the examination, a one-time deferment to the next available examination date will be granted. Corroborating documentation of a true emergency will be required and should be sent to ISTM. All requests will be reviewed by the Executive Director.

  • 220 multiple-choice questions
  • 200 scored questions and 20 unscored pilot questions
  • Four answer choices per question
  • Single testing session lasting 4 hours and 45 minutes
  • Administered in British English
  • Sample questions

Helpful tools to prepare for the CTH Exam, such as reviewing CTH Exam sample questions and the ISTM Body of Knowledge for Travel Medicine, the CDC Yellow Book 2026: Health Information for International Travel and participating in the 2026 Travel Medicine Review and Update Course can be effective ways to prepare for the examination. ISTM members are also encouraged to create discussion boards or study groups to support collaborative learning. 

Following the examination, the questions are analyzed statistically to identify any hidden flaws. Questions that appear to be flawed are discussed by the Examination Committee to determine if they should be deleted from scoring entirely or if credit should be given for more than one answer. Once these issues are resolved, the examination is scored.

Performance on the examination will be measured against a predetermined standard of knowledge. This standard is the level of knowledge that can reasonably be expected of individuals with basic competence in travel medicine practice. Candidates will NOT be measured against the performance of the other individuals taking the examination. This means that if everyone who takes the examination meets the knowledge standard, everyone will pass. It also means that there is no pre-determined passing score; the required number of questions answered correctly to pass the examination changes each time the examination is presented. Unfortunately, there will always be some people who miss passing by one or two correct answers. Please realize that to maintain the integrity of the examination, no exceptions can be made regarding the score required to pass the examination.

The passing score for the examination is set by an international panel of experts, representative of the field of travel medicine, supervised by the ISTM Examination Committee. These experts review each examination question, evaluate the difficulty of the question and judge how a professional with basic competence would perform on the question. These judgments are analyzed statistically to determine the passing score.

  • If you pass: You will be notified that you have successfully completed the CTH® examination (numerical scores are not provided).
  • If you do not pass: You will receive your score, the minimum passing score and a diagnostic report by content area to help guide future study.

Results are emailed within 8-10 weeks after the examination date. Results are sent only to the email address provided during application.

Please be sure to add [email protected] and [email protected] to your email address book to ensure that spam filters on your email account will accept email from these addresses.

Cancellation of Scores
If for any reason a candidate decides that they do not want their score reported, they must email the Professional Team requesting cancellation of your scores. Your written request must be signed and must be received within five (5) days after the date of the examination. No refunds will be given for score cancellations. To retake the examination after a score cancellation, a new application and fee must be submitted.

Appeals
All complaints and appeals related to the Certificate of Knowledge™ Program are governed by the ISTM Certificate of Knowledge™ Program Appeals Procedures. This appeals process is the only way to resolve any application, eligibility, examination, qualification or other related challenge, complaint, and claim of irregularity. ISTM Examination Committee decisions concerning such requests are not subject to appeal.

The CTH® designation is valid for five (5) years. A renewal fee will be required as the expiration date approaches.

Yes. There is no limit to the number of times you may retake the examination. A new application and full examination fee are required for each attempt. The examination is only held twice a year.

No. The CTH® recognizes demonstrated knowledge but does not guarantee clinical competence. Due to the evolving nature of travel medicine, examination content may not always reflect the most current guidelines.

Who should I contact with questions?
For general questions and support, email ISTM or call +1-404-373-8282.