Inside CIC Exam Trends and the Future of Infection Preventionists’ Training Pathways

Infection prevention is a cornerstone of patient safety, but the road to becoming a certified infection preventionist (IP) remains uneven. In a new interview with Infection Control Today^® (ICT^®), Kayla E. Ruch, PhD, MPH, CPH, HACP, CIC, shares insights from her recent study published in the American Journal of Infection Control. As the field faces both mounting threats and workforce attrition, Ruch’s findings underscore the urgent need for standardized, accessible education and stronger institutional support for certification efforts.

Rush has spent years on the frontlines of infection prevention. Her latest study, part of her doctoral dissertation, analyzes 10 years of data on the Certification in Infection Control (CIC) exam, revealing critical trends that reflect broader shifts in the profession. From 2013 to 2022, the number of first-time CIC exam takers nearly doubled. However, pass rates fluctuated sharply, dipping as low as 57% during the height of the COVID-19 pandemic.

“The first thing I looked at was my study period data from 2013 to 2022, so a nice, robust, 10-year-ish period to try not to pinpoint certain events,” Ruch told ICT. “It gives us more ways to look at what's going on in the field. The first thing I noticed back in 2013 was that we had only 655 first-time test CIC takers, compared to 1172 in 2022, which is almost double the number over time.”

Ruch attributes this variation to both the growing demand for certified professionals and the extraordinary challenges IPs faced during the pandemic. Many candidates lacked protected study time and struggled to reconcile pandemic-era practices with standardized exam expectations. Encouragingly, pass rates have since rebounded to over 70%, suggesting a return to stability in certification preparation.

The study also highlights where IPs excel and where training needs improvement. The strongest areas included identifying infectious disease processes, epidemiologic investigation, and controlling transmission—all foundational tasks for IPs in any health care setting.

However, domains such as environmental care, sterilization, occupational health, and communication were mastered more inconsistently. These are often areas where IPs play a supportive, rather than primary, role, and where formal training may be lacking.

Without guidance and training, Ruch admits that it is not always easy to get into the field, “but once you're there, you get hands-on experience. You have a job for life, and it will always be around.”

To bridge these gaps, Ruch advocates for protected education time, financial support for exam fees and prep courses, and widespread adoption of tools like the APIC Competency Model and IPC Education Pathway. Institutions can also help by recognizing certification as a professional development milestone and supporting novice IPs through structured mentorship.

Ruch told ICT that training “needs to be standardized. Just like any other allied health professional, we at IPS provide critical knowledge and expertise to organizations to create safe environments for patients, reduce health care-related infections, and create safe working environments for our health care workers to reduce exposure transmission and be safe at work. We need more educational track pathways.”

Ruch said during the interview that, as the field braces for an anticipated wave of retirements and burnout-related exits, the time to invest in workforce development is now. Ruch’s study affirms that certification matters, but so does the infrastructure that makes certification possible. With better training, clearer career pathways, and institutional backing, IPs will be better prepared to protect patients, staff, and public health.