The ACEM exams explained: format, timing and how they are passed

The FACEM is awarded by the Australasian College for Emergency Medicine. On the way, emergency medicine trainees sit 4 examinations: Primary Written Examination; Primary Examination: Integrated Viva; Fellowship Written Examination; Fellowship Clinical Examination (OSCE). Here is how each is put together and how it is passed.

Primary Written Examination

When: Training Stage 1; must pass before the Primary Viva.

Primary Written (SCQ)

2 papers of 3 hours on one day · up to 180 SCQs each (up to 360) · anatomy, pathology, physiology, pharmacology

How it is passed: Criterion-referenced: candidates must reach a pre-set standard, not a fixed pass percentage. Maximum 3 attempts.

Primary Examination: Integrated Viva

When: Training Stage 1, after passing the Primary Written.

Viva

4 oral stations of 10 minutes · anatomy, pathology, physiology, pharmacology

How it is passed: Criterion-referenced; ACEM does not publish the detailed pass rule. Maximum 3 attempts.

Fellowship Written Examination

When: Training Stage 3.

SCQ paper

Select-choice paper · 3 hours · reported as up to 120 questions

How it is passed: ACEM does not publish the pass rule. Maximum 3 attempts at the Fellowship Written.

SAQ paper

Short-answer paper · 3 hours · computer-based · reported as up to 30 questions

How it is passed: Marked against an answer key; ACEM does not publish the pass rule.

Fellowship Clinical Examination (OSCE)

When: Training Stage 4.

OSCE

Up to 12 ED stations over 2 days · 4 min reading · 7 min each

How it is passed: Domain-based marking; ACEM does not publish the current pass rule. Maximum 4 attempts.

What the exams draw on

Resuscitation and critical care (10–15% of the paper)
Cardiovascular (8–12% of the paper)
Respiratory and airway (6–10% of the paper)
Neurology (6–10% of the paper)
Trauma and orthopaedics (8–12% of the paper)
Toxicology and envenomation (8–12% of the paper)
Paediatric emergency medicine (10–15% of the paper)
Obstetrics and gynaecology (4–8% of the paper)
Mental health emergencies (5–8% of the paper)
GI, renal, endocrine and metabolic (6–10% of the paper)
Infectious disease and sepsis (5–8% of the paper)
Environmental, ENT, eyes and skin (5–8% of the paper)
ED leadership, teaching, communication and quality (5–10% of the paper)

Answers are expected to reflect Australian and New Zealand practice. The references the questions assume include: Australasian Triage Scale (ATS); ANZCOR / Australian Resuscitation Council guidelines; Therapeutic Guidelines and Australian Medicines Handbook; Poisons Information Centre (13 11 26) and Australian toxicology practice (e.g. Murray's Toxicology Handbook); Australian snake and spider envenomation practice and CSL antivenoms; Australian Immunisation Handbook (tetanus, rabies and Australian bat lyssavirus post-exposure); State and territory Mental Health Acts and guardianship law; ED access targets (4-hour rule / NEAT; NZ shorter stays in ED) and ACEM policies and standards; RACP paediatric emergency medicine curriculum (for the Paediatric Emergency Requirement).

Formats change. Always confirm the current format, eligibility and dates on the ACEM website before you sit.

Where do you stand?

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