How the ACEM exams are marked
Each ACEM exam turns your answers into a pass in its own way. Knowing how it is marked, and how much time each question gets, changes how you should answer.
Primary Written Examination
How it is passed: Criterion-referenced: candidates must reach a pre-set standard, not a fixed pass percentage. Maximum 3 attempts.
On the clock: Paper 1: 180 questions in 3 h, about 60 seconds each. Paper 2: 180 questions in 3 h, about 60 seconds each.
Primary Examination: Integrated Viva
How it is passed: Criterion-referenced; ACEM does not publish the detailed pass rule. Maximum 3 attempts.
On the clock: 4 stations and 10 min each.
Fellowship Written Examination
How it is passed: ACEM does not publish the pass rule. Maximum 3 attempts at the Fellowship Written.
On the clock: 120 questions in 3 h: about 90 seconds each.
How it is passed: Marked against an answer key; ACEM does not publish the pass rule.
On the clock: 30 questions in 3 h: about 6 minutes each.
Fellowship Clinical Examination (OSCE)
How it is passed: Domain-based marking; ACEM does not publish the current pass rule. Maximum 4 attempts.
On the clock: 12 stations, 4 min reading and 7 min each.
What that means for how you answer
Single-best-answer papers reward the best option for this patient, not a true statement. Read the last line of the stem first, and do not let one hard question eat the time of three easy ones.
Clinical stations are marked against a station guide. Do what the task asks, in the time given, and say your reasoning out loud so the examiner can credit it.
Written answers are marked against a fixed list of points. A point you do not write earns nothing, however obvious it seemed; a long answer that misses the points earns nothing more.
Where marks are most often lost
- Vague SAQ answers ("supportive care", "consider antibiotics") instead of the drug, dose, route, threshold and disposition the key rewards.
- Poor SAQ time allocation: over-writing the early questions and leaving the later ones thin or blank.
- Resus case-based discussions without prioritisation: listing everything instead of saying what you do first, second and why.
Pass marks and formats change. Always confirm the current rules on the ACEM website before you sit.
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