ABEM Certifying Exam scoring, by case type

ABEM publishes what a successful physician does in each case. Turn those lists into habits you say out loud.

Last reviewed October 2026. Details change — check ABEM’s site for the latest.

How ABEM scores the exam

ABEM says the Certifying Exam is criterion-referenced and not graded on a curve; all physicians meeting the standard pass (ABEM scoring). Because each case type tests different skills, the scoring criteria differ by case type. The summaries below paraphrase ABEM’s general criteria; read the original page too.

Clinical Decision-Making

  • Focused history
  • Exam findings and why they matter
  • Differential diagnosis
  • Right tests, read accurately
  • Stabilize and treat
  • Reassess and adjust
  • Anticipatory guidance at disposition
  • Explain your reasoning and the pathophysiology

Practice tip: Narrate in that order, and say “because…” after each decision.

Prioritization

  • Determine acuity
  • Immediate stabilizing care
  • Respond to changes and new arrivals
  • Use team resources

Practice tip: State who is sickest, what you delegate, and when you will come back.

Difficult Conversations

  • Establish rapport
  • Find out what they already know
  • Disclose the information
  • Respond to emotion
  • Provide closure

Practice tip: Pause after the news. Silence is part of the skill.

Managing Conflict

  • Establish rapport
  • Understand their position
  • Explain yours
  • Acknowledge the difference
  • Find shared interests
  • Propose a path forward

Practice tip: Name the goal you share before you negotiate the plan.

Patient-Centered Communications

  • Establish rapport
  • Respect the patient’s perspective
  • Communicate clearly for mutual understanding
  • Share results and information
  • Support shared decision-making

Practice tip: Check understanding with teach-back, not “any questions?”

Procedures

  • Indications, contraindications, complications
  • Preparation
  • Technical proficiency
  • Post-procedure care

Practice tip: Say the consent and the aftercare, not only the steps.

Reassessment

  • Gather new information after an unexpected change
  • Analyze its impact
  • Modify care
  • Reassess
  • Describe next steps and any change in treatment
  • Consider system-based factors

Practice tip: Say out loud what changed and what you are doing differently.

Ultrasound

  • Obtain images proficiently
  • Interpret videos accurately
  • Provide patient-centered care

Practice tip: Know how to fix a poor image: mode, gain, depth.

Next steps

Build these into a weekly plan with our Certifying Exam prep guide, or go deeper on prioritization, difficult conversations and procedures.

Common questions

Is the ABEM Certifying Exam curved?

No. ABEM says it is criterion-referenced: everyone is judged against a predetermined standard and everyone who meets it passes.

How is the passing score set?

ABEM’s FAQ says passing scores are set with a modified Angoff method, and that post-exam analysis (including scaling, equating and a multifaceted Rasch model) helps score candidates fairly across exam versions and examiners.

What happens if I don’t pass?

ABEM says you will need to retake the Certifying Exam, and by policy you must wait 9 months to reattempt it.

Get scored on what you say

DOME’s AI examiner gives credit only for what you actually say, then shows a debrief. Try a practice case and see what you left out.

See how DOME works →Browse practice cases

Pricing

Educational only — not medical or career advice. DOME is not affiliated with or endorsed by the American Board of Emergency Medicine (ABEM). Facts here are summarized from abem.org; ABEM’s pages are the final word.

Sources