How to prepare for the ABEM Certifying Exam

The exam is in person at the AIME Center in Raleigh, NC. You complete 10 cases in a half-day session (ABEM Certifying Exam page). ABEM’s morning schedule, when your first case is a clinical care case:

1. 7:00 a.m. ET: arrival and registration at the Hyatt House Raleigh North Hills.
2. 7:30–7:45: walk to the AIME Center. 7:45–7:50: orientation.
3. Cases 1–4, clinical care, 15 minutes each, starting 8:00, 8:20, 8:40 and 9:00.
4. 9:15–9:45: break.
5. 9:45–9:50: orientation for the communication and procedural cases.
6. Cases 5–10, 10 minutes each, starting every 15 minutes from 10:00.
7. 11:25 a.m.: session ends.

If your first case is a communication or procedural case, the order flips: six 10-minute cases, the break, then four 15-minute cases. The afternoon session has the same shape, with registration at 12:00 p.m. ET (afternoon schedule). ABEM’s schedules say: “Be aware that break time is fixed and cannot be moved.” and “At registration, you will receive a personalized, more detailed schedule.”

ABEM groups the cases into two types: Clinical Care Cases (Clinical Decision-Making and Prioritization) and Communication & Procedural Cases (Reassessment, Difficult Conversations, Managing Conflict, Ultrasound, Procedures and Patient-Centered Communications). ABEM’s FAQ says the scoring criteria “can also be unique to the case type” (FAQ).

“This case is a structured discussion with an examiner where a physician will describe the steps necessary to diagnose and treat a patient with an undifferentiated presentation.”

“The successful physician will:”

• “identify the focused historical information a physician would ask”
• “describe physical exam findings and their significance to the presentation”
• “develop an appropriate differential diagnosis”
• “order appropriate tests and interpret them accurately”
• “stabilize and treat the patient”
• “reassess the patient as care evolves and modify care as needed”
• “provide anticipatory guidance at time of disposition”
• “discuss clinical decision-making rationales”
• “demonstrate comprehension of pathophysiology”

“This case is a structured discussion with an examiner. This case will assess the ability to prioritize multiple patients in the emergency department or prehospital setting and provide stabilizing care.”

“The successful physician will:”

• “Determine acuity of patient(s)”
• “Provide appropriate and immediate stabilizing care”
• “Respond to changes in patient acuity and triage new cases as presented”
• “Use team resources appropriately”

ABEM’s content page adds that the case includes new arrivals, patient deterioration and realistic workflow interruptions (content page, last checked Nov 3, 2026).

“For this case, the physician must demonstrate an understanding of procedures integral to the practice of emergency medicine as well as demonstrate the proper technique for performing the procedure.”

“The successful physician will:”

• “Describe the indications, contraindications, and potential complications associated with performing the procedure”
• “Prepare for the procedure”
• “Demonstrate technical proficiency while performing the procedure”
• “Provide post-procedure management”

ABEM publishes a Procedures List; start there (content page, last checked Nov 3, 2026).

“For this case, physicians must demonstrate the ability to acquire and interpret multiple ultrasound videos.”

“The successful physician will:”

• “Demonstrate proficiency at obtaining ultrasound images”
• “Interpret ultrasound videos accurately”
• “Provide patient-centered care”

ABEM also says: “Candidates will obtain ultrasound images on a standardized patient with the aid of the examiner who is able to change the settings of the machine to acquire the images.” and “The physician does not need to be familiar with the specific ultrasound machine being used, but should be able to troubleshoot a suboptimal image with respect to mode, gain, depth, etc.” ABEM publishes an Ultrasound List.

“This case requires a reassessment of the patient that integrates new information.”

“The successful physician will:”

• “Obtain additional information after an unexpected change in a case that is in progress”
• “Analyze impact of new information”
• “Modify the patient’s care as appropriate”
• “Reassess case”
• “Describe next steps in patient’s care”
• “Articulate any change in treatment”
• “Consider system-based factors”

“This case involves disclosing sensitive, unwanted, or unexpected information to a patient or family member.”

“The successful physician will:”

• “Establish rapport”
• “Determine baseline knowledge”
• “Disclose information”
• “Respond and react appropriately”
• “Provide closure”

“This case requires a physician to negotiate patient care when there are differing opinions about what is best for the patient.”

“The successful physician will:”

• “Establish rapport”
• “Understand the other person’s position”
• “Explain their own position”
• “Acknowledge divergent positions”
• “Identify shared interests”
• “Propose a path forward”

“This case assesses a candidate’s ability to effectively communicate with patients, families, or advocates”

“The successful physician will:”

• “Establish rapport”
• “Acknowledge and respect the patient’s perspectives”
• “Communicate information effectively to facilitate mutual understanding”
• “Share results of relevant diagnostic studies and other information”
• “Support shared decision-making to optimize outcomes.”

ABEM does not set a study time. It says it “cannot endorse any specific preparation course”, and lists its own resources: “sample cases with videos, case summaries and references, scoring guidelines, procedure and ultrasound lists, orientation videos, and a Know Before You Go Guide.”

• Registration is at the Hyatt House Raleigh North Hills: 7:00 a.m. ET for the morning session, 12:00 p.m. ET for the afternoon. A proctor walks you to the AIME Center; you cannot enter without your proctor.
• ABEM recommends you arrive in Raleigh no later than the day before your exam. It may not be possible to change your exam schedule for travel delays.
• Dress: whatever is comfortable, including scrubs. Closed-toe shoes are required. No logos or institution names on clothing. Wear the name badge you are given at all times.
• Prohibited items go in a sealed bag in a locker and are not available until the exam is over, including during the break. They include wallets, watches (smart or analog), cell phones, notes or reference materials, and pens and pencils. ABEM provides all materials you need.
• Snacks and beverages can be kept in your locker and used during exam breaks.
• Requests for accommodations must be made in advance. ABEM says requests to extend case time will not be considered.

• “The Certifying Exam is a criterion-referenced examination, meaning that all physicians are judged against a predetermined standard.”
• “The exam is not graded on a curve. All physicians meeting the standard will pass the exam.”
• “Scores will be available within 90 days of the last day of the exam administration.”
• The FAQ adds that passing scores are set with a modified Angoff method, that physicians who do not pass must wait 9 months to try again, and that there is a maximum of five attempts within six years of board eligibility (FAQ).