Prioritization cases on the ABEM Certifying Exam

Several patients, one of you. The score comes from showing who you see first, what you hand off, and how you react when things change.

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

How the case works

ABEM says the Prioritization case asks you to evaluate and treat multiple patients while making sure those who need immediate care get it quickly. You may face more arrivals, deterioration of existing patients and realistic interruptions (ABEM content). The scoring criteria are: determine acuity, give immediate stabilizing care, respond to changes and triage new patients, and use team resources well (ABEM scoring).

A loop you can say out loud

  1. Scan: one sentence per patient on how sick they look and why.
  2. Rank: say who you see first and the reason (airway, breathing, circulation, time-critical diagnosis).
  3. Stabilize: the first life-saving actions for the sickest patient.
  4. Delegate: name what the nurse, tech or another physician does for the others right now (monitor, ECG, IV, pain control, labs).
  5. Re-triage: each time something changes, say the new order out loud before you act.

Common pitfalls

  • Going deep on one patient and forgetting to come back to the others.
  • Not saying what you delegated, so the examiner can’t give you credit for it.
  • Not reassessing after an intervention.

See all the case types in our scoring guide.

Common questions

What is a prioritization case?

ABEM describes it as a structured discussion in which you evaluate and treat multiple patients, may face new arrivals, deterioration and workflow interruptions, and must make sure those who need immediate care get it quickly.

Is prioritization a Clinical Care Case?

Yes. ABEM groups Clinical Decision-Making and Prioritization as Clinical Care Cases.

How should I practice?

Watch ABEM’s sample prioritization video and debrief first so you know how the case runs, then practice narrating several patients at once, out loud, with a timer.

Practice thinking out loud

Prioritization rewards clear narration. Build the habit with a DOME practice case and its debrief.

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