Exam Process

The Oral Exam is a half-day session held at the O’Hare Marriott hotel in Chicago, Illinois. It consists of seven patient scenarios that you must manage. You are expected to handle each simulated case as though these are real patients in the emergency department.

In the Exam Room

The exam is held in a hotel sleeping room. See a picture of the exam set up for both a traditional and an eOral case.

Typically, only you and the examiner will be in the exam room. A third person may be in the room to verify that the examiner is delivering and scoring the exam according to Board standards. The verifier will not interact with you. Only the examiner’s scores will count toward your final score. On occasion, a staff person may enter the room. They will not interact with you or have a part in your exam. It's important to ABEM that you receive an unbiased examiner. All ABEM examiners are clinically active, ABEM-certified emergency physicians who have gone through extensive training on the examination process.

Starting the Case

Before starting the case, verify your identity. The examiner will then answer any of your administration questions. You may begin the case once you have received the introductory materials from the examiner.

Managing the Case

You are in charge of the patient and should take an appropriate patient history, collect physical date, develop a differential diagnosis, provide treatment as appropriate, and communicate your requests, diagnosis, and treatment to the other hospital personnel, patient, and others.

Some information may be withheld to give you a chance to show your skills in a particular area.

Review Sample Cases

Obtaining Physical Examination Information

Some patient information will be provided on the admitting sheet or in other opening statements. Additional physical information you need will be provided by the examiner as you ask for it. Be specific about what information you are seeking. If your question is not specific enough, the examiner may ask, “What you are looking for?”

Available Resources

You can request any resource commonly available in an emergency department. However, ABEM may ask you to manage the patient without certain resources or information to assess a particular skill area. If you would like to request alternative tests, resources, or information, you may do so. You will be given a list of laboratory normal values, common abbreviations, and a body outline to use.

Change in Condition

The patient’s condition may change during treatment and an audible alert will be given to notify you that the vital signs have changed. If you wish to reassess the patient’s condition, you must verbally tell the examiner. Consider vital signs to be current readings, unless the examiner directs otherwise by turning off the vital signs monitor.

Knowing Drugs and Dosages

You may need to know common drugs and dosage amounts, especially for critical situations. You can look up drug and dosage information without penalty, but the examiner may deny your request. If you are permitted to look up the drug or dose, the examiner will reply, "The correct drug/dose has been given." But you must specify the drug and dosage amount.

Laboratory Data and Imaging

Order laboratory data and imaging, such as CT scans and X-rays, as you would in the emergency department. Lab and imaging results are delivered differently depending on the type of case.

Discussing the Case with Other Medical Professionals

Part of your score is based on your interactions with nurses, consultants, and other medical professionals. When the examiner plays the part of the nurse or consultant, remember to use medical language.

Informing the Patient and Family

Part of your score is based on your interactions with the patient and their loved ones. The examiner can only score you on verbal interactions. If you would discuss the patient’s condition with the patient, family, or others in your hospital, you should do so during the exam. Remember to explain information in a way that your patient will understand.

Help from Other Hospital Personnel

If you need help from hospital personnel to manage the patient, you must ask the examiner. This includes a nurse, consultant, security officer, social worker, or other personnel. When you are ready to ask for the patient’s history information, the examiner will play the role of the patient. The examiner will answer the questions you ask, so you may need to ask follow-up questions. Keep in mind that the simulated patient may not understand medical jargon, and they may be hesitant to provide information about sensitive subjects.

Time Limits

Because of the dynamic nature of the cases, the examiner cannot give you a time warning, but will keep track of the time. Instead, you should listen for cues from the examiner that tell you whether you should slow down or speed up. For example, “the nurse is asking what you would like to do next,” is a cue that you should move a little more quickly. “The nurse asks you to repeat your orders,” is a cue that the examiner needs more to time to record your actions. It's important to demonstrate effective time management during each case. Cases are designed to be manageable within the time limits, and the examiners help by guiding the pace of each encounter, so you have enough time to finish. You are not scored on speed, so be responsive to examiners' efforts to either slow down or move the case along.

Ending the Case

Once you have finished managing the patient, the examiner will end the case. Usually, the examiner will say something like, “This ends the case.” You may not need the full testing time, which is not a reflection of your performance. Leave the room promptly when the case ends.