Scoring

When to Expect Your Scores

Results are posted online within 90 days, but typically are posted within 45-60 days of the last scheduled Oral Exam. ABEM will send an email to candidates notifying them when scores are available. ABEM cannot release your scores over the phone. 

Physicians who pass are recognized as ABEM-certified emergency physicians, and begin participating in the ABEM continuing certification process

Scoring

All scored cases contribute equally to your final score as part of a weighted average. Your examiners determine your individual case scores. There are currently two case types: single-patient cases and the structured interview.

Single-patient Cases

Single-patient case scores are the mean of their eight performance ratings (described below). Some ratings are driven by predetermined behaviors called “critical actions.” Each of these actions is associated with a performance rating scale. Critical actions do not include all the behaviors expected of candidates, but rather, guide examiners’ scoring by pointing out actions that best distinguish acceptable or unacceptable performance. If you perform a critical action, the examiner typically scores at least a 5 on the associated rating scale. If you do not perform a critical action, the examiner will likely score you a 4 or lower on the associated rating scale.

Rating Scales

In each case, your examiners will score you on eight performance ratings:

  • Data Acquisition: Collecting critical patient information.
  • Problem Solving: Using critical information to manage patients.
  • Patient Management: Making appropriate treatment decisions.
  • Resource Utilization: Using the resources at your disposal to care for patients.
  • Health Care Provided (Outcome): The actual outcome of the patient's health after receiving your care.
  • Interpersonal Relations and Communication Skills: Clearly communicating with your patient, family, and medical staff.
  • Comprehension of Pathophysiology: Understanding the case from a medical science standpoint, rather than memorized routine.
  • Clinical Competence (Overall): How well you handled the types of conditions or problems presented in the case.
Detailed Performance Criteria

Examiners assign a score from 1 to 8 on each rating scale using the following general guidelines:

  • Very Acceptable (7,8): The candidate confidently and correctly collected data and gave a diagnosis, managed patients with current and accepted techniques, and showed anticipation of and concern for the psychological, sociological, and economic patient needs.
  • Acceptable (5,6): There were several minor inefficiencies or errors in the case management. Candidate showed an underlying working knowledge for safe medical practice. The patient had adequate care without significant, unnecessary pain, or life-threatening procedures or medications.
  • Unacceptable (3,4): One or more critical actions were not taken, or dangerous actions were taken. Health care may have been incomplete, unorganized, or generally unsatisfactory. The candidate demonstrated partially inadequate knowledge of the pathophysiology of the problem.
  • Very Unacceptable (1,2): Candidate was unable to proceed beyond routine data acquisition and management because he or she lacked knowledge of the presented pathology. Gross negligence or gross mismanagement was observed, and the candidate was without self-awareness of his or her own inadequacies.

Additional scoring criteria or indications of good, bad, or neutral behavior are provided to the examiner, but the final score is at the discretion of each individual examiner. Earning a score of 5 or above is not an indication of success or failure on a case or the Oral Exam. For more information on the passing score, please refer to “Passing Scores” below. Sample scoring sheets are available here:

Sample Single Case Score Sheet

Structured Interview

Structured interviews are scored as 25 points spread across eight stages of a typical patient interaction. Cases may focus more or less heavily in one of the eight areas. 

1. History
2. Physical Exam
3. Differential Diagnosis
4. Testing
5. Treatment
6. Final Diagnosis
7. Disposition
8. Transitions of Care

Examiners will score a candidate's answers to questions related to each stage.

Sample Standard Interview Score Sheet

How ABEM Determines a Passing Score

ABEM does not use quotas or passing percentages to determine a passing score. A representative sample of examiners recommend the passing score in a process known as standard setting. Candidate performance is compared to the Board's performance expectations using ABEM's KSAs. The final passing score was approved by the Board. The entire scoring process is fully and independently replicated. As such, ABEM does not provide a hand score or rescore service since in the interests of fairness to all test takers, it has already been performed.
 
May 2022 Oral Certification Exam Scoring FAQs

Understanding Standard Setting