Written by the ABEM Resident Ambassador Panel:
Haig K. Aintablian, M.D.; Alaa M. Aldalati, M.D.; and William Spinosi, D.O.
Panel members serve two-year terms during their residency training and provide a resident perspective to ABEM activities. Working with ABEM over the past year, the 2020-2022 ABEM Resident Ambassador Panel has gained insights into the process of becoming ABEM-certified, and have outlined those steps from their perspective. We hope this helps residents in preparing for the certification process.
Becoming board certified in Emergency Medicine by the American Board of Emergency Medicine is a simple process requiring three steps for residents who are in their final years of training.
STEP 1: Applying for certification
During the last year of a resident’s emergency medicine training, graduating residents destined to finish residency by October 31st can access application information by signing into the ABEM initial certification page. ABEM will also send application information to the program director of the residency program, usually around April. Those graduating later than October 31, will apply in the next application cycle. For EM residents who graduate between November 1st and October 31st, it’s important to apply in the current application period. If you delay this, you may need additional certification requirements, including a state medical licence, if you do not have one already. The entire application and fee payment process is online. Applications are processed as soon as they are completed.
Board eligible means that a resident graduated from a ACGME or
RCPSC accredited emergency medicine program or an ABEM-approved combined program. Additionally, you must fulfill all medical licensure per ABEM policy. If you are applying right out of residency, you do not need to hold a state medical license. This starts on the day you graduate from residency and extends to December 31st five years after your graduation date.
STEP 2: Passing the qualifying exam 
The second step in becoming ABEM board certified is to pass the qualifying examination, a “written examination” that is actually a computerized test with 305 multiple choice questions (with only single best answer choices). The qualifying examination is offered in about 200 Pearson testing centers across the US, making it easy to take the exam in the state you graduated from or plan on practicing in. The exam itself is offered during one 6-day period, typically in the Fall. In order to take the exam during this time, you must schedule yourself during one 8-hour block in this 5-day period.
Should you be unable to attend the exam, you can cancel the exam before 24 hours from the start of the exam. Please arrive 30 minutes before your exam time and make sure to bring a valid form of identification. This process is similar to many of the other examinations you have taken to get to this point in your career as a physician!
The exam appointment is a total of 8 hours long, but divided into two testing sections, each about 3 hours and 10 minutes long with a one hour break in between. The question topics are based on the EM Model, similar in makeup to the in training exams, which you have likely already experienced during your residency training.
Once you have completed this qualifying examination, you can expect your score within 90 days of completion.
STEP 3: Passing the oral board exam 
The third, and final step, in completing board certification is to pass the oral board examination. To be eligible for this section of board certification, you must have passed the qualifying examination, as well as have a state medical license. Once you pass your qualifying examination, you must take the oral board exam the next calendar year.
It’s important to note that given the Covid-19 pandemic, there have been some changes to the implementation of this section of board certification. Notably, the examination has been offered on a virtual platform, as opposed to in-person, for the safety of test takers and testing staff.
The oral board examination comprises 6 single patient cases, each 15-minutes long. The examiner will provide pertinent history and offer answers to the examinee’s questions. The examiner will track eight specific markers during these patient cases. These markers include:
- Data acquisition
- Problem solving
- Patient management
- Resource utilization
- Healthcare provided or outcome
- Interpersonal relations and communication skills
- Comprehension of pathophysiology
- Clinical competence
Examiners assign a score from 1-8, with 1 being very unacceptable to 8 being very acceptable.
In addition to the 6 single patient cases, a discussion on your approach to patient care will evaluate your thought processes. Structured interviews are scored as 25 points spread across eight stages of a typical patient interaction. These include:
- History
- Physical Exam
- Differential Diagnosis
- Testing
- Treatment
- Final Diagnosis
- Disposition
- Transitions of Care
Ultimately, once you are done with the oral board examination, ABEM will let you know if you have passed or failed typically within 45-60 days, and definitely within 90 days. ABEM does not use quotas or percentages to determine a passing score, instead after each examination, ABEM testers meet to determine the standard of care for each case and then determine whether testers passed or failed. The final passing score is then sent to the ABEM Board to determine performance expectations for a pass or fail score. ABEM does not allow for rescoring or second scoring any examinations.
Once you have passed the Oral Board Examination, congratulations! You are now an ABEM board certified EM physician!
ABEM-certified physicians serve a valuable and irreplaceable clinical role in the care of the critically ill and injured. The delivery of emergency care is best led by physicians with EM training, experience, and ABEM certification. ABEM will support you throughout your career in continuing certification activities and promoting the important and valuable role ABEM-certified physicians bring to emergency care in the ED.
Do you have questions about the certification process? Reach out to your program director, or contact ABEM at abem@abem.org.