The format for this paper is eight questions over 120 minutes (approximately 15 minutes per question). The paper will focus on assessment, interpretation, prioritization, clinical and non-clinical management issues and written communication at a consultant level. All questions are evenly weighted and are marked out of 10 (see Pass/Fail Criteria). Candidates are required to pass a minimum of five questions and have a total score of 40 or greater to pass this component of the examination. These questions are marked by two examiners who give a single agreed mark. Candidates are required to have both the raw score and the number of questions passed in order to obtain a particular grade.
One question will be asked from each of the core topics (Administration, Paediatrics, Medicine, Resuscitation and Anaesthetics, Trauma, Surgery). In addition, two further questions will be sourced from this group of topics (Emergency Medical Systems, ENT/Eyes, Environmental, Obstetrics and Gynaecology, Psychiatriy, Toxicology and Minor Trauma - including orthopaedics).
Scenarios may be combined to ensure that all the required topics are covered. A scenario which involves a fitting child with an overdose may cover the topic areas of paediatrics, toxicology and resuscitation.- ACEM Training and Examination Handbook, 2009