100+ Free ABEM ACCM Practice Questions

The ACCM subspecialty certification is co-sponsored by ABEM and the American Board of Anesthesiology (ABA). The ABA develops, administers, and scores the examination; ABEM credentials and issues the certificate for emergency medicine diplomates. The exam is a one-day computer-based MCQ exam (~200 single-best-answer questions) at Pearson VUE testing centers, split into two sessions over approximately 6 hours. Content covers multidisciplinary critical care: cardiovascular and shock, respiratory failure and ARDS, sepsis and infections, neurocritical care, renal failure and CRRT, GI and liver failure, hematology and coagulation, endocrine emergencies, perioperative ICU management, nutrition/sedation/delirium, and ethics/end-of-life care.

Eligibility requires (1) active ABEM primary certification (Qualifying + Certifying) in good standing, (2) successful completion of an ACGME-accredited 1-year Anesthesiology Critical Care Medicine fellowship (typically based at an anesthesiology department), (3) an active unrestricted medical license, and (4) ABEM credentialing approval. Eligibility to sit for the subspecialty exam typically remains valid for 7 years after fellowship completion. ACCM is one of three primary critical care pathways available to EM physicians (alongside ABIM Internal Medicine Critical Care and ABS Surgical Critical Care).

The ABA examination fee is approximately $2,100 (subject to annual update). ABEM also charges a separate credentialing fee of approximately $1,500-$2,000. Total cost is approximately $3,500-$4,100, excluding study materials and travel. Fellows should also budget $300-$1,500 for question banks and review courses (SCCM SelfPrep, SCCM Multiprofessional Critical Care Review, ACE, Harvard ICU Review, commercial Q-banks). Both ABEM and ABA fees are set annually.

The ACCM exam is a one-day computer-based MCQ exam at Pearson VUE testing centers consisting of approximately 200 single-best-answer multiple-choice questions split into two sessions of about 3 hours each. Stimulus materials include hemodynamic tracings, ventilator waveforms, ECGs, ABGs, chest imaging, and echocardiographic clips. Passing is criterion-referenced (scaled score determined by ABA standard-setting). First-time pass rates historically run approximately 85-92% across all specialty pathways (anesthesiology, EM, surgery, IM); EM-pathway specific data is not separately published.

Build study around the ABA Critical Care Medicine content outline. Core resources: Marino's ICU Book or Civetta's Critical Care as reference texts; question banks (SCCM SelfPrep, ACE, commercial ICU Q-banks) - aim for 1,500-2,500 questions during/after fellowship; SCCM Multiprofessional Critical Care Review course or Harvard ICU Review; major guidelines (Surviving Sepsis Campaign 2021, ARDSNet/PROSEVA/EOLIA for ARDS-ECMO, KDIGO for AKI, ESETT for status epilepticus, brain death determination guidelines); 2-3 full-length timed practice exams in the final month. Typical successful candidates invest 300-500 hours of dedicated study layered onto fellowship clinical experience.

Three ABMS pathways credential EM physicians as critical care intensivists: (1) ACCM via ABA - 1-year fellowship at an anesthesiology department, broadest exposure to OR-adjacent perioperative ICU care and cardiothoracic ICU; (2) Internal Medicine Critical Care via ABIM - 2-year fellowship (1 year IM + 1 year CCM via the EM-IM-CCM pathway), strong medical ICU focus; (3) Surgical Critical Care via ABS - 1-year fellowship at a surgery department, focused on trauma/SICU. All three result in critical care board certification. ACCM is the most popular pathway for EM-trained intensivists due to the 1-year fellowship length and comprehensive multidisciplinary curriculum.

Continuing certification is maintained through two parallel programs: (1) the ABA MOCA Subspecialty (Maintenance of Certification in Anesthesiology - Subspecialty) program for the ACCM credential - a 10-year continuous cycle including MOCA Minute longitudinal assessment, CME requirements, practice improvement activity, and licensure attestation; and (2) ABEM MyEMCert for primary EM certification - 4 of 8 modules per 5-year cycle. EM-trained ACCM diplomates must keep both primary EM certification and ACCM subspecialty certification current to claim the ABEM ACCM credential.

High-yield areas: shock physiology and vasopressor selection (norepinephrine first, vasopressin add-on, dobutamine/milrinone for cardiogenic), ARDS management (6 mL/kg PBW, plateau ≤30, prone positioning per PROSEVA, ECMO per EOLIA), sepsis bundle (SSC 2021 Hour-1, hydrocortisone for refractory shock), neurocritical care (TBI CPP 60-70, SAH nimodipine, status epilepticus per ESETT, brain death apnea test), AKI/CRRT (KDIGO staging, STARRT-AKI on timing, regional citrate anticoagulation), hematology (TTP - PLEX + caplacizumab; HIT - 4Ts + argatroban; DIC - treat cause), liver failure (King's College criteria, hepatorenal terlipressin), endocrine (thyroid storm sequence, adrenal crisis hydrocortisone), perioperative cardiac surgery complications, and brain death/DCDD ethics.

EM-trained intensivists work in mixed ED/ICU practices (split shifts in the ED and ICU), dedicated ICU practices (medical, surgical, neuro, cardiothoracic, or mixed), academic positions, tertiary referral center transport teams, and ECMO programs. Total compensation often exceeds $400,000 annually for hybrid ED/ICU roles, with academic positions slightly lower and pure ICU positions in busy tertiary centers comparable. Demand for intensivists continues to outpace supply, particularly in community hospitals expanding ICU services. The ACCM credential opens doors to ECMO program leadership, perioperative ICU management, and trauma resuscitation leadership.