100+ Free ABEM EM Practice Questions

The Qualifying Examination is the written portion of ABEM primary certification. It consists of approximately 305 single-best-answer multiple-choice questions delivered at Pearson VUE testing centers across the US and Canada over one week each fall (October 29 - November 7, 2026). Questions cover the Model of the Clinical Practice of Emergency Medicine and include stimulus images such as ECGs and radiographs. The exam is split into two 'books' of 3 hours 10 minutes each, with a ~1-hour break between them - total time at the testing center is approximately 8 hours. Passing requires a criterion-referenced scaled score determined by ABEM standard-setting.

The Oral Certification Exam retired in 2025. Starting in 2026, ABEM is administering a new in-person Certifying Examination at the AIME Center in Raleigh, NC. The half-day session includes 10 cases split between clinical decision-making cases (~15 minutes each, assessing clinical judgment, prioritization, and adaptability) and OSCE stations (10-15 minutes each, using standardized patients or procedural setups to assess communication, technical skills, and conflict management). There are approximately 9 exam administrations per year to improve scheduling flexibility. The exam fee is expected to be in the $1,000-$1,500 range.

For the 2026 Qualifying Exam: standard application and registration is $960 (May 4 - September 8, 2026) and $1,260 for late registration (September 9 - October 15, 2026). The new Certifying Examination fee is expected to be approximately $1,000-$1,500 pending formal ABEM release. Total initial certification cost is approximately $2,000-$2,800 excluding travel, review courses, and question banks. Fees are set annually by ABEM.

Candidates must hold an MD or DO (or equivalent) and have successfully completed an ACGME-accredited emergency medicine residency, typically 3 years (PGY-1 through PGY-3) or 4 years (PGY-1 through PGY-4). Combined pathways exist for EM/IM, EM/Pediatrics, and EM/Family Medicine. Eligibility to sit for initial certification is valid for 5 years after residency. An active unrestricted medical license is required for certification. Foreign medical graduates must complete an ACGME residency in the US to be eligible.

MyEMCert is ABEM's continuous certification program that replaced the decennial ConCert Exam. Diplomates complete 4 of 8 topic-specific open-book online modules per 5-year cycle: (1) Abdominopelvic, (2) Abnormal Vital Signs and Shock, (3) Head and Neck, (4) Neurology, (5) Resuscitation, (6) Social and Behavioral Health, (7) Thoracorespiratory, (8) Trauma and Bleeding. Each module includes 'Key Advances' questions on recent EM literature. You have up to 3 attempts to pass each module. Other requirements: annual fee (replaces prior per-activity fees), one practice improvement activity, compliance with ABEM's medical licensure policy, and agreement to the Code of Professionalism.

High-yield areas per the Model of the Clinical Practice of Emergency Medicine: resuscitation (ACLS/PALS algorithms, TTM, anaphylaxis), cardiology/EKG (STEMI + equivalents - Wellens, de Winter, Sgarbossa, Brugada; SVT/WPW; aortic dissection; PE - Wells/PERC/PESI), stroke (NIHSS, tPA ≤4.5h, thrombectomy ≤24h), trauma (ATLS, FAST, massive transfusion 1:1:1, TXA), toxicology (antidotes - NAC, pralidoxime, DigiFab, fomepizole, naloxone, idarucizumab, andexanet, 4F-PCC), pediatrics (febrile neonate, bronchiolitis, DKA cerebral edema, intussusception, bilious emesis in neonate), airway (difficult airway algorithm, cricothyrotomy), and sepsis (Hour-1 bundle, norepinephrine, MAP ≥65).

Historical first-time pass rates on the Qualifying Exam run approximately 88-92%. The previous Oral Exam (retired 2025) had first-time pass rates around 91% in 2023. Overall certification success (both exams combined) is >95% within a few attempts for graduates of ACGME-accredited EM residencies. Specific 2026 pass-rate data for the new Certifying Exam has not yet been reported.

Build a structured study plan anchored to the ABEM EM Model blueprint. Key resources: Tintinalli's Emergency Medicine or Rosen's Emergency Medicine as reference texts; question banks (ROSH Review, TrueLearn, HippoEd, Peer IX) - aim for 4,000-5,000 questions total during residency; the ABEM In-Training Exam (ITE) taken annually to baseline progress; at least 2 full-length timed practice exams in the final month; high-yield topic review including EKG interpretation (STEMI equivalents), toxicology antidotes, pediatric emergencies, and resuscitation algorithms. Typical successful candidates invest 300-600 hours of dedicated study combined with residency clinical experience.