100+ Free ACEM Fellowship Written Practice Questions

Pass your ACEM Fellowship Written Examination (SCQ paper, Emergency Medicine) exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

100+ Questions

100% Free

Loading practice questions...

2026 Statistics

Key Facts: ACEM Fellowship Written Exam

2 papers, 6 hours

The Fellowship Written Examination has an SAQ paper and an SCQ paper, each 180 minutes

ACEM - Examinations

SCQ = MCQ only

The Select Choice Question paper consists of multiple-choice questions only

ACEM - Examinations

AUD $3,145

Fellowship examination - written fee for the 2026 training year

ACEM - Fees and payments

3 attempts

Maximum number of attempts permitted at the Fellowship Written Examination

ACEM - Examinations

Criterion-referenced

Passing standard is set to junior-consultant level, with no fixed percentage cut-off

ACEM FACEM Training Program Handbook

6 test cities

Held at Adelaide, Auckland, Brisbane, Melbourne, Perth and Sydney

ACEM - Examinations

Twice yearly

The Fellowship Written Examination sits twice a year, usually May and November

ACEM FACEM Training Program Handbook

100

Free original SCQ-style practice questions here

OpenExamPrep

The ACEM Fellowship Written Examination is the written barrier exam for FACEM trainees in Training Stage Three, run by the Australasian College for Emergency Medicine. It comprises two 180-minute papers on the same day - an SAQ paper and an SCQ (multiple-choice) paper - assessed at junior-consultant level with no fixed pass mark and a maximum of three attempts. The 2026 written-exam fee is AUD $3,145. This 100-question bank provides original SCQ-style single-best-answer practice across resuscitation, cardiovascular, respiratory, trauma, toxicology, paediatric emergency medicine and general medical/surgical presentations.

Sample ACEM Fellowship Written Practice Questions

Try these sample questions to test your ACEM Fellowship Written exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During adult basic life support with a single rescuer and no advanced airway in place, what is the recommended compression-to-ventilation ratio?

A.Continuous compressions with a breath every 6 seconds only after intubation

B.5:1

C.15:2

D.30:2

Explanation: The Australian Resuscitation Council (ANZCOR) BLS guideline recommends 30 chest compressions to 2 ventilations for adult CPR without an advanced airway. This ratio balances adequate coronary perfusion pressure from compressions with periodic ventilation.

2In adult cardiac arrest, what is the standard adult IV/IO dose of adrenaline given during advanced life support?

A.1 mg

B.0.1 mg

C.10 mg

D.0.5 mg IM

Explanation: The standard adult dose of adrenaline during cardiac arrest is 1 mg IV or IO, repeated approximately every 3-5 minutes (every second cycle of CPR) per ANZCOR advanced life support guidelines.

3The '4 Hs and 4 Ts' mnemonic for reversible causes of cardiac arrest includes hypoxia, hypovolaemia, hypo/hyperkalaemia (and other metabolic disturbances), and hypo/hyperthermia. Which four conditions make up the 'Ts'?

A.Tension pneumothorax, tachycardia, toxins, thrombocytopenia

B.Tension pneumothorax, tamponade (cardiac), toxins, thrombosis (coronary and pulmonary)

C.Thyrotoxicosis, tamponade, tachyarrhythmia, trauma

D.Tachycardia, tamponade, toxins, trauma

Explanation: The 'Ts' in the reversible causes mnemonic are tension pneumothorax, cardiac tamponade, toxins (poisoning/overdose), and thrombosis (either coronary, causing cardiac arrest, or pulmonary embolism). Actively considering and excluding these during resuscitation can identify a treatable cause.

4A patient in refractory ventricular fibrillation has received three shocks without return of spontaneous circulation. According to ANZCOR advanced life support guidelines, which antiarrhythmic drug is indicated at this point, and at what dose?

A.Amiodarone 300 mg IV

B.Adenosine 6 mg rapid IV push

C.Magnesium sulfate 2 g IV

D.Lignocaine 1.5 mg/kg IV

Explanation: For shock-refractory VF/pulseless VT, ANZCOR guidelines recommend amiodarone 300 mg IV/IO after the third shock, with a further 150 mg dose available if VF/VT persists. Amiodarone is the first-line antiarrhythmic in this setting.

5A trauma patient requires a massive transfusion. Which ratio of packed red blood cells to fresh frozen plasma to platelets is most consistent with contemporary massive transfusion protocols?

A.1:4:1

B.10:1:1

C.4:1:1

D.1:1:1

Explanation: Contemporary massive transfusion protocols, informed by trials such as PROPPR, use a balanced 1:1:1 ratio of packed red cells, fresh frozen plasma, and platelets to reduce the risk of dilutional and consumptive coagulopathy in major haemorrhage.

6During CPR with a supraglottic airway or endotracheal tube in place, continuous waveform capnography is recommended. Which statement best describes its clinical value during resuscitation?

A.It is used only to titrate supplemental oxygen therapy

B.It replaces the need for pulse checks during CPR

C.It is only useful after successful defibrillation

D.It confirms correct airway placement and can help indicate CPR quality and detect return of spontaneous circulation

Explanation: End-tidal CO2 (ETCO2) monitoring confirms tracheal tube placement, reflects the adequacy of chest compressions (a persistently low ETCO2 suggests poor compression quality), and a sudden sustained rise in ETCO2 can be an early sign of return of spontaneous circulation.

7A hypotensive trauma patient has absent breath sounds on the left, tracheal deviation to the right, and distended neck veins. What is the most appropriate immediate action?

A.CT chest to characterise the underlying injury

B.IV fluid bolus alone and reassessment in 15 minutes

C.Immediate needle decompression or finger thoracostomy of the chest without waiting for imaging

D.Urgent portable chest X-ray to confirm the diagnosis before treatment

Explanation: These findings (absent breath sounds, tracheal deviation away from the affected side, distended neck veins, hypotension) are classic for tension pneumothorax, an immediately life-threatening diagnosis made clinically. Decompression should not be delayed for imaging.

8Before performing rapid sequence induction and intubation, a patient is given a period of high-flow oxygen via a well-fitted mask. What is the primary purpose of this preoxygenation step?

A.To sedate the patient before induction drugs are given

B.To reduce gastric aspiration risk

C.To lower the patient's heart rate before induction

D.To create a reservoir of oxygen and denitrogenate the lungs, extending the safe apnoea time during intubation

Explanation: Preoxygenation washes nitrogen out of the functional residual capacity and replaces it with oxygen, creating a physiological oxygen reservoir. This extends the time available for laryngoscopy and intubation before clinically significant desaturation occurs.

9A patient presents with hypotension, distended neck veins, and clear lung fields. Which category of shock is most consistent with this picture, and which conditions typically cause it?

A.Obstructive shock, caused by cardiac tamponade, tension pneumothorax, or massive pulmonary embolism

B.Distributive shock, caused by sepsis or anaphylaxis

C.Cardiogenic shock, caused by extensive myocardial infarction with pulmonary oedema

D.Hypovolaemic shock, caused by haemorrhage

Explanation: Obstructive shock results from a mechanical impediment to cardiac filling or output. Elevated jugular venous pressure with clear lung fields (rather than pulmonary oedema) points to an obstructive process such as tamponade, tension pneumothorax, or massive PE rather than primary pump failure.

10Following return of spontaneous circulation after cardiac arrest, which post-resuscitation care principle is most strongly supported?

A.Allow permissive hypotension to reduce cardiac workload

B.Give high-dose supplemental oxygen at 100% regardless of saturation to maximise tissue oxygen delivery

C.Aggressively hyperventilate to a low PaCO2 to protect the brain

D.Titrate oxygen to avoid hyperoxia while avoiding hypoxia, and control temperature to avoid hyperthermia

Explanation: Post-ROSC care emphasises avoiding both hypoxia and hyperoxia by titrating oxygen to target saturations, avoiding hyperventilation-induced hypocapnia (which can worsen cerebral ischaemia), and actively preventing hyperthermia, all aimed at limiting secondary brain injury.

About the ACEM Fellowship Written Exam

The ACEM Fellowship Written Examination is a major assessment in the FACEM Training Program, tested at the level expected of a junior emergency medicine consultant. It is sat as two 180-minute papers on the same day - a Short Answer Questions (SAQ) paper and a Select Choice Question (SCQ) paper of multiple-choice questions only - covering the full range of medical presentations in the ACEM Curriculum: resuscitation, cardiovascular and respiratory emergencies, trauma, toxicology, paediatric emergency medicine, and general medical/surgical presentations, alongside the non-clinical curriculum domains applied to case-based scenarios. Trainees must pass the Fellowship Written Examination before attempting the Fellowship Clinical (OSCE). The passing standard is criterion-referenced with no fixed percentage cut-off, and candidates get a maximum of three attempts.

Assessment

The Fellowship Written Examination is the written component of the FACEM Fellowship Examinations, sat during Training Stage Three. It comprises two separate 180-minute papers held the same day: a Short Answer Questions (SAQ) paper of structured written responses and a Select Choice Question (SCQ) paper of multiple-choice questions only. ACEM's FACEM Training Program Handbook specifies up to 30 SAQs and 120 SCQs, with 10 minutes' reading time before each paper. Both papers are criterion-referenced to junior-consultant-level emergency medicine practice. This bank focuses on the SCQ/MCQ paper.

Time Limit

6 hours of written examination in total: two 180-minute papers (one SAQ, one SCQ) held on the same day.

Passing Score

No fixed percentage cut-off. ACEM sets a criterion-referenced passing standard for the SAQ and SCQ sections based on the level expected of a junior emergency medicine consultant.

Exam Fee

AUD $3,145 for the Fellowship Written Examination in the 2026 training year (same fee for Australia and Aotearoa New Zealand/overseas). The Fellowship Clinical (OSCE) is a separate AUD $4,450 fee. (Australasian College for Emergency Medicine (ACEM))

ACEM Fellowship Written Exam Content Outline

Core

Resuscitation and Critical Care

Cardiac arrest management, airway and ventilation, and shock states tested at consultant level.

Core

Cardiovascular and Respiratory Emergencies

Acute coronary syndromes, arrhythmias, heart failure, respiratory failure, and airway/pulmonary emergencies.

Core

Trauma and Toxicology

Major trauma resuscitation, orthopaedic injuries, poisoning, overdose and envenomation management.

Core

Paediatric Emergency Medicine

Paediatric resuscitation, common presentations, and age-specific dosing and decision-making.

Core

General Medical, Surgical and Neuro/Psych Presentations

Stroke, seizures, behavioural disturbance, endocrine/metabolic emergencies, abdominal, renal and obstetric/gynaecological presentations.

Consultant-level

Professional Practice and Prioritisation

Clinical prioritisation, disposition and department-flow decisions applied through case-based questions.

How to Pass the ACEM Fellowship Written Exam

What You Need to Know

Passing score: No fixed percentage cut-off. ACEM sets a criterion-referenced passing standard for the SAQ and SCQ sections based on the level expected of a junior emergency medicine consultant.
Assessment: The Fellowship Written Examination is the written component of the FACEM Fellowship Examinations, sat during Training Stage Three. It comprises two separate 180-minute papers held the same day: a Short Answer Questions (SAQ) paper of structured written responses and a Select Choice Question (SCQ) paper of multiple-choice questions only. ACEM's FACEM Training Program Handbook specifies up to 30 SAQs and 120 SCQs, with 10 minutes' reading time before each paper. Both papers are criterion-referenced to junior-consultant-level emergency medicine practice. This bank focuses on the SCQ/MCQ paper.
Time limit: 6 hours of written examination in total: two 180-minute papers (one SAQ, one SCQ) held on the same day.
Exam fee: AUD $3,145 for the Fellowship Written Examination in the 2026 training year (same fee for Australia and Aotearoa New Zealand/overseas). The Fellowship Clinical (OSCE) is a separate AUD $4,450 fee.

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ACEM Fellowship Written Study Tips from Top Performers

1Work through the FACEM Curriculum's medical presentations sections systematically, since the Fellowship Written Examination draws on the full syllabus rather than a narrow subset of topics.

2Practise timed single-best-answer questions across resuscitation, cardiovascular, respiratory, trauma and toxicology, since these high-acuity domains recur heavily on both the SCQ and SAQ papers.

3Build paediatric emergency medicine into every study block rather than leaving it for last; age-specific dosing and presentations are commonly tested alongside adult emergencies.

4Answer at consultant level: prioritise the immediately life-threatening diagnosis and disposition first, since the exam is criterion-referenced to junior-consultant performance.

5Use past SAQ/SCQ papers and study groups to simulate the two-paper, 6-hour exam day so timing and stamina are not a surprise on the day.

6Don't neglect the non-clinical ACEM Curriculum domains (prioritisation, communication, professionalism); Fellowship case-based questions can test these alongside pure medical knowledge.

Frequently Asked Questions

What is the ACEM Fellowship Written Examination?

It is the written component of the FACEM Fellowship Examinations, sat during Training Stage Three. It comprises two 180-minute papers on the same day: a Short Answer Questions (SAQ) paper and a Select Choice Question (SCQ) multiple-choice paper, both assessed at the level of a junior emergency medicine consultant.

How many questions are on the Fellowship SCQ paper?

ACEM's FACEM Training Program Handbook specifies 120 select-choice questions (SCQs) and up to 30 short-answer questions (SAQs). ACEM's Examinations page confirms that each paper is 180 minutes; always check ACEM's current candidate information for changes.

What is the ACEM Fellowship Written Examination fee?

For the 2026 training year the Fellowship examination - written fee is AUD $3,145, the same in Australia and Aotearoa New Zealand/overseas. The Fellowship Clinical (OSCE) is a separate AUD $4,450 fee.

Is there a fixed pass mark?

No. Both the SAQ and SCQ sections are criterion-referenced to the standard expected of a junior emergency medicine consultant, not a fixed percentage or a norm-referenced curve.

How many times can I attempt the Fellowship Written Examination?

Candidates are allowed a maximum of three attempts. The exam is held at Cliftons (or affiliate) venues in Adelaide, Auckland, Brisbane, Melbourne, Perth and Sydney, twice a year (usually May and November).

What topics does the Fellowship Written Examination cover?

The full range of medical presentations in the ACEM Curriculum: resuscitation, cardiovascular and respiratory emergencies, trauma, toxicology and environmental medicine, paediatric emergency medicine, neurological, psychiatric and endocrine/metabolic emergencies, and general medical, surgical, renal, GI and obstetric/gynaecological presentations, plus the non-clinical curriculum domains applied through case-based questions.

Are these official ACEM practice questions?

No. These are original OpenExamPrep questions modelled on the FACEM Curriculum's medical presentations syllabus for the Fellowship Written Examination's SCQ paper. ACEM publishes its own sample questions and past papers separately for enrolled trainees.