The Fellowship Examination is changing…

The following information is taken directly from the ACEM Page regarding the upcoming changes to the structure of the Fellowship Examination:

From 2015 onwards, the structure of the Fellowship Examination (FEx) will be revised. The written and clinical components of the FEx will be divided into separate, stand-alone assessments. All components of the FEx will continue to be assessed at consultant level. These two assessments are summarised in the table below.


Fellowship Examination (FEx) – Written

The FEx (Written) will:

  • Continue to examine at consultant level, with a focus on knowledge-application
  • Be a separate assessment from the FEx (Clinical)

The FEx (Written) will comprise two components:

1. Select-choice Question

  • Multiple Choice Questions (MCQs) – Each MCQ comprises a stem (i.e. a short lead-in phrase) and a number of alternative options for response. The correct response is presented, along with a number of plausible distractors. The MCQs will be written to current best-practice guidelines.  In the ACEM format, trainees select one best option from four options.
  • Extended Matching Questions (EMQs) – Each set of EMQs comprise a theme (e.g. a particular presentation, investigation, diagnosis, or treatment); a list of possible options (i.e. options related to the theme), and a number of stems requiring a response chosen from the list.  In the ACEM format, trainees select one best option from the options provided (which could be up to 20 options).
The proportion of MCQs to EMQs in each paper is not fixed. It is likely that the proportion of EMQs will expand over time. The total number of items in each exam will remain constant.

2. Short Answer Question (SAQ)

The revised SAQ component will incorporate the previous Visual Aid Question (VAQ) format and be structurally modified to align with current best-practice guidelines. The revised format SAQs will use questions that are highly structured and specific, with responses that will require single words or short phrases, rather than mini-essays. The key feature of SAQs is that they allow the trainee to demonstrate the integration of their knowledge and application of this knowledge to clinical scenarios. SAQs will generally be of the format where the candidate is given a clinical or ED related scenario, followed by specific related questions that can be answered using relatively few words or short statements. When asked for a defined number of answers, additional marks will not be given for additional responses. The most relevant/highest priority responses should be listed.

The written examination will be held on a single day and comprise 2 x 180 minutes papers with a break in between.

FEx (Written) Example Questions:

  • Multiple Choice Questions (MCQs)
  • Extended Matching Questions (EMQs)
  • Short Answer Questions (SAQs)

Eligibility Requirements:
Candidates for the FEx (Written) must meet the following criteria:

  • They must be a registered and financial trainee of the College
  • They must hold current registration to practice medicine in Australia or in New Zealand
  • They must have successfully completed the ‘Early-Phase’ WBA requirements, which includes completion of at least 12 months (of the 48 month minimum) of accredited ED time in Advanced Training

Candidates must have met these eligibility criteria, as per official College records, by the closing date for the relevant examination sitting.

Fellowship Examination (FEx) Clinical

The FEx (Clinical) will:

  • Continue to examine at consultant-level, with a focus on knowledge-application, skills and attributes
  • Be a separate assessment from the FEx (written)

The FEx (Clinical) will comprise one component:

1. Objective Structured Clinical Examination (OSCE)
A set of clinical examination stations. The OSCE stations may include standardised patients, observation stations, clinical scenarios, communication scenarios and simulations of management of critically ill patients. Most stations will be of ten minutes duration. Where appropriate, there may be ‘double length’ OSCEs allowing assessment of more complex competencies such as a simulated resuscitation station or sequential management aspects of the same clinical scenario. The administration of the test may include rest stations. There will be either one or two examiners in each station appropriate to the case. Where an examiner is required to role play, the other examiner will be present to observe and assess. The format of the OSCEs will be as current, with candidates moving sequentially from one station to another in a timed fashion.

OSCE Examples:

Eligibility Requirements:
Candidates for the FEx (Clinical) must meet all of the following criteria:

  • They must be a registered and financial trainee of the College
  • They must hold current registration to practice medicine in Australia or in New Zealand
  • They must have completed at least 36 months of the 48 months of accredited Advanced Training time prior to the examination (not including any required ED remediation time)
  • They must have satisfied the trainee research requirement
  • They must have successfully completed the FEx (Written)

Candidates must met these eligibility criteria, as per official College records, by the closing date for the relevant examination sitting.

Standard Setting for all formats
The examination pass mark for each examination will be set by formal standard setting processes by a panel of experts (consultant emergency physicians). These processes enable a consistent standard to be set across different examinations, ensuring the examination is maintained at the level of consultant, and that an appropriate pass standard is applied to all trainees irrespective of the difficulty of the particular examination they attempt.

Candidate Feedback
The open release of examination questions after each examination will cease. The Fellowship Examination content will be used to create robust and validated item banks for the examination use. There will be a timely and detailed examination report released after each examination. Unsuccessful candidates will have access to this report and their results to assist in developing a learning plan with their DEMT. To assist with exam preparation, the practice of providing example questions will be ongoing.

Need further information?
If you would like more information about the ACEM Fellowship Examination contact the Assessment Team at E: 

Clinical Examination Resources

SCE Resources

How to Be A Doctor              A document summarising the Clinical Examination handbook, which is a guide to Short and Long Cases.

Short Cases Template          A vital document that you must learn from front to back. Be able to perform each examination smoothly and quickly – this is a performance, not real medicine. Practice on your cat / significant other. Take it with you as you trawl around the wards pestering those poor patients unfortunate enough to have been listed as “good for examination”.

Heart Murmurs                    A fantastic document to support the “Short Cases Template”.

SCE Resources

Below are listed links to many many SCE’s. It’s time to do these with your study group… be prepared to look like an idiot and be critiqued by your peers!



FE Course SCE 1

FE Course SCE 2

FE Course SCE 3

FE Course SCE 4

FE Course SCE 5

FE Course SCE 6


















MCQ Resources

This is every MCQ I own. They are in no particular order, and they may repeat themselves. Some have answers, some don’t. For MCQ’s by topic, see Resources By Topic.


Brand New Practice 60 question MCQ paper (you shouldn’t have seen any of these questions before, as of August 2014)


50 pages of MCQ’s

100 pages of MCQs

200 pages of MCQ’s



MCQ 2008 Real questions

MCQ Exam August 2009 Answers

MCQ March 03 Answers


MCQs 2009.2




Crisis intervention MCQ

Dermatology MCQ


Emerg med systems MCQ

Emerg med topics MCQ

Endocrine MCQ- di

Endocrinology MCQ

Environmental MCQ

Eye ENT Dental MCQ

Fluids Electrolytes MCQ


Radiology MCQ

Repiratory MCQ

Research MCQs

Respiratory MCQ


Stats legal wounnds MCQ

Trauma MCQ – di

Trauma MCQ


Cramming Resources

Important Facts

This document includes lists of drugs doses, acronyms, important research, tests and scores…. Basically all the stuff you don’t bother to remember up until the very end when you just cram numbers and lists into your head. I went over this document again and again during the final countdown, and as a study group we tested each other until we had the vital statistics drummed in to our brain.

ABG Resources

How To Interpret ABG’s         How to read an ABG. Make your own proforma and follow it for every ABG. Do ABG’s again, and again, and again, and again. Learn your formulae and practice the arithmetic. You do get it in the end.

ABG VAQ’s                Every ABG VAQ known to man. You should have done each one at least once. You should have done each ACEM ABG at least three times.

HyperK fact sheet

HyperNa fact sheet

HypoK fact sheet

HypoNa fact sheet

Respiratory acidosis fact sheet

Respiratory alkalosis fact sheet

Metabolic acidosis fact sheet

Metabolic alkalosis fact sheet

NaHCO3 fact sheet

Other metabolic derangements fact sheet