FACEM Examination Family Guide

The Australasian College for Emergency Medicine (ACEM) conducts the Primary and Fellowship examinations within its FACEM Training Program. This guide covers the Primary Written Examination, Primary Oral Examination (also called the Oral Exam or Integrated Viva), Fellowship Written Examination, and Fellowship Clinical Examination (OSCE).

The Primary examinations assess anatomy, pathology, physiology, and pharmacology as they relate to emergency medicine. Candidates must pass Primary Written before attempting the Primary Oral Examination. Fellowship Written must be passed before a trainee is eligible to sit Fellowship Clinical.

The examinations are major parts of the training and assessment program. The FACEM curriculum also includes other assessments and training requirements, so passing these four examinations alone does not complete every Fellowship requirement.

ACEM lists history taking, physical examination, challenging communication, Resus Standardised Case-Based Discussion, teaching or advice to junior staff, and Standardised Case-Based Discussion among the Fellowship Clinical station types. The curriculum also describes scenarios involving procedures, simulation, resuscitation, emergency-department management, teamwork, case synthesis, management planning, and interpretation of investigations.

There is a wording difference on ACEM’s page: its detailed OSCE description says 12 stations, while its key-details panel says up to 12. The current curriculum also describes 12 stations. Check the sitting-specific candidate information for your examination.

For the Primary examinations, ACEM identifies anatomy, pathology, physiology, and pharmacology as the foundational sciences. The curriculum assigns Levels of Assessment to Primary learning outcomes: Level 1 topics are assessed in greater depth and more frequently; Level 2 topics are assessed in some detail; and Level 3 emphasizes overarching concepts and general principles rather than fine detail.

Use the curriculum learning outcomes to organize review. The guide does not assign numeric topic weights.

The following summarizes the standard trainee criteria on ACEM’s current Examinations page. They are component-specific and should not be treated as universal eligibility rules.

ACEM directs transitioned trainees to Regulation G for possible variations and Specialist International Medical Graduates to separate Fellowship Examination eligibility criteria. Check the provision that applies to your training pathway before applying.

1. Confirm sequence and eligibility first. Check your training stage, completed modules and requirements, remaining attempts, and the current application information. Primary Written precedes Primary Oral; Fellowship Written precedes Fellowship Clinical.

2. For Primary Written, connect the four sciences to emergency medicine. Organize review around anatomy, pathology, physiology, and pharmacology. Use the curriculum’s Levels of Assessment to guide depth, and practice timed MCQs in sessions that reflect the two-paper structure.

3. For Primary Oral, practice explaining basic-science reasoning aloud. Rehearse four 10-minute stations. Explain mechanisms clearly and connect them to emergency medicine; written notes alone do not reproduce a verbal examination.

4. Prepare separately for the Fellowship Written papers. Practice concise, organized SAQ responses and timed MCQ sets. Use the curriculum scaffold to integrate foundational knowledge, principles of practice, and clinical management.

5. Rehearse Fellowship Clinical as an OSCE. Practice the 4-minute reading and 7-minute assessment periods. Rotate through the published station types and curriculum scenarios, including communication, examination, procedures, resuscitation, teaching, teamwork, and emergency-department management. Seek focused feedback on prioritization, clarity, and completing the station task.

6. Use ACEM’s examination resources. ACEM directs trainees to eLearning resources that include past papers and examination reports. Match rehearsal to the exam: written and oral practice can support clinical reasoning, but they do not substitute for timed OSCE station practice.

• The broader training program matters. The examinations sit alongside other curriculum assessments and requirements. Plan exam preparation with your training-stage progression in mind.

• Track attempt limits. ACEM publishes maximums of three attempts for each Primary examination and Fellowship Written, and four attempts for Fellowship Clinical. Attempts before January 1, 2018, are not counted toward these limits; a new application is required for each attempt.

• Check registration and location details. Standard trainee eligibility specifies current registration to practice medicine in Australia or Aotearoa New Zealand. ACEM lists examination locations and arrangements by sitting.

• Use the current sitting information. ACEM’s Examinations page provides application access and sitting-specific information, including dates, fees, locations, and eligibility deadlines. Fellowship Clinical has a separate eligibility deadline as well as an application closing date.

• Confirm pathway-specific rules. Transitioned trainees may have variations under Regulation G, and Specialist International Medical Graduates are directed to separate Fellowship Examination eligibility criteria.

• Keep the examination formats distinct. Primary Oral is a basic-science viva; Fellowship Written has SAQ and MCQ papers; Fellowship Clinical is an OSCE. Prepare for the performance required in the component you are taking.