FACEM Examination Family Guide

The Fellowship of the Australasian College for Emergency Medicine pathway is assessed through a staged Australasian College for Emergency Medicine training program in Australia and Aotearoa New Zealand. This guide covers the Primary Written Examination, Primary Viva, Fellowship Written Examination, and Fellowship Clinical Examination.

The Primary Examinations establish knowledge and understanding of the four basic medical sciences as they relate to emergency medicine: anatomy, pathology, physiology, and pharmacology. The Primary Written Examination must be successfully completed before the Primary Viva can be attempted.

The Fellowship Examinations assess knowledge and skills at the level expected of a junior Emergency Medicine consultant. Fellowship Written must be passed before a trainee is eligible to sit Fellowship Clinical.

These examinations are major components of the FACEM Training Program. ACEM's curriculum places them alongside workplace-based assessments, in-training assessments, research, procedural, pediatric, and other training requirements, so passing the examinations is not the complete set of requirements for Fellowship.

ACEM specifies at least one Fellowship Clinical station in each of these formats: history taking, physical examination, challenging communication with a patient, relative, or staff member, Resus Standardised Case-Based Discussion, teaching or advice to junior staff, and Standardised Case-Based Discussion. The curriculum also identifies procedural skills, simulation, resuscitation, emergency-department management, teamwork, case synthesis, management planning, and interpretation of investigation results as part of the clinical examination scenarios.

ACEM's key-details panel describes the clinical examination as having up to 12 stations, while the detailed format and current curriculum describe 12 stations. Candidates should use the sitting-specific candidate information supplied by ACEM if the published wording changes.

For the Primary Examinations, the FACEM curriculum assigns Levels of Assessment to learning outcomes in the Foundations of Emergency Medicine section:

• Level of Assessment 1: assessed in depth through knowledge, comprehension, application, and/or analysis; these topics are expected to appear more frequently.
• Level of Assessment 2: assessed in some detail through knowledge, comprehension, and/or application.
• Level of Assessment 3: assessed less frequently and focused on overarching concepts and general principles rather than fine detail.

The current curriculum provides a scaffold and learning-outcome assessment labels rather than a numeric Fellowship percentage table. This guide therefore does not assign invented topic weights.

ACEM publishes component-specific eligibility requirements. The requirements below are jurisdiction- and training-status-specific rather than universal medical licensing rules.

For the Primary Written, Primary Viva, and Fellowship Written examinations, ACEM states that the listed requirements must be met by the application closing date. Fellowship Clinical uses a separate eligibility deadline in addition to its application closing date.

ACEM directs transitioned trainees to Regulation G for possible variations. Specialist International Medical Graduates are directed to separate Fellowship Examination eligibility provisions; the standard trainee checklist should not be assumed to apply unchanged.

1. Plan around the sequence. Identify the next examination for which you can meet the published eligibility conditions. The Primary Written precedes the Primary Viva, and Fellowship Written must precede Fellowship Clinical. Review your remaining attempts before applying.

2. Prepare Primary Written as applied basic science. Organize study under anatomy, pathology, physiology, and pharmacology. Use the curriculum's Levels of Assessment to decide where to pursue detailed understanding and where broad principles are sufficient. Complete timed MCQ practice in two substantial sessions that reflect the two-paper, six-hour structure.

3. Prepare Primary Viva as spoken reasoning. Rehearse four separate 10-minute stations. Practice explaining a mechanism clearly, relating it to emergency medicine, and responding to follow-up questions without losing structure. Speaking aloud is essential because written notes do not reproduce the demands of the oral format.

4. Split Fellowship Written preparation by paper. For SAQs, practice concise, prioritized responses that make assessment, immediate management, escalation, and disposition clear. For the MCQ paper, work through integrated clinical problems spanning the curriculum scaffold, including diagnostic evaluation, resuscitation, organ-system emergencies, special populations, toxicology, trauma, investigation interpretation, and professional practice. Alternate timed papers with targeted review.

5. Prepare Fellowship Clinical through station-based performance. Rehearse the four-minute reading period and seven-minute assessment period. Rotate through history, physical examination, challenging communication, Resus Standardised Case-Based Discussion, teaching, Standardised Case-Based Discussion, procedural performance, resuscitation, teamwork, and ED-management scenarios. Use a partner or supervisor to assess prioritization, signposting, examination technique, escalation, communication, and closure.

6. Use an integrated curriculum-to-format matrix. For each major domain, pair a written knowledge task with a verbal-management task and a station-based task. SAQ or structured oral practice can support clinical reasoning, but neither replaces rehearsal of Fellowship Clinical OSCE stations.

ACEM's Examinations page directs trainees to its eLearning resources, including past papers and examination reports. Use those resources with the current curriculum and sitting-specific candidate information.

• Training-program context: The four examinations sit within a broader assessment program that includes workplace-based assessments, in-training assessments, training requirements, and other progression decisions. Plan examination preparation alongside training-stage requirements rather than treating the examinations as an isolated sequence.

• Attempt management: Each examination attempt requires a new application and the applicable examination fee. The current maximum is three attempts for Primary Written, Primary Viva, and Fellowship Written, and four attempts for Fellowship Clinical. ACEM states that examination attempts before 1 January 2018 are not counted toward these limits.

• Australia and Aotearoa New Zealand: Current registration to practice medicine in Australia or Aotearoa New Zealand is included in the published eligibility criteria for the four components. Examination locations and venue arrangements can vary by sitting, so candidates should rely on the current ACEM Examinations page and their candidate information.

• Application versus eligibility dates: ACEM publishes application opening and closing dates for each sitting. Fellowship Clinical also has a separate eligibility deadline. Do not rely on a prior examination cycle when planning progression or application timing.

• Transition and SIMG pathways: Trainees who transitioned into the current training arrangements may have variations under Regulation G. Specialist International Medical Graduates have separate Fellowship Examination eligibility provisions. Both groups should check the provision ACEM identifies for their status before applying.

• Terminology: ACEM uses Primary Written Examination and Primary Oral Examination or Integrated Viva for the basic-science examinations. Fellowship Written consists of SAQ and MCQ papers, while Fellowship Clinical refers to the OSCE. Keeping these components distinct helps ensure that preparation matches the required performance format.

For current dates, application access, fees, locations, eligibility deadlines, and terms of candidature, use ACEM's current Examinations page rather than reproducing information from an earlier sitting.