In Service Examination Overview

Like some other American Board of Medical Specialties (ABMS) member boards, ABEM develops and administers an in service examination (or in-training examination). It is offered annually on the last Wednesday in February to all ACGME-accredited and RCPSC-accredited Emergency Medicine residency programs for a small fee. Programs are not required to participate in this examination. 


The in-service examination targets the expected knowledge base and experience of an EM3 resident. Unlike other ABEM examinations, the in serviceexam does not have a passing score. It is a standardized examination that residents and program faculty can use to judge an individual resident’s progress toward successful ABEM certification. There is a strong relationship between in-training and qualifying examination scores. Physicians with higher in-training scores have a higher likelihood of passing the qualifying examination and those with lower scores have a lower likelihood of passing the qualifying examination. 


The in service examination is not designed for program evaluation, and the results should not be used to compare programs or residents across programs.


The in-training examination is a comprehensive examination that covers the breadth of Emergency Medicine. It is a single-session written examination containing 225 multiple-choice questions and takes about 4.5 hours to complete. 


Questions are drawn from The Model of the Clinical Practice of Emergency Medicine, which defines the universe of the specialty. All questions are written by a group of emergency physicians with special training in question writing. New questions pass through an extensive series of reviews, followed by field-testing. Because of this, a question may take two to three years from inception to appearance on an in-training examination as a validated question.