Five Difficult Areas on the Emergency Medicine Board Review Textbook

The five most difficult areas of the Emergency Medicine Board Review  are usually going to be the five areas that you spent the least time reviewing, reviewed in the most distant period, or that that you just never quite understood. If there is an area with which you have always had trouble, your success in this area is not going to improve unless you have put the time in to alleviate the difficulty. As you study the emergency medicine board review textbook , take advantage of the fact that some material just follows you from the beginning to the end of your medical career. Add these questions from your problem areas to the top of your list, and hit one or two questions in this region every day. Though we are discussing what we have called the most difficult areas below, the most difficult area is really a customized entity for each individual.

1).Opthalmological disorders and emergencies are at the top of the “difficult” lists of many.

Many don’t see or treat a lot of subacute opthalmologic disorders , though this content has a firm place on the boards. Know the symptoms, opthalmological exam, and method of treating the following: retinal artery occlusion, papilloedema, corneal ulceration (pseudomonas being the most common causative organism), hypopyon, pterygium, retinal detachment (review the way it looks on ultrasound (US)) and the normal parameters of intraoccular pressure (nl IOP = 10-21). Don’t ignore the IOP associations with open and closed angle glaucoma.

2).Don’t forget the spinal cord injuries.

Thankfully, this is another example of a time-honored area of which we do not see a lot in clinical practice. As a result, one often remembers to look over the spinal cord lesions and the corresponding anatomical area, but forgets to review the mechanisms of injury. For instance, the hangman’s fracture is the result of a hyperextension injury, not a flexion injury. Make a chart and memorize whether associated symptomatology is anterolateral or contralateral for anterior cord, central cord, and Brown Sequard syndromes.

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ABEM Emergency Medicine Board Review

Emergency Medicine board review probably has you feeling a little overwhelmed right about now. There are many topics on the ABEM board review that require equal attention. Although the strategy required to study for the boards requires focus, EM is one of the most broad topics in medicine. Finding your footing may be difficult, but the first step to success is to recognize the diagnosis hidden in each case presentation. Resist the temptation to go out and buy every book, take every course or go to every review session out there for the boards. You’re only going to confuse and overwhelm yourself. The right method involves focusing your energies on those topics that show up the most frequently on the board exams. Without that kind of concentrated focus, you’ll get lost in the haze of all the information out there.

Centering your studies will be imperative. Unlike standard medical exams in the past, the board exams tend to test on overall knowledge of a topic, rather than information regurgitation. With that in mind, it is important to focus on the American Board of Emergency Medicine’s (ABEM) clear-cut set of topics that get tested year after year.

Specifically, you will want to concentrate on how to get to the right diagnosis when doing practice ABEM exam questions. Coming to the right diagnosis requires two elements: pattern recognition and knowing associations. If you can take a set of symptoms, physical signs, and/or laboratory values and recognize that they represent the pattern of a particular disease, you will be ahead of the game. Knowing associations should be a somewhat familiar skill for you at this point. This concept has to do with the classic recognition of medical “buzzwords.” These are those terms that are pathognomonic for a disease and give you the clues necessary to make the proper diagnosis.

The following list will give you the approximate percentage of emphasis for major topics found on the ABEM Exam. Focus your studies on some of these topics and remember to exercise your pattern recognition and association skills throughout:

Traumatic Disorders at 11% of overall exam

Within the traumatic disorders, the subtopics include abdominal trauma, chest trauma, cutaneous injuries, facial fractures, genitourinary trauma, head trauma, injuries of the spine, lower extremity bone trauma, neck trauma, ophthalmologic trauma, otologic trauma, pediatric fractures, pelvic fractures, soft-tissue extremity injuries, vascular injuries, spinal cord and nervous system trauma, upper extremity bony trauma, trauma in pregnancy and multi-system trauma.

Cardiovascular Disorders at approximately 10% of overall exam
Signs, Symptoms and Presentations at approximately 9% of overall exam
Abdominal and Gastrointestinal Disorders at approximately 9% of overall exam
Thoracic-Respiratory Disorders at approximately 8% of overall exam

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ConCert Examination Description and Content Specifications

ConCert Examination Description

The Continuous Certification (ConCert) examination is similar to the former recertification LLSA examination.  There are, however, two important differences.

• It is administered at over 200 Pearson VUE professional computer-based testing centers.
• It is a shorter examination of approximately 205 multiple-choice questions.

The ConCert exam is a comprehensive examination that covers the breadth of Emergency Medicine.  Each examination appointment is approximately five and one-quarter hours in length, with four and one-quarter hours devoted to actual testing time. Between 10% and 15% of the questions will have a pictorial stimulus.  The style of the test questions is identical to that of the recertification examination test questions, i.e., single-best-answer, positively-worded, multiple-choice questions focused on what the practicing emergency physician needs to know when treating patients.

The ConCert exam is a criterion-referenced examination.  All candidates achieving a final score of 75 or greater will pass the examination. 

LLSA Content on the ConCert Examination

The link between previous LLSA readings and the ConCert examination review course no longer exists.  ConCert examinations are focused on assessing knowledge needed for clinical practice.  Although LLSA questions will no longer appear on the ConCert examination, similar concepts may still be represented as they become the standards for practice in EM.  The questions of detailed information found on the LLSA tests, however, will not be found on the ConCert examinations. 

Content Specifications

The Model of the Clinical Practice of Emergency Medicine (EM Model) forms the basis of each of ABEM’s MCQ examinations. ABEM is currently using the 2011 version of the EM Model for its examinations. The lists below describe the relative weight given to different elements of the EM Model in constructing ABEM’s MCQ examinations. The complete EM Model was published in Academic Emergency Medicine [Acad Emerg Med. 2012; doi: 10.1111/j.1553-2712.2012.01385.x [Epub ahead of print]]. It is also on ABEM’s website.

Reference: https://www.abem.org/public/abem-maintenance-of-certification-%28moc%29/moc-assessment-of-cognitive-expertise-%28concert%29%28tm%29-examination/concert%28tm%29-examination-description-and-content-specifications

What are ABEM's Mission and Purposes?

What is ABEM? 

The American Board of Emergency Medicine (ABEM) is one of 24 medical specialty certification boards recognized by the American Board of Medical Specialties. ABEM board certifies emergency physicians who meet its educational, professional standing, and examination standards. ABEM certification is sought and earned by emergency physicians on a voluntary basis; ABEM is not a membership association. 

ABEM Mission

The ABEM mission is to ensure the highest standards in the specialty of Emergency Medicine. 

ABEM Purposes

ABEM’s purposes are:

• To improve the quality of emergency medical care
• To establish and maintain high standards of excellence in Emergency Medicine and subspecialties
• To enhance medical education in the specialty of Emergency Medicine and related subspecialties
• To evaluate physicians and promote professional development through initial and continuous certification in Emergency Medicine and its subspecialties
• To certify physicians who have demonstrated special knowledge and skills in Emergency Medicine and its subspecialties
• To enhance the value of certification for ABEM diplomates
• To serve the public and medical profession by reporting the certification status of the diplomates of the American Board of Emergency Medicine

In-training Examination Overview

Like some other American Board of Medical Specialties (ABMS) member boards, ABEM develops and administers an InTraining 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 In Service examination

The ABEM inservice examination targets the expected knowledge base and experience of an EM3 resident. Unlike other ABEM examinations, the in-training examination 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 examination is not designed for program evaluation, and the results should not be used to compare programs or residents across programs.

Preparing for the ABEM Inservice Examination using AAEM Emergency Medicine Textbook

Emergency medicine (EM) residency graduates need to pass both the written in service examination and oral certification exam as the final benchmark to achieve board certification through The American Board of Emergency Medicine (ABEM).  Following the successful completion of an accredited emergency medicine residency, candidates for board certification take the written abem inservice examination in the fall after graduation as the first step to becoming an ABEM board diplomate.  If successful in this first step, candidates will take the oral certification exam in the spring or fall of the following year.

Many residents and recent graduates spend a significant amount of time and money preparing for the board exams.  As a result, EMRA would like to help you to make informed decisions about how best to spend your time and money preparing for the boards. As EMRA neither produces nor promotes any specific board review product, the EMRA Board of Directors has sponsored a survey of recent graduates to assess their overall preparation for the boards and their opinions and comments about specific board review products that they may have used during their preparations.  Every effort was made to include a comprehensive list of all textbooks, review courses, tutoring, and online products available. 

Preparation:

Many residencies seek to prepare their residents by including written (67%) and oral board (85%) preparation activities.  The majorities of the written board preparation activities occurs around the in-service exam (50%), but are often spread throughout the academic calendar. Similarly, residency-sponsored oral board review sessions are clustered around an annual educational activity, such as a retreat (36%), or are administered on a quarterly basis (33%). For this reason AAEM spent two years developing a comprehensive written board review AAEM Emergency Medicine Textbook. Emergency Medicine: A Focused Review of the Core Curriculum is a 22-chapter text like the Rivers emergency medicine textbook written by experts on each topic and targeted at graduating EM residents, emergency physicians approaching recertification and EM residents taking the annual in-service exam. The AAEM textbook also serves as a comprehensive review of emergency medicine for the motivated medical student. The book includes color images and a 225 question practice in-service examination.

The AAEM Emergency Medicine Textbook

The American Academy of Emergency Medicine (AAEM) is the specialty society of emergency medicine. AAEM is a democratic organization committed to great principles.

AAEM is proud to be celebrating 20 years at the specialty society of emergency medicine. We kicked off the celebration at the 19th Annual Scientific Assembly in Las Vegas in February and will be highlighting AAEM's history and founders throughout 2013.

AAEM spent two years developing a comprehensive written board review AAEM Emergency Medicine Textbook. Emergency Medicine: A Focused Review of the Core Curriculum is a 22-chapter text like the Rivers emergency medicine textbook written by experts on each topic and targeted at graduating EM residents, emergency physicians approaching recertification and EM residents taking the annual in-service exam. The AAEM textbook also serves as a comprehensive review of emergency medicine for the motivated medical student. The book includes color images and a 225 question practice in-service examination.

ABEM In Service Examination

Like some other American Board of Medical Specialties (ABMS) member boards, ABEM LLSA develops and administers an in-training examination (or In Service 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 examination targets the expected knowledge base and experience of an EM3 resident. Unlike other LLSA ABEM examinations, the in-training examination 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 In Service Examination. 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.

AAEM Emergency Medicine Textbook

The powerful AAEM Emergency Medicine Textbook is organized in a succinct outline format featuring updated emergency medicine board review content and more than 500 pre-chapter questions and answers. It is an excellent source of reference and review for the Qualifying or In service examination. This book features:

• A comprehensive review of the core content of emergency medicine!
• Highly focused text leaves out superfluous information
• Specially designed sections that address trends from past exams
• Packed with hundreds of pictures, mnemonics, and case scenarios this book will make exam prep more efficient and effective for the busy emergency physician
• Strategic layout to promote retention of key concepts
• Tabbed for quick reference    
• Chapters in order of most-tested to least-tested content
• "Crash course review" final chapter to maximize score immediately before exam
• With its extensive breadth of key EM points, this will undoubtedly become a great asset in your reference catalog