Aim of In Training Exam

The In Training Examination is a national and yearly exam administered by the American Board of Emergency Medicine to all emergency medicine residents in the USA. It helps to evaluate a resident’s progress in obtaining the fundamental knowledge to practice independent emergency medicine. This study helps to point out  the effects of a 40 hour board review lecture course on the resident in-training examination in emergency medicine.

A 40 hour board review lecture course was designed and implemented during the weekly 5 hour long resident conferences during the 8 weeks preceding the in-training examination date in 2006. Attendance was mandatory at the Accreditation Council for Graduate Medical Education (ACGME) standard of 70% or greater. A positive result was considered to be a 10% increase or greater in the resident’s individual national class percentile ranking among their national peers for their class year for the emergency medicine in-training examination.

According to the ABEM website ,persons having higher In Training Exam scores possess higher chance of passing the initial qualifying examination to be certified emergency medicine physicians than residents with lower exam scores.

Read More:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657258/

Inservice Exam & Intraining

Inservice Exam helps to identify areas of deficiency in a resident's surgical education, ,to track a resident's progress from year to year and ,  to enable the program director, director of medical education, and the Residency Evaluation and Standards Committee to evaluate the strengths and deficiencies of each training program.

Intraining Exam helps residents to become well equipped with basics of emergency surgeries. The American Board of Emergency Medicine ( ABEM ) in-training examination is a yearly national cognitive test administered to emergency medicine residents in USA to evaluate progress toward obtaining the fundamental knowledge to be independent emergency physicians.

A 40 hour board review lecture course was designed and implemented during the weekly 5 hour long resident conferences during the 8 weeks preceding the in-training examination date in 2006. The review course was based on the topics outlined in the “model of clinical practice of emergency medicine”. The course consisted of lecture reviews of test taking skills, trauma, pediatric emergencies, toxicological emergencies, cardiac emergencies, pulmonary emergencies, gastroenterology emergencies, neurology-psychiatry emergencies, endocrine emergencies, hematology-oncology emergencies, otorhinolaryngology-ophthalmology emergencies, genitourinary emergencies, obstetric-gynecology emergencies, orthopedic emergencies, dermatology-environmental emergencies, and emergency medicine potpourri given by the emergency medicine faculty at a university medical center. To accommodate the inclusion of the 40 hour review lecture series, the 4 hour monthly journal club was suspended for 10 months. Furthermore, attendance was mandatory at these lectures at the standard Accreditation Council for Graduate Medical Education (ACGME) guideline of 70% or greater. A positive result was chosen to be a 10% increase or greater in the resident’s individual national class percentile ranking among their national peers for their class year for the emergency medicine in-training examination. A resident was excluded from the study if there was no 2005 in-training examination score for self-comparison. The 95% confidence intervals (CI) were used to analyze the results. Of 16 residents, 1 (6.25%; 95% CI: 0–18%) showed a positive result of increasing their national class percentile ranking by 10% or greater. For the PGY2, one of the eight had a positive result (12.5%; 95% CI: 0–35.4%). For PGY3, no resident (0%; 95% CI: 0–35.4%) had a positive result.

Read More: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657258/

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.

Read More: http://www.boardvitals.com/blog/five-difficult-areas-emergency-medicine-boards/

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

Read More: http://www.boardvitals.com/blog/abem-emergency-medicine-board-review/

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.