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There’s a new ABEM oral/practical exam (“Certifying Exam”) this year — super curious what people think.
From what it seems, there are a few different case “types”:
1. Clinical Decision Making / Prioritization (4 cases!)
There are 4 of these, so it’s the meat of the test (40%). It seems pretty similar to the old format in that you’re managing/diagnosing a totally undifferentiated patient (of any age). The difference is they really want you to explain WHY — discussing your differential, what questions you’d want to ask next, what you’re looking for on exam, and why certain tests would be ordered to rule things in/out.
It sounds like there are two proctors guiding the case, and it’s more of a discussion while they document and give you materials to review - not just a back and forth with a patient. Prep-wise, this feels closest to the old exam. Probably just need reps to nail this, since it could be anything from a pediatric code to eclampsia to tox. Super broad so best to use some dedicated resource for this so you don’t miss anything since there's a lot of content that could be tested here.
2. Procedures (1 case)
You have a procedure model and a proctor. You obtain consent, discuss indications and risks/benefits, walk through the procedure on the model, and then discuss post-procedure care. There’s a long list of possible procedures — some are a bit out there (e.g., umbilical vessel catheterization?… can’t say I’ve ever done that one…) but most seem straightforward stuff we do every day.
3. Ultrasound (1 case)
There’s a standardized patient along with a proctor. You’re given a scenario with an obvious POCUS indication. You describe probe selection, obtain views on the patient actor, interpret what you’re seeing, and they may show you an actual image to test recognition of pathology. Then you describe how it changes management (e.g., positive FAST).
4. Patient-Centered Communication (1 case)
You’re talking to a patient actor who’s distraught about something (bad news, missed diagnosis, family member, etc.). Probably one of the easier cases since we do this all the time. They’re looking for empathy, plain layman language, checking understanding, and next steps.
5. Reassessment (1 case)
A patient has already been worked up, admitted, or signed out — and something goes wrong. Again, this could overlap with any of the CDM content (peds, OB, elderly septic patient, etc.). Best prep is just solid medicine and practice cases. I’d expect some “thinking out loud” here too.
6. Managing Conflict (1 case)
You’re at odds with another person regarding management, flow, or care. Another soft-skills case similar to PCC. You listen, acknowledge concerns, explain your reasoning, handle some pushback, and try to find common ground. Should be straightforward if you approach it like real ED life.
For prep resources...Critical Cases updated their content for the new format and seems to be the go-to now. Okuda is still solid for the Clinical DM cases specifically (there's just so much they could test for those case types) but most people I've talked to seem to have shifted toward CC. I’ve used both and think both are very good.
Curious to hear what others who’ve taken it think
From what it seems, there are a few different case “types”:
1. Clinical Decision Making / Prioritization (4 cases!)
There are 4 of these, so it’s the meat of the test (40%). It seems pretty similar to the old format in that you’re managing/diagnosing a totally undifferentiated patient (of any age). The difference is they really want you to explain WHY — discussing your differential, what questions you’d want to ask next, what you’re looking for on exam, and why certain tests would be ordered to rule things in/out.
It sounds like there are two proctors guiding the case, and it’s more of a discussion while they document and give you materials to review - not just a back and forth with a patient. Prep-wise, this feels closest to the old exam. Probably just need reps to nail this, since it could be anything from a pediatric code to eclampsia to tox. Super broad so best to use some dedicated resource for this so you don’t miss anything since there's a lot of content that could be tested here.
2. Procedures (1 case)
You have a procedure model and a proctor. You obtain consent, discuss indications and risks/benefits, walk through the procedure on the model, and then discuss post-procedure care. There’s a long list of possible procedures — some are a bit out there (e.g., umbilical vessel catheterization?… can’t say I’ve ever done that one…) but most seem straightforward stuff we do every day.
3. Ultrasound (1 case)
There’s a standardized patient along with a proctor. You’re given a scenario with an obvious POCUS indication. You describe probe selection, obtain views on the patient actor, interpret what you’re seeing, and they may show you an actual image to test recognition of pathology. Then you describe how it changes management (e.g., positive FAST).
4. Patient-Centered Communication (1 case)
You’re talking to a patient actor who’s distraught about something (bad news, missed diagnosis, family member, etc.). Probably one of the easier cases since we do this all the time. They’re looking for empathy, plain layman language, checking understanding, and next steps.
5. Reassessment (1 case)
A patient has already been worked up, admitted, or signed out — and something goes wrong. Again, this could overlap with any of the CDM content (peds, OB, elderly septic patient, etc.). Best prep is just solid medicine and practice cases. I’d expect some “thinking out loud” here too.
6. Managing Conflict (1 case)
You’re at odds with another person regarding management, flow, or care. Another soft-skills case similar to PCC. You listen, acknowledge concerns, explain your reasoning, handle some pushback, and try to find common ground. Should be straightforward if you approach it like real ED life.
For prep resources...Critical Cases updated their content for the new format and seems to be the go-to now. Okuda is still solid for the Clinical DM cases specifically (there's just so much they could test for those case types) but most people I've talked to seem to have shifted toward CC. I’ve used both and think both are very good.
Curious to hear what others who’ve taken it think
