The ACEM Primary Written Exam

The ACEM Primary exam consists of two main components - a Written Exam and an Oral (or Viva). At Ace The Exam, we provide a multiple choice question bank for the Written component.

The ACEM Primary Written has two sittings (or "diets") per year, in February and October. Registration opens several months before - we keep a reminder of these dates on the Ace The Exam Calendar - make sure you don't miss out!

Fees for the exam are AUD $2329 at the time of writing, with exams held in Adelaide, Auckland, Brisbane, Melbourne, Perth, and Sydney.

As per ACEM, to be eligibile, candidates must:

• Be formally enrolled as a trainee of ACEM in the FACEM training program.
• Have no financial debts to the College.
• Hold current registration to practice medicine in Australia or Aotearoa New Zealand.
• Must not be on a Wellbeing Interruption to Training at any stage from the date they apply for an examination to the date/s they sit the examination.

You have a maximum of three attempts at the Primary Exam. After this, no further attempts are allowed.

The written component of the ACEM primary consists of two papers, each lasting three hours. These are taken on the same day, making for a long and hard day of concentration!

Each paper consists of up to 180 multiple choice questions. Four broad subject areas are examined:

• Anatomy
• Physiology
• Pathology
• Pharmacology

This means about one minute per question, which is not a lot of time. Efficiency - synthesising the information in the stem, confidently identifying the best answer, and moving on - is absolutely key. This is one essential skill that comes out of doing practice questions on a bank, such as Ace The Exam.

Practically speaking, the ACEM exam bears a lot of similarities to the GSSE exam for the surgeons, from RACS. The main subject areas are the same, with the addition of pharmacology, and the questions are multiple choice.

The questions are largely drawn from the same reference texts, too:

• Last's Anatomy, 9th edition
• Ganong’s review of medical physiology, 26th edition
• Robbins & Cotran Pathologic basis of disease, 10th edition

The questions in each exam bear a lot of similarity to each other. There is a predominantly basic science focus, rather than clinical, which is reserved for the oral component of the primary. You need to know your anatomy well! ACEM particularly focuses on upper and lower limb anatomy, as this has more relevance to the EM trainee.

The FACEM Curriculum provides more detail on the subjects found in the exam. Check out from page 22.

Firstly, you are not alone! Join the ACEM Facebook group or AusJDocs on Reddit to find other people preparing for the exam.

Review the ACEM eLearning (available to members).

Finally, do as many practice questions as you can! Ace The Exam has over 5000 practice questions for the ACEM written . There is no substitute for practice and repetition when it comes to multiple-choice exams. It has been well-demonstrated that repetition and practice of key points, in bite-size or question-and-explanation form, shows much better retention than massed study or rote learning.

We think the below represent the highest-yield textbooks to use for ACEM written prep. Others may be found in the recommended reading list (page 162).

Last's Anatomy (Specifically the 9th edition).

Despite being around for donkeys' years (though revised in 2019), this still remains the reference text for the anatomy questions. Many questions in the GSSE can be traced back near verbatim to lines in this edition of Last's. It is a depressing book to study, with pages and pages of text. Nevertheless, this makes it easy to write question on and examine, and is probably why it was chosen. You need a copy of this to be used as the primary component of your anatomy revision. PDF copies are available online, though we have not linked to them out of respect for the publisher' and author's copyright. Of note, the FACEM curriculum lists other anatomy books as recommended reading. But the questions in the exam bear very close resemblance to sentences and sections in Last's.

Ganong’s review of medical physiology, 26th edition

A decent physiology book. Many of the questions in the GSSE were written from this; it aligns more closely to the exam than the other suggested book, Guyton and Hall.

Robbins & Cotran Pathologic basis of disease, 10th edition

Pretty heavy going. Common advice is to know the first ten chapters well, and everything else is a bonus. This reflects the fact that the GSSE is largely testing basic science knowledge. Much of the pathology component of the exam is taken from these first ten chapter. Know them well.

There are other recommended books in the recommended reading list (page 162), but the three above are absolutely key and should be where you spend the majority of your time.

We hope that this has provided you some useful information on the ACEM Primary Written structure and some tips on where to focus your study. Have any tips for us, or think we've missed something? Let us know! Best of luck in your exam!