Passing the emergency medicine written certi cation examination is an important milestone in the process o becoming a board-certi ed emergency physician. The written exam, ormerly called the Written Certi cation Examination and now re erred to by the American Board o Emergency Medicine (ABEM) as the “Quali ying Examination,” is used to identi y candidates who are ready to take the oral exam, the nal step in becoming board certi ed. The Quali ying Examination measures core knowledge, and, to many who must take it, it is an intimidating hurdle. Every year approximately 10% o examinees ail the test and must retake it the ollowing year. Given that many test takers are completing their residency and may be moving to start a new job in the months leading up to the test, it is clear that there is a need or a ocused, easy-to-use review book to help them prepare.
First Aid for the® Emergency Medicine Boards is such a book. The First Aid series is based on the idea that people who have recently prepared or and taken the test know best how to teach others to study or it. We have drawn on the experience o 26 individual chapter authors and nearly as many senior reviewers, integrating clinical experience, in ormation rom existing review books, and the ABEM practice questions to create a book designed to improve your score on the Quali ying Examination. First Aid for the® Emergency Medicine Boards contains dozens o challenging cases (“minicases”) and rein orces important in ormation in highlighted “key acts” and “mnemonics.” Filled with tables and gures, it presents key ndings and must-know in ormation in a clear, concise, and highly accessible ormat that makes it easy to recall both on test day and in the emergency department.
ABOUT THE QUALIFYING EXAMINATION
The Quali ying Examination consists o approximately 305 questions. Candidates are given six-and-a-hal hours o time to complete the test. All questions are the multiple choice, single-best-answer type. You will be presented with a case scenario and a question, ollowed by ve answer options. Approximately 10% o the questions include a gure (radiograph, photograph, ECG, rhythm strip, or ultrasound image). There are no penalties or wrong answers, so i you nd a question unanswerable, make your best guess and move on. Candidates who achieve a score o 75% or higher pass. The exam is given in the all o each year at one o 200 PearsonVUE pro essional computer-based testing centers. Test locations can be ound by selecting “Locate a Test Center” on www.pearsonvue.com. In ormation on registration, ees, and test composition can be obtained rom the ABEM website, www.abem.org. Exam content is de ned by ABEM’s Model o the Clinical Practice o Emergency Medicine (EM Model). The table lists the relative weight given to di erent elements o the exam. A minimum o 8% o the questions involve pediatrics cases, and a minimum o 4% o the questions involve geriatrics cases
Knowing the right answers is the most obvious way to pass the test, but studying is not the only way to prepare. Knowing how to take a multiple choice test can also help. There are ve key components. First, anticipate the answer as you read the question. With most questions, you should already have an answer in mind be ore you look at the choices. For example, a question might describe a young lady who presents with odd neurologic complaints. She is not obviously sick, and she reports that she had a di erent neurologic problem two months ago. Just as when you listen to real patients describe their symptoms, a di erential should orm in your mind. At the top o the list or the test patient should be multiple sclerosis. I you are con dent in your answer, you can avoid wasting the time it takes to care ully consider the merits o each answer choice. Instead, you can scan or the one you know is right, check the alternatives to make sure they don’t compete with your anticipated answer, and move on.
Second, when you cannot anticipate the answer, use the ollowing guidelines to help you make your choice:
1. Opposites attract. I two o the answers are the opposites o each other, one o them is usually the right answer.
2. Similars attract. I two answers are similar, one o them is usually the right answer. Test writers don’t usually create two similar wrong answers.
3. Grammar is a guide. Sometimes wrong answers can be identi ed through minor grammatical inconsistencies between the question and the answer choice. The right answer should link to the question without grammatical errors, as i it is part o a sentence that was cut neatly in hal .
4. Avoid “always” and “never.” Answers that include always and never are almost never correct. This act has become so well known that you will probably not see these words on the test. I you do, be wary.
5. Worst-case answers are often right. One o the goals o emergency medicine training is to teach you to consider li e-threatening illnesses rst. Be always on the look out or the pulmonary embolus or the ectopic pregnancy, and anticipate the need or immediate surgical consultation and early intubation. The diagnoses o GERD, gastroenteritis, or musculoskeletal low-back pain should be made only a ter you have ruled out more serious diseases with similar presentations.
Third, don’t be fustered i you have di culty interpreting a gure on the test. Like diagnostic tests in the emergency department, images on the written exam should be used to con rm or re ute a clinical suspicion. The question will o ten guide you to the answer without the image. Use the picture to strengthen your con dence in your answer choice. For example, a 72-year-old man presents with hip pain and di culty walking a ter a ground-level all at home. What is his diagnosis? I you were seeing this patient in the emergency department, you would put hip racture at the top o the di erential. The purpose o the radiograph would be to exclude a hip dislocation (although your exam will usually do this) and to identi y the location o the racture. I the radiograph is negative and the patient really cannot walk without a lot o pain, you will probably proceed to a CT or an MRI to nd the racture that you cannot see on radiograph. Take the same approach to this patient on the test as you would in the emergency department. Determine the answer rom the story, and look to the image to con rm your diagnosis. I you can’t interpret the image, answer the question without it.
Fourth, read the question care ully. As in the emergency department, there is a danger in being overly con dent in a diagnosis. It is good to anticipate an answer as you read, but be sure to read the entire question. Don’t be so certain about your diagnosis o glaucoma that you miss the sul a allergy, the history o sickle cell disease, or COPD. Paying attention to such details can mean the di erence between choosing the right answer and a wrong one.
Fifth, be aware that test writers like to mislead test takers. It has been said that writing good test questions is easy—it is writing good test answers that is di cult. A good test answer choice captures the imagination o unprepared test takers, and lures them down the wrong path. Here, again, knowledge is your riend. In this book, we include in ormation about unusual problems to help you hone in on the correct diagnosis and alert you when you are being led astray. For example, strychnine causes muscle convulsions leading to asphyxia two hours a ter ingestion and is there ore unlikely to be the right answer to any question, but i you don’t know that, you might end up choosing it. O course, good oils sometimes are right answers; knowing the key in ormation covered by each question should help you tell the di erence. Finally, good luck and enjoy your time studying. There are ew careers that o er as much opportunity to positively impact the lives o others as that o the emergency physician. The investment you make in yoursel by studying will make you a stronger test taker and a more competent emergency physician
Best Medical Books: First Aid for the Emergency Medicine Board PDF