Emergency Medicine Certifying Exam Practice Cases by Domain
A domain map for building original, high-fidelity scenarios without reproducing secure ABEM content. Rotate clinical topics through the official case types rather than studying diagnoses in isolation.
Key takeaways
- The official blueprint contains eight content areas but ten cases because Clinical Decision-Making and Prioritization each appear twice.
- Practice should rotate adult, pediatric, trauma, toxicologic, obstetric, behavioral, cardiovascular, neurologic, respiratory, and infectious presentations through multiple station types.
- Every scenario should have an observable target, a time limit, a complication or new-information branch, and a debrief tied to public scoring criteria.
- The examples below are original educational prompts, not recalled or official ABEM examination cases.
Clinical Decision-Making cases
Undifferentiated shock with evolving bedside data
Assess threat recognition, parallel resuscitation, ultrasound integration, test interpretation, etiologic refinement, and destination.
Febrile infant with subtle deterioration
Assess age-specific history, examination, sepsis risk, testing, treatment, family communication, reassessment, and disposition.
Chest pain with conflicting initial studies
Assess dangerous differential, serial interpretation, risk communication, consultation, and anticipatory guidance.
Altered mental status after unknown exposure
Assess glucose and airway priorities, toxidrome reasoning, targeted treatment, temperature and rhythm management, and reassessment.
Pregnant patient with abdominal pain and instability
Assess maternal stabilization, focused obstetric differential, ultrasound, hemorrhage planning, consultation, and definitive destination.
Prioritization cases
Four-room emergency department with a new arrival
A stable fracture, a child with respiratory distress, an older adult with hypotension, and a psychiatric hold are interrupted by an arriving seizure patient.
Prehospital multi-casualty response
Limited crews, evolving hazards, one entrapped patient, one hemorrhaging patient, and several ambulatory patients require explicit triage and resource allocation.
Overnight department boarding crisis
A septic patient deteriorates, a stroke candidate arrives, an admitted patient develops hypoxemia, and consultant availability is constrained.
Pediatric surge
Respiratory distress, dehydration, fever, trauma, and a new unresponsive arrival test age-specific stabilization and delegation.
Procedure stations
| Procedure family | Station concept | Observable target |
|---|---|---|
| Airway | Failed first-pass intubation with worsening oxygenation | Preparation, positioning, oxygenation, technique, failed-airway recognition, rescue device, surgical-airway threshold |
| Thoracic | Unstable patient requiring emergent thoracostomy | Indication, landmarks, analgesia, sterile setup, technique, complication avoidance, confirmation, post-care |
| Vascular access | Shock with failed peripheral access | IO versus central choice, site, sterile technique, ultrasound guidance, confirmation, complications |
| Sedation | Pediatric fracture reduction | Selection, fasting context, consent, monitoring, medications, airway rescue, recovery |
| Cardiovascular | Unstable tachydysrhythmia | Synchronized cardioversion preparation, sedation when feasible, pad placement, energy, rhythm reassessment |
| Obstetric | Imminent delivery | Preparation, controlled delivery, shoulder dystocia branch, neonatal resources, postpartum hemorrhage response |
Ultrasound stations
Undifferentiated hypotension
Acquire cardiac, thoracic, abdominal, and vascular views as indicated; optimize images and connect findings to resuscitation.
Early pregnancy pain
Explain the study, obtain pelvic views, identify anatomy and limitations, interpret free fluid or pregnancy findings, and state next steps.
Ocular complaint
Use safe technique, recognize normal structures and pathologic clips, and integrate the result without overclaiming.
Ultrasound-guided vascular access
Differentiate vessel, optimize view, maintain needle visualization, avoid adjacent structures, and confirm access.
Communication, conflict, and reassessment stations
| Case type | Scenario | Performance target |
|---|---|---|
| Difficult Conversation | Unexpected death after prolonged resuscitation | Rapport, baseline knowledge, clear disclosure, silence and emotion, questions, next steps, closure |
| Managing Conflict | Family demands antibiotics or admission that are not clinically indicated | Understand concerns, explain risk, shared interests, alternatives, safety plan, professionalism |
| Patient-Centered Communication | Shared decision about imaging after minor trauma | Perspective, risk communication, uncertainty, values, mutual plan, return precautions |
| Reassessment | Patient treated for presumed benign condition develops new hypotension | Recognize change, obtain focused data, revise diagnosis, change treatment, escalate destination |
Build complete ten-case sets
- Exactly two Clinical Decision-Making cases at 15 minutes each.
- Exactly two Prioritization cases at 15 minutes each.
- One each: Procedure, Ultrasound, Patient-Centered Communication, Reassessment, Difficult Conversation, and Managing Conflict at 10 minutes each.
- At least one pediatric or neonatal presentation.
- At least one trauma or hemorrhage presentation.
- At least one toxicologic, obstetric, behavioral, or environmental presentation across repeated mocks.
- A fixed 30-minute break and no feedback until the entire block ends.
- No use of recalled secure content.
Put the framework under pressure
Practice the answer out loud—not only on paper.
Voice-first cases, adaptive examiner follow-up, imaging, complications, and structured educational feedback for emergency medicine.
Questions candidates ask
Frequently asked questions
Are these actual ABEM cases?
No. They are original educational scenario concepts derived from public case types and scoring criteria. They are not recalled, secure, or official ABEM cases.
How many Clinical Decision-Making and Prioritization cases should a full mock contain?
The published blueprint contains two Clinical Decision-Making cases and two Prioritization cases, for four Clinical Care Cases total.
Should every practice case include a deterioration?
Not every station requires dramatic deterioration, but repeated practice should include new information, interruptions, technical difficulty, emotion, or conflict so the candidate demonstrates adaptability.
How should I rotate clinical topics?
Use a matrix crossing station type with major emergency presentations and age groups. This prevents a strong topic library from masking a weak performance domain.
Does SurgiTest reproduce actual ABEM exam cases or guarantee certification?
No. SurgiTest uses original educational scenarios and public exam information. It does not reproduce secure examination content, calculate an official ABEM result, claim Board endorsement, or guarantee certification.
Source transparency
Official references
Board requirements, dates, and candidate instructions can change. Confirm current details directly with ABEM and the Board’s candidate portal.
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