Emergency Medicine Board Review: Qualifying, Certifying and ITE

Emergency medicine board review means preparing for two exams, not one. To become certified by the American Board of Emergency Medicine you pass the written Qualifying Exam, about 305 multiple-choice questions given one week each fall (ABEM Qualifying Exam), and then the Certifying Exam, ten cases in a half-day session that has taken the place many people still search for as the “oral boards” (ABEM Certifying Exam). Along the way, residents sit the In-Training Exam every year.

This guide covers all three with ABEM’s current dates, fees and scoring, then how to study for the written exam and how to practice for a case-based one.

By Dr. Sahith Valluru. For The Boards Professor, founded by Dr. Sean Moazezi, DO. Published and last updated October 28, 2026.

The ABEM Qualifying Exam at a glance

Checked October 28, 2026. Rules change; the linked page is the authority.

Topic	Official rule	Source
Questions	Approximately 305 single-best-answer multiple-choice questions; some include images such as x-rays or ECGs.	ABEM: Qualifying Exam
Passing score	77 out of 100, the standard ABEM last examined in 2019.	ABEM: take and pass the Qualifying Exam
Board eligibility	Begins after graduation once your program director verifies training, and expires five years later on December 31 of the final year. Passing the Qualifying Exam in that window can earn a second five-year period.	ABEM: board eligibility
Fee	$960 when registering May 7 to September 8, 2026; $1,260 from September 9 to October 15, 2026. Fees are subject to change.	ABEM: Qualifying Exam registration and scheduling
Results	Within 90 days of the exam, ABEM emails you when results are available in your MyABEM portal.	ABEM: take and pass the Qualifying Exam
When and where	Given one week each fall at more than 200 Pearson computer-based test centers in the US and Canada. 2026: October 29 to November 7. 2027: November 1 to 13.	ABEM: Qualifying Exam

Three ABEM exams, in the order you meet them

1. In-Training Exam (ITE), every year of residency. 225 questions in about four and a half hours. Your program registers you; there is no passing score (ABEM ITE).
2. Qualifying Exam, after training. The written board: about 305 questions, offered once a year in the fall at Pearson centers, passed at 77 out of 100 (ABEM).
3. Certifying Exam, the final step. Ten cases in one half-day session, in person in Raleigh, North Carolina, scheduled in windows across the year (ABEM).

All three are written from the same outline. ABEM says the 2022 Model of the Clinical Practice of Emergency Medicine, the EM Model, is the basis for the content of every exam it gives (ABEM EM Model). Download it once and use it as the checklist for every stage below.

Studying for the Qualifying Exam

The Qualifying Exam rewards breadth. With roughly 305 questions and some items built on ECGs and x-rays (ABEM), it samples the whole EM Model rather than the cases you happened to see on shift. A workable plan has three parts:

• Start from your last ITE report. ABEM says there is a strong relationship between ITE and Qualifying Exam scores (ABEM ITE), so your weakest ITE areas are the first places to spend time.
• One question bank, done completely, in timed mixed blocks, with every miss reviewed the same day. Tag each miss as content you did not know or a decision you got wrong.
• Image and tracing practice every week. ECGs and plain films are fast points for people who have drilled them and slow ones for people who have not.

Because the exam runs only one week a year, missing it costs you a year. The 2026 window is October 29 to November 7, and 2027 is November 1 to 13 (ABEM). Registering early also costs less: $960 before September 9 in 2026, $1,260 after (ABEM fees).

The Certifying Exam, formerly the oral boards

Searches for “ABEM oral boards” now lead to what ABEM calls the Certifying Exam: ten cases completed in a half-day session at the AIME Center in Raleigh (ABEM Certifying Exam). It is criterion-referenced, so you are measured against a standard rather than against the other candidates, and everyone who meets it passes. Scores arrive within 90 days, and after a fail ABEM requires a nine-month wait before the next attempt (ABEM scoring). The registration fee is $1,255 (ABEM).

A case-based exam is a performance, and performances need rehearsal. Our approach is to run timed cases out loud with a partner who plays the examiner: stabilize first, say what you are doing and why, reassess after every intervention, and close with a clear disposition. Record a few sessions. Most candidates find they know what to do but skip saying the reassessment, or wander when a case turns. Those habits are fixable in a handful of practice runs, not in the week before the exam.

Using the in-training exam well

The ITE is ABEM-written practice that your program already pays for, and residents tend to waste it. It has no passing score (ABEM ITE), which makes it easy to sit cold. Treat at least your PGY-2 and senior ITEs as dress rehearsals instead: a timed block a week in the month before, and a full review of the score report afterward. The 2027 ITE runs February 23 to 27. Programs register their residents, so if you are unsure whether you are on the list, ask your program coordinator rather than ABEM.

Board eligibility: the clock you are on

Your board eligibility starts once your program director verifies that you finished training and ends five years later, on December 31 of the final year (ABEM board eligibility). If you pass the Qualifying Exam during that period you may qualify for a second five-year period to finish the Certifying Exam. Plan the Qualifying Exam for the first fall you can take it; every skipped year shortens the room you have for the second step.

Board review with Dr. Chris Sawyer

Chris Sawyer, DO, is an emergency medicine physician who completed his EM residency at Ascension Saint John Hospital in Detroit, and he tutors emergency medicine board certification for The Boards Professor. He has worked with our founder since his second year of medical school, and his sessions build real emergency department encounters into board-style questions, so a fact you missed is tied to a patient you will remember. Read his profile on the Chris Sawyer page. Sessions run online by live video (Zoom or Google Meet) around your shift schedule.