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The Certifying Exam: What It Is—and What It Isn’t

ABEM recently announced that a new Certifying Exam will launch in 2026 as the final step for physicians in the process of becoming ABEM certified. The Certifying Exam resulted from a rigorous review of ABEM’s Oral Exam and the critical exploration of how physicians become certified that was conducted by the Becoming Certified Task Force. Over 4,000 stakeholders participated in the process and ABEM learned that its certification process can be even more relevant to practice and can assess additional competencies that the current Oral Exam format cannot such as critical communication and procedural skills.  Looking across the medical specialty boards, more than half have an oral exam, the majority of which are “in person.”

So that’s the “why.” Here’s what the exam is (and isn’t):

The Certifying Exam will test additional competencies that cannot be tested on the current Oral Exam. Examples of competencies to be tested on the new examination will include:

  • Procedural Skills
  • Prioritization
  • Patient-centered communications
  • High-stakes communications/difficult conversations
  • Managing Conflict

The Certifying Exam will be an in-person assessment conducted at the AIME Center in Raleigh, North Carolina. The Center is a one-of-a-kind, state-of-the-art facility that can support medical equipment and simulators used in testing. The AIME Center also allows ABEM to partner with a diverse group of professional actors who work as standardized patients. At the outset there will be an estimated nine administrations of the Certifying Exam per year. (Learn more about why the AIME Center in Raleigh was chosen.) This will provide scheduling flexibility for physicians seeking certification.

The Certifying Exam will have two assessment types (cases): Clinical care cases and objective structured clinical examination (OSCE) cases. Clinical care cases are based on guided scenarios that will require candidates to have a dialogue with examiners to demonstrate how they prioritize patient care, assess their adaptability to unexpected clinical changes, and interact with various sources of information. OSCE cases will assess complex communication, professionalism, and technical skills. Scenarios could involve standardized patient actors or procedural equipment. This assessment format will allow candidates to use the skills learned in residency and apply them to simulated, real-world clinical scenarios to determine if they meet the high standards required for the independent practice of Emergency Medicine.

The Certifying Exam is the final step to becoming ABEM certified. This exam is directed only toward those physicians seeking initial ABEM certification. Since you are receiving this newsletter, you are already ABEM certified so you will not take the new Certifying Exam. Similarly, those physicians who successfully pass the current Oral Exam in either 2024 or 2025, will not take the new Certifying Exam.

The Certifying Exam will not be an in-person version of the virtual Oral Exam. The current Oral Exam has been shown to be a valid and reliable assessment that measures factors that are different than what is measured on the Qualifying Exam. However, moving into the future, the Certifying Exam will be comprised of NEW types of cases that test ADDITIONAL competencies that the current virtual Oral Exam cannot. Setting the highest standard in emergency medicine requires that the format for the evaluation of future diplomates be flexible, adaptable to the changes in medicine, and not be able to be replaced by artificial intelligence.  The new exam will better represent the clinical practice of physicians working in the emergency department every day.

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