FACEM
Fellowship of the Australasian College for Emergency Medicine.
Overview
The ACEM Exam which is the Fellowship Examination of the Australasian College for Emergency Medicine (FACEM) is a rigorous assessment process designed to determine whether candidates have reached the standard required to practise independently as specialist emergency physicians. The examination is deliberately demanding and is structured to assess not only medical knowledge, but also the clinical reasoning, judgement, and decision-making skills essential in the high-pressure environment of emergency medicine.
The examination is divided into two main components. The written examination evaluates a candidate’s understanding of core emergency medicine knowledge across a wide range of clinical presentations. This includes the assessment and management of acute medical and surgical emergencies, trauma, paediatrics, toxicology, resuscitation, and critical care. Questions are designed to test applied knowledge rather than rote memorisation, requiring candidates to demonstrate sound clinical reasoning and familiarity with current evidence-based practice.
The second component is the clinical examination, delivered in an Objective Structured Clinical Examination (OSCE) format. This part focuses on practical, real-world performance. Through structured scenarios, candidates are assessed on their ability to rapidly assess patients, prioritise care, make safe and effective management decisions, communicate clearly with patients and colleagues, and demonstrate professionalism under time pressure. The OSCE format reflects the realities of emergency department practice, where clinicians must integrate clinical knowledge with efficient decision-making and teamwork.
The FACEM examinations are known for their high standards, with pass rates typically around 50%, underscoring the level of competence expected of future emergency medicine specialists. Importantly, candidates are required to successfully complete the primary examination before they are eligible to progress to advanced training within the ACEM program. This staged approach ensures that trainees have a solid foundational knowledge and clinical capability before undertaking more senior responsibilities and advanced specialist training.
Overall, the FACEM examination process serves as a key quality assurance mechanism, ensuring that those who achieve Fellowship are well equipped to deliver safe, effective, and high-quality emergency care across Australia and New Zealand.
Important Considerations
Important Considerations
- Attempts: Trainees generally have a maximum of three attempts at an examination.
- Withdrawal: After three failed attempts, a trainee may be removed from the Training Program.
For the most up-to-date, specific, and official information, visit the ACEM Examinations page.
Eligibility
Eligibility to sit examinations set by the Australasian College for Emergency Medicine (ACEM) is closely linked to a candidate’s formal training status and professional standing, ensuring that only appropriately prepared trainees progress through the assessment pathway.
To be eligible, applicants must be officially enrolled as trainees in the ACEM training program, confirming that they are undertaking accredited emergency medicine training under the College’s supervision. In addition, candidates are required to hold current and valid medical registration in either Australia or Aotearoa New Zealand, allowing them to legally practise medicine within the relevant healthcare system.
ACEM also requires that trainees are in good financial standing with the College, meaning there must be no outstanding fees or debts at the time of application. This administrative requirement ensures compliance with College membership obligations.
From a training progression perspective, candidates must have advanced to specific stages of the training program, such as Stage Four, before they are eligible to attempt certain examinations. This reflects ACEM’s structured, competency-based training model, where examinations are aligned with expected levels of clinical experience and responsibility.
Finally, candidates must be actively engaged in training at the time of application. Those who are currently on, or have been approved for, a wellbeing interruption—a formal pause in training—are not eligible to sit the examination during that period. This requirement ensures that candidates are clinically active and appropriately supported when undertaking high-stakes assessments.
Taken together, these eligibility criteria ensure that ACEM examinations are attempted by trainees who are suitably experienced, professionally registered, financially compliant, and fully engaged in their emergency medicine training, thereby maintaining the high standards expected of future FACEM specialists.
How we assist candidates in clearing this exam
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