ACEM Primary Examination

The Primary Examination is a test of the basic sciences of anatomy, pathology, physiology and pharmacology. The candidate is expected to show an understanding of the subject matter and demonstrate their ability to apply their knowledge to the practice of emergency medicine.

Eligibility &
Dates and Fees
ACEM Examination Bulletins

Image: ACEM Primary Exam
The Application Process

In order to be eligible to apply for the Primary Examination, candidates must:
  • Be a registered and financial trainee of the College (see registration deadlines in the 'Dates and Fees' tab)
  • Hold current registration to practice medicine in Australia or New Zealand
Submissions are now closed.

For each attempt at the Primary Examination, a fresh application must be made and the relevant examination fee paid.

The examination may be attempted at any stage during Provisional Training, but the written component must be successfully completed before attempting the Viva. It is not necessary for Provisional Training time to be completed before the examination is undertaken.


Key dates for the Primary Examination application will be strictly adhered to. If a candidate fails to present for any part of the examination, or withdraws from any part of the examination after the application closing date, they are not entitled to a refund. Please see the Dates and Fees tab for key dates.

To withdraw from the Primary Examination, please complete the Withdrawal Form.

If you would like more information about the ACEM Primary Examination contact the Assessment Team at [email protected].
The Primary Examination is held twice annually. Applications must be received at the College office in Melbourne by close of business on the closing date specified.
Special Note:

The ACEM Primary Exam viva takes place in Melbourne at the AMC National Test Centre.

Primary Exam – 2018 Dates
Examination Must be registered as a trainee Applications
Application closing date and withdrawal deadline Examination date Examination location Examination fee (AUD)
PE2018.1 Written 5 January 2018 1 December 2017 19 January 2018 16 Febuary 2018 Adelaide
PE2018.1 Viva   1 December 2017 19 January 2018 22 – 23 March 2018 Melbourne $2065
PE2018.2 Written 22 June 2018 1 June 2018 29 June 2018 27 July 2018 Adelaide
PE2018.2 Viva   1 June 2018 29 June 2018 13 – 14 September 2018 Melbourne TBC
Primary Exam – 2019 Dates
Examination Must be registered as a trainee Applications
Application closing date and withdrawal deadline Examination date Examination location Examination fee (AUD)
PE2019.1 Written 4 January 2019 3 December 2018 11 January 2019 8 February 2019 Adelaide
PE2019.1 Viva   11 February 2019 8 March 2019 2 – 3 May 2019 Melbourne TBC
PE2019.2 Written 21 June 2019 3 June 2019 28 June 2019 2 August 2019 Adelaide
PE2019.2 Viva   12 August 2019 6 September 2019 31 October – 1 November 2019 Melbourne TBC

* From 2019 the time between the PE written and PE viva examinations will be further apart. Therefore, a separate application period will take place for each individual examination rather than trainees applying for both at the same time.


The objective of the Primary Examination is to ensure that as a trainee, you have the required level of knowledge and understanding of the four basic sciences of anatomy, pathology, physiology and pharmacology — as they relate to emergency medicine. This is to ensure you have gained the core knowledge considered necessary towards a career as an emergency medicine physician. 

The examination is criterion-referenced, which means that as a candidate, you are required to reach a predefined level of performance to pass the examination rather than a fixed percentage of candidates being successful.  

Exam sittings

Two sittings of the Primary Examination are held annually, and are comprised of:

  • an online written examination (held regionally) 
  • ​an oral viva examination (held in Melbourne).

The written and oral components of the examination are held approximately six weeks apart. A pass in the Primary Examination is awarded upon obtaining a pass in both the written and viva components individually.

Online Written Examination

The written component of the Primary Examination will be an integrated examination. It will contain up to 360 questions in total, made up of Select Choice Questions (SCQ), Multiple Choice Questions (MCQ) and Extended Matching Questions (EMQ).

The exam will be split into two papers of up to 180 questions each, with each paper having a time limit of three hours, and held over the course of one day:

Examination Day Breakdown Primary Exam  Total testing time Number of items
Morning Paper 1 180 minutes 180
Afternoon Paper 2 180 minutes 180

Each ‘subject’ (e.g. anatomy, pathology, pharmacology, physiology) will comprise approximately 25 per cent of the questions. The blueprint will describe topic coverage by a subject using approximate percentages of questions rather than by exact numbers of questions.

Use of Scenarios

With integrating the examination, many of the questions (but not all) will be linked by a clinical scenario to demonstrate the clinical relevance of the topic. Each question that follows a scenario will be from the one subject, however, the set of questions that are associated with this scenario may be from one or more of the four subjects. For example, a scenario of a patient with asthma may have two MCQs relating to respiratory physiology, two MCQs relating to asthma pathology, one on medications used in asthma, and one on lung anatomy.
Obtaining a Pass

In order for you to pass the SCQ examination, you will have to reach the overall passing score, as set by the Angoff method. There is no minimum number of questions required to be correct in each subject to pass, as long as a candidate reaches the cut score.
A pass in the Primary Examination is awarded upon obtaining a pass in both the written and Viva omponents individually.

Multiple Choice Questions (MCQ)

The multiple choice questions are 'type A' questions: choose the one most correct response from four options.

Extended Matching Questions (EMQs)

Each set of EMQs comprise a theme - a list of possible options (e.g. options related to the theme), and a number of stems requiring a response chosen from the list. In the ACEM format, you select one best option from the options provided (which could be up to 25 options).

The proportion of MCQs to EMQs in each paper is not fixed. A selection of example EMQs is available to view in the Resources page.
For more information on the integrated written examination, see the Future Changes page.

Oral Examination - Integrated Viva

The oral examination comprises four, ten-minute integrated Vivas, examined on one day. Each Viva assesses the four basic science subjects. 
You are required to obtain a scaled score of five (5) or greater out of 10 in at least two of the four integrated Vivas. You must have a total score of 20 or greater out of 40 at the one examination in order to pass the Viva component of the examination and successfully complete the Primary Examination. 
Viva results will be released online on the Results page (Member login required) on the Wednesday following the last day of the exam.

Clinical Building Blocks

Props such as bones, normal X-rays and anatomical models may be used in the integrated Vivas, however pathology specimens are not used. 

As a Primary Exam candidate, you will be expected to label, describe and analyse abnormal ABGs, X-rays ECGs etc. For example you may be shown an ECG and be expected to identify that it shows a STEMI and then explain the physiology underlying these changes. These changes will reflect the activities and expectations of trainees in the workplace who are at a level to sit their Primary Examination. 

Success in the Primary Examination is necessary to progress to ACEM Advanced Training.

Standard Setting

Standard setting is the process used to determine a passing score for an examination that requires a pass/fail decision. High stakes examinations, such as those conducted at the AMC and specialist medical colleges including ACEM, use a method known as criterion-referenced standard setting. This method involves setting the passing score to an absolute standard that denotes the required/acceptable level of competence or performance that needs to be demonstrated in order to pass a particular question or station, and then ultimately the examination, when all questions or stations are combined.

Exam results have been moved

To ensure privacy for all candidates sitting ACEM Examinations, your results are now provided directly via the ACEM Member Portal.
Preparing for the Primary Exam

The following documents have been created to help you prepare for the exam, the resources contain information on the code of conduct, marking scheme and results. Candidates are requested to fully familiarise themselves with the information contained in each PDF. 

The Primary Examination is blue printed to the ACEM Curriculum Framework. References that may be of assistance to trainees are taken from Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7th edition. However, these chapters are by no means the only reference that the trainee can use and trainees are encouraged to use other relevant references to assist them in their preparation.

Chapter Title Page/s
19 Acid-Base Disorders 102
20 Blood Gases 112
21 Fluids and Electrolytes 117
22 Cardiac Rhythm Disturbances 129
226 Anemia 1457
227 Tests of Hemostasis 1460
228 Aquired Bleeding Disorders 1464
229 Clotting Disorders 1470
264 Initial Evaluation and Management of Orthopedic Injuries 1786-1789

ACEM Examination Bulletins

ACEM Exam Bulletin - Feb 2017
ACEM Exam Bulletin - Aug 2016
ACEM Exam Bulletin - May 2016

Change to the number of exam attempts

Commencing from the beginning of the 2018 training year, the number of attempts at each examination required to be passed as part of the ACEM Specialist Training Program will be limited to three (3).


That is, as a trainee, you will have a maximum of three attempts at each examination:

  • the Primary Written Examination
  • the Primary Viva Examination
  • the Fellowship Written Examination
  • the Fellowship Clinical Examination (OSCE). 

This means that if you don't pass an examination within the three attempts available, you will be recommended for removal from the training program. 


Attempts made at any of the four examinations that have not resulted in the examination in question being passed prior to the 2018 training year will not count towards the allowed three attempts. 

Please note that the current training time limits still apply. Provisional training must be completed within five (5) years and all training requirements must be completed within 12 years from the time of registration as a trainee.