ACEM Fellowship Examination (FACEM) Format Explained
Overall structure
Two components: a written paper (SAQ + SCQ) and a multi-station OSCE over two days.
Components and structure
The ACEM Fellowship Examination (FACEM) is assessed across the following components:
- Written SAQ paper (short-answer (SAQ)) — 180 min. Criterion-referenced.
- Written SCQ paper (select-choice (SCQ)) — 180 min. Criterion-referenced.
- Clinical OSCE (OSCE) — 12 stations, 132 min. Criterion-referenced. Up to 12 stations of 11 minutes each, over two consecutive days.
Both components must be passed. Max 3 attempts Written, 4 attempts OSCE.
Attempt limits: Max 3 attempts Written, 4 attempts OSCE.
Exam format glossary
Key assessment formats used in the ACEM Fellowship Examination (FACEM), defined. Each definition is general and applies across colleges.
- Short Answer Question (SAQ)
- A written question that requires a structured free-text response, marked by examiners against a model answer or rubric rather than by machine.
- Objective Structured Clinical Examination (OSCE)
- A circuit of timed stations, using real or simulated patients, that assesses clinical, procedural and communication skills against a standardised marking scheme.
What the format means for your preparation
The single most common preparation mistake is studying as if the examination only had an MCQ component. Format-aware preparation looks like this:
- MCQ components reward high question volume and pattern recognition. Read explanations, not just answers, and revisit weak domains with spaced repetition.
- Short answer / SAQ components reward a prioritised, structured response under time pressure. Practise writing complete answers in the available time, not just outlining points.
- Viva or OSCE components reward verbalised structured reasoning. Practise aloud, ideally with feedback, rather than rehearsing silently.
- Practical or image-based components reward repeated exposure under time pressure. Build a routine that includes timed slide or image interpretation.
What separates pass from fail under this format
Across multiple sittings, these failure modes recur:
- Unstructured SAQ answers - the written paper rewards a clear management framework with prioritised steps, not comprehensive lists.
- OSCE station anxiety: candidates who practise structured responses aloud under simulated time pressure consistently outperform those who only read.
- Neglecting low-frequency but high-stakes presentations: toxicology, resuscitation of special populations, and procedural stations.
- Leaving OSCE preparation too late - clinical skill stations require repeated practice, not last-minute review.
How PRIMEX maps to the format
- SAQ grading with AI feedback calibrated to ACEM examiner expectations for the written paper.
- OSCE simulation prompts covering all station categories for structured practice.
- Curriculum-mapped content across all FACEM Fellowship domains.
Start your 7-day free PRIMEX trial for the ACEM Fellowship Examination (FACEM) and practise in the format you will actually sit.
Start free trialFrequently asked questions
What is the format of the ACEM Fellowship Examination (FACEM)?
Two components: a written paper (SAQ + SCQ) and a multi-station OSCE over two days.
How many components does the ACEM Fellowship Examination (FACEM) have?
The examination has 3 assessed components, examined and weighted as the examining body specifies. The structured breakdown above reflects the official examination materials.
Which component is hardest?
Difficulty varies by candidate. Most fail-tier outcomes trace back to underprepared structured-answer technique or insufficient question practice volume rather than to one specific component.
How should the format change how I prepare?
Match your practice mode to the format. SAQ paper means write structured timed answers; viva or OSCE means rehearse speaking aloud under time pressure; MCQ means build pattern recognition through high-volume practice.
Does PRIMEX cover every component?
PRIMEX covers each component of the ACEM Fellowship Examination (FACEM) with format-specific practice: MCQ banks, AI-graded SAQ practice, and viva or OSCE simulation as the format requires.