How to Tackle the PEx


The ACEM Primary Exam (PEx) is a summative assessment which is completed by trainees between stage 1 and stage of 2 of training.

The PEx is divided into written and oral (VIVA) components. The objective is to ensure that trainees possess the required level of knowledge and understanding of the four basic medical sciences – Anatomy, Pathology, Physiology and Pharmacology – as they form the foundation for the practice of emergency medicine. 

The PEx can be difficult to prepare for as it covers basic sciences which clinicians may not have thought about in detail since medical school.

The following information will assist you in your first steps to tackling the ACEM Primary Exam.

Step 1. All or Nothing

Once you have made the decision to sit the PEx stick with it. There will be a large amount of time which you will need to dedicate in preparing for this exam. Sacrifices will need to be made regarding commitments to social activities, friends and family. You do not want to go through this process more than once. ACEM only allows 3 attempts at sitting this exam. Make your first attempt your best attempt.

Step 2. It is Not a Sprint

The PEx assesses in-depth intricate knowledge of Anatomy, Physiology, Pathology and Pharmacology. You cannot achieve this level of understanding if you CRAM! You will need at least 12-months to prepare.

Step 3. Purchase the Relevant Texts

The recommended texts for Anatomy include Moore & Dalley Clinically Orientated Anatomy, Last's Anatomy and McMinn's Clinical Atlas of Human Anatomy. Each of these texts are available as a hard copy in Daniel's office.

The recommended texts for Anatomy models for the VIVA can be found in Alex's office.

The recommended texts for Physiology include Ganong's Review of Medical Physiology and West's Essentials of Respiratory Physiology. Hard copies of these texts are available in Daniel's office. Ganong's can be accessed online via CIAP for free.

The recommended texts for Pathology include Robbins and Cotran Pathologic Basis of Disease. A hard copy of this text is available in Daniel's office and can be accessed online via CIAP for free.

The recommended texts for Pharmacology include Katzung Basic and Clinical Pharmacology. A hard copy of this text is available in Daniel's office and can be accessed online via CIAP for free.

Step 4. Know Your Enemy

The ACEM Primary Exam Syllabus is outlined in the FACEM Curriculum.

The ACEM PEx Matrix demonstrates the weighting assigned to topics within each subject i.e., in the Anatomy written exam, 25% of questions will be related to upper limb, 25% to lower limb and 20% to head and neck. Use this matrix to focus on high yield areas and structure your study program.

Each subject is also assigned a level of assessment (LoA). LoA 1 are assigned to areas which require a detailed understanding. LoA 2 are assigned to areas which require an adequate understanding but not as detailed as LoA 1, but more than LoA 3. LoA 3 are assigned to areas which require a good understanding but not in as much detail as LoA 1 and 2. Use LoA when determining the amount of detail needed when developing your notes.

Step 6. Study Plan

Develop a study program which focuses on covering the high yield topics in detail and low yield topics covered in the weeks leading up to the exam.

Step 7. Preparation Programs

The Southwest Sydney Local Health District runs a network based PEx preparation program across Liverpool, Campbelltown and Bankstown Hospitals which is co-ordinated by Dr Ed Park (Staff Specialist, Liverpool Hospital). Click here for more information.

Campbelltown ED has its own ACEM Primary Exam 18-week Boot Camp which consists of online presentations covering high yield topics and weekly practical sessions covering material across all 4 subjects.

Step 8. Practice Makes Perfect

There are several subscription MCQ banks e.g., iMeducate, which can test your knowledge of topics studied. Practice MCQs can also be found under the ACEM Primary Exam Resources tab.

Step 9. What to expect on the day

ACEM exams are held in Clifton's facilities within each capital city across the country. The written exam is an online MCQ. The VIVA exam will be conducted with you sitting across from 2 examiners, one of which will ask you questions, the other will mark your responses.