ABEM's latest figures put the oral (certifying) exam pass rate at 96% for first-time takers who were EM residents in 2025, and the written Qualifying Exam at 83% (ABEM statistics). So the step that stops most candidates is the Qualifying Exam, not the case-based exam that follows it.
Below are five years of ABEM's numbers for both steps, what each exam contains, how to look up your own residency program's record, and how to plan for a written exam that is offered only once a year.
Passing standard at a glance
| Topic | Official rule | Source |
|---|---|---|
| Certifying Exam | The final step to certification: 10 cases in a half-day session, in person at the AIME Center in Raleigh, North Carolina. 2026 registration fee $1,255 ($1,565 late). | ABEM: Certifying Exam |
| Qualifying Exam | About 305 single-best-answer multiple-choice questions based on the EM Model, given one week each fall at more than 200 Pearson centers in the US and Canada. | ABEM: Qualifying Exam |
| Qualifying Exam, first-time pass rate | 83% of first-time takers who were EM residents passed in 2025 (82% in 2024, 88% in 2023, 91% in 2022, 92% in 2021). | ABEM: exam and certification statistics |
| Oral Exam, first-time pass rate | 96% of first-time takers who were EM residents passed in 2025 (96% in 2024, 93% in 2023, 93% in 2022, 90% in 2021). | ABEM: exam and certification statistics |
ABEM pass rates by year, 2021 to 2025
These are ABEM's own figures for first-time takers who were EM residents, the group ABEM charts on its statistics page (ABEM exam and certification statistics).
| Year | Qualifying Exam | Oral Exam |
|---|---|---|
| 2025 | 83% | 96% |
| 2024 | 82% | 96% |
| 2023 | 88% | 93% |
| 2022 | 91% | 93% |
| 2021 | 92% | 90% |
Two patterns stand out. The Qualifying Exam rate fell ten points between 2021 and 2024 and recovered only one point in 2025, so roughly one first-time resident in six did not pass it in each of the last two years. The oral rate moved the other way, from 90% to 96%. ABEM's chart does not give reasons for either trend, and we will not guess at them here.
What the numbers do say is where to spend preparation time. Once the Qualifying Exam is behind you, history says the case-based step is very likely to follow.
The two steps: Qualifying Exam, then Certifying Exam
Qualifying Exam (QE). A written exam of about 305 single-best-answer questions built on the EM Model, given during one week each fall at more than 200 Pearson centers in the US and Canada (ABEM Qualifying Exam). The next one runs November 1 to 13, 2027 (ABEM).
Certifying Exam. ABEM calls it the final step to becoming ABEM certified: 10 cases in a half-day session, taken in person at the AIME Center in Raleigh, North Carolina. The 2026 registration fee was $1,255, or $1,565 in the late window (ABEM Certifying Exam). Unlike the QE, it runs in several windows through the year, and ABEM assigns you to one before you book a session (ABEM).
ABEM's pass-rate chart labels this second step the Oral Exam, which is why the table above uses that name.
What the Qualifying Exam covers
ABEM publishes the QE blueprint as percentages of the EM Model (ABEM Qualifying Exam). The largest categories:
| EM Model category | Share of exam |
|---|---|
| Signs, symptoms and presentations | 10% |
| Cardiovascular disorders | 10% |
| Traumatic disorders | 9% |
| Procedures and skills | 8% |
| Abdominal and gastrointestinal disorders | 7% |
| Systemic infectious disorders | 7% |
| Thoracic-respiratory disorders | 7% |
| Nervous system disorders | 6% |
| Endocrine, metabolic and nutritional disorders | 5% |
The remaining 11 categories run from 2% to 4% each, including toxicology, head, ear, eye, nose and throat, obstetrics and gynecology, and renal and urogenital disorders. ABEM also sets acuity targets: 30% critical, 40% emergent, 21% lower acuity and 9% with no acuity frame. At least 8% of questions involve pediatric patients and at least 6% geriatric patients, and some show an x-ray or ECG.
Read that as a study plan. Seventy percent of the exam sits in critical or emergent presentations, so management under time pressure matters more than rare diagnoses.
How to look up your residency program's pass rate
ABEM publishes a report of each EM residency program's initial certification pass rates on both exams, grouped by graduation years rather than exam years, for programs that have graduated at least three classes (ABEM program pass rates report). Only first-time takers are counted, and programs with fewer than six first-time takers in a three-year window are not shown (ABEM program report FAQs).
If you are a resident, the report tells you how your program's graduates have done against the national figures above. A program below them is a reason to start QE preparation earlier in your final year, not a verdict on you.
Planning around a once-a-year written exam
Because the QE is given in one week each fall (ABEM), a miss usually means waiting for the next fall administration. That makes the first attempt worth protecting. Three things we build every QE plan around:
- Take the seat you are given. Skipping your first assigned QE seat moves your status to Delayed Certification, which may add requirements to stay board eligible (ABEM).
- Weight study to the blueprint. Cardiovascular, trauma, presentations and procedures together make up more than a third of the exam (ABEM); start there.
- Practise at exam length. Around 305 questions is a long day. Timed blocks in the last month show where your attention drops off.
For the Certifying Exam, the work is different: talking through cases out loud, in order, the way you would run them in the department.
Preparing for the ABEM boards with a tutor
EM board preparation with us is led by Chris Sawyer, DO, an emergency physician who completed his EM residency at Ascension Saint John Hospital in Detroit. He builds board-style questions from real emergency department encounters, so a high-yield fact comes with the bedside situation where it matters.
Sessions are one-on-one by live video (Zoom or Google Meet) and fit around shift schedules. Bring your in-training scores or a recent block of practice questions to the first call; the plan starts from where your misses cluster on the EM Model.
One-on-one ABEM board tutoring with The Boards Professor costs $349 per 50-minute session, online by live video (Zoom or Google Meet). Book a free intro consult.