ACEM has posted details about the proposed structure for the new Fellowship exam, and you can see the details here. Click on the “2015 Onwards” tab.
At a glance the format seem much fairer and much more objective than the old exam format. There are no examples of the question types available yet, but the written exam will comprise MCQ’s (which we’ve all been doing our whole lives), and Extended Matching Questions (EMQ’s). EMQ’s are new, and will no doubt take some getting used to, and I think will introduce a whole new level of controversy.
If you’re not familiar with EMQ’s, there’s a good explanation from RACP here, and some good examples here. As you can see, these questions require more thought than standard MCQ’s and require you to really think and apply reasoning skills. The challenge will be for whoever is tasked with writing these questions to make them fair and unambiguous, So much of modern Emergency Medicine is controversial, in state of flux, or a state of dogmalysis that giving definitive, unambiguously “correct” answers will be really hard. I predict a whole new genre of Australian EM education/training looming: EMQ Coaching.
The other part is SAQ’s which from what I can gather will be a combo of the old VAQ and SAQ style questions, so they shouldn’t be too hard to adapt to.
And then a very long OSCE, which I think is much fairer than the old clinical exams.
My main concern with the new format as it stands, is the proposed duration of the exams and the number of questions. A 3-hour MCQ/EMQ, plus a 3-hour SAQ! That’s insane. 6 hours of written exams in one day? That’s a guaranteed recipe for brain-meltdown. I defy anyone to be able to think clearly after 2 hours of intense concentration, and the thought of the old 2-hour written SAQ makes my writing hand quiver with memories of cramps and spasms in the hand and forearm… Adding an hour… Not sure this is the best idea.
And a 3-hour OSCE! 3-hours! Will there be a break in the middle for a toilet stop/rehydration. Never mind the candidates, how will the examiners fare after 3-hours listening to the same answers over and over?
I’m sure there will be refinements, and as soon as example questions come to hand, I’ll pass them on. In the meantime Trevor Jackson has popped an example of what he thinks the SAQ’s might look like up over at his site, TJ Dogma, so check it out.