Launceston General Hospital

ACEM Primary Exam

For queries please contact

Riaz Khan

Co-DEMT / FACEM LGH Emergency

education.lghemergency@gmail.com

0400232353

03-6777-6422

LGH Emergency

ACEM Primary Exam Preparation

Online Written Exam

Duration: 6 hours (2 x 3-hour exams)

No. of questions: 360 in total

Method: Online integrated exam

Types of questions: Select Choice Questions (SCQ), Multiple Choice Questions (MCQ), Extended

Matching Questions (EMQ).

Maximum no. of attempts: 3

Location: Adelaide, Auckland, Brisbane, Melbourne, Perth, Sydney

Fee: AUD $1859

Exam dates

Next sitting Friday 8 February 2019 Applications open: 3 December 2018 Applications close: 11 January 2019 For 2018, the Primary written and Viva exams have the same Application opening and closing dates. These will be different from 2019 onwards. Future sittings Friday 2 August 2019 Applications open: 3 June 2019 Applications close: 28 June 2019

Oral Exam (Integrated Viva)

Duration: 40 minutes (4 x 10minute stations) although approx. 1 hour including examiner marking

time.

Method: Verbal stations based on the four basic science subjects.

Maximum no. of attempts: 3

Location: AMC National Test Centre, Melbourne

Fee: AUD$2065

Exam dates

Next sitting

2 – 3 May 2019

Applications open: 11 February 2019

Applications close: 8 March 2019

Future sitting

31 October – 1 November 2019

Applications open: 12 August 2019

Applications close: 6 September 2019

PLAN YOUR EXAM

Each topic in the primary syllabus has been assigned one of the following three levels of assessment:

Level of assessment 1 (LOA 1)

In general, these topics have a strong relation to, such that they underpin or are core to areas of the

fellowship curriculum designated “expert” or “high level of practice”. As such, they will be eligible to

be assessed in depth both in the MCQ and viva components of the primary examination. These

topics are considered essential knowledge. Candidates should demonstrate a detailed knowledge

and understanding of the topic including the ability, where relevant, to use formulae, construct

graphs and use diagrams to explain concepts.

Level of assessment 2 (LOA 2)

In general, these topics have a relation to areas of the fellowship curriculum designated “high level

of practice” and, as such, these topics are of importance in emergency medicine. Candidates should

demonstrate a good understanding of key concepts related to these topics. These topics will be

eligible for being assessed in some detail, both in the MCQ and viva components of the primary

examination.

Level of assessment 3 (LOA 3)

In general, these topics relate to areas of the fellowship curriculum designated as “general level of

practice”. Questions will assess knowledge and comprehension only. Topics at this level will be

examined less frequently than LOA 1 and LOA2. Candidates will demonstrate a basic understanding

of the overarching concepts and a knowledge of the general principles involved in the topic without

the need for fine detail.

HIGH YIELD CHAPTERS

Anatomy

Candidates are expected to have a detailed knowledge of the upper and lower limbs, with a special

emphasis on anatomy important to the practice of emergency medicine.

Knowledge of the surface and general anatomy of other regions of the body relevant to the practice

of emergency medicine is expected. This includes areas on which procedures are performed or

where anatomy is important in the understanding of injury patterns and complications, patterns of

disease or which demonstrate important anatomical principles.

Detailed neuro-anatomy is not expected, but candidates should be able to describe lobes, ventricles

and other gross structures.

Histology and embryology will not be examined.

Candidates must be familiar with anatomy essential for the interpretation of diagnostic imaging used

by emergency physicians. The candidate is expected to be familiar with common X-rays and with

cross-sectional anatomy necessary for the interpretation of CT scans.

CT levels are most likely to demonstrate important anatomical levels, e.g. level of transpyloric plane,

aortic arch. Imaging (CT and X-ray) Imaging of regions important to emergency medicine will be

examinable as LOA 2 with the aim of demonstrating normal anatomical structures and relationships.

Sectional imaging via CT will be examined in relation to brain, thorax and abdomen.

Pathology

Candidates are expected to have a detailed understanding of the general principles of the pathology

of common diseases.

Candidates are advised to familiarise themselves with the syllabus and MCQ matrix, as these outline

the areas of most importance and are a guide to the examination content.

Microbiology will not be examined as a separate subject, but those aspects that bear directly on

infectious disease will be considered part of the syllabus.

Genetic and molecular pathology are not emphasised in the pathology syllabus and exam.

Physiology

A thorough knowledge of cardiovascular, respiratory and renal physiology and of fluid and

electrolyte balance is required.

A working knowledge of the physiology of the nervous system, muscles, digestion and absorption

and the gastrointestinal tract is also required.

Biochemistry will not be examined separately, but candidates will be expected to be familiar with

those aspects of metabolism and endocrine function that are relevant to emergency medicine.

Pharmacology

A detailed knowledge of pharmacology is an essential part of emergency medicine. The principles of

pharmacokinetics, pharmacodynamics, therapeutics and toxicology must be understood.

The pharmacology of agents acting on the central nervous system, drugs acting on the

cardiovascular system and drugs used in the treatment of infectious diseases should be known in

some detail.

Candidates should also have an adequate knowledge of antacids, analgesic agents, anti-

inflammatory agents and drugs acting on the pulmonary and gastrointestinal systems.

The pharmacology of drugs acting on the endocrine system and haematologic agents will not be

stressed.

Candidates will be expected to be familiar with recent developments or reviews of drugs published

in such journals as the Medical Journal of Australia, British Medical Journal, New England Journal of

Medicine, Current Therapeutics and Emergency Medicine Australasia.

In approaching their study, candidates should use the prototypical drug of a class (where relevant)

to identify the key pharmacodynamics or pharmacokinetic principles which can then be applied to

other drugs in the same group as their knowledge is expanded.

TEXTS

Anatomy

o Clinically Oriented Anatomy 7 th edition 2013 Moore, Dalley, Agur (Lippincott Williams & Wilkins)

o McMinn’s Clinical Atlas of Human Anatomy 7 th edition 2013 Mosby

Pathology

o Robbins and Cotran Pathologic Basis of Disease 9 th edition 2014 Kumar, Abbas, Fausto, Aster

(Saunders Elsevier)

Physiology

o Ganong Review of Medical Physiology 25th edition 2015 Barrett, Brooks, Boitano, Barman

(McGraw Hill)

o West’s Respiratory Physiology: The Essentials 10th edition 2015 J B West & Andrew M Luks

Pharmacology

o Basic and Clinical Pharmacology 13 th edition 2014 Katzung, Masters, Trevor (McGraw Hill)

o Goodman & Gilman’s The Pharmacological Basis of Therapeutics 12th edition 2011 Brunton Lazo

Parker (McGraw Hill)

Suggested additional resources:

o Murray, Daly: Toxicology Handbook

o Therapeutic Guidelines

o Australian Prescriber Journal

o Selected Proprietary Product Information

MODELS

The following is a representative list of the models used in the examination. This is not a complete

list and additional or alternate models may be used.

Somso CS 2 Eyeball with Part of Orbit (new model – may be used in conjunction with F 13 (see

below)

GS 4 Larynx with Tongue

FS 5 Nasal Cavity, Oral Cavity and Pharyngeal Cavity including Larynx (old model – may be used in

conjunction with GS 4)

HS 1 Heart

NS 9 Muscles of the Foot

NS 10 Muscles of the Leg with Base of Pelvis

NS 13 Muscles of the Hand with Base of Forearm

NS 15 Muscles of the Arm with Shoulder Girdle

NS 50 Functional Model of the Knee Joint

NS 52 Functional Model of the Elbow Joint

NS 53 Functional Model of the Shoulder Joint

NS 54 Functional Model of the Ankle Joints

QS 23 Skeleton of the Foot

QS 54 Case with Collection ‘Vertebrae and Spinal Cord’

F13 Eye (older model – may be used in conjunction with CS 2 (see above)

Half Skeleton, disarticulated – both right and left

COMMON VERBS

Analyse: provide a structured description of an investigation result or image (e.g. clinical photo, ECG,

or medical imaging scan), highlighting the most significant findings

Calculate: provide a result after insertion of appropriate values into a formula

Interpret: provide conclusion/s after analysing an investigation result or image

List: provide the requested number of answers, where each answer should be no more than a few

words long

Outline: provide a logical framework in which all key decisions/topics are covered (not used in

written exam formats)

State: provide the requested number of answers, where each answer should be no more than a

phrase or short sentence.

PRIMARY EXAM MULTIPLE CHOICE

SUBJECT MATRICES

Each of 4 subjects will comprise approximately 25% of the total examination.

Anatomy Physiology

Tissues & Structures 5 % Principles of Cellular Function 5 %

Nerves & Muscles 5 %

Upper Limb 25 % Nervous System 5 %

Lower Limb 25 % Endocrinology 10 %

Gastrointestinal & Metabolism 10 %

Head, Neck & CNS 20 % Circulating Body Fluids 5 %

Thorax 12.5 % The Heart & the Circulation 25 %

Abdomen & Pelvis 12.5 %

Respiratory Physiology 20 %

Renal Physiology 15 %

PRIMARY EXAM MULTIPLE CHOICE

SUBJECT MATRICES

Pathology Pharmacology

GENERAL

Cellular Injury 5 % General Pharmacology 15 %

Tissue Response to Injury 10 % Respiratory System 5 %

Fluid & Haemodynamic 10 % Cardiovascular System 20 %

Immunity 5 % Nervous System 15 %

Neoplasia 5 % Antimicrobial Agents 10 %

Infectious Diseases 10 % Immune System 5 %

Environmental Pathology 5 % Endocrine System 5 %

SYSTEMIC

Cardiovascular System 10 % Gastrointestinal Tract 5 %

Haemopoietic System 5 % Analgesics 10 %

Respiratory System 10 % Toxicology 5 %

Gastrointestinal System 5 % Fluids and Electrolytes 5 %

Liver, Biliary Tract 10 % Safe Prescribing 5 %

Renal System 10 % Miscellaneous 5 %

Endocrine System 5 %

Musculoskeletal System 5 %

CNS & Eye 5 %

The Primary Examination is blue printed to the ACEM Curriculum Framework. References that may be of

assistance to trainees are taken from Tinitinalli's Emegency Medicine: A Comprehensive Study Guide, 7th edition. However, these chapters are by no means the only reference that the trainee can use. Trainees are

encouraged to use other relevant references to assist them in their preparation

Launceston General Hospital

ACEM Primary Exam Preparatory Course

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LGH August 2019 Primary Exam Preparatory Course

Starting Thursday 7th February 2019

Approximately 6 months to exam from start of the course

22 weeks course, each week MCQs / EMQs followed by discussion.

First 12 weeks high scoring chapters from Anatomy, Physiology, Pathology, Pharmacology

Next 6 weeks of relevant topics remaining chapters all four subjects

Last 4 weeks of revision

Full mock exam mid July 2019

Post course individual guided study for 3 weeks before exam

Post exam dedicated VIVA course will start soon after exam for successful candidates

(22 weeks course will have formal viva practice as well)

Week 1 to 4

Mainly Upper Limb Anatomy, General Pathology and General Pharmacology weeks

Only initial introduction to Physiology

Week 1

Anatomy: General Anatomy, Tissue and Structure 5%

Pathology: General Pathology 50%

Cellular Injury, Tissue response to injury

Pharmacology: General Pharmacology 15%

Physiology: Principals of Cellular Functions 5%

Week 2

Anatomy: Upper Limb 25 %

Pectoral Girdle, Upper arm

Pathology: General Pathology 50%

Immunity and Neoplasia

Pharmacology: General Pharmacology 15%

Physiology: Circulating body fluids 5%

Week 3

Anatomy: Upper Limb 25 %

Elbow, Forearm

Pathology: General Pathology 50%

Fluid & haemodynamic, Environmental pathology

Pharmacology: Revision General Pharmacology

Physiology: Nerves & muscles 5%

Week 4

Anatomy: Upper Limb 25 %

Wrist, Hand

Pathology: General Pathology 50%

Infectious Disease

Pharmacology: Fluids and Electrolytes 5%

Physiology: Revision General Topics

Week 5 to 8

Mainly Lower limb Anatomy and System Physiology Pathology and Pharmacology

Week 5

Anatomy: Lower limb 25 %

Pelvic girdle and thigh

Physiology: Heart and Circulation 25%

Heart

Pathology: Cardiovascular System 10%

Pharmacology: Cardiovascular System 20%

Week 6

Anatomy: Lower limb 25 %

Knee and leg

Physiology: Heart and Circulation 25%

Circulation

Pathology: Cardiovascular System 10%

Pharmacology: Cardiovascular System 20%

Week 7

Anatomy: Lower limbs 25%

Ankle and Foot

Physiology: Respiratory Physiology 20%

Pathology: Respiratory System 10%

Pharmacology: Respiratory System 5%

Week 8

Anatomy: Revision Upper and Lower limb

Physiology: Respiratory Physiology 20%

Pathology: Revision Cardiovascular and Respiratory System

Pharmacology: Revision Cardiovascular and Respiratory Systems

Week 9 to 13

Rest of Anatomy and again System Physiology Pathology and Pharmacology

Week 9

Anatomy: Head & Neck and CNS 20%

Head & CNS

Physiology: Renal Physiology 15%

Pathology: Renal System & Genitourinary 10%

Pharmacology: Fluids and Electrolytes 5%

Week 10

Anatomy: Head Neck & CNS 20%

Neck

Physiology: Renal Physiology 15%

Pathology: Renal System & Genitourinary 10%

Pharmacology: Safe Prescribing and Miscellaneous ( 5+ 5 = 10% )

Week 11

Anatomy: Abdomen and Pelvis 12.5 %

Physiology: Gastrointestinal & Metabolism 10 %

Pathology: Gastrointestinal System, Liver, Biliary Tract and Pancreas (5 + 10 = 15%)

Pharmacology: Gastrointestinal Tract 5 %

Week 12

Anatomy: Thorax 12.5 %

Physiology: Nervous System 5%

Pathology: CNS & Eye 5%

Pharmacology: Nervous System 15%

Week 13

Anatomy: Anatomy free week

Physiology: Endocrinology 10%

Pathology: Endocrine System 5%

Pharmacology: Endocrine System 5%

Week 14 & 15

Anatomy Revision, Miscellaneous remaining topics of mainly Pharmacology but also Pathology,

Physiology

Week 14

Pharmacology: Antimicrobial Agents 10%

Pathology: Musculoskeletal System 5%

Anatomy: Revision Thorax

Physiology: Revision Heart & Circulation

Week 15

Pharmacology: Toxicology 5%

Pathology: Haemopoietic System 5%

Anatomy: Abdomen and Pelvis

Physiology: Revision Heart and Circulation

Week 17 to 22

Revision weeks of high yield chapters only. Topics to be rescheduled as per candidates’ performance

and areas of weakness. Study will be invidualised from this point onwards.

Week 16

Anatomy: Revision Upper Limb

Physiology: Revision Herat & Circulation

Week 17

Anatomy: Revision Lower Limb

Physiology: Revision Respiratory Physiology

Week 18

Anatomy: Revision Head & Neck

Physiology: Revision Renal Physiology

Week 19

Pathology: Revision General Pathology

Pharmacology: Revision General Pharmacology

Week 20

Pathology: Revision Cardiovascular and Respiratory Systems

Pharmacology: Revision Cardiovascular System

Week 21

Pathology: Revision Renal and GIT

Pharmacology: Revision Nervous System and Antimicrobial Agents

Week 22

Mock Exam Thursday: MCQ Friday: Integrated Vivas

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LGH Feb 2019 Primary Exam

Course Revision

Approximately 12 weeks to exam

10 weeks course, each week SCQs / MCQs / EMQs followed by discussion.

First 4 weeks high scoring chapters from Anatomy and Physiology

Next 3 weeks high scoring chapters from Pathology and Pharmacology

Last 3 weeks of relevant topics remaining chapters all four subjects

Post course individual guided study

Full mock exam at the end of January

Anatomy and Physiology Month

Week 1

Anatomy: Upper Limb 25 %

Physiology: Heart & Circulation 25%

Week 2

Anatomy: Lower limb 25 %

Physiology: Respiratory Physiology 20 %

Week 3:

Anatomy: Head & Neck and CNS 20%

Physiology: Renal Physiology 15%

Week 4:

Anatomy: Thorax 12.5 %

Physiology: Gastrointestinal & Metabolism 10 %

Pathology and Pharmacology Month

Week 5

Pathology: General Pathology 50%

Pharmacology: General Pharmacology 15%

Week 6

Pathology: Cardiovascular, Respiratory Systems 10 + 10 = 20 %

Pharmacology: Cardiovascular System, Analgesics & Anti-inflammatories 10 + 10 = 20 %

Week 7

Pathology: Liver Biliary Track & Pancreas, Renal System & Genitourinary 10 + 10 = 20 %

Pharmacology: Nervous System, Antimicrobials 15 + 10 = 25 %

Miscellaneous

Week 8

Anatomy: Abdomen and Pelvis 12.5 %

Physiology: Endocrinology 10 %

Pathology: Gastrointestinal System 5 %

Pharmacology: Gastrointestinal System 5 %

Week 9

Anatomy: General Anatomy 5 %

Physiology: Nerves and Muscles 5 %

Pathology: Endocrinology 10 %

Pharmacology: Toxicology 5 %

Week 10

Physiology: Nerves and Muscles + Circulating Fluids 5 + 5 = 10 %

Pathology: CNS and Eye 5 %

Pharmacology: Fluids & Electrolytes 5 %