EMRA Statement on New ABEM Certifying Exam

Jan. 10, 2024 | Download a PDF

The Emergency Medicine Residents' Association (EMRA) is troubled by today's announcement regarding the new in-person American Board of Emergency Medicine (ABEM) Certifying Exam to take place in Raleigh, NC, starting in 2026.

EMRA supports ABEM/ABOEM board certification as the gold standard for the independent practice of emergency medicine,¹ and we have initiated discussions with ABEM, as well as ACEP, to share our concerns. We will be meeting with both groups later this week to learn more about the evidence and information behind this decision. Prior to our meeting, we are seeking our members' feedback, which you can email directly to emra@emra.org. 

EMRA's initial concerns include:

• Undue Burden
  We are distressed by the financial and logistical burden this would place on debt-ladened and cash-strapped emergency medicine resident graduates. Last year, more than 2,500 physicians took ABEM’s Oral Certification Exam.² With a conservative estimated cost of $1,000 to attend the new in-person exam,^3,4 ABEM would be adding a yearly burden of over $2 million to the specialty's new attendings. 

We believe these costs would more heavily impact under-represented in medicine (URiM) physicians and those choosing to work in rural areas farther from travel hubs – two groups that EM has highlighted as needing more support to make our specialty the best it can be.

• Unclear Evidence
  While ABEM shares that their Oral Certification Exam provides unique competency data and has been validated,^5,6 we are unaware of patient outcome-based evidence showing a clear and proven benefit to in-person certifying exams. In fact, a 2023 report found "substantial validity evidence and reliability to support ongoing use of the ABEM virtual oral exam."⁷

• Lack of Stakeholder Input
  While EMRA and other resident organizations were invited to a Summit in Spring 2022, we are unaware of any resident or early-career physician representation on the Becoming Certified Task Force (BCTF) itself. We believe key stakeholders should always have a seat at the table and a voice in decisions that will affect their futures.

Next Steps: Tell us your thoughts!

Please share your thoughts with us by emailing emra@emra.org.

References

1. Emergency Medicine Residents’ Association. Policy Compendium: The Physician-Led Workforce. October 2023. XVII. The Physician Led Workforce. Adopted March 1992, amended October 2018. Accessed at https://www.emra.org/siteassets/emra/about-emra/governing-docs/policy-compendium-march-2023-final.pdf.
2. American Board of Emergency Medicine. 2022-2023 Annual Report. Accessed at https://www.abem.org/public/docs/default-source/default-document-library/2022-2023-Annual-Report.pdf.
3. United States Department of Transportation. Bureau of Transportation Statistics: Average Domestic Airline Itinerary Fares by Origin City for Q2 2023 Ranked by Total Number of Domesitc Passengers in 2022. Accessed at https://www.transtats.bts.gov/averagefare/. 
4. U.S. Bureau of Labor Statistics. Consumer Price Index: Lodging away from home in U.S. city average, all urban consumers, not seasonally adjusted. Accessed at https://data.bls.gov/timeseries/CUUR0000SEHB?output_view=data. 
5. American Board of Emergency Medicine. New Certifying Exam Launching in 2026. Accessed at https://www.abem.org/public/become-certified/certifying-exam. 
6. American Board of Emergency Medicine. Becoming Certified Initiative Key Findings. 2023. Accessed at https://www.abem.org/public/docs/default-source/default-document-library/BCI-Key-Findings.pdf.
7. Chudnofsky CR, Reisdorff EJ, Joldersma KB, Ruff KC, Goyal DG, Gorgas DL. Early validity and reliability of evidence for the American Board of Emergency Medicine Virtual Oral Examination. AEM Educ Train. 2023;7(2):e10850.