What Replaced the ABEM Oral Boards? The New Certifying Exam

If you searched for "oral boards prep" and found conflicting information, here's the short version: ABEM retired the Oral Certification Exam after its final administrations in fall 2025 and replaced it with the Certifying Exam in 2026. The new exam keeps the goal — verifying you can practice emergency medicine — but changes the format, the location, the case types, and what's actually being scored.

Old vs. new at a glance

	Oral Exam (retired)	Certifying Exam (current)
Format	Virtual, examiner role-play through linear cases	In-person simulation + structured discussion
Location	Remote	AIME Center, Raleigh, NC
Case style	Oral cases with examiner role-playing as everyone	Clinical Care cases + OSCE-style standardized-patient cases
Skills scored	Primarily clinical management	Clinical reasoning, communication, professionalism, procedural competency
Role-play	Throughout	Only in Communications cases
Procedures	Verbalized	Articulated and performed (mannequin / task trainers)

Who has to take the new exam?

Passed the Oral Exam in 2024 or 2025 → you're done; the new exam doesn't apply to you.
Graduating in 2026 or later → the Certifying Exam is your path.
The written Qualifying Exam is unchanged — only the oral component was replaced.

What the new exam looks like on test day

You'll complete your cases in a half-day session at the AIME Center, in two formats. Clinical Care cases (~15 min each) include Clinical Decision-Making — a direct, no-role-play structured discussion with an examiner about a bread-and-butter EM patient — and Prioritization, where you manage an entire trackboard of patients: triage with limited data, stabilize the sickest first, delegate to a nurse, resident, or tech, and adapt when new patients arrive or a case takes a turn. Mass-casualty variants test formal triage systems and the hard skill of recognizing expectant patients.

Communication & Procedure cases (10–15 min) are OSCE-style encounters with actors — difficult conversations, managing conflict, patient-centered communication, and reassessment — plus procedural stations where you talk through indications, risks, consent, and technique, and perform the skill on a mannequin. Ultrasound expectations follow ABEM's published lists.

If you trained for the old oral boards, the biggest adjustments are: no more role-playing your way through every case (CDM and Prioritization are direct Q&A), procedures are hands-on, and Prioritization is a genuinely new format that legacy prep books (including Okuda) simply don't cover.

Why ABEM made the change

ABEM's stated intent is an exam that better reflects actual emergency practice: managing uncertainty, juggling priorities, communicating with upset families and consultants, performing bedside skills, and adapting when patients deteriorate. The old exam rewarded a systematic, linear approach; the new one is built to resemble a shift.

How to prepare for the replacement exam

Watch ABEM's sample case and debrief videos — the closest thing to an official blueprint for each case type.
Retrain your instincts for the format changes. If you prepped for oral boards before: drop the role-play habit in CDM (answer the examiner directly), and practice case-specific answers ("on head and neck exam I'm looking for JVD"), not general ones.
Give Prioritization dedicated reps. It's the format with no legacy equivalent: practice running a board, delegating, and re-triaging on new information.
Practice communications scenarios out loud with the pushback built in — the cases are designed to have patients or colleagues resist, and the skill being scored is how you guide the conversation.
Do timed, spoken practice with feedback — program mock exams, study partners, or BoardED's AI practice cases built specifically for the new formats with feedback matched to ABEM's published criteria.

Full prep guide: How to study for the ABEM Certifying Exam.

Practice the New Format Free

Frequently asked questions

Is the ABEM oral exam cancelled?

Retired, not cancelled mid-cycle: the final virtual Oral Exams ran through fall 2025, and the Certifying Exam replaced them starting in 2026.

Do old oral boards prep materials still work?

Truly, no. Content review transfers; format prep largely doesn't. CDM removed role-play, procedures became hands-on, and Prioritization/MCI are entirely new. Materials built for old oral cases won't prepare you for those as they focus heavily on medical knowledge.

Is the new exam harder?

It's different more than harder: broader skills (communication, professionalism, procedures) but bread-and-butter medicine rather than zebras. Candidates who struggle usually struggle with format unfamiliarity — which is what practice is for.

Where can I practice the new case types?

ABEM's sample videos show you the formats; BoardED lets you actually run them — CDM, Prioritization, MCI, and all four Communications types — with physician-verified cases and per-case feedback.

About the authors

Nathan A. Friedman, MD — Board-certified in Emergency Medicine and Medical Toxicology; emergency physician at Eisenhower Health. Co-founder of BoardED.

Naseem Moridzadeh, MD — Board-certified emergency physician; Clinical Assistant Professor of Emergency Medicine at Olive View UCLA Medical Center. Co-founder of BoardED.

The ABEM Oral Boards Are Gone. Here's What Replaced Them.