Guest Post by Kate Willis
*Disclaimer- this is based on my experience of doing the EBEEM part A and thus cannot be considered authoritative.
Having recently sat, and perhaps more importantly, passed the Emergency Board Examination in Emergency Medicine (EBEEM) Part A I thought it would be useful for those interested to share my experience and offer some practical advice to fellow trainees interested in doing the exam as the available information on the EUSEM website is rather scant.
Why do the exam?
It is not a requirement here in Denmark as it is in some european countries (including Belgium and Malta), but coming from the UK where post graduate specialist exams are an essential part of training and having made the move from general practice, I felt that a little external validation combined with a good incentive to do some reading wouldn’t hurt as well as not doing any harm to my CV. There could be a broader motivation however in reinforcing our place in emergency medicine to our colleagues in the hospital sector.
Practicalities:
First, a few facts about the EBEEM part A.
Part A is a multiple choice exam which you sit online over 2 sessions of 2 hours each separated by a 1 hour break. You are filmed and on camera while doing it so do not need to be in a specific location as long as you are alone and follow the examination instructions. There are two sittings per year.
It costs €600 if you are not a member of EUSEM, reducing to €350 for EUSEM members in training (€100 preregistration +€250 exam fee). EUSEM membership is €50 for trainees so this is definitely worthwhile.
Preparing for the exam:
EUSEM have a short section regarding exam preparation as well as very few sample questions on their website, but as they advise reading primarily Tintinalli’s Emergency Medicine as well as ESC guidelines, Sign guidelines, NICE guidelines, European Rescucitation council guidelines as well as an emergency medicine ultrasound book I would suggest that unless you are starting several years in advance then perhaps a few shortcuts might be sensible. Unlike for the english or american post graduate examinations there are not any past papers to give a more accurate idea of what to revise and what level is necessary.
EUSEM also link to their Academy which contains very few resources, as well as the curriculum and curriculum + (a list of free online learning materials) which is reasonably useful though some of the links have expired and it is bewilderingly long and largely consists of links to podcasts, which although useful are very time intensive.
So what did I do to prepare?
Well, firstly yes, I did buy Tintinalli’s Emergency medicine and read at least some of it. Should you choose to do the same I would suggest that you be very targeted about what you read. For example the pathophysiology sections are largely irrelevant. Some targeted reading around the curriculum is probably useful however many of the chapters are much too detailed and unnecessary for the purposes of the exam.
I also signed up for a question bank which I found online called StudyPRN which is apparently specifically for the EBEEM. I do not know how validated it is and what they base their questions on. I found it reasonably relevant and certainly it helped maintain some motivation though some of their questions are almost laughably niche (for example a question about causes of purple urine). I also have heard other question banks recommended such as Rosh Review (this is very american- I signed up for a trial and it seemed to have a lot of intensive care questions which I didn’t think were relevant to the exam or the way our emergency departments work), and Hippo EM Question bank (which I haven’t tried). They all seem to offer trial subscriptions so it might be worth having a go and seeing which you get on with most.
The european resuscitation council guidelines are essential revision material and otherwise I would suggest a bit of targeted revision in the various guidelines suggested on EUSEMs website.
What was the exam like?
I found it rather hard to know what I would be going into despite all the preparation, as the preparatory information provided was pretty brief, so I had no idea whether there would be any paediatrics on the exam (there was none in my question bank, and there is no specific paediatric section on the overall EM curriculum on EUSEMs website). As it turned out there were the expected questions on ECG, ABG analysis, electrolyte derangements and toxidromes which our day to day jobs plus a bit of background reading should cover. As to what was more uncertain, the following are my take home points:
- Read the European Resus Council Guidelines cover to cover! There were lots of extremely detailed questions based on the European Resus Council Guidelines (for example on left ventricular assist devices) so I would suggest reading that very thoroughly including all of the special scenario chapters.
- Paediatrics is covered- There were questions on paediatrics but they largely fell within the disease specific subjects on the curriculum (for example about the differential diagnosis of airway disease and testicular torsion).
- Remember orthopaedics and trauma- There were a number of questions on trauma so if your department doesn’t handle acute orthopaedic injuries, eye injuries or trauma calls I would suggest doing some basic reading to cover the most typical injuries and their treatment as well as some basic major trauma stuff such as triage systems.
- Lungs- There were lots of very specific questions on lung pathology- the guidelines for management of asthma, pneumothorax, and pleural effusions would be essential reading.
- Scoring systems- There were some specific questions on scoring systems so it would be worth trying to remember the most commonly used of these (for example CURB 65, Wells score, CHA2DS2-VASC, Parkland formula for burns etc) as it is easy points if you can remember them.
Finally all there is to say is good luck and I hope this proves useful!