- The AOBEM written exam has 300 questions in six 50-question, 60-minute sections - six hours of active testing.
- Abdominal/GI and Cardiovascular disorders are tied for the largest blueprint weight at 9% each.
- Passing requires a scaled score of 500 on a 200-800 range; the written exam fee is $1,100.
- Once a section closes on the remotely proctored exam, you cannot go back to it.
What This Cheat Sheet Covers
This is a one-page distillation of the facts that matter most for the AOBEM Emergency Medicine Part I Written Exam - the initial certification exam administered by the American Osteopathic Board of Emergency Medicine, not the separate CORE continuing-certification pathway. If you need the full walkthrough of any single fact below, the EM Study Guide 2026 and the EM Exam Domains 2026 guide go deeper. Use this page as your final-week recall sheet, not your primary study source.
Every number here is sourced directly from AOBEM's certification pages, source-checked September 23, 2026. Nothing is borrowed from other credentials that happen to share the "EM" abbreviation - if a fact isn't confirmed for AOBEM specifically, it's left out.
Exam Format at a Glance
The written exam is 300 multiple-choice questions, generally one-best-answer items with five answer options. It is split into six sections of 50 questions each, with 60 minutes allotted per section - six hours of active testing time total. That total excludes the optional 10-minute breaks between sections and an optional 40-minute lunch break after Section 3.
- Sections: 6 sections × 50 questions = 300 total questions
- Time per section: 60 minutes (6 hours active testing)
- Breaks: Optional 10-minute breaks between sections; optional 40-minute lunch after Section 3
- Section lock: Once a section closes, you cannot return to it
- Delivery: Remotely proctored via AOA MonitorEDU/PARADIGM arrangements
Remote proctoring means you'll need a secure-browser setup, a compatible computer and mobile device, and a private testing space free of prohibited materials. Electronics and study materials are not allowed during breaks, so don't count on sneaking in a last-minute glance at notes between sections. For a deeper breakdown of what makes this format demanding, see How Hard Is the EM Exam? Complete Difficulty Guide 2026.
Fees, Eligibility, and Key Dates
The written exam fee is $1,100 USD. This is distinct from the Part II Oral Exam fee of $800 USD - the two stages are billed and scheduled separately. Full details on both charges live in the EM Certification Cost 2026 breakdown.
- Written exam fee: $1,100
- Oral exam fee: $800
- Next written exam window: March 22-24, 2027
- Eligibility timing: Written exam may be taken after at least 80% of residency training is complete
Eligibility also requires approved emergency-medicine residency training plus required licensing documentation and professional/ethical compliance. The written-exam eligibility criteria describe both graduates and final-year residents as candidates. Written and oral exams can be taken in either order once their respective eligibility conditions are met, but residency must be fully complete before sitting the oral exam. For the complete list of prerequisites and documentation, check EM Requirements 2026: Eligibility, Prerequisites & How to Qualify and the scheduling specifics in EM Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
The 18 Domains Ranked by Weight
The blueprint covers 18 content domains that total 100%. Abdominal and gastrointestinal disorders and Cardiovascular disorders are tied for the top spot at 9% each, with Traumatic disorders close behind at 8%. Weighting should directly shape how many practice questions and review hours you spend on each area.
| Domain | Weight |
|---|---|
| Abdominal and gastrointestinal disorders | 9% |
| Cardiovascular disorders | 9% |
| Traumatic disorders | 8% |
| Systemic infectious disorders | 7% |
| Nervous system disorders | 7% |
| Thoracic-respiratory disorders | 7% |
| Obstetrics and gynecology disorders | 6% |
| Procedures/skills | 6% |
| Endocrine, metabolic and nutritional disorders | 5% |
| Head, ear, nose and throat disorders | 5% |
| Musculoskeletal disorders (nontraumatic) | 5% |
| Renal and urogenital disorders | 5% |
| Toxicological disorders/clinical pharmacology | 5% |
| Environmental disorders | 4% |
| Psychobehavioral disorders | 4% |
| Cutaneous disorders | 3% |
| Hematologic and immune system disorders | 3% |
| EMS, disaster medicine and administrative aspects of emergency medicine | 2% |
This ranking is the single most important prioritization tool on this page. If your review time is limited, spend it top to bottom. For a full explanation of what each domain actually tests, the EM Exam Domains 2026 guide covers all 18 in depth.
High-Yield Domain Snapshots
Abdominal and Gastrointestinal Disorders (9%)
The single largest domain alongside Cardiovascular disorders. Expect heavy coverage of acute abdominal presentations across all age groups.
- Recognize surgical abdomen presentations requiring immediate escalation
- Differentiate GI bleed etiologies and initial management priorities
- Know hepatobiliary and pancreatic emergency presentations cold
Cardiovascular Disorders (9%)
Tied for top weight; this domain rewards pattern recognition on ECG-style vignettes and risk stratification.
- Master ACS, dysrhythmia, and acute heart failure decision pathways
- Know when imaging or immediate intervention changes disposition
- Review vascular emergencies including aortic and peripheral presentations
Traumatic Disorders (8%)
The third-largest domain; questions often integrate multiple organ systems in a single trauma vignette.
- Primary and secondary survey sequencing under time pressure
- Blunt versus penetrating trauma management differences
- Pediatric and geriatric trauma nuances
EMS, Disaster Medicine, and Administrative Aspects (2%)
The smallest domain by weight, but still tested - don't skip it entirely just because it's low-yield.
- Mass-casualty triage principles
- Basic administrative and legal considerations in emergency practice
- EMS system roles and prehospital care coordination
Key Takeaway
Spend roughly proportional time to domain weight, but don't zero out the smallest domains - every domain still contributes scored questions across the 300-item exam.
Passing Score and Scoring Mechanics
The written exam uses a scaled score range of 200-800, and the passing threshold is 500. That scaling means raw question counts don't map directly to a percentage - a full explanation of how the scale works and what it means for your margin lives in EM Passing Score 2026: Exactly What You Need to Pass.
The commonly cited 93.63% pass rate figure is a five-year aggregate across first-time board-eligible examinees - it is not a single-year statistic, and it shouldn't be read as "your odds this cycle." For the full context on how that number is calculated and what it does and doesn't tell you, see EM Pass Rate 2026: What the Data Shows.
Written Exam, Oral Exam, and OCC/CORE
Full AOBEM certification requires completing both examination stages - the Part I Written Exam and the Part II Oral Exam - followed by AOA approval. The two can be attempted in either order once eligibility conditions are independently met, but the oral exam requires residency to be fully complete first.
Once certified, physicians enter Osteopathic Continuous Certification (OCC), which requires active licensure, 60 CME credits per three-year cycle, and two practice-performance improvement projects across a ten-year span (one in each five-year half). CORE has replaced the old ten-year high-stakes recertification exam; new certificants move directly into this annual model.
- CORE structure: Two required core modules plus four selected article modules, 40-60 questions total
- CORE format: Open-book, requiring 75% on each module, with two attempts allowed one week apart
- Annual OCC fee: $210, which includes CORE, due by December 1
Final-Week Review Schedule
If you're in the last stretch before a scheduled sitting, sequence your remaining days by domain weight rather than alphabetically or by comfort level. This isn't a generic study plan - it's built around the actual blueprint percentages above.
Top-Weight Domains
- Abdominal/GI disorders (9%) and Cardiovascular disorders (9%)
- Drill high-acuity presentations and disposition decisions
Mid-Weight Core Domains
- Traumatic disorders (8%), Systemic infectious disorders (7%), Nervous system disorders (7%), Thoracic-respiratory disorders (7%)
Remaining Mid-Tier Domains
- OB/GYN (6%), Procedures/skills (6%), Endocrine (5%), HEENT (5%), Musculoskeletal (5%), Renal/urogenital (5%), Toxicology (5%)
Lower-Weight Domains and Logistics
- Environmental, Psychobehavioral, Cutaneous, Hematologic/immune, EMS/disaster domains
- Confirm remote-proctoring setup, secure browser, and testing space
Run a full timed section under section-lock conditions at least once before test day so the "no going back" rule doesn't surprise you. For a broader multi-week version of this approach, see the EM Study Guide 2026.
Who Hires AOBEM-Certified Physicians
AOBEM certification signals board-level competency in emergency medicine to hospital credentialing committees, emergency department staffing groups, and academic programs that require or prefer board certification for ED privileges. Because the credential is tied to a completed emergency-medicine residency plus passing both written and oral stages, it's used as a hiring and credentialing benchmark much the way other specialty boards are used in their respective fields. If you're weighing the career return on the time and fees involved, Is the EM Certification Worth It? Complete ROI Analysis 2026 and the EM Salary Guide 2026 walk through that calculus in more detail.
Quick Reference Table
| Item | Detail |
|---|---|
| Total questions | 300 |
| Sections | 6 sections of 50 questions |
| Time per section | 60 minutes |
| Active testing time | 6 hours |
| Written exam fee | $1,100 |
| Oral exam fee | $800 |
| Passing score | 500 (scale of 200-800) |
| Five-year aggregate pass rate | 93.63% (first-time board-eligible examinees) |
| Next written exam | March 22-24, 2027 |
| Annual OCC fee | $210 (includes CORE) |
Bookmark this table alongside your practice question routine at emergencystudy.com's practice test platform so you can cross-check pacing against the real section structure while you drill.
FAQ
300 multiple-choice questions, split into six sections of 50 questions each, with 60 minutes per section.
A scaled score of 500 on the 200-800 range. See EM Passing Score 2026 for more on how the scale works.
Abdominal and gastrointestinal disorders and Cardiovascular disorders are tied for the highest weight at 9% each, followed by Traumatic disorders at 8%.
Optional breaks exist between sections and a longer optional lunch after Section 3, but electronics and study materials are prohibited during any break, and closed sections cannot be reopened.
No. The written exam is the initial Part I certification exam. CORE is the separate, open-book, annual continuing-certification pathway required after you're already certified.
For structured practice that mirrors this exact section-and-domain breakdown, explore the question sets at emergencystudy.com and pair them with the domain-specific review linked throughout this page.