OutLoud MD

The 4 ABEM oral board stations

The ABEM Certifying Exam runs on four station formats. Clinical decision-making walks one undifferentiated patient from history to disposition. Prioritization gives you a board of emergency-department patients to triage under a hard clock. Communication puts you in a difficult conversation. Procedures and ultrasound has you talk through technique and read the results out loud. Every station is spoken and timed, each preceded by a short task-sheet review, and the examiner releases findings on request without ever hinting. For official rules and dates, see abem.org.

At a glance

  • Clinical decision-making (CDM): one evolving patient, history to disposition. About 15 minutes.
  • Prioritization: a board of patients you triage and stabilize under a clock. About 15 minutes.
  • Communication: a difficult conversation with a patient, family, or colleague. About 10 minutes.
  • Procedures and ultrasound: verbalized technique plus image and result interpretation. About 10 minutes.
  • Each station is preceded by a task-sheet review of about 5 minutes; the examiner never hints, corrects, or names the diagnosis.

Clinical decision-making (CDM)

CDM is the station most people picture when they think of the oral boards: one undifferentiated patient, one continuous case. You work from history and physical, to a differential, to the studies you order and then interpret, to treatment, to disposition. You drive it by saying out loud what you would do next, and the examiner releases the finding, lab, or image that your action would return. Nothing is handed to you unprompted, and the diagnosis comes from your interpretation of the studies, never from the examiner. This station runs about 15 minutes.

Prioritization

Prioritization puts a board of emergency-department patients in front of you at once. You triage by acuity, stabilize the most urgent first, and delegate resources, all under a hard clock, while new patients arrive and existing ones change. The skill being tested is not any single diagnosis but how you order competing demands and adapt when the board shifts. This station runs about 15 minutes.

Communication

The communication station is a difficult conversation. It might be a death notification, a conflict with a colleague, or shared decision-making with a patient who wants something different from what you recommend. You are graded on how you carry the conversation, not on a workup: rapport, honesty, responding to reactions, and reaching a clear close. This station runs about 10 minutes.

Procedures and ultrasound

This station tests hands-on skills on a spoken exam, so you describe rather than perform. You verbalize the indications and each step of a procedure such as intubation, a lumbar puncture, or a chest tube, and you interpret the images or results the examiner returns, including point-of-care ultrasound clips. Because it is spoken, the AI and the real examiner alike never pretend a needle went in; you talk through the technique and read what comes back. This station runs about 10 minutes.

How every station is run

The four stations differ, but the conduct is the same. Before each one you get a short task-sheet review, about 5 minutes, to read the setup. Inside the station the examiner presents the case and releases the next finding, result, or image only when you ask for it by narrating an action. The examiner does not hint, does not correct, and never names the diagnosis. Your own narration is the control surface, which is why practicing out loud matters more than silent reading. For how the exam fits together as a whole, see the ABEM Certifying Exam, and for a plan, see how to prepare.

Frequently asked questions

How many stations are on the ABEM oral board?
Four formats: clinical decision-making, prioritization, communication, and procedures with ultrasound. Each is a spoken station, and together they cover reasoning, triage, communication, and hands-on skills verbalized aloud.
How long is each station?
Stations run about 10 or 15 minutes depending on the type. Clinical decision-making and prioritization run longer; communication and procedures run shorter. Each station is preceded by a short task-sheet review of about 5 minutes.
Does the examiner give hints during a station?
No. The examiner presents the case and releases findings, results, or images when you ask for them, but never hints, corrects you, or names the diagnosis. What you narrate is what moves the case forward.
How can a procedures station work on a spoken exam?
You describe rather than perform. You verbalize the indications and technique step by step and interpret the images or results the examiner returns. It is a spoken board, so nothing is physically done to a patient or trainer.
Where do I find the official station rules and dates?
ABEM publishes the current station formats, timing, eligibility, fees, and exam dates at abem.org. OutLoud MD is a free practice tool and is not affiliated with ABEM.

Key takeaways

  • The oral board runs four station formats: CDM, prioritization, communication, and procedures with ultrasound.
  • Timing is about 15 minutes for CDM and prioritization, about 10 for communication and procedures.
  • Each station starts with a short task-sheet review and an examiner who releases stimuli on request but never hints.
  • Procedures are described, not performed, because it is a spoken exam.
  • Practice each station out loud; check abem.org for official rules and logistics.

Updated September 2026