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[ Home ](https://mdster.com) 2. [ Blog ](https://mdster.com/blog) 3. [ Study Tips ](https://mdster.com/blog?category=study-tips) 4. American Osteopathic Board of Emergency Medicine (Emergency Medicine Clinical Exam (Legacy)): Chart Review Study Tips [ Study Tips ](https://mdster.com/blog?category=study-tips) American Osteopathic Board of Emergency Medicine (Emergency Medicine Clinical Exam (Legacy)): Chart Review Study Tips ======================================================================================================================= Build a compliant case portfolio that lets reviewers see your clinical decisions clearly. [ MDster Editorial Team ](https://mdster.com/about) · Oct 19, 2026 · 6 min read · 35 [ Reviewed by Dr. Ali Ragab, MBBCH, MSc, MCAI ](https://mdster.com/medical-reviewers/dr-ali-ragab) [Editorial Policy](https://mdster.com/editorial-policy) | [Corrections Policy](https://mdster.com/corrections) [ Emergency Medicine ](https://mdster.com/blog?tag=emergency-medicine) [ Study Tips ](https://mdster.com/blog?tag=study-tips) [ AOBEM ](https://mdster.com/blog?tag=aobem) [ Chart Review ](https://mdster.com/blog?tag=chart-review) [ Clinical Exam ](https://mdster.com/blog?tag=clinical-exam) ![American Osteopathic Board of Emergency Medicine (Emergency Medicine Clinical Exam (Legacy)): Chart Review Study Tips](https://mdster.com/storage/blog/images/american-osteopathic-board-of-emergency-medicine-emergency-medicine-clinical-exam-legacy-c.png) Share this article Share this post On this page 1. [ 1. Select cases against the rules, not your memory ](#1-select-cases-against-the-rules-not-your-memory) 2. [ 2. Rehearse the reviewer's clinical reading ](#2-rehearse-the-reviewers-clinical-reading) 3. [ Use an eight-point case audit ](#use-an-eight-point-case-audit) 4. [ 3. Treat completeness and de-identification as separate audits ](#3-treat-completeness-and-de-identification-as-separate-audits) 5. [ 4. Build a submission calendar, not a cram schedule ](#4-build-a-submission-calendar-not-a-cram-schedule) 6. [ Study Schedule Template: four weeks ](#study-schedule-template-four-weeks) 7. [ Common pitfalls to avoid ](#common-pitfalls-to-avoid) 8. [ Key Takeaways: act this week ](#key-takeaways-act-this-week) 9. [ Frequently Asked Questions ](#blog-faqs) 10. [ References ](#references-heading) On this page 1. [ 1. Select cases against the rules, not your memory ](#1-select-cases-against-the-rules-not-your-memory) 2. [ 2. Rehearse the reviewer's clinical reading ](#2-rehearse-the-reviewers-clinical-reading) 3. [ Use an eight-point case audit ](#use-an-eight-point-case-audit) 4. [ 3. Treat completeness and de-identification as separate audits ](#3-treat-completeness-and-de-identification-as-separate-audits) 5. [ 4. Build a submission calendar, not a cram schedule ](#4-build-a-submission-calendar-not-a-cram-schedule) 6. [ Study Schedule Template: four weeks ](#study-schedule-template-four-weeks) 7. [ Common pitfalls to avoid ](#common-pitfalls-to-avoid) 8. [ Key Takeaways: act this week ](#key-takeaways-act-this-week) 9. [ Frequently Asked Questions ](#blog-faqs) 10. [ References ](#references-heading) Finding 20 strong emergency department cases is only half the challenge. For the American Osteopathic Board of Emergency Medicine (Emergency Medicine Clinical Exam (Legacy)), you must also show your own management through complete, readable records—without adding an explanation that was not documented at the time. **First, confirm that you need this exam.** As of October 2026, AOBEM says the Clinical Exam applies only to candidates approved to sit the Written (Part I) Exam before September 1, 2013. If your eligibility is uncertain, ask AOBEM before requesting records or building a portfolio. This is a chart-review submission, not another question-based or simulated-patient exam. [\[1\]](#cite-1 "Reference [1]") 1. Select cases against the rules, not your memory -------------------------------------------------- Start a secure tracking sheet with one row per potential case. Record its encounter date, category, diagnosis, procedure, disposition, your role, and which required documents are available. Keep identifiers only in your institution-approved system; use a nonidentifying working code in your planning sheet. AOBEM requires **two sets of 20 de-identified cases**, drawn from at least five separate treatment dates within the 12 calendar months before submission. At least eight must be admissions; an appropriate transfer counts. No more than two cases may come from one listed category, and cases cannot repeat a diagnosis or procedure. Use the board’s category list to check your proposed mix before ordering copies. [\[1\]](#cite-1 "Reference [1]") Selection checkAction before requesting a recordPersonally managedConfirm you provided the care, rather than supervised a house-staff case.Category and dispositionLabel the case; count category slots and admissions.Distinct clinical workCheck for repeated diagnoses or procedures.Source documentsConfirm the chart and supporting records can be obtained. > **Pro tip:** Identify several backup cases across different categories. If one record is incomplete, you can replace it without losing your required case mix. AOBEM’s checklist says cases involving residents, medical students, or other emergency physicians in the care cannot be submitted; ask the board about any uncertain case before relying on it. [\[2\]](#cite-2 "Reference [2]") 2. Rehearse the reviewer's clinical reading ------------------------------------------- AOBEM lists history, physical examination, testing, treatment, diagnosis, disposition or discharge, overall assessment, and critical errors as review criteria. For each candidate case, read only the original record and ask whether a reviewer can follow the sequence from presentation to decision. This is a **record audit**, not an invitation to rewrite care after the encounter. [\[1\]](#cite-1 "Reference [1]") ### Use an eight-point case audit 1. **History and examination:** Can the reviewer find the findings that shaped your assessment? 2. **Testing:** Are ordered studies and their available results included and legible? 3. **Treatment:** Do orders and notes show what you did and the recorded response? 4. **Diagnosis:** Does the documented assessment fit the findings available at that time? 5. **Disposition:** Is the admission, transfer, or discharge decision apparent? 6. **Discharge:** If applicable, are instructions and their receipt present? 7. **Overall coherence:** Do physician, nursing, order, and result records tell a consistent story? 8. **Potential critical errors:** Would an unexplained gap make a consequential decision difficult to evaluate? For example, in a chest-pain record, locate the original electrocardiogram, relevant test results, treatment orders, and disposition documentation. If a necessary element is absent, choose a better-documented case rather than inventing a retrospective rationale. Use an emergency medicine reference or focused question-bank item only when it helps you recognize a clinical issue to audit; question-bank scores do not substitute for a complete chart. [\[2\]](#cite-2 "Reference [2]") 3. Treat completeness and de-identification as separate audits -------------------------------------------------------------- Request the **entire ED record**, not just your physician note. AOBEM specifies physician orders, nursing notes, laboratory results, ECGs, official radiology interpretations, and discharge documentation among case materials. Check which items apply to each encounter and follow the board’s current instructions for the complete packet. Incomplete cases delay grading; its checklist says that when a case must be completed, the entire case—not merely the missing page—must be resubmitted. [\[1\]](#cite-1 "Reference [1]") Then inspect every page for patient and hospital identifiers, including headers, imaging reports, ECG printouts, order pages, and discharge forms. Preserve the clinical content AOBEM requests, including patient age, sex, and encounter date, while removing identifying information as instructed. Coordinate the release and redaction process with your medical-records or privacy team; do not send identifiable records to a study partner or personal cloud account. [\[2\]](#cite-2 "Reference [2]") > **Pro tip:** Audit the duplicate binder independently after copying. One clean original does not guarantee that its duplicate has every page or that redaction remains effective. 4. Build a submission calendar, not a cram schedule --------------------------------------------------- Work backward from AOBEM’s published grading-cycle deadlines: March 31, June 30, September 30, and December 31. Allow time to obtain records and administrative documents before assembling the two indexed, tabbed, securely bound sets. Verify the applicable deadline and mailing instructions with AOBEM before sending a legacy submission. [\[1\]](#cite-1 "Reference [1]") ### Study Schedule Template: four weeks WhenPortfolio taskWeek 1Confirm eligibility; build a 25–30-case candidate list and test its category mix.Week 2Obtain institution-approved records; audit clinical criteria and select the best 20.Week 3Check supporting documents, legibility, de-identification, and both copies.Week 4Index and tab both sets; verify administrative materials and submission instructions. Schedule a short weekly review with a trusted emergency physician or educator using only records shared through an approved process. Ask them where the original documentation becomes hard to follow, then use that feedback to **select** stronger cases—not to add new material to old notes. AOBEM’s checklist permits verbatim typed transcripts for handwritten portions but says no new material may be added. [\[2\]](#cite-2 "Reference [2]") Common pitfalls to avoid ------------------------ - **Preparing for the wrong exam:** Written questions and oral-case practice do not assemble this portfolio. - **Choosing impressive but ineligible cases:** Recheck personal management, encounter dates, category limits, and admissions. - **Submitting the physician note alone:** Match each case against AOBEM’s supporting-document checklist. - **Polishing an old narrative:** Submit faithful records and permitted verbatim transcripts, not reconstructed reasoning. - **Forgetting the application package:** Check the current license, privileges letter, CME records, six-month attending schedule, application, and fee requirements. [\[1\]](#cite-1 "Reference [1]") Key Takeaways: act this week ---------------------------- - Confirm your pre–September 1, 2013 Written Exam approval status with AOBEM. - Build a secure case matrix and find backup cases in underrepresented categories. - Audit two original records against the eight review criteria. - Ask medical records how to obtain complete, properly de-identified packets. - Set an internal deadline ahead of the board’s next grading cycle. You do not need a more dramatic case collection. You need eligible cases whose original records let a reviewer see the care you actually delivered. Start with the case matrix, and let its gaps determine your next task. Frequently Asked Questions ---------------------------- ### Do candidates first approved for the AOBEM Written Exam after August 2013 need this Clinical Exam? No. AOBEM says the legacy Clinical Exam is required only for candidates approved to sit the Written (Part I) Exam before September 1, 2013. Confirm uncertain eligibility with the board. ### Can an appropriate transfer count toward the eight admitted cases? Yes. AOBEM states that an appropriate transfer to another institution counts as an admission for this portfolio requirement. ### Can I add a typed explanation to make an older handwritten chart clearer? You may provide the verbatim typed transcript required for handwritten material, but AOBEM says you may not add new clinical material. ### What should I do if a selected case lacks a required supporting record? Look for the missing material through approved records channels or select a complete backup case. AOBEM says incomplete cases delay grading and that a completed case must be resubmitted in full. References (3) ------------------ 1. 1. [ American Osteopathic Board of Emergency Medicine, Clinical Exam: eligibility, process, and scoring ](https://certification.osteopathic.org/emergency-medicine/certification-process-overview/specialty-certification-process/clinical-exam/) [↩](#cite-ref-1-1 "Back to text") 2. 2. [ American Osteopathic Board of Emergency Medicine, Clinical Exam Checklist and Instructions to Candidates ](https://certification.osteopathic.org/emergency-medicine/wp-content/uploads/sites/17/aobem-clinical-exam-checklist.pdf) [↩](#cite-ref-2-1 "Back to text") 3. 3. 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