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Fellowship of the Australasian College for Emergency Medicine (Primary Oral Exam (Integrated Viva)) Study Tips [ Study Tips ](https://mdster.com/blog?category=study-tips) Fellowship of the Australasian College for Emergency Medicine (Primary Oral Exam (Integrated Viva)) Study Tips ================================================================================================================ How to turn anatomy, pathology, physiology, and pharmacology into fast, clinically linked viva answers under pressure [ MDster Editorial Team ](https://mdster.com/about) · Mar 07, 2026 · 6 min read · 54 [ 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 Boards ](https://mdster.com/blog?tag=emergency-medicine-boards) [ Emergency Medicine ](https://mdster.com/blog?tag=emergency-medicine) [ Study Tips ](https://mdster.com/blog?tag=study-tips) [ ACEM Primary Viva ](https://mdster.com/blog?tag=acem-primary-viva) [ Oral Exam Prep ](https://mdster.com/blog?tag=oral-exam-prep) [ FACEM ](https://mdster.com/blog?tag=facem) Share this article Share this post Most candidates who struggle in the **Fellowship of the Australasian College for Emergency Medicine (Primary Oral Exam (Integrated Viva))** have not under-studied; they have under-rehearsed. This exam is four 10-minute verbal stations built around clinical scenarios that integrate anatomy, pathology, physiology, and pharmacology. ACEM’s published format also makes the target clearer than many candidates realise: you need repeatable, bankable performances across four stations, not perfection everywhere. [\[1\]](#cite-1 "Reference [1]") Understand What the Viva Actually Rewards ----------------------------------------- The Integrated Viva is designed to test more than recall. ACEM describes it as an assessment of your **explanation of factual knowledge** and your ability to **transfer principles to clinical situations**, with marks driven by depth of knowledge, problem solving, clinical reasoning, judgment, and analytical skills. That means your answer must do three things out loud: **state the science, explain the mechanism, and link it to the bedside**. [\[2\]](#cite-2 "Reference [2]") A simple response structure works well: 1. **Name the concept clearly**. 2. **Explain the mechanism in one or two linked steps**. 3. **Apply it to the scenario**. 4. **Finish with the clinical implication**. If you practise every answer in that order, you sound organised even when you are thinking under pressure. That matters in oral exams, and it fits what we know about self-explanation and practice testing as effective learning techniques. [\[3\]](#cite-3 "Reference [3]") > **Pro Tip:** If asked why a shocked patient becomes acidotic, do not stop at “poor perfusion.” Push one step further: reduced oxygen delivery, anaerobic metabolism, lactate generation, buffering limits, then the bedside consequence. Build Integrated Topic Sheets, Not Four Separate Subject Binders ---------------------------------------------------------------- The ACEM syllabus is only a guide, and it explicitly states that **any area of basic medical science relevant to emergency medicine can be examined**. That is why siloed revision fails. Instead of keeping separate anatomy, pathology, physiology, and pharmacology notes, build **one-page integrated sheets** around ED presentations: airway failure, sepsis, shock, trauma, chest pain, arrhythmia, status epilepticus, poisoning, acid-base problems, renal failure, and respiratory failure. [\[4\]](#cite-4 "Reference [4]") For each sheet, use four boxes: - **Anatomy:** key structures, blood supply, innervation, spaces, imaging landmarks - **Physiology:** normal function, compensatory responses, equations worth verbalising - **Pathology:** mechanism of disease, tissue injury, inflammatory or cellular changes - **Pharmacology:** receptors, kinetics, adverse effects, why one drug is chosen over another Then add one bottom line: **“Why this matters in the ED.”** This is the line candidates often forget. Do not revise those sheets by rereading. Turn each into **oral retrieval prompts** and **flashcards**. Ask yourself, “Explain this mechanism in 30 seconds,” not “Do I recognise this page?” Practice testing and distributed practice are consistently stronger learning methods than passive review, and a 2026 medical-education meta-analysis found spaced repetition effective in medical learners. [\[3\]](#cite-3 "Reference [3]") > **Pro Tip:** If you cannot explain a concept without looking at your notes, you do not know it well enough for a viva, even if you can still answer it on paper. Train for the 10-Minute Station, Not for Unlimited Time ------------------------------------------------------- ACEM’s format is short, verbal, and examiner-led. Some stations may include bones, X-rays, anatomical models, ECGs, or abnormal blood gases. So your mocks should be **10 minutes**, spoken, and slightly uncomfortable. Use a partner who interrupts, redirects, or asks “why?” after every first answer. That is much closer to the real task than a friendly untimed discussion. [\[1\]](#cite-1 "Reference [1]") Run **three mock vivas per week**. Each mock should have one explicit performance target: - concision - signposting - precise terminology - linking basic science to clinical relevance - recovering after being redirected That is deliberate practice: repetition of a narrow skill with feedback and correction. In medical education, deliberate practice and structured rehearsal improve oral performance better than passive exposure alone. [\[5\]](#cite-5 "Reference [5]") Use your resources deliberately: - **ACEM eLearning resources:** mine past papers and past exam reports for style and blind spots. [\[1\]](#cite-1 "Reference [1]") - **Core textbooks and atlases:** clarify mechanisms and anatomy after mocks, not before. - **Question banks:** use them to generate viva prompts, not just written answers. - **Study group of 3–4:** one candidate, one examiner, one scorer, then rotate. - **Image/prop sets:** weekly practice with ECGs, ABGs, X-rays, bones, and labelled models. Study Schedule Template ----------------------- Time before examMain focusWeekly output**8–6 weeks**Build integrated sheets for major ED presentations6 topic sheets, daily flashcards, 1 mock viva**5–3 weeks**Convert knowledge into spoken answers3 mocks/week, 2 prop sessions/week, error log after each mock**2–1 weeks**Tighten timing and clarityFull 4-station circuits twice weekly, rapid-fire 30-second explanations daily**Final 5 days**Consolidate onlyReview error log, high-yield sheets, light mocking; no new major topics This schedule works because it combines **retrieval**, **spacing**, and **repeated oral performance**, which match both the exam format and the strongest evidence-based study methods. [\[3\]](#cite-3 "Reference [3]") Common Pitfalls That Cost Marks ------------------------------- The first mistake is answering like the written exam: long, dense, and poorly signposted. The second is drifting into management protocols when the examiner is asking for science. The third is giving isolated facts without a causal chain. The fourth is ignoring props until the final fortnight, even though ACEM explicitly states they may be used. The fifth is doing all your revision solo, which hides hesitation, imprecision, and rambling. [\[2\]](#cite-2 "Reference [2]") A useful post-mock review is brutally simple: - **One content gap** I need to fix - **One communication habit** I need to stop - **One timing issue** I need to correct next session That keeps your improvement specific. Key Takeaways ------------- - Build **12–15 integrated topic sheets** around common ED presentations. - Schedule **three timed mock vivas each week**. - Do **daily oral retrieval** from flashcards or prompt cards. - Include **one weekly prop session** using ECGs, ABGs, imaging, or anatomy models. - After every mock, write down **one science fix, one delivery fix, and one timing fix**. - In every answer, finish with: **“the clinical implication is…”** This viva is very passable when your study matches the task. Read less, explain more, and rehearse until clear, clinically linked science becomes your default speaking style. References (12) ------------------- 1. 1. [ acem.org.au/Content-Sources/Training/How-the-FACEM-Training-Program-works/Examinations ](https://acem.org.au/Content-Sources/Training/How-the-FACEM-Training-Program-works/Examinations) [↩](#cite-ref-1-1 "Back to text") 2. 2. [ acem.org.au/getmedia/ce28ef8e-1d78-4c91-8622-b51ab4361be1/ACEM\_Reaccreditation\_SubmissionV2.aspx ](https://acem.org.au/getmedia/ce28ef8e-1d78-4c91-8622-b51ab4361be1/ACEM_Reaccreditation_SubmissionV2.aspx) [↩](#cite-ref-2-1 "Back to text") 3. 3. [ pubmed.ncbi.nlm.nih.gov/26173288 ](https://pubmed.ncbi.nlm.nih.gov/26173288/) [↩](#cite-ref-3-1 "Back to text") 4. 4. [ acem.org.au/getmedia/4aa1fbe3-b013-4fd3-b191-dc8556dc6f5f/WEB-Primary-Exam-Syllabus-%28Apr-17%29.aspx ](https://acem.org.au/getmedia/4aa1fbe3-b013-4fd3-b191-dc8556dc6f5f/WEB-Primary-Exam-Syllabus-%28Apr-17%29.aspx) [↩](#cite-ref-4-1 "Back to text") 5. 5. [ pubmed.ncbi.nlm.nih.gov/22934592 ](https://pubmed.ncbi.nlm.nih.gov/22934592/) [↩](#cite-ref-5-1 "Back to text") 6. 6. Australasian College for Emergency Medicine. Examinations: Primary Exam – Oral Exam (Integrated Viva). Accessed March 2026. 7. 7. Australasian College for Emergency Medicine. FACEM Training Program Handbook v1.10. Accessed March 2026. 8. 8. Australasian College for Emergency Medicine. Primary Examination Syllabus. Accessed March 2026. 9. 9. Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students’ Learning With Effective Learning Techniques. Psychol Sci Public Interest. 2013;14(1):4-58. 10. 10. Maye JA, Hurley F. The Effectiveness of Spaced Repetition in Medical Education: A Systematic Review and Meta-Analysis. Clin Teach. 2026;23(2):e70353. 11. 11. Heiman HL, Uchida T, Adams C, et al. E-learning and deliberate practice for oral case presentation skills: a randomized trial. Med Teach. 2012;34(12):e820-e826. 12. 12. Causer J, Barach P, Williams AM. Expertise in medicine: using the expert performance approach to improve simulation training. Med Educ. 2014;48(2):115-123. 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