New FACEM Exam – Tips for writing Short Answer Questions


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I have some old Short Answer Questions (SAQs) with words like ‘describe’ and ‘discuss’.  Can I still use these questions for new FACEM SAQ exam practice?

Not really.  In the New exam the wording and content has changed in an attempt to increase objectivity. Questions are built around discrete, concrete information from referenced texts.

What words can I use in my questions?

Words to use when writing a question for the new FACEM SAQ:

  • State

  • List

  • Calculate

  • Prescribe

  • Name

  • Fill in the Boxes‘ (see below)

  • Asking about features of “history“, “examination” and “investigations” is acceptable

  • If testing the candidates clinical reasoning use “Which is the ‘most likely’…

  • Props such as pictures, guidelines, flow diagrams, medication charts and fluid charts can have labels to be filled in by the candidate:


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What types of question can I no longer use?

Words not to use when writing a question for the new FACEM SAQ (these phrases are not in the new exam format):

  • Describe‘ (instead use ‘List’ or ‘State’)

  • Discuss‘ (instead use a table of ‘pros and cons’

  • Outline‘ (instead use ‘List’ or ‘State’)

  • What is your ‘assessment‘.  This is now considered too subjective and non-specific (instead use specific parts of the History, Exam or Investigations)

  • What is your ‘management

    Instead use ‘list the key steps in your management’

    Asking about “procedures“, “specific treatment” or “disposition” is preferable

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What should my approach be when changing an old question or writing a new question?

General Points to consider when writing a question:

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  • Make your questions about discrete, concrete or factual information from referenced sources (e.g. Camerorn, Tintinalli or Dunn textbooks)
  • Limit ‘Basic’ Material (it is not an exam for medical students or residents).  In the old exam experts in ‘scripted waffle’ including ourselves seemed to get through (i.e. things like Move to Resus, Team Leader, IV, O2, Monitor while useful approaches are effectively ‘dogmatic sound bites’ for the exam).  The new exam avoids the pitfall of judgement on the ‘way things are said’ and looks instead for direct information.
  • Tested material for the new SAQ and new OSCE exams should be focused on the colleges ‘CanMEDS‘ domains:


Are there any other tips for writing questions?

  • Weigh the allocation of your marking scheme to allow discrimination between a pass and fail candidate – provide your learners an ideal answer with references
  • Each fact is allocated one mark (1 mark = 1 fact)
  • Use tables for testing connected information – for example:
    • ‘Drug – Dose – Pros – Cons’ in a table
    • ‘Ketamine – 0.5mg/kg – Analgesia, Amnesic – Emergence, Secretions’
  • For Calculations ask for both a number and conclusion
  • A complex, longer question stem is good in combination with less questions to test the candidates clinical reasoning skills
  • A shorter clinical question stem can be matched with more questions to assess a broader range of factual knowledge

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How long should a question be?

  • Most questions are 6 minutes long
  • A 6 minute question should test approximately ’13 facts’
  • A ‘double question’ can allow more detailed testing of facets of reasoning or management

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Further Reading

  • Andy Buck – ED Exam – Click Here
  • Fellowship Curriculum (ACEM) – Click Here
  • If you are an EMRAP listener look at Amit and Andy’s recent interview – Click here
  • Adelaide Emergency Medicine – Click Here