NBME Advanced Clinical Examinations (ACE)
The web-based Advanced Clinical Examinations (ACE) are designed to assess performance at the end of the medical school sub-internship. Residency program directors have also found them useful for assessing baseline competency of incoming residents. The 75-item examinations consist mainly of test items that describe clinical situations and require examinees to provide one or more of the following: a diagnosis, a prognosis, an indication of underlying mechanisms of disease, and/or the next step in medical care, including preventive measures. In addition to the traditional multiple-choice, one-best-answer items, the examinations include several sequential item sets that unfold and challenge examinees to use their clinical knowledge in problem solving and in managing patients over time. The examinations are designed to be administered in 2 hours. Program directors can access score reports by logging into the NBME Services Portal 48-72 hours after test administration.
Advanced Clinical Examinations are available in the following areas:
- Internal Medicine
- Pediatrics (Pilot Test, June – August 2012)
Surgery and Pediatrics ACE scores are percent-correct only.
Internal Medicine ACE score reports include:
- A scaled score roster
- A keyword phrase item analysis (if there are at least 10 examinees)
- Norm data reflecting the performance of 2010 first-year residents and fourth-year students from LCME-accredited medical schools
- Individual performance profiles identifying areas of strength and weakness
Fees for Advanced Clinical Examinations can be found here.
Residency Program Director,
Fourteen hours after admission to the hospital for treatment of severe hypertension, a 32-year-old woman has stridor. On admission, she was given captopril. She appears anxious. Her blood pressure is 140/85 mm Hg, pulse is 140/min, and respirations are 32/min. Examination shows swelling of the lips and tongue. Diffuse stridorous wheezes are heard on auscultation. There is diminished air movement. Which of the following is the most appropriate next step in management?
(A) Observation only
(B) Measurement of serum captopril
(C) Measurement of serum IgE
(D) X-ray of the chest
(E) Tracheal intubation