Date Updated: June 27, 2013

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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 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.

Advanced Clinical Examination Information

Exam	Number of Items	Length	Score Reports*
Emergency Medicine	110	2 hours, 45 minutes**	The score report includes: Score Interpretation Guide with norm data Scaled score descriptive statistics Scaled score roster Scaled score frequency distribution Downloadable comma-delimited file of scaled scores for each examinee Content area item analysis Content area summary report Performance profiles for each examinee
Internal Medicine	100	2 hours, 30 minutes	The score report includes: Score Interpretation Guide with norm data Scaled score descriptive statistics Scaled score roster Scaled score frequency distribution Downloadable comma-delimited file of scaled scores for each examinee Content area item analysis Content area summary report Performance profiles for each examinee
Pediatrics	75	1 hour, 45 minutes	Percent correct during the initial phase.
Surgery	75	1 hour, 45 minutes	The score report includes: Score Interpretation Guide with norm data Scaled score descriptive statistics Scaled score roster Scaled score frequency distribution Downloadable comma-delimited file of scaled scores for each examinee Content area item analysis Content area summary report Performance profiles for each examinee

*Score reports are posted to the NBME Services Portal 48-72 hours after test administration.
** Web-based Emergency Medicine ACE Timing Change Effective July 10, 2014

Fees

Fees for Advanced Clinical Examinations can be found here.

Content Outlines

Quote

"This is potentially a very important tool to enable us to get a better idea of what the weaknesses (and strengths, of course) of our internship class are from the outset."

Residency Program Director,
Internal Medicine

Sample Item

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
       concentration
(C)  Measurement of serum IgE
       concentration
(D)  X-ray of the chest
(E)  Tracheal intubation