Board Certification in Emergency Medicine: ABEM and ABOEM

Board certification in emergency medicine establishes a physician's demonstrated competency in the specialty through a structured examination and credentialing process overseen by two distinct certifying bodies: the American Board of Emergency Medicine (ABEM) and the American Osteopathic Board of Emergency Medicine (AOBEM). This page covers the definitions, eligibility pathways, examination structures, and practical distinctions between these two pathways. Understanding how certification works matters for hospital credentialing, insurer contracting, and the regulatory landscape that governs emergency department staffing across the United States—detailed further at Regulatory Context for Emergency Medicine.

Definition and Scope

Board certification in emergency medicine is a voluntary credentialing designation granted by a specialty-specific board that independently verifies a physician has met defined training and examination standards. It is distinct from medical licensure, which is a state-level legal requirement, and from hospital privileging, which is an institutional decision. Certification signals to hospitals, insurers, and patients that a physician has completed accredited training and passed rigorous assessment in emergency medicine-specific knowledge and clinical judgment.

The American Board of Emergency Medicine (ABEM) was founded in 1976 and is a member board of the American Board of Medical Specialties (ABMS). ABEM certifies physicians who completed allopathic (MD) training pathways and is the primary certifying authority for emergency medicine in the United States. As of the data ABEM publishes, the organization has certified more than 45,000 physicians since its inception (ABEM).

The American Osteopathic Board of Emergency Medicine (AOBEM) operates under the American Osteopathic Association (AOA) and certifies physicians completing osteopathic (DO) training pathways. Following the 2020 single accreditation merger between the Accreditation Council for Graduate Medical Education (ACGME) and the AOA, DO graduates may now pursue either ABEM or AOBEM certification, creating a meaningful overlap between the two pathways.

Both boards are recognized by hospital credentialing committees and by the Centers for Medicare & Medicaid Services (CMS) for purposes of defining qualified emergency medicine practitioners under federal conditions of participation.

How It Works

Certification through ABEM follows a structured, multi-phase process:

1. Eligibility verification — The applicant must have completed a three-year emergency medicine residency accredited by the ACGME (or an AOA-accredited program for AOBEM candidates).
2. Qualifying Examination (QE) — A written, computer-based examination covering the breadth of emergency medicine knowledge. ABEM administers this examination annually.
3. Oral Certification Examination (OCE) — A structured oral examination in which candidates respond to standardized patient scenarios presented by examiners. Passage of the QE is a prerequisite.
4. Certification issuance — Upon passing both examinations, ABEM issues initial certification, which is valid for a defined period.
5. Continuous Certification (CC) program — ABEM moved from a 10-year recertification cycle to a continuous certification model. The ABEM Continuous Certification program requires annual completion of self-assessment modules and periodic examination components to maintain active status (ABEM Continuous Certification).

AOBEM follows a parallel structure—written examination, clinical oral examination, and a continuing certification requirement—governed by AOA policies (AOBEM).

Physicians who trained before formal residency programs were widely available may have pursued an older "practice pathway," but ABEM closed that route in 1988. No grandfathering pathway remains open.

Common Scenarios

Newly graduated residency programs — The most common pathway. A physician completes a three-year ACGME-accredited emergency medicine residency and applies to sit for the ABEM qualifying examination within the defined eligibility window following graduation.

DO graduates post-2020 — Following the ACGME/AOA single accreditation merger completed in 2020, osteopathic graduates from ACGME-accredited programs may choose between ABEM and AOBEM. Those from programs that maintained dual accreditation before the merger may hold or pursue certification through either board.

Subspecialty certification — ABEM offers added qualifications (CAQs) in subspecialties including pediatric emergency medicine, sports medicine, undersea and hyperbaric medicine, and medical toxicology, each requiring additional fellowship training and a separate examination. Pediatric emergency medicine is also co-sponsored with the American Board of Pediatrics (ABP). These subspecialties intersect directly with the topics covered in Pediatric Emergency Medicine Overview and Toxicology and Poisoning Emergencies.

Hospital credentialing — Hospitals that participate in Medicare and Medicaid are required under CMS Conditions of Participation (42 CFR §482.22) to maintain a credentialing process for medical staff. Board certification, while not federally mandated as an absolute condition, is widely used by credentialing committees as a threshold criterion. Physicians without active board certification may face restricted privileges depending on institutional policy.

A broader overview of the specialty's professional infrastructure, including physician training pathways, is available at Emergency Medicine Physician Training and Residency and on the site index.

Decision Boundaries

ABEM vs. AOBEM — The core structural difference lies in the sponsoring accreditation framework and organizational lineage, not in examination difficulty or scope. Both boards test equivalent clinical competency domains. Hospital credentialing committees generally accept both designations. ABEM board certification is more common in volume terms given the larger pool of ACGME-trained MD graduates.

Certified vs. board-eligible — "Board-eligible" is an informal term describing a physician who has completed residency but has not yet passed the certification examinations. ABEM eliminated the formal "board-eligible" designation from its official vocabulary; the term carries no standardized meaning across institutions and should not be equated with full certification.

Active vs. lapsed certification — Physicians who fail to complete continuous certification requirements transition to an inactive or lapsed status. Lapsed certification is publicly visible through the ABMS Certification Matters database (ABMS Certification Matters). Hospitals and insurers may treat lapsed certification as grounds for credentialing review.

Emergency medicine vs. related specialties — Internal medicine or family medicine physicians who work in emergency settings are not emergency medicine board certified unless they have completed an emergency medicine residency and passed ABEM or AOBEM examinations. The scope distinctions between emergency medicine practitioners and other clinical roles are covered at Scope of Practice: Emergency Medicine.

References

• American Board of Emergency Medicine (ABEM)
• ABEM — About ABEM
• ABEM Continuous Certification Program
• American Osteopathic Board of Emergency Medicine (AOBEM)
• American Board of Medical Specialties (ABMS)
• ABMS Certification Matters
• Accreditation Council for Graduate Medical Education (ACGME)
• American Board of Pediatrics (ABP)
• Centers for Medicare & Medicaid Services (CMS) — Conditions of Participation, 42 CFR §482.22

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