This first-pass, review and exit plan is for FACEM trainees using ACEMCQ to prepare for the ACEM Fellowship written examination — the Short Answer Questions (SAQ) paper and the Single Choice Questions (SCQ) multiple-choice paper. ACEMCQ is a strong, purpose-built written-exam bank with automated SAQ marking, but it does not reproduce the clinical OSCE, and a rising overall percentage can quietly hide syllabus areas you have never attempted. The plan below keeps a protected pool of unseen questions so your final blocks still measure readiness rather than recall.
What ACEMCQ offers for the ACEM Fellowship right now
The figures below are vendor-reported (acemcq.com.au) and were current at the last-checked date of 20 July 2026. ACEMCQ states it is not affiliated with, endorsed by or connected to ACEM, so treat its curriculum-coverage claims as the vendor's own summary, not an official blueprint. Verify live counts and prices on the product page before you subscribe.
| Item | Vendor-reported position (20 July 2026) |
|---|---|
| Exam covered | ACEM Fellowship written exam (SAQ + SCQ/MCQ); no OSCE component |
| MCQ bank | 2,000+ multiple-choice questions |
| SAQ bank | 700+ short-answer questions |
| Curriculum mapping | "23 topic domains", vendor-claimed alignment to the ACEM curriculum |
| Automated feedback | AI-marked SAQ feedback: a mark out of the total, a mark-by-mark breakdown and targeted feedback |
| Price (AUD) | Basic AUD $29/month or $249/year; Premium AUD $49/month or $499/year |
| Access | Subscription (monthly or annual); Premium adds unlimited SAQ marking and randomised SAQ mocks |
The principal limitation is structural. ACEMCQ is a written-exam product: it can rehearse SAQ writing and SCQ selection, and its automated SAQ marks are a useful drafting signal, but it cannot stand in for the OSCE, and an algorithmic mark is a training cue, not an examiner's judgement.
The exam you are actually sitting
Anchor every study decision to the official format, not to a bank's completion bar. ACEM's Fellowship written examination is two 180-minute papers — one SAQ paper and one SCQ (multiple-choice only) paper — for six hours of written assessment in total. The clinical examination is an OSCE of up to 12 stations, each 11 minutes long (four minutes of reading, then seven minutes of assessment), for 132 minutes across two consecutive days; stations span history, examination, communication, resuscitation discussion, teaching and case-based discussion. College-reported fees at the last-checked date were AUD $3,145 for the written exam and AUD $4,450 for the OSCE (verify on acem.org.au). The papers are built on the FACEM curriculum and pitched at the level of a junior consultant. The official requirement is the curriculum plus this format; a vendor's "23 domains" or "100% coverage" line is a marketing summary — useful for navigation, but not the blueprint you audit against.
Baseline week: sample before you personalise
Before you let any bank's tracking start shaping your feed, take a small, blueprint-stratified sample of unseen questions and mark where you actually stand. Draw eight to ten questions from each major domain in a single timed pass, mixed rather than topic-filtered, and record first-attempt accuracy per domain and your seconds-per-item. This baseline does two jobs: it gives you a coverage map that is honest about breadth, and it protects a reference point you can retest later. Resist the urge to warm up on your weakest topic first — a topic-filtered warm-up cues the answer and inflates the very number you will spend months trying to beat.
First pass: set domain floors, not an overall target
The failure mode of any large bank is that a rising overall percentage hides the domains you have barely touched. Answer this by setting a minimum attempted-question floor for every domain — for example, no domain below 60% of its available items attempted before you call the first pass "done". Track attempted and first-attempt-correct separately, per domain, and rank domains by first-attempt accuracy, not by how many questions remain. If toxicology and paediatric resuscitation sit at the bottom, they earn the next block, regardless of how satisfying it would be to push an already-strong domain higher. Floors stop the algorithm — and your own preference — from parking the uncomfortable syllabus behind an attractive headline number.
Review with an error code, not a highlighter
Re-reading a full explanation feels like work and teaches little. Instead, give every miss one code and one corrective action. Six codes cover almost everything in Fellowship written practice: knowledge gap (you did not know the fact or rule); misread stem (you knew it but read the wrong detail, or missed "except" or "most likely"); premature closure (you locked onto the first plausible option); guideline error (your rule has moved on from current practice); calculation error (a dose, rate, clearance or units slip); and time-pressure error (a mistake that only appears at pace). The distribution matters more than any single miss: a pile of misread-stem codes is a reading-under-pressure problem, not a knowledge problem, and no amount of extra reading will fix it.
Which misses earn a repeat, and which do not
Not every error deserves the same treatment, and repeating the original question is rarely right — you will remember the item, not the principle. Sort by code. A knowledge gap earns a short, bounded source read and a fresh transfer question a day or two later. A guideline error earns a note of the current rule and its date, then a transfer question. Premature closure and misread stems earn deliberate slow-then-fast drilling under a clock, not more re-reading. Calculation errors earn a handful of worked variants until the method is automatic. Only genuine, isolated knowledge gaps justify spaced review of the same fact; everything else is trained on new items, so you are testing the rule rather than your memory of one stem.
When to switch from topic blocks to timed random
Topic-filtered practice is a scaffold for weak foundations, and it should come down as soon as it has done its job. Switch a domain from topic-filtered to timed random blocks when it clears three objective bars: its attempted floor is met, its first-attempt accuracy is stable across two separate sessions, and your pace on it sits within the paper's per-item budget. You do not need every domain to clear the bar at once — retire them one at a time. By the final phase, the majority of your practice should be full-length, mixed, timed blocks, because that is the only condition that rehearses both retrieval and the switching cost of moving between unrelated problems at speed.
Exit criteria: what "ready", not "finished", looks like
Bank completion is not an exit criterion. Stop when five things are simultaneously true: every domain has cleared its coverage floor; first-attempt accuracy on unseen, mixed items is stable across at least two timed sessions; your pace holds to the paper's per-item budget under full-length conditions; corrected rules survive a delayed retest rather than decaying within a week; and — the step candidates skip — your performance calibrates against official ACEM material, not just the bank. A finite official specimen or past paper is the gold standard for the exam's register and expectations; a commercial bank supplies the volume the official set cannot. If your bank score is strong but you have never checked it against official material, the audit is not finished.
A worked seven-day loop around clinical work
This is a realistic week for a trainee working clinical shifts, using ACEMCQ for one defined job — Fellowship-level written practice — and iatroX for a different, honestly narrower job. iatroX covers ACEM Primary, not the Fellowship: use it only to keep the basic-science foundation (anatomy, physiology, pharmacology, pathology) that Fellowship stems assume solid, and to measure that foundation on unseen MCQs. It is not a Fellowship SAQ or OSCE tool, and nothing here claims access to any platform's internal algorithm.
- Monday (30 min): one timed ACEMCQ SCQ block, mixed, floors updated.
- Tuesday (30 min): review Monday's misses by code, one corrective action each.
- Wednesday (40 min): two ACEMCQ SAQs under the clock; read the automated marks as a checklist of points covered, then compare against a model answer's structure.
- Thursday (20 min): an iatroX unseen block on a weak basic-science thread — say, acid–base or inotrope pharmacology — to confirm the foundation under a Fellowship gap is not the real problem.
- Friday (30 min): transfer questions on the week's error themes, new items only.
- Saturday (45 min): one full-length mixed timed block; log pace.
- Sunday (15 min): delayed retest of last week's corrected rules; anything that decayed goes back into the pool.
Continue, supplement, switch or stop
- Continue with ACEMCQ if your coverage floors are rising, misses are shifting from knowledge gaps to technique, and your unseen first-attempt accuracy is trending up.
- Supplement (do not replace) if a measurable gap sits outside what a written bank trains — OSCE performance, or a shaky basic-science foundation. For the foundation layer, a free Primary-level measurement bank such as iatroX earns its place under the two-Q-bank rule; for the OSCE, you need real cases and observers, not more MCQs.
- Switch banks only for a measured reason — a domain the bank genuinely under-covers, or explanations you cannot trust — never for novelty.
- Stop adding new questions when all five exit criteria hold. More volume past that point buys reassurance, not readiness.
Frequently asked questions
Is ACEMCQ enough for ACEM Fellowship on its own? For the written papers, ACEMCQ is a strong, purpose-built option: vendor-reported figures of 2,000+ MCQs and 700+ SAQs (20 July 2026) give enough volume to drill both papers properly. But "enough" for the Fellowship as a whole is a different question, because the Fellowship includes an OSCE that no written bank reproduces. Use ACEMCQ as your written engine and pair it with genuine, observed clinical case practice for the OSCE.
Which ACEM Fellowship component does ACEMCQ not reproduce well? The clinical OSCE. ACEMCQ can rehearse SAQ writing and SCQ selection, and its automated SAQ marking is a useful drafting signal, but the OSCE's stations of history, examination, communication, resuscitation discussion and teaching require observed, timed, interactive practice with a human assessor. The automated marks also need calibrating against a real examiner rubric before you trust the number.
How many ACEMCQ questions should I complete per day for ACEM Fellowship? There is no magic count, and daily volume is the wrong target. A sustainable pattern around shifts is one timed block of roughly 20–40 SCQs plus one or two marked SAQs on writing days, with review time protected. Consistency and honest review beat large daily totals; a smaller number of questions you actually analyse will move your score more than a bank you race through.
When should I stop using ACEMCQ and move to mixed mocks? Move the balance towards full-length, mixed, timed mocks once each domain has cleared its coverage floor and its first-attempt accuracy is stable at exam pace. You do not stop using the bank; you change how you use it — from topic-filtered learning blocks to random timed assessment that rehearses switching between unrelated problems, which is what the real paper demands.
How should I combine ACEMCQ with iatroX without duplicating practice? Give each a separate job. ACEMCQ is your Fellowship-level written practice; iatroX covers ACEM Primary, so use it only as the foundation-knowledge and unseen-MCQ measurement layer, checking that the basic sciences beneath a Fellowship stem are solid. Never re-answer the same item in two places; iatroX supplies the unseen block that tells you whether an ACEMCQ correction actually transferred.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. Question counts, access periods and prices for ACEMCQ are vendor-reported (acemcq.com.au) and were current at that date; verify the live figures and any offer changes on the product page before you buy. Disclosure: iatroX operates a question bank that competes at the ACEM Primary / foundation-knowledge level; this article confines iatroX's role to the underlying-knowledge and unseen-MCQ measurement layer and does not present it as a Fellowship SAQ or OSCE product. Corrections are welcome via the feedback route on iatrox.com. References: ACEM Fellowship examinations (acem.org.au); ACEMCQ product and pricing pages (acemcq.com.au); Your Q-Bank Percentage Is Not Your Exam Score; What MCQ banks cannot prepare you for in ACEM Fellowship; the iatroX two-Q-bank rule.