Start with an honesty check, because it changes the whole plan: ED MCQ (edmcq.com) is a spaced-repetition multiple-choice app built around the ACEM Primary examination and everyday emergency-department practice, not the ACEM Fellowship. If you are sitting the Fellowship written papers, ED MCQ is a foundation and knowledge-maintenance tool, not a Fellowship SAQ or SCQ bank. This article shows how to use it well for the job it genuinely does — and, just as importantly, where to get the Fellowship-level practice it cannot give.
What ED MCQ actually covers (and what it does not)
The figures below are vendor-reported (edmcq.com) and were current at the last-checked date of 20 July 2026; verify them on the product page.
| Item | Vendor-reported position (20 July 2026) |
|---|---|
| Primary focus | ACEM Primary examination and emergency-clinician education |
| Fellowship coverage | Not a Fellowship SAQ/SCQ product; no SAQ component |
| Question count | 550+ questions, added weekly |
| Format | Multiple-choice only, delivered with spaced repetition |
| Topics | 70+ ED topics (including orthopaedics, paediatrics and toxicology); a growing radiology set |
| Price / access / AI | Not clearly published on the reviewed pages — verify current pricing, access period and any adaptive features before relying on them |
The honest headline for a Fellowship candidate is that ED MCQ sits a level below the exam you are sitting. That is not a criticism: a solid Primary-level foundation in the basic sciences is exactly what Fellowship stems assume. It simply means ED MCQ belongs in your foundation-and-maintenance layer, with Fellowship-specific practice coming from a Fellowship bank and from clinical case work.
The exam you are actually sitting
The ACEM Fellowship written examination is two 180-minute papers — a Short Answer Questions (SAQ) paper and a Single Choice Questions (SCQ, multiple-choice only) paper — for six hours in total. The clinical examination is an OSCE of up to 12 stations, each 11 minutes (four minutes reading, seven minutes assessment), for 132 minutes over two consecutive days. College-reported fees at the last-checked date were AUD $3,145 (written) and AUD $4,450 (OSCE); verify on acem.org.au. The Fellowship is pitched at junior-consultant level and built on the FACEM curriculum. ED MCQ maps to the basic-science and core-practice foundation beneath that level — worth having solid, but not the same register as a Fellowship SAQ. Keep the official ACEM pages, not a third-party app, as your source of truth on format and blueprint.
Build a blueprint inventory and protect an unseen pool
Because ED MCQ is topic-tagged rather than mapped to the Fellowship blueprint, do the mapping yourself. List the Fellowship domains, then note which ED MCQ topics feed each one, and — crucially — set aside a protected pool of questions you will not touch until a timed mixed assessment. Spaced-repetition apps are designed to resurface items you have seen, which is excellent for retention but corrosive for measurement: if every question is one you have met before, your accuracy tells you about recognition, not readiness. Reserve perhaps a fifth of the available items as an unseen pool and guard it.
First pass: mixed by default, topic-filtered only where foundations are weak
Start mixed. Topic-filtered blocks are a crutch that cues the answer — knowing every question is a toxicology question does half the discrimination for you. Reserve topic-filtered practice for the specific foundations that are genuinely weak (a physiology thread you never nailed, a drug class you avoid), and drop the filter the moment first-attempt accuracy in that topic is stable. Everywhere else, mixed blocks better simulate the cognitive switching the real paper demands.
Review each miss with one code and one action
Do not transcribe the explanation. For every miss, write one error code — knowledge gap, misread stem, premature closure, guideline error, calculation error or time-pressure error — and one corrective action. The code is the useful artefact: a run of misread-stem codes means you are reading too fast under pressure, and the fix is pacing drills, not more content. Transcribing full explanations produces beautiful notes and little retention; a one-line code you can count is what tells you where the week's effort should go.
Use transfer practice, not repetition, to beat the memorisation trap
This is how you use ED MCQ "without memorising the bank". When you get an item wrong, do not simply re-queue the same question — spaced repetition will eventually make you recognise it regardless of whether you understand it. Instead, answer a fresh item that tests the same principle in a different presentation before you allow the original back into rotation. If you cannot find one in the app, that is precisely where an unseen measurement bank earns its keep: iatroX (ACEM Primary level) can supply a new MCQ on the same underlying basic-science point, so you are testing the rule, not your memory of one screen.
Switch to mixed timed blocks when domain floors are met
Move from learning mode to assessment mode when your self-mapped domains clear their floors — attempted-question minimums met and first-attempt accuracy stable — even if you have not seen every item. Completing the app is not the goal; a stable, unseen, timed performance is. From that point, most sessions should be full-length mixed timed blocks drawn partly from your protected pool.
Exit criteria: coverage and unseen performance, not 100% completion
Stop when coverage floors are met across your mapped domains, unseen timed performance is stable across at least two sessions, your pace holds under full-length conditions, corrected rules survive a delayed retest, and your standard is calibrated against official ACEM material rather than the app's internal scoring. Reaching 100% completion of a spaced-repetition app tells you that you have seen every card, which is not the same as being ready — and for the Fellowship specifically, none of it speaks to the SAQ or the OSCE.
A worked seven-day loop around clinical work
Here ED MCQ does one job — keeping the Primary-level foundation solid and spaced — while iatroX supplies unseen transfer measurement at the same foundation level, and a Fellowship bank plus clinical case work carry the Fellowship-specific load. No proprietary-algorithm claims are made about any platform.
- Monday (15 min): ED MCQ due cards cleared; misses coded.
- Tuesday (25 min): a Fellowship-bank SCQ block (your Fellowship-level engine), reviewed by code.
- Wednesday (15 min): ED MCQ topic-filtered block on this week's weak foundation only.
- Thursday (20 min): an iatroX unseen MCQ block on the same basic-science threads, to confirm the foundation transferred.
- Friday (30 min): Fellowship-bank SAQ practice against a model answer.
- Saturday (40 min): full-length mixed timed block from your protected pool; log pace.
- Sunday (10 min): delayed retest of corrected rules; decayed items re-queued.
Three mistakes to avoid with a Primary-level app
First, reading a high ED MCQ percentage as Fellowship readiness. The app sits at Primary level, so a strong score confirms your foundation is solid — genuinely useful — but says nothing about your SAQ writing or OSCE performance. Track it as a foundation signal, never as a headline number.
Second, letting spaced repetition drift into recognition. When the same items keep resurfacing, accuracy climbs even as understanding stands still. Break the loop with transfer questions on unseen items, so you are testing the principle rather than your memory of a screen.
Third, over-investing time here because it is comfortable. A shift-friendly app is easy to open on a break, and it is tempting to let it absorb hours that belong to Fellowship-level written and clinical practice. Cap the daily maintenance at fifteen to twenty-five minutes and spend the rest where the marks actually are.
Continue, supplement, switch or stop
- Continue ED MCQ if your foundation is measurably firming up and you value the spaced-repetition maintenance around shifts.
- Supplement it — this is the honest default for a Fellowship candidate — with a genuine Fellowship written bank for SAQ/SCQ practice and with observed clinical practice for the OSCE. ED MCQ cannot carry the Fellowship alone.
- Switch the bulk of your effort to Fellowship-level resources once your foundation is stable; keep ED MCQ only as light maintenance.
- Stop when foundation coverage and unseen performance are stable; do not chase a completed deck.
Frequently asked questions
Is ED MCQ enough for ACEM Fellowship on its own? No, and this is the key honesty point: ED MCQ is built around the ACEM Primary examination and core ED practice, not the Fellowship. It has no SAQ component and no OSCE component, and its vendor-reported 550+ MCQs (20 July 2026) sit at foundation level. It is a reasonable maintenance and foundation tool, but Fellowship readiness needs Fellowship-level SAQ/SCQ practice and observed clinical case work in addition.
Which ACEM Fellowship component does ED MCQ not reproduce well? Almost all of the Fellowship-specific assessment. It does not train SAQ construction, it does not simulate the OSCE, and because it is multiple-choice only at Primary level, it does not rehearse the junior-consultant register the Fellowship written papers expect. Treat it as underpinning knowledge, not exam rehearsal.
How many ED MCQ questions should I complete per day for ACEM Fellowship? Enough to clear your due spaced-repetition cards plus a short topic block on a current weak foundation — often 15–25 minutes is plenty. Because it is a maintenance layer rather than your main engine, more time each day is better spent on Fellowship-level written practice and clinical cases than on grinding additional foundation MCQs.
When should I stop using ED MCQ and move to mixed mocks? Shift the centre of gravity to mixed, timed Fellowship-level mocks as soon as your foundation is stable on unseen items. You can keep ED MCQ ticking over as light maintenance, but it should never be the thing standing between you and full-length Fellowship written practice.
How should I combine ED MCQ with iatroX without duplicating practice? Keep them at the same level but on different jobs. ED MCQ is your spaced maintenance of the Primary-level foundation; iatroX (also ACEM Primary) is your unseen measurement of whether that foundation is genuinely retained and transferable. Do not answer the same item in both — let iatroX's fresh MCQs verify what ED MCQ has drilled, and send Fellowship-specific practice to a Fellowship bank.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. ED MCQ's question count, topic list and delivery model are vendor-reported (edmcq.com) and were current at that date; pricing, access period and any adaptive features were not clearly published on the reviewed pages, so verify them before relying on them. Disclosure: iatroX operates a question bank at the ACEM Primary / foundation level that overlaps with ED MCQ's register; this article confines iatroX's role to unseen-MCQ measurement of that foundation 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); ED MCQ (edmcq.com); Your Q-Bank Percentage Is Not Your Exam Score; What MCQ banks cannot prepare you for in ACEM Fellowship; Question-bank completion is not coverage.