This workflow is for ACEM Fellowship candidates who lean on Life in the Fast Lane (LITFL) and want to use it well without letting it blur into their question practice. LITFL addresses the knowledge that underpins every Fellowship component — the reading behind your written answers and your OSCE reasoning. Its principal limitation is that it is a reference library, not a measurement tool: you cannot get a timed, scored, unseen readiness signal from prose, however good the prose is. The job here is to keep reference and measurement in separate lanes.
What LITFL offers for the ACEM Fellowship right now
The description below is vendor/site-reported and last checked on 20 July 2026. Confirm current details on litfl.com.
| Item | What LITFL is (site-reported, 20 July 2026) |
|---|---|
| Type | A free FOAM reference library and blog — not a structured, native question bank with analytics. |
| Core assets | The Critical Care Compendium, a large ECG library, a clinical-cases collection, and toxicology and imaging resources, organised by topic. |
| Exam material | A curated ACEM Fellowship resources page that links to external MCQs, practice SAQs and OSCE examples, rather than hosting a large native question bank. |
| Question count / analytics | Not applicable in the Q-bank sense; LITFL curates and links question resources but is not a scored, adaptive bank. |
| Price | Free to access. |
| Components supported | Reference knowledge underpinning all three components; not a scored SCQ engine, not an SAQ-marking tool, not an OSCE circuit. |
The honest framing is that LITFL is one of emergency medicine's best free reference libraries, and a genuinely strong option in a revision stack — but its role is to teach, not to measure. Asking "how many LITFL questions per day?" is a small category error; LITFL is where you go to understand something, not to score yourself on it.
The exam you are actually training for
The ACEM Fellowship written examination is two 180-minute papers, six hours total: a Short Answer Question paper and a Single/Select Choice Question (multiple-choice) paper. The OSCE is separate — up to twelve stations of eleven minutes each (four minutes reading, seven minutes assessment), 132 minutes over two consecutive days. The written papers sample the FACEM Curriculum Framework, dominated at written level by Medical Expertise and Prioritisation and Decision Making, with ACEM publishing no fixed percentage weightings. The full blueprint treatment is in the ACEM Fellowship content-gap checklist.
Where iatroX fits, stated precisely: iatroX covers the ACEM Primary examination — a foundation-knowledge and unseen single-best-answer bank at Primary-level anatomy, physiology, pharmacology and pathology. It is not a Fellowship SAQ, SCQ or OSCE product. Alongside LITFL it plays the measurement role LITFL cannot: an unseen, timed check on whether the foundational science you read about has actually stuck.
Defining the library's role
Be deliberate about which of four roles you are asking LITFL to play, because they demand different discipline. As an authoritative reference it is excellent for deep dives — the Critical Care Compendium and ECG library reward genuine study. As a concise revision text it is patchier: some pages are exhaustive, others are pointers, so it is not an even syllabus. As a clinical-update source it is strong and current. What it is not is an examination syllabus surrogate: reading LITFL end to end will not guarantee blueprint coverage, and its curated exam links are a starting map, not the territory. Name the role before each session so you do not drift from learning into aimless browsing.
Mapping content to the blueprint
Map LITFL's strengths against what the written and OSCE actually sample, and the gaps become clear. Its ECG library, toxicology content and critical-care material map beautifully onto high-yield written domains, and its clinical cases build reasoning that helps the OSCE. But several exam demands are difficult to practise through prose alone: SAQ construction under time, the discrimination between four defensible SCQ options, spoken OSCE performance, and calculation-heavy items. Prose can explain these; it cannot drill them. Those are exactly the domains where a question bank and a mock circuit, not a reference library, do the work.
Assessing the library on its own terms
Judge LITFL as a reference on five practical criteria. Recency: generally current, though undated or older pages exist, so check the last-updated signal on anything guidance-sensitive. Jurisdiction: strong on Australasian practice, including local toxinology, which is a real advantage for this exam. Citation quality: variable — some pages are heavily referenced, others are expert summary, so treat it as a well-informed guide rather than a primary source, and confirm critical facts against current Australasian guidance. Images and tables: a particular strength, especially the ECG and imaging collections. Findability under time pressure: good, but the very richness that makes it excellent for study makes it a poor place to "quickly look something up" mid-block without derailing your timing.
The transfer test
Reading feels productive, which is exactly why it needs a check. After you study a LITFL topic, close it and attempt a fresh vignette that demands application, not recall of LITFL's wording — ideally a question you have never seen, in your bank or in an unseen iatroX foundation block for the underpinning science. If you can reason the fresh case, the reading transferred. If you can only recall what the page said, you have learned the page, not the principle, and the topic needs active practice rather than another read.
The duplication test
The overlap risk is subtle. When your question bank's explanations already cover a concept well, re-reading the same concept on LITFL feels like progress but adds little — it is duplicated exposure, not new learning. Reserve LITFL for where it adds genuine depth beyond the bank's explanation: the mechanism the bank glossed, the ECG the bank described in one line, the toxicology the bank simplified. If LITFL is only restating your bank, you are duplicating; if it is deepening, you are compounding. Audit which one is happening.
The closed-book rule
This is the discipline that keeps the workflow honest. During learning, open-book lookup on LITFL is fine and encouraged — that is what a reference is for. During measurement, it must be removed entirely: no LITFL tab open, no "just checking" mid-question. A readiness signal earned with a reference library open is not a readiness signal; it measures your searching, not your knowing. Separate the two modes by the clock — reference time and closed-book measurement time never overlap.
A seven-day pattern around clinical shifts
Use LITFL for one defined job — deepening the knowledge behind a weak topic — and iatroX for a separate, closed-book job: measuring whether the underpinning foundation transferred.
- Day 1: Identify your weakest domain from your bank's distribution; study it on LITFL (for example the ECG library for a cardiology weakness).
- Day 2: Closed-book, attempt fresh timed questions on that domain in your Fellowship bank; code the misses.
- Day 3: A short, closed-book iatroX block of unseen Primary-level items on the underpinning science, to confirm the floor is solid.
- Day 4 (clinical): Look up one real case on LITFL after your shift; no measurement today.
- Day 5: Transfer test — a fresh vignette on the week's topic, closed-book, to prove application.
- Day 6: SAQ or OSCE practice on the same topic, marked by a peer or against a model answer — the format work LITFL cannot supply.
- Day 7: Review; decide whether the topic is closed or needs another reference-and-test loop.
Decision checklist: continue, supplement, switch or stop
- Continue using LITFL for depth wherever it genuinely extends your bank's explanations.
- Supplement it — always — with a scored question bank and format-specific SAQ and OSCE practice, because a reference library measures nothing.
- Switch a topic out of "reference" mode and into "drill" mode once you can recite the page but still miss fresh questions on it.
- Stop re-reading LITFL on a topic when it only duplicates your bank and your unseen accuracy there is already stable — that time belongs to a thinner domain.
The bottom line
Life in the Fast Lane is a strong, free reference library and a legitimate part of an ACEM Fellowship stack, especially for ECGs, toxicology and critical care in an Australasian context. It is not a question bank, not a scored readiness tool, and not an OSCE circuit, and treating it as any of those confuses reading with rehearsal. Keep it firmly in the reference lane, protect a closed-book measurement lane beside it, and let each do the job it is actually good at.
Frequently asked questions
Is Life in the Fast Lane enough for ACEM Fellowship on its own? No, because it is a reference library rather than a complete preparation product. LITFL can teach much of the knowledge the Fellowship assumes, and it is strong on Australasian ECGs, toxicology and critical care, but it does not provide scored SCQ practice, marked SAQ technique or an OSCE circuit. Used alone it builds understanding without ever measuring readiness, so it belongs alongside a question bank and format-specific practice, not in place of them.
Which ACEM Fellowship component does Life in the Fast Lane not reproduce well? None of the assessed formats, strictly speaking, because it does not assess. It cannot mark a timed SAQ against an examiner rubric, it does not run a scored SCQ paper, and it does not stage the twelve-station OSCE. Its curated exam page links to external examples of these, which is useful orientation, but a reference library reproduces the knowledge behind the exam, not the performance conditions of it.
How many Life in the Fast Lane questions should I complete per day for ACEM Fellowship? This question does not quite fit LITFL, because it is a reference library rather than a per-day question engine; it curates and links questions rather than hosting a large scored bank. The better daily habit is to study one weak topic on LITFL and then test it closed-book in your actual question bank. Chasing a daily LITFL "question count" misreads what the resource is; use it to understand, and use a bank to score.
When should I stop using Life in the Fast Lane and move to mixed mocks? You do not really "stop" a reference library — you keep it for targeted depth — but you should shift the balance towards mixed, timed mocks once your coverage is even and your knowledge gaps are closing. As the exam approaches, reference reading should shrink to answering specific, identified gaps, while closed-book timed mocks and OSCE rehearsal dominate. If you are still reading broadly instead of testing, you are postponing the measurement that actually predicts exam day.
How should I combine Life in the Fast Lane with iatroX without duplicating practice? Keep them in different lanes by design. Use LITFL as an open-book reference to learn and deepen a topic, and use iatroX only as a closed-book, unseen, timed check on the ACEM Primary-level foundation beneath that topic — never with a LITFL tab open. Because LITFL hosts no large native scored bank, the duplication risk is low, but the discipline that matters is temporal: reference time and measurement time never overlap, or your iatroX signal stops meaning anything.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. LITFL details are site-reported on that date and can change; confirm current content and any exam-resource links on litfl.com, and confirm the examination format and fees on acem.org.au. Honesty flag: Life in the Fast Lane is a free FOAM reference library, not a structured scored question bank; it curates and links external question resources rather than hosting a large native bank with analytics, so this audit treats it as a reference source. Disclosure: iatroX operates a question bank, but only at ACEM Primary level; it is not a Fellowship SAQ, SCQ or OSCE product and is confined here to unseen, closed-book measurement of foundational knowledge. Corrections are welcome via the feedback route on iatrox.com. References: Life in the Fast Lane (litfl.com), including its ACEM Fellowship resources, ECG and toxicology libraries; Australasian College for Emergency Medicine examination and FACEM curriculum pages (acem.org.au); iatroX ACEM Primary bank, the comparison hub, the two-Q-bank rule, and Your Q-Bank Percentage Is Not Your Exam Score.