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*|
||2 hours, 45 minutes**||The score report includes:
|Internal Medicine||100||2 hours, 30 minutes||The score report includes:
*Score reports are posted to the NBME Services Portal 48-72 hours after test administration.
Fees for Advanced Clinical Examinations can be found here.
Residency Program Director,
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
(C) Measurement of serum IgE
(D) X-ray of the chest
(E) Tracheal intubation