ABEM prioritization cases, explained
The prioritization case is one of the clinical cases on the ABEM Certifying Exam. Instead of a single patient, you are handed a department. Here is what the case is really testing and how to practice it.
What the case looks like
You are handed several patients at once
Instead of one patient, you get a board of them — each with a chief complaint and a snapshot of vitals. Your job is to decide the order: who you see, treat, and act on first, and who can safely wait.
It tests triage judgment, not encyclopedic recall
The case rewards recognizing which patient is sickest and cannot wait, and acting on that fast. It is about the shape of your judgment under time pressure — the same instinct you use walking into a full department.
The board changes on you
New information and new patients arrive mid-case, and you are expected to re-sort as they do. Staying flexible — and re-checking who is now most dangerous — matters as much as your first call.
You use your team
You are not doing everything yourself. Part of the case is delegating — directing nurses and staff — so that the sickest patient gets acted on while other work happens in parallel.
Common traps
- Anchoring on the first interesting patient and leaving a sicker one waiting.
- Being lulled by a normal-looking vital sign and under-triaging a dangerous complaint.
- Trying to do everything yourself instead of delegating to the team.
- Not re-sorting the board when a new patient or new information arrives.
How to practice it
You cannot build triage instinct by reading — you build it by being handed a board and forced to choose, over and over, under a clock. Practice sorting a live multi-patient board out loud, commit to an order, and then see how the case grades your calls as new patients arrive.
PrepEM includes timed prioritization cases on a live tracking board, with sequential examiner questions and mid-case interruptions. See also the clinical decision-making cases guide and how to pass the ABEM oral boards.