Emergency medicine (EM) is rich in what is known as narrative medicine. Stories are the foundation of our practice. Patients tell us their stories. We edit them and add in our own details (test results, radiography, etc). We often retell these stories: if we are students to attending physicians during clinical rotations; if we are attendings or residents to colleagues and consultants when we seek input into a complex case; and even back to patients when we have solved the case, or at least written the next chapter.

It is wholly appropriate that the American Board of Emergency Medicine (ABEM) incorporates an oral examination into its certification process. As a process the ABEM oral examination involves elements of an Observed Structured Clinical Encounter (OSCE) and simulation, though it does not incorporate high-fidelity simulation (yet). As with an OSCE the process must be organized and thorough because it is observed and scored. Like a simulated patient it evolves in a version of “real time” in which decisions and commitment to certain pathways must be made. You must interact with the examiner as if you are speaking to a real patient, a real family member, a real consultant, or other real staff.

The oral board examination “stories” actually unfold in hotel bedrooms. The exam is given at the Chicago Marriott O'Hare Airport Hotel. The cases are administered within the guest rooms along a long hallway. It is important to know this upfront so months of preparation are not undone by surprise at the setting.