EFMB Written Test: What's on It

The EFMB written test is 60 multiple-choice questions, 90 minutes, taken on a digital platform with a proctor in the room, and it is the only EFMB event you're allowed to fail once. Every other event is single-attempt. That makes the written test both the most forgiving event on the calendar and the one with the least excuse for failing: it's the only part of the EFMB you can fully prepare for from home, months in advance.

The format

Per MEDCoE PAM 350-10, Chapter 5:

• 60 multiple-choice questions, completed within one hour and 30 minutes.
• Administered digitally, in the physical presence of a proctor (an EFMB awardee, SGT or above), in a controlled setting. You'll get one blank sheet of scratch paper, which is collected and shredded after.
• Candidates must earn a passing score before the final day of EFMB testing.
• One retest (RT) is available to candidates who fail the written test, the only retest anywhere in the EFMB. The RT is taken on a subsequent day, never the same day as the WT.
• Both the WT and RT are non-rebuttable. There's no appeal process for the written events.
• A passing result is valid for 120 days from the completion date on the certificate, which matters if your unit administers the test before the site's train-up period.

Host units choose when to run it: some administer the written test as a prerequisite before you ever travel to the test site; others run it at the site during train-up or testing. The digital test window stays open no more than 60 days either way.

What it tests: the 24 CPGs

The written test evaluates institutional knowledge of selected Joint Trauma System Clinical Practice Guidelines. The CPGs listed at Table 5-1 of PAM 350-10. That table is the test's complete stated reference list: 24 guidelines spanning, among others:

• Trauma care: whole blood transfusion, blood transfusion, war wound debridement and irrigation, infection prevention in combat-related injuries
• Burns and environment: burn care, burn wound management in prolonged field care, frostbite and immersion foot, drowning management, inhalation injury
• Prolonged field care: TBI management, nursing intervention, documentation, pain/anxiety/delirium
• The unusual ones people skip: military working dogs, unexploded ordnance management, global snake envenomation, spider and scorpion envenomation, aural blast injury, the i-STAT portable blood analyzer, imaging trauma patients in a deployed setting, frozen and deglycerolized red blood cells, interfacility transport, and CBRN injury response (parts 1 and 2)

Notice what that list implies about strategy. Most candidates are comfortable with the core trauma material. It overlaps their MOS training. The questions that separate passing from failing tend to come from the guidelines nobody reads voluntarily: the working-dog CPG, envenomation, UXO management, CBRN. Sixty questions across 24 references means every guideline you skip is a cluster of questions you're guessing on.

How to prepare

Study the actual CPGs, not summaries of summaries. The JTS publishes them publicly. They're long, but the testable material (indications, thresholds, sequences, dosing rules of thumb) is a small fraction of each document.

Use practice questions to find your weak guidelines, not to memorize answers. The value of a practice bank is diagnostic: 60 questions across 24 CPGs is a coverage problem, and you want to discover before test day that you've never actually read the frostbite guideline. Every question in our EFMB bank is written against PAM 350-10's reference list and carries its citation, so when you miss one, you know exactly which CPG to open.

Respect the retest rule but don't plan on it. One RT exists, on a different day. It's a genuine safety net, and it's also the difference between a stressful week and a relaxed one. Candidates who arrive at the site with the written test already passed (where the host unit allows it) carry one less event through train-up.

Timing: the pass certificate's 120-day validity means you can bank a written-test pass well before testing if your unit administers it early. If you get the choice, take it. It converts your site time into pure lanes-and-events preparation.

Where it fits in your overall prep

The written test is the knowledge event; everything else is performance. The right sequencing is to handle the CPG study early and steadily, since you can read a guideline on staff duty and it competes with nothing, then reserve the weeks near the test for lane score-sheet drilling and the physical peaking the EPFA and 12-mile march demand. The full study plan puts the pieces in order.