ASCeXAM · PTEeXAM · CCEeXAM
The National Board of Echocardiography (NBE) certifies cardiologists, anesthesiologists, and intensivists through a family of high-stakes echo exams — the ASCeXAM for adult echocardiography, the Advanced and Basic PTEeXAM for perioperative transesophageal echo, and the CCEeXAM for critical care echo. These are the credentials hospitals, fellowship directors, and cardiac imaging labs look for, and each exam runs on a single fixed date once a year. Miss it, fail it, or stumble on the image-heavy case block and you wait an entire cycle. This page breaks down exactly how each NBE exam is built, how it's delivered, and how to clear it the first time.
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Four separate echocardiography board exams — one for each specialty pathway
| Exam | Official code | Who takes it | Format | 2026 fee |
|---|---|---|---|---|
| Adult Echocardiography | ASCeXAM | Cardiologists | 5 blocks · 200 items | $1,295 |
| Advanced Perioperative TEE | Advanced PTEeXAM | Cardiac anesthesiologists | 5 blocks · 200 items | $1,295 |
| Basic Perioperative TEE | Basic PTEeXAM | Anesthesiologists | 5 blocks · 150 items | $1,095 |
| Critical Care Echocardiography | CCEeXAM | Intensivists, EM physicians | Multiple-choice · annual | $1,295 |
The ASCeXAM and Advanced PTEeXAM are administered in July; the CCEeXAM runs on its own annual date (most recently scheduled for January). Recertification is now handled through the NBE's Maintenance of Certification in Echocardiography (MOCE) program rather than the retired ReASCE and RePTE exams.
How the NBE echo boards are built — at a glance (ASCeXAM / Advanced PTEeXAM)
5
Five blocks of 40 questions each, 54 minutes per block. You move through them in order — you cannot return to a previous block once it closes.
200
200 questions on the ASCeXAM and Advanced PTEeXAM (150 on the Basic PTEeXAM), mixing text multiple-choice with image- and video-clip interpretation.
25
A pooled 25 minutes of break time that may only be taken between blocks — never mid-block. Plan it carefully across a 4.5-hour exam.
A large share of items are tied to moving echo clips — 2D loops, color and spectral Doppler tracings, M-mode, and TEE views. You're asked to recognize pathology, measure, or interpret hemodynamics from real study material rather than from a static photo. This is where many candidates lose time and points, because reading a degraded loop under the clock is a different skill from answering a textbook stem.
The NBE reports a scaled score adjusted for the difficulty of the specific form you sat, with a single pass/fail outcome rather than a percentile rank. There is no negative marking, so every item should be answered. Pearson provides an on-screen calculator, a laminated note board, and dry-erase markers; no personal reference material is allowed.
The six published ASCeXAM content areas — bars show their approximate share of the exam
Ultrasound and Doppler physics, M-mode, 3D echo, artifacts, and the technical principles behind TEE and ICE. The most heavily missed area for clinicians who learned echo at the scanner rather than from the physics up.
Stenosis and regurgitation of all four valves, prosthetic valve assessment, endocarditis, and the quantitative methods (PISA, continuity, pressure half-time) used to grade severity.
Systolic and diastolic function, strain, stress echo, and the cardiomyopathies — including how to grade diastolic dysfunction from the full set of Doppler indices.
Segmental anatomy, nomenclature, shunt lesions, and post-operative evaluation — a low-frequency area in adult practice that is over-represented relative to how often clinicians actually scan it.
Cardiac tumors and thrombi, pericardial disease and tamponade physiology, contrast echo, and newer perfusion applications.
Heart failure, cardiac trauma, and echo guidance for structural interventions such as TAVR and MitraClip — the fastest-growing part of the blueprint.
Percentages are approximate and drawn from the published NBE content areas; the NBE does not commit to a fixed item count per domain. The PTEeXAM blueprint is anatomy- and view-based rather than disease-based, and the CCEeXAM emphasizes point-of-care and hemodynamic assessment, but all share the same image-heavy, scaled-scoring philosophy.
Two ways to sit an NBE exam — and what to expect on test day
You sit the exam in a quiet, monitored Pearson VUE Professional center. You must present two original, unexpired IDs whose names match — one government-issued primary ID plus a secondary ID with a name and signature or photo. Belongings are stored, and you're given a laminated note board and dry-erase markers.
The NBE added Pearson OnVUE as a remote alternative for all exams. You take it from a private room at home, monitored by a proctor through OnVUE. You run a system check, show ID, and complete a webcam room scan beforehand. The image and Doppler clips demand a sharp, well-calibrated screen — a real consideration for the online option.
Two valid, unexpired IDs with matching names. For OnVUE, the proctor photographs your ID and face before the exam unlocks; the name must match your NBE registration exactly.
For OnVUE: a clear desk, no second monitor, no phone within reach, and a full webcam sweep of the room. No one else may enter for the duration of the exam.
Breaks may only be taken between blocks, drawing from the pooled 25 minutes. Stay in frame on OnVUE; leaving the seat or losing connection can flag the session.
The NBE exams gate echo credentialing across several specialties
A physician credential with a real-world image bar
Difficulty: The echo boards are hard for a specific reason — the physics and quantitative methods are unforgiving, the image and Doppler clips reward pattern recognition you can only build from volume, and the exam runs once a year with no quick retake. Busy clinicians often underestimate the physics block and the congenital content. That single-sitting, image-under-the-clock pressure is exactly what our help is built to absorb.
The NBE exams are once-a-year, image-heavy, and stand between you and a credential your lab or fellowship depends on. Exam Assist pairs you with a vetted echocardiography specialist and works on a pay-after-you-pass model — so the risk sits with us, not you. No upfront fee, guaranteed results: Exam Assist handles the sitting end to end, and you settle only after the verified result.
Tell us which NBE exam (ASCeXAM, PTEeXAM, or CCEeXAM), your delivery method (center or OnVUE), and your test date. Takes a couple of minutes over WhatsApp, Telegram, or Discord.
We review your timeline against the annual date and tell you plainly whether it's realistic — before any money is discussed. If it isn't a fit, we say so.
Exam Assist handles the sitting end to end. You're matched with an echo specialist who maps the work around the physics block, the image and Doppler clips, and the OnVUE environment — discreetly and confidentially.
You only pay once your passing result is confirmed. No verified result, nothing owed.
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Straight answers about the NBE echocardiography board exams
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