There are many different aspects of successful exam administration. To ensure that everyone taking an Aquifer exam is able to do so effectively, we have detailed the activities that need to happen and the responsibilities of everyone participating in the exam, including Custom Course Managers, Proctors, your institution’s Technical Support Staff, and Aquifer Support Staff. Aquifer has also developed several tools to enhance CDME exam administration that are provided here in one convenient location.


Aquifer will only offer a summative assessment option for Internal Medicine after June 2023.June 2023. Learn more about Aquifer Calibrate, our new formative assessment system for Family Medicine, Internal Medicine, Pediatrics, and Radiology.


Assessment Administrator’s Responsibilities

Custom Course Managers and Lead Course Administrators (Clerkship Administrators and/or Clerkship Directors) play a critical role in administering exams.

  • Complete our Aquifer Annual Exam Survey so we can be prepared and identify any challenges long before you need to administer the exam.
  • Secure a computer lab/testing room for each CDMEbeing administered.
  • Arrange for proctor(s) to monitor eachCDME. There should be one proctor for every 20-25 students, and at least one proctor in each examination room. Make sure each proctor understands his/her responsibilities and has access to the tools needed (see below).
  • Schedule technical support to be on call while each CDMEis taking place and make sure they are aware of their responsibilities (see below).
  • Ensure that all technology is tested in advance of administering each exam.

Please allow 75 minutes for the CDME exam. In addition, you may wish to plan on an additional 15-20 minutes to allow for orientation and other logistical items.

  • Schedule your CDMEwith Aquifer by completing the Aquifer Exam Request Form. To complete the form, you will need the following information:
    • Name of the Aquifer course for which you are ordering the exam
    • School name
    • Exam start date and time (ET)
    • Request for any additional time you will need for students with academic accommodations
    • Purpose of the exam (Pre-test, Practice, Midterm, Final)
    • Primary person to contact if there’s an issue during the exam (name, email, and phone number)
    • Any special circumstances not already cited (extended length exams, special accommodations, etc.)
  • Ensure that all students taking the CDME have registered to use Aquifer courses. Students who have not registered with Aquifer at least two weeks prior to the exam will not be able to take the exam.
  • Submit an Exported List of Students scheduled to take the exam from the Aquifer Reports Section.
  • Once the Exam Request Form and the Exported List of Students have been submitted, Aquifer will provide you with handouts the you may provide to the proctors to use for exam orientation.inate logins and passwords.

Aquifer will email CDMEresults to the Program/Course Manager within two business days of the completion of the exam. The Program/Course Manager will be responsible for releasing those results at his/her school.


Proctor’s Responsibilities

Aquifer requires that proctors are present during the exam to ensure that all exams are administered in a secure, proctored setting.

Please view our Video-proctoring FAQ’s for more information on video proctoring.

Ensure a standard testing room environment, including:

  • Exam workstations in a dedicated room that can be closed off from the rest of the facility to minimize noise and outside distractions during testing.
  • Exam workstations that are forward facing with adequate spacing in order to reduce students’ ability to view another’s monitor and to ensure sufficient spacing between each workstation.
  • A designated area where students can store personal items such as cell phones, iPads, tablets, media devices, papers, books, coats, purses and backpacks. These are NOT allowed in the exam space.
  • Appropriate access to the room for people with disabilities in compliance with the Americans with Disabilities Act of 1990 (in the United States) or your country-specific requirements.
  • Proctors may also want to consider designating a separate testing room for students who have been approved for extra testing time.

Proctors should be prepared to access appropriate tools and technical support staff should any issues arise, including:

  • A dedicated workstation that has been checked for exam compatibility before the exam day
  • Access to a telephone with an outside line for use during the test session in case the proctor needs assistance during the exam.
  • The phone number and email address for relevant technical support staff.
  • Access to our Exam Troubleshooting Tips, which provides suggested solutions to the most common problems that may arise during the testing session

Proctors will fulfill duties which include:

  • Arrive at least 15 minutes before the exam session.
  • Startup institution workstations (if necessary).
  • Admit students to the exam room, ensure students do not bring phones or tablets into the room, check students off the roster, and distribute student handouts.
  • Orient students to the exam and read the following statement to students:
    “The materials used in the Aquifer examinations are the copyrighted property of Aquifer. If you distribute examination materials, by any means, including reconstruction through memorization, you are in violation of the rights of the owners. You are prohibited from communicating, publishing, reproducing, or transmitting any part of your exam, in any form, or by any means, verbal or written, for any purpose. Every legal means available to protect Aquifer examination materials and secure redress against those who violate copyright law may be pursued. If you become aware of any suspicious activity related to an Aquifer exam administration, please notify the proctor or clerkship director, or submit a report.”
  • Direct students to begin the exam at the designated time using the login and password on the student handouts.
  • Monitor the progress of all students after they launch their exams and report any issues.
  • Ensure that the exam is being monitored at all times (students should never be left alone in the room).
  • Check that each student has submitted his/her exam once they have completed the test and collect each student’s handout before he/she leaves the room.

Exam Support

If an issue arises during the exam:

    1. Contact your institution’s technical support staff.
    2. Access Aquifer Exam Troubleshooting Tips.
    3. If neither of those addresses the issue, contact Aquifer’s exam support staff weekdays 8 am – 5 pm ET, except federal holidays.

Contact exams@aquifer.org or (603) 727-7002 ext. 2 with any questions about test administration activities.


Security Reminder

Please remind all faculty and students that all exam content is confidential and should not be shared with anyone, at any time, in any way.