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Advanced PTEeXAM® Examination of Special Competence in Advanced Perioperative Transesophageal Echocardiography

The Advanced PTEeXAM® is intended for those who wish to utilize the full diagnostic potential of perioperative TEE including direction of the perioperative surgical decision-making process. This computer-based exam is administered one day a year at Pearson VUE Professional Centers. To locate a test center click here.

Fees and Deadlines

Early Registration Fee Ends:  11:59 PM EST on Tuesday, March 21, 2023
Price: $995.00
Late Registration Fee Begins: 12:00 AM (Midnight) EST on Wednesday, March 22, 2023
Price: $1,195.00
Registration Closes: Promptly at 11:59 PM on June 20, 2023
** NO EXCEPTIONS will be made beyond this deadline **
Withdrawal/Refund Deadline: Wednesday, July 5, 2023
Deferments are no longer available
Exam Administration Date: Tuesday, July 25, 2023

Applicants for the Advanced PTEeXAM® must provide proof that they can practice medicine (MD, DO, MBBS, etc.). Please see the examination eligibility requirements below:

North American Trained Physicians must submit ONE of the following:

  • A valid (unexpired) license to practice medicine with expiration date
    • training or temporary licenses with valid expiration dates are accepted
  • Letter of Good Standing from ACGME Accredited program director
    • Letter must be on official letterhead, be signed by director and be notarized.
    • See Sample Letter of Good Standing here.

Non-North American Trained Physicians must submit ONE of the following:

  • A valid (unexpired) license to practice medicine with expiration date

If your license does not contain an expiration date, you will need ONE of the following:

  • An original letter from the Medical Council stating your license is permanent


  • An original certificate of good standing dated no more than 12 months prior to date application received.

All documentation must be supplied in English. If original documentation is not in English, a certified translation must be attached to each document. The examinee will be responsible for all costs associated with certified translation. Please allow yourself appropriate time if you need to obtain your medical license from a third party or translation is necessary.

NOTE: Only a copy of the Applicant’s current proof to practice medicine or a letter from current program director, completed application, and application fee are required in order to sit for the Advanced PTEeXAM®. Documentation for certification is not required when registering to take the Advanced PTEeXAM®, however, you may submit your certification documentation at any time after applying for your exam.

Prepare your information and submit your application for the ASCeXAM®.

You will need the following information to complete the application:

  • Personal contact information
  • Proof of license to practice medicine (pdf)
  • Supporting Documentation (pdf) if special accommodations are needed (see details below)
  • Payment information

VERY IMPORTANT: Please remember to type your name the SAME as it appears on the unexpired, photo-bearing, signed, government-issued identifications you will be using at the Pearson VUE Testing center. The name you provide on this application will be used to create the Authorization to Test (ATT). Discrepancies in your first and last names will cause you to be denied admittance to the examination.

Requests for Special Accommodations

NBE will provide, upon approved request, reasonable accommodations necessary to afford an individual with a documented disability an equal opportunity to participate in the ASCeXAM®. To support a request for special accommodations, please provide an original letter signed by the applicant and an evaluator, qualified psychologist, physician, or other health care professional who specializes in the stated disability.

The documentation must:

  • Be current (completed within the last five years)
  • Clearly state the diagnosed disability or disabilities
  • Describe the functional limitations resulting from the disability
  • Describe the specific accommodations requested and the rationale for such accommodations
  • Be typed or printed on official letterhead and signed by the evaluator qualified to make the diagnosis
  • Include example, when possible, of where special accommodations have been requested and granted. If no prior accommodations have been provided, the evaluator, psychologist, physician, or health care professional should include a detailed explanation as to why no accommodations were given in the past and why the accommodations are needed now. The purpose of the documentation is to validate that the candidate is covered under the ADA as a disabled individual. Additional documentation may be required to support the request.

All documentation submitted in support of a request for special accommodations will be kept confidential.

If breastfeeding/pumping accommodations are needed, please choose YES in the online application. You will need to upload supporting documentation during the registration process. Contact NBE’s office if you have questions or concerns. Requests for special accommodation must be received at NBE headquarters before 5:00 PM EST Tuesday, June 20, 2023.

Exam Length and Format

NDA: 5 minutes to complete

Tutorial: 10 minutes to complete

Block 1: Exam Section

  • Allotted Time-54 Minutes
  • 40 items in block

Block 2: Exam Section

  • Allotted Time-54 Minutes
  • 40 items in block

Block 3: Exam Section

  • Allotted Time-54 Minutes
  • 40 items in block

**Scheduled 15 Minute Break**

Block 4: Exam Section

  • Allotted Time-54 Minutes
  • 40 items in block

Block 5: Exam Section

  • Allotted Time- 54 Minutes
  • 40 items in block

End of Exam Survey: 10 minutes to complete

Totals for Day:

  • 200 total multiple-choice items
  • Timing:
    • 4.5 hours for exam items
    • A maximum of 5 hours including break, NDA, tutorial, and survey

Approved NBE Exam Candidates

Upon the approval of an application, candidates are sent an Authorization to Test (ATT) notification which will include your 1-day eligibility window to take the examination. The ATT provides instructions and details for scheduling your test date and location.

NBE’s examinations are administered on only 1 day at over 230 Pearson Professional Centers (PPC) in the United States and US territories and over 3,000 Pearson VUE Authorized Test Centers (PVTC) internationally. Examination site availability is provided when scheduling your examination with Pearson VUE. Do not contact Pearson VUE until you have received an Authorization to Test (ATT). Available sites may be viewed at

  • IMPORTANT: While the NBE tries to accommodate location preferences, preferred testing sites are NOT guaranteed, and travel may be necessary.

In the event you need to reschedule your examination, contact Pearson VUE at least two full working days in advance of your scheduled appointment. (Click here to review NBE’s exam cancellation/refund policy.)

  • Via phone: Call (800) 869-4102, 7:00 am to 7:00 pm, Central Standard Time, Monday through Friday (Outside of the U.S. (952) 681-3789).
    • $10.00 fee associated
  • Via internet (no fee): Go to

If you do not contact the Pearson VUE within 48 hours in advance of your scheduled appointment you cannot reschedule the examination.

Exam Day

The only people admitted into the examination room are

  • Test Administrators
  • Authorized Candidates

Identification (ID) Requirements

  • The first and last name that the candidate uses to register must match exactly the first and last name on both ID’s that are presented on test day.
  • All ID’s required must be issued by the country in which the candidate is testing. If the candidate does not have a qualifying primary ID issued from the country they are testing in, an International Travel Passport from their country of citizenship is required, along with a secondary ID.
  • Candidate is required to present two forms of original (no photo copies), valid (unexpired) ID’s; one form as a primary ID (government issued with name, recent recognizable photo, and signature) and one form as a secondary ID (with at least a name and signature, or name and recent recognizable photo).

Primary ID:

International Travel Passport

  • Driver’s license
  • Military ID (including spouse & dependents)
  • Identification card (national/state/province identity card)
  • Alien registration card (green card, permanent resident, visa)
  • Local language ID (not in Roman characters) – accepted only if issued from the Country the Candidate is testing in

Secondary ID:

  • Any ID containing at least name and signature, or name and recent recognizable photo that meets above ID requirement
  • In Japan, a valid Blue Japanese Health Card is acceptable

Click here to view Pearson VUE ID Policy

Maintaining Credentials

Testamurs and Diplomates of the NBE are required to take and pass the RePTE® in either the 8th, 9th, or 10th year surrounding their 10-year anniversary date to maintain their status with the NBE. Individuals who allow their status to expire will have their names removed from the NBE’s online Testamur/Diplomate listing page.

  • If a Diplomate does take and pass the RePTE® in the compulsory timeframe, but does not submit the required documentation for recertification, the candidate is eligible to apply for recertification at any time before the expiration of their Testamur status; however, when they do apply for recertification, they will have to pay a $200.00 reinstatement fee along with the recertification requirements. Once their application for recertification is approved, their status will be changed from Testamur to Diplomate of the level in which they were approved.
  • If a Testamur/Diplomate does NOT take and pass the RePTE® in the compulsory timeframe, the individual’s status will expire and then must pass the Advanced PTEeXAM® again. Additionally, Diplomates who do not take the RePTE® in the required 3-year period must meet the initial certification requirements and the CME requirements for recertification.
  • Testamurs who pass the Recertification examination will retain their status for an additional ten (10) years; e.g. if the Advanced PTEeXAM® was passed in 2020, the current Testamur status is valid until December 31, 2030. The recertification status will be extended until December 31, 2040, if taken and passed in the 8th, 9th or 10th year.
  • If Testamur or Diplomate status expires, applicants must then take the Advanced PTEeXAM® again.

Refund/Cancellation Policy

Candidates who wish to cancel/withdraw their registration and receive a partial refund (exam fee paid minus $200.00) MUST submit a written request to cancel/withdraw via email to or before Wednesday, July 5, 2023.

Any requests received after this deadline will not be processed.

*Deferments are no longer an option. We apologize for any inconvenience. *

Notice: It is REQUIRED to provide NBE with a copy of your appointment cancellation from Pearson VUE prior to receiving a refund.


Examination Administration Grievance Policy

If you believe that some unusual event or condition occurred during your exam administration at the Pearson VUE testing center that caused a significant adverse effect on your performance or ability to take the exam, you may submit an exam grievance.

Examples of an unusual event or condition include but are not limited to; issues with the ID presented for exam entry, computer issues, the internal or external environment at the test center and issues with the exam delivery or interruption of the exam delivery.

Please note: Medical issues or unforeseen acts of nature (such as weather) that keep you from arriving at the test center as scheduled, or a sudden onset of an illness during your exam that prevented you from completing your exam should not be filed as exam grievances. These types of issues must be submitted as an exception to policy and you should contact Krista Russell at Also, exam grievances may not be used to challenge the exam design, content or a failing score.

If you need to file an exam grievance regarding the administration of your exam, you must submit a detailed email and any appropriate and verifiable supporting documentation, if applicable, to the NBE within three (3) business days after the exam administration in question to

Contact an Examination Specialist
Our examination team is available M-F 8:45am-4:45pm EST