Authentication is vital for the Internet of Things (IoT) applications involving sensitive data (e.g., medical and financial systems). Digital signatures offer scalable authentication with non-repudiation and public verifiability, which are necessary for auditing and dispute resolution in such IoT applications. However, digital signatures have been shown to be highly costly for low-end IoT devices, especially when embedded devices (e.g., medical implants) must operate without a battery replacement for a long time.We propose an Energy-aware Signature for Embedded Medical devices (ESEM) that achieves near-optimal signer efficiency. ESEM signature generation does not require any costly operations (e.g., elliptic curve (EC) scalar multiplication/addition), but only a small constant-number of pseudo-random function calls, additions, and a single modular multiplication. ESEM has the smallest signature size among its EC-based counterparts with an identical private key size. We achieve this by eliminating the use of the ephemeral public key (i.e, commitment) in Schnorrtype signatures from the signing via a distributed construction at the verifier without interaction with the signer while permitting a constant-size public key. We proved that ESEM is secure (in random oracle model), and fully implemented it on an 8-bit AVR microcontroller that is commonly used in medical devices. Our experiments showed that ESEM achieves 8.4× higher energy efficiency over its closest counterpart while offering a smaller signature and code size. Hence, ESEM can be suitable for deployment on resource limited embedded devices in IoT. We open-sourced our software for public testing and wide-adoption.