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Overview of the MRCEM examinations

• June 27, 2022

The Royal College of Emergency Medicine is made up of three examinations which will lead to the award of the Membership of the Royal College of Emergency Medicine (MRCEM) or the Fellowship of the Royal College of Emergency Medicine (FRCEM) of the College.

Once you have achieved either FRCEM or MRCEM both qualifications will be considered an acceptable GMC postgraduate qualification, thus eligible for registration.

The MRCEM is divided into:

1.MRCEM Primary 

2.MRCEM Intermediate SBA

3.MRCEM OSCE

The Fellowship examination consists of the following components:

1.FRCEM SBA examination

2.FRCEM OSCE

RCEM Examination fees 2022

MRCEM and FRCEM Intermediate exams:

MRCEM Primary - £330

MRCEM (OSCE) Objective Structured Clinical Examination - £450 / £650 India / £750 (Malaysia)

MRCEM SBA - £335

FRCEM SBA - £345

FRCEM OSCE - £465

MRCEM Examinations - Overseas Centres Any candidate who wishes to sit the examination in an overseas centre will be required to contact the local administrator to pay the local fee. Full details will be sent to all candidates allocated a place.

 

1.FRCEM Primary Examination

The MRCEM Primary examination is a theoretical exam mapped to the Emergency Medicine 2021 Curriculum with more detailed information provided in the RCEM Basic Sciences Curriculum (June 2010) which is available on the RCEM website. All applicants for the MRCEM Primary examination are strongly advised to familiarise themselves with the Basic Sciences Curriculum in preparation for sitting the MRCEM Primary examination.

Exam structure:

The MRCEM Primary examination consists of a 3-hour, multiple choice question (MCQ) paper of 180, single best answer questions (SBAQ).

The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of MRCEM and FRCEM examinations. The blueprint for the MRCEM Primary Examination is as follows:

Category	Sub-Category	Questions
Anatomy	Upper limb Lower limb Thorax Abdomen Head and Neck Central Nervous System Cranial Nerve Lesions	60
Physiology	Basic celluar physiology Respiratory physiology Cardiovascular physiology Gastrointestinal physiology Renal physiology Endocrine physiology	60
Pharmacology	Gastrointestinal Pharmacology Cardiovascular system Respiratory system Central Nervous System Infections Endocrine system Fluids and electrolytes Muscoskeletal system Immunological products and vaccines Anaesthesia	24
Microbiology	Principles of microbiology Pathogen groups	17
Pathology	Inflammatory responses Immune responses Infection Wound healing Haematology	9
Evidence Based Medicine	Statistics Study methodology Principles of critical appraisal	10
TOTAL		180

How do I prepare for FRCEM Primary Exam?

We advise that you start preparing for your exam at least 6 months in advance and the Royal College recommended textbooks should help you cover each of the areas tested in the exam. The two topics which account for two-thirds of the marks are Anatomy and Physiology so it would be logical to focus most of your revision on those two areas. Nevertheless, do not neglect the other topics – it is important to cover all areas.

What is a single-best answer question?

In MRCEM A, the exam asked multiple-choice questions however, they have now changed the FRCEM Primary Exam to ask single-best answer questions. The examiner will now be testing your order of thinking, such as application and evaluation of knowledge, rather than a true or false style question that was previously used.

A standard single-best answer question will typically have three parts:

1. A statement or a clinical scenario
2. The question
3. The answer options, which will include one single correct answer

2. FRCEM Intermediate SBA

The MRCEM Intermediate SBA examination consists of 180 SBA questions presented across two papers each lasting two hours. An hour’s break is provided in the middle of the exam.

Curriculum Category	Syllabus categories/highlighted descriptors	Questions
SLO 1 Complex stable patient	Allergy Cardiology Dermatology Ear, nose and throat Elderly care / frailty Endocrinology Environmental emergencies Gastroenterology and hepatology Haematology Infectious diseases Maxillofacial / dental Mental Health Musculoskeletal (non-traumatic) Nephrology Neurology Obstetrics & Gynaecology Oncological Emergencies Ophthalmology Pain & sedation Pharmacology and poisoning Respiratory Sexual health Surgical emergencies Urology Vascular	55
SLO3 Resuscitate ACCS LO8 organ failure (Excluding major trauma)	Resuscitation Palliative and end of life care Trauma including other clinical presentations	40
SLO4 injured patient	Pain and sedation Major trauma including other clinical presentations	30
SLO 5 PEM	All clinical syllabus categories as applicable to PEM, specific categories: neonatal emergencies Safeguarding and psychosocial emergencies in children	25
SLO6 Procedural skills (ACCS) ACCS LO7 basic anaesthetic care	Advanced airway management Chest drain External pacing Fracture/ dislocation manipulation Lumbar puncture Pain and sedation POCUS Vascular access in emergency- IO, femoral vein Wound management	20
SLO7 Complex or challenging situations	legislation and legal framework Organ/tissue donation Information governance Safeguarding Evidence and guidelines	10
TOTAL		180

How do I prepare for the Intermediate SBA?

The FRCEM Intermediate Exam does not require as much volume of knowledge as the FRCEM Primary Exam, but it is still a difficult and challenging examination. Most of the questions will take on the form of data interpretation, such as blood tests, an X-ray or an ECG. Similarly, to the Primary Exam, we advise that you start preparing at least 6 months in advance to your exam. In addition, it is important to practice answering questions under timed conditions to give you a realistic experience of what to expect in the exam.

4.FRCEM OSCE

The MRCEM Objective Structure Clinical Examination (OSCE) is mapped to the Specialty Learning Outcomes (SLO) of the Emergency Medicine 2021Curriculum which is available on the curriculum website. All applicants for the MRCEM are strongly advised to familiarise themselves with the Year 1-3 competences in preparation for sitting this examination.

The MRCEM OSCE consists of 18 7-minute stations, with one minute reading time between stations. There are also two rest stations in the exam.

The MRCEM OSCE assesses the common competences and clinical competences required for the evaluation and immediate management of common clinical conditions seen in the Emergency Department in adults and children. Competence in children’s emergencies is expected at a level delivered in a general Emergency Department and focuses mainly on the seriously ill and injured child, or the management of common childhood emergencies.

The MRCEM OSCE is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the MRCEM and FRCEM examinations.

The blueprint for the examination is as follows:

Station		Specialty Learning Outcome
1	Complex stable patient	SLO1
2	Complex stable patient	SLO1
3	Complex stable patient	SLO1
4	Complex stable patient	SLO1
5	Answer questions	SLO2
6	Answer questions	SLO2
7	Resus	SLO3
8	Resus	SLO3
9	Injured patient	SLO4
10	Injured patient	SLO4
11	PEM	SLO5
12	Procedural skills	SLO6
13	Procedural skills	SLO6
14	Procedural skills	SLO6
155	Complex challenging situations	SLO7
16	Complex challenging situations	SLO7
17	Supervise & teach	SLO9
18	Supervise & teach	SLO9

What should I expect in my FRCEM Final OSCE Exam?

Your OSCE Exam will be very similar to the PLAB 2 Exam. The purpose of the exam is to test your ability to apply your knowledge and experience to the care of patients, rather than examining your ability to remember facts.

During the exam, you will find different scenarios at each station which will consist of an actor or manikin playing the patient and you will be observed by an examiner, either in person or via a remote camera. The exam will not be recorded and typically examiners do not intervene, except in limited circumstances.

Remember not to talk to other candidates or write down any details about the exam while you are taking it. You cannot bring books, a mobile phone or a smartwatch into the exam.
 

Can I sit the FRCEM overseas?

The Royal College runs several examinations overseas (India, Singapore, Oman and Iceland). For further details on sitting your exam overseas visit the Royal College’s Page.

DI’s Advice to help you pass

1. Preparation is key – It is important to give yourself over 6 months to revise for each exam and that you revise thoroughly and comprehensively as all the exams are very tough.
2. Utilise the curriculum – The Royal College’s 2015 Curriculum will strongly aid you in your revision. Although the document is very large it is very representative of the exam content – an opinion of those who have taken all the exams.
3. Use varied revision resources – Using a mix of online revision resources, textbooks and perhaps a revision course will help you keep your learning varied and thus you will be more likely to obtain the information you are learning.
4. BDI Resourcing work closely with “FRCEM Exam Prep” who are the longest established and most experienced provider of online revision courses for the Royal Collee of Emergency Medicine (RCEM) examinations. Access to courses starts from £35.

 

If you are an IMG who wants to relocate to the UK and work for the NHS then send your CV to [email protected] – and one of our Specialist Advisers will be happy to guide and support you through your journey to the UK. We look forward to hearing from you!