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Fellow of the Royal College of Anaesthetists examinations

  • May 06, 2022

To become a Fellow of the Royal College of Anaesthetists by examination, you must pass:

  1. The Primary Exam
    1. Multiple-Choice-Question Paper
    2. OSCE and SOE
  2. The Final Exam
    1. Multiple-Choice-Question Paper
    2. Short-Answer-Question Exam
    3. SOE

Those who pass the above exams will then be able to use the letters FRCA (Fellowship of the Royal College of Anaesthetists) after their name, as long as you are a Fellow or Member of the College.

Exam Fees

Primary MCQ


Primary OSCE & SOE


Primary OSCE


Primary SOE


Final Written Exam


Final SOE


Primary FRCA

This part of the exam is broken into two sections (taken separately)

  1. Multiple Choice Question (MCQ)
  2. The Objective Structured Clinical Examination (OCSE) and Structure Oral Examination (SOE)


Please note that you must pass the Primary FRCA MCQ before you can apply to sit the OSCE/SOE.

The MCQ has a three-year validity.

You must then pass the Primary Exam before applying for the Final FRCA.

A pass in the Primary FRCA is valid for seven years as part eligibility towards the Final FRCA.

Multiple-Choice-Question Exam Format

Structure of the Exam

The Primary MCQ consists of 90 multiple-choice-questions (60 x Multiple True False and 30 Single Best Answers in three hours).

  • 20 MTF question in pharmacology
  • 20 MTF questions in physiology, including related biochemistry and anatomy
  • 20 questions in physics, clinical measurement and data interpretation
  • 30 SBA questions in any of the categories listed above


The exam is held three times a year in March, September and November.

The exam is held at several venues across the UK in London, Birmingham, Sheffield, Manchester, Cardiff, Edinburgh and Belfast.

The format of the Primary exam is changing from September 2022 the Primary FRCA MCQ exam will comprise 90 MCQs in three hours: 60 Single Best Answer (SBA) questions and 30 Multiple True False (MTF) questions.

The Objective Structured Clinical Examination (OCS) and Structure Oral Examination

Please note that the FRCA OSCE and SOE must be taken together at the first attempt. If one component is failed only that component must be retaken. If you fail both sections, then you must retake them together.

Purpose of the Exam

The Primary OSCE and SOE examinations are blueprinted to the Basic Level Curriculum.

The OSCE examination tests skills (both procedural and cognitive) which are underpinned by knowledge.

The SOE tests your depth of knowledge and understanding of mechanisms and relevance.

These exams will take place at the Royal College, Churchill House, 35 Red Lion Square, London WC1R 4SG.

Structure of the OSCE Exam

During this part of the exam, there will be 16 stations, candidates must complete each station in succession.

Currently, the stations comprise of:

  • Resuscitation
  • Technical Skills
  • Anatomy (General)
  • History-taking
  • Physical Examination
  • Communication Skills
  • Anaesthetic Hazards
  • Interpretation of x-rays

Structure of the SOE Exam

There are two sub-sections to the SOE section comprising:

  1. 30-minutes; consisting of three-questions in pharmacology and three-questions in physiology and biochemistry; followed by
  2. 30-minutes consisting of three-questions in physics, clinical measurement, equipment and safety and three-questions on clinical topics (including a critical incident).

Final FRCA


This part of the exam has two sections (taken separately)

  1. Final Written exam consisting of MCQ and a Short Answer Question (SAQ) exam
  2. The Structure Oral Examination (SOE)


Please note you must pass the Primary FRCA before you can apply for the Final FRCA. You must also pass the Final Written component before you apply for the SOE.

The Final Written exam has a three-year validity.

Purpose of the Exam

The Final Written Examination is a stand-alone exam, applied for separately from the Final SOE Examination.

The aim of the MCQ is to test your factual knowledge. The SAQ aims to test your higher thinking including judgement, ability to prioritise and summarise, and capability to present an argument clearly and succinctly in writing.

Structure of the Exam

Multiple Choice Questions (MCQs)

90 MCQ Examinations (60 x Multiple True False and 30 Single-Best-Answers in three-hours)

Short-Answer-Questions (SAQs)


12 compulsory questions in three-hours normally comprising of:

  • Six questions from mandatory units: Anaesthetic practice relevant to neurosurgery, neuroradiology and neuro-critical care, cardiothoracic surgery, intensive care medicine, obstetrics, paediatrics and pain medicine.


  • Six questions from the remaining part of the curriculum. This includes general duties (airway management, day surgery, critical care incidents, general/urology/gynaecology surgery, ENT/maxilla-facial/dental surgery, management of respiratory and cardiac arrest, non-theatre duties, orthopaedic surgery, regional anaesthesia, sedation practice, transfer medicine, trauma and stabilization practice) optional units (ophthalmic surgery, plastics and burns surgery, vascular surgery), advanced sciences (anatomy, applied clinical pharmacology, applied physiology/biochemistry, physics/clinical measurement and statistical basis of clinical trial management) and professionalism in medical practice.

There will be a maximum of one question from the optional units.

The written exam is held twice a year in September and March and is held at several venues across the UK. Currently: London, Birmingham, Manchester, Sheffield, Cardiff, Edinburgh and Belfast.


The Structure Oral Examination (SOE)

The purpose

The Final SOE comprises of two sections:

  1. Clinical short cases with linked clinical science questions
  2. Clinical anaesthesia (long and short cases)


The aim of the clinical parts of the exam is to allow you to complement the Written Based Answers and examine the understanding and theoretical application of knowledge in clinical practice.

Please note you must pass the Final Written Examination (in the preceding three-years) is required before you can sit the SOE.

Link to example SOE Questions.

Our guide to passing FRCA

The fundamental reason people fail their FRCA exams is the lack of preparation. In this section of the blog, we aim to provide you with guidance on how to successfully pass your exams.

  1. Plan plan plan – This planning period involves both mental preparation and physical preparation. Revising for your exams will take up a lot of your time and energy and so it is important to get organised in order to motivate yourself for an exam in six months’ times.
  2. Finances – It is important to calculate how much taking the FRCR exams is going to cost you. These financial factors include the cost of books, courses (with concurrent travel and accommodation), the exam fees, and accommodation and travel to London or other UK cities for the exam.
  3. Syllabus – The Royal College has revealed that candidates who fail their exams is a result of poor study technique, particularly an ability in following the syllabus when structuring their revision. So, our advice to you is to use the syllabus for the exam and create a road-map ticking off each section of the revision when you have completed it.
  4. Courses – Some candidates enjoy partaking in a revision course. Courses are beneficial because they allow you to apply your knowledge to medical practise whilst providing you with valuable teaching and experience which cannot be gained from revising from books. Please click here for a list of available courses.
  5. Books – Some books are fundamental to passing FRCA, and some others are available that are a personal choice depending on your learning style. The best place to start is to look at the Anaesthesia UK recommended Primary FRCA Book List. Second, is the Royal College’s Resources list.

Study leave – If you are planning on attending a revision course, you will need to check with your department how much study leave you qualify for prior to booking and do not forget to factor in the exam periods

We would like to wish anyone who is sitting their FRCA exams a big good luck! And if you are a doctor who has recently obtained your fellowship of the Royal College of Anaesthetists then send your CV to [email protected] and one of our Specialist Advisers will be in touch.

Come and join our Facebook Group IMG Advisor! Here you will have frequent access to our relocation blog posts, the opportunity to ask questions and receive professional answers and to meet other IMGs!

References (2018). Primary FRCA MCQ | The Royal College of Anaesthetists. [online] Available at: [Accessed 3 Sep. 2018]. (2018). Primary FRCA OSCE/SOE | The Royal College of Anaesthetists. [online] Available at: [Accessed 3 Sep. 2018]. (2018). Final FRCA Written | The Royal College of Anaesthetists. [online] Available at: [Accessed 3 Sep. 2018]. (2018). Final FRCA SOE | The Royal College of Anaesthetists. [online] Available at: [Accessed 3 Sep. 2018].


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