MRCEM/FRCEM Exam Structure – New RCEM Exam Curriculum

MRCEM/FRCEM Exam Structure – New RCEM Exam Curriculum

Introduction – FRCEM / MRCEM

The current RCEM MRCEM and FRCEM exam structure will change from August 2021 with the new curriculum. 

The RCEM examinations are an integral part of RCEM’s programme of assessment. They provide trainees with the opportunity to demonstrate, at critical progression points, the required outcomes of their training programme.  The RCEM exams comprise a programme of summative assessments in two parts: Membership of the Royal College of Emergency Medicine (MRCEM) and Fellowship of the Royal College of Emergency Medicine (FRCEM) examinations.  Each part uses validated assessment methods to test a broad-spectrum of knowledge, understanding, skills, behaviours and attitudes, as defined by the RCEM curriculum.

The MRCEM examination consists of three components:  Two Single Best Answer (SBA) multiple-choice papers and an Objective Structured Clinical Examination (OSCE).  All MRCEM components are blueprinted to the RCEM curriculum – focussing on SLOs 1-7 and 9.  Questions used in each component are tagged to the RCEM basic science and clinical syllabi. The SLOs and the capabilities relevant to each SLO are set out in the assessment blueprint. Successful completion of all three Primary exam components is required to complete intermediate training as part of a programme of assessment designed to ensure readiness for Higher Training.

The FRCEM examination consists of two components: A Single Best Answer (SBA) test of knowledge, and a Multi Station Oral (MSO) exam.  The examinations used in the FRCEM are blueprinted to SLOs 1-12.  The questions used in the FRCEM examinations are also tagged to the RCEM Clinical Syllabus. The SLO and the relevant capabilities are set out in the assessment blueprint.  Successful completion of the FRCEM examination is the part of the Programme of Assessment that signifies readiness for independent practice at completion of training.


MRCEM Primary (Previously FRCEM Primary) – Single Best Answer paper.

This examination samples the basic science syllabus, ensuring a sound background knowledge in the basic science underpinning EM care. It can be undertaken at any point post registration as a medical practitioner. It comprises 180 questions to be answered in three hours.

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MRCEM Intermediate SBA – previously FRCEM Intermediate SAQ (short answer question)

The FRCEM Intermediate short answer question paper will become the MRCEM SBA (single best answer question).

This exam will sample the RCEM Clinical Syllabus and will test a sound understanding of the full range of conditions and presentations that may present to the ED. It samples how the trainee synthesises and interprets data and clinical findings to make decisions and inform management plans. The exam will have 180 questions which will be answered in four hours, presented as two 90 question papers with two hours per paper sat on the same day.

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The MRCEM OSCE (Objective Structured Clinical Examination) comes back and replaces the FRCEM Intermediate SJP exam.

This exam objectively is made up of 18 stations which assess the clinical and communication skills of trainees and ensures they are at the level of someone ready for Higher Training. Stations that will be examined are: history taking, examination, communication, decision making, dealing with challenging situations and resuscitation scenarios, using medium fidelity simulation.

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FRCEM Finals

FRCEM SBA (Previously FRCEM Final SAQ)

This is a Single Best Answer (SBA) paper. This examination is blueprinted to the advanced clinical elements within the SLOs and the RCEM Clinical Syllabus. In addition to specific knowledge-based competences, examination material may be developed from guidance or recommendations published by healthcare organisations such as the RCEM, NCEPOD, NICE, SIGN, NPSA, etc. The public expects doctors to keep up to date with important developments and such material may be examined under the collective umbrella of ‘professionalism’. This paper can be sat from the start of ST5. It comprises 180 questions, four hours testing time sat in two papers on the same day.

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Face-to-face, multi station examination. This examination is blueprinted to the complex or challenging situations an EM clinician will face, including the requirements of leadership and support within the ED. These are found in SLOs 3, 7-12. It will consist of 16 stations. It will involve simulation using simulated patients and medium fidelity simulation equipment. A key feature of this assessment is structured viva exploring decision-making and data analysis. It is geared towards ‘evaluating and analysing’ in Bloom’s Revised Taxonomy . Here we are more concerned with the trainee’s reasoning than with whether they simply reach a reasonable conclusion or undertake an appropriate action. Reflection-in-action may be a more reliable predictor of future performance than an appropriate response to a single challenge. The examination consists of 16 stations with one examiner per station. This examination can be sat from the start of ST5.

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RCEM Exam Timetable 2022

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