Exams and Qualifications

An overview of MRCEM



What is the MRCEM qualification?

  • MRCEM stands for: Membership of the Royal College of Emergency Medicine
  • FRCEM stands for: Fellowship of the Royal College of Emergency Medicine

The Royal College of Emergency Medicine is responsible for setting the standards of training and administering examinations in Emergency Medicine.

In August 2016, the College’s exam structure was redefined, merging both the MRCEM and FRCEM exams together. FRCEM is awarded to doctors who have passed the entire suite of exams however, some parts of the Final FRCEM exam are very difficult to complete overseas.

As such, the Royal College of Emergency Medicine offer Membership by Examination (MRCEM), which is a GMC recognised postgraduate qualification and the most suitable pathway for overseas Emergency Medicine doctors to attain GMC registration.

To achieve MRCEM, the below exams must be passed:

  • FRCEM Primary exam
  • FRCEM Intermediate Short Answer Question (SAQ) Paper
  • MRCEM Objective Structure Clinical Exam (OSCE)

If you passed any of the MRCEM exams prior to August 2016 then you may be entitled to use a different combination of exams to qualify for MRCEM. Please click here for further information.


FRCEM Primary exam

Entry Requirements

To enter the FRCEM Primary exam, candidates must hold a GMC recognised primary medical qualification (PMQ).

In addition to this, the Royal College of Emergency Medicine recommend that overseas candidates should have a level 7 IELTS standard to complete the FRCEM exams.

Exam Structure

The FRCEM Primary exam is based on the Emergency Medicine Curriculum.

Sat over a 3-hour period, the exam contains 180 multiple choice single best answer questions, broken down into the following areas:

  • Anatomy (60 questions)
  • Physiology (60 questions)
  • Pharmacology (27 questions)
  • Microbiology (18 questions)
  • Pathology (9 questions)
  • Evidence Based Medicine (6 questions)

Single best answer (SBA) questions will test a candidate on their order of thinking. They usually have 3 parts: a clinical scenario, a question and then the answer options.

Dates, Locations and Cost

Applicants are able to take the FRCEM Primary exam in numerous locations including the UK, Iceland, Malaysia and Oman.

The cost to take the FRCEM Primary exam is:

  • £310.00 for UK Centres
  • £390 for Iceland, Malaysia and Oman

For a fully up to date list of the locations and dates, please click here

Royal College Resources


FRCEM Intermediate SAQ

Entry Requirements

To take the FRCEM Intermediate SAQ, candidates must hold a GMC recognised primary medical qualification (PMQ). They must have also completed the equivalent of the UK Foundation Programme and have passed the FRCEM Primary exam.

For the entry requirements for candidates who have passed any of the exams from the previous format, please click here.

Exam Structure

Sat over a 3-hour period, this exam is a short answer question (SAQ) paper compromising of 60 questions in the following areas:

  • Common Competences
  • Clinical Presentations – Core Major and Acute Presentations
  • Anaesthetic Competences CT1&2
  • ICM within ACCS
  • Acute Presentations – Additional Adult ST3
  • Paediatric Presentations – Major & Acute Presentations
  • Practical Procedures (ACCS)

To find a full list of the sub-categories within these areas, please click here.

A maximum of 6 attempts are allowed to complete this exam.

Dates, Locations and Cost

Applicants are able to take the FRCEM Intermediate SAQ exam in numerous locations, including the UK, Iceland, Malaysia and Oman.

The cost to take the FRCEM Intermediate SAQ exam is:

  • £305.00  for UK Centres
  • £385 for Iceland, Malaysia and Oman

For a fully up to date list of the locations and dates, please click here.

Royal College Resources


MRCEM OSCE

Entry Requirements

Applicants for the MRCEM OSCE must meet the following criteria:

  • Hold a GMC Recognised primary medical qualification (PMQ)
  • Passed the FRCEM Primary exam 
  • Passed the FRCEM Intermediate SAQ 
  • Have 36 months experience including 6 months above Foundation level 1 (post full registration) in Emergency Medicine. 

For entry requirements for candidates who have passed any of old format of exams, please click here.

Exam Structure

OSCE stands for: Objective Structure Clinical Examination

The MRCEM OSCE assesses the common and clinical competences required to evaluate and immediately manage the most common clinical conditions seen in real life situation with patients.

The OSCE consists of 18 seven-minute stations, 16 patient encounters and 2 rest stations, all of which assess candidates on both their medical knowledge and the manner in which they interact with both adult and child patients.

One minute of reading time is provided between each OSCE station, thus the total exam time is circa 2 hours and 23 minutes.

A maximum of 6 attempts are allowed to complete this exam.

Dates, Locations and Cost

The MRCEM OSCE can be taken in The UK, India and Malaysia.

The cost to take the MRCEM OSCE is:

  • £450.00 for UK and India Centres 
  • £650 for Malaysia centres

For a fully up to date list of the locations, dates and fees please click here.

Royal College Resources


Applicants who passed the MRCEM exams Pre-August 2016

For doctors who have passed the MRCEM exams prior to August 2016, the following combination of exams will lead to Membership of the Royal College of Emergency Medicine:

  • FRCEM Primary or MRCEM Part A
  • FRCEM Intermediate SAQ or MRCEM Part B 
  • MRCEM Part C/OSCE

A pass in the MRCEM Part A exam, achieved prior to August 2012, is now deemed expired. Candidates who’ve sat the MRCEM Part A prior to this date are now therefore required to pass the FRCEM Primary exam.

In addition to this, MRCEM Part B passes attained prior to August 2012 are also deemed expired. Candidates are now therefore required to pass the FRCEM Intermediate SAQ exam.


If you’re interested in working in the UK and would like to discuss the positions available in your specialty, and how we can assist you, please contact our team.