Exams and Qualifications

MRCEM: An Overview for Emergency Medicine Doctors

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Understanding the MRCEM postgraduate qualification for EM doctors


Emergency Medicine Doctors applying for GMC registration via the postgraduate route will need to hold either the MRCEM or FRCEM qualifications. We’ve written an MRCEM overview to help overseas Emergency Medicine Doctors better understand this postgraduate qualification. In this blog we cover:

What is the MRCEM qualification?

FRCEM Primary Exam: Overview

  • Entry requirements
  • Exam Structure
  • Marking
  • Dates, Locations and Costs
  • Royal College Resources

FRCEM Intermediate SAQ: Overview

  • Entry requirements
  • Exam Structure
  • Marking
  • Dates, Locations and Costs
  • Royal College Resources

MRCEM OSCE: Overview

  • Entry requirements
  • Exam Structure
  • Marking
  • Dates, Locations and Costs
  • Royal College Resources

Applicants who passed the MRCEM exams pre-August 2016


What is the MRCEM qualification?

Our MRCEM overview for Emergency Medicine doctors begins by detailing what the MRCEM qualification is and why the FRCEM qualification is also included in this article.

  • 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 now awarded to doctors who have passed the entire suite of exams but, importantly, some parts of the Final FRCEM exam are very difficult to complete overseas.

In light of this, the Royal College of Emergency Medicine do still offer Membership by Examination (MRCEM). This remains a recognised postgraduate qualification by the GMC and is therefore the more suitable postgraduate route for international EM 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)

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

PLAB

International doctors can also use the PLAB pathway to attain a licence to practise with the GMC.

FRCEM Primary exam: Overview

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. For more detailed information, please refer to the RCEM Basic Sciences 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.

Marking

To determine the cut off score, the Royal College use the Angoff Method. This means that a group of experts judge how difficult each item is in an exam. For this reason, the pass mark varies between exams.

Dates, Locations and Costs

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 Primary Information Pack

2015 curriculum page

2021 Curriculum changes

FRCEM Primary Sample questions

FRCEM Intermediate SAQ: Overview

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.

Marking

To determine the cut off score, the Royal College use the Angoff Method (similarly to that in the FRCEM Primary exam).

Dates, Locations and Costs

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

Glossary of terms used

Exam FAQ’s

Royal College practice questions

FRCEM Success

MRCEM OSCE: Overview

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.

Marking

Marking for this exam is standard set using the Borderline Regression method, which focuses on the subjective grades given by examiners, rather than the overall scores. One standard error of measurement will be added to the cut score identified using the Borderline Regression Method to calculate the final pass mark. 

Dates, Locations and Costs

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

Royal College Curriculum

Applicants who passed the MRCEM exams Pre-August 2016

For any overseas 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 are interested in working in the UK, want to discuss available job opportunities or may have already begun your journey and need further advice, please contact our team today.