Fellowship of the Royal College of Emergency Medicine (FRCEM) Exam Guide

FRCEM is the Royal College of Emergency Medicine’s Fellowship by Examination. Candidates must pass both the FRCEM SBA and the FRCEM OSCE, and eligible candidates may take the components in either order. This is distinct from MRCEM, the College’s membership-by-examination pathway.

The SBA assesses emergency medicine knowledge and includes research, management, and quality improvement. The OSCE assesses complex and challenging situations encountered in emergency medicine practice.

The OSCE uses domain-based marking, with its pass standard set using borderline regression and a standard-error adjustment. The SBA and OSCE have separate pass standards; candidates must pass both components, subject to the historical RCEM equivalences specified in the regulations.

The detailed allocations below are from the FRCEM information pack that RCEM links on its current FRCEM examination page. The pack is marked applicable from August 1, 2021. RCEM’s Curriculum 2021 was updated to version 1.5 on August 6, 2025; its assessment blueprint maps examination areas to Specialty Learning Outcomes (SLOs), while the information pack provides the detailed counts shown here. Check RCEM’s current exam materials before your sitting.

FRCEM SBA allocation in the linked information pack

FRCEM OSCE station plan in the linked information pack

The published OSCE domains include clinical reasoning and decision-making; communication, including conflict; history taking and information gathering; clinical examination; practical skills; teaching; organization and prioritization; and leadership and management.

Candidates must meet the applicable requirements when they apply. RCEM distinguishes UK trainee and non-trainee routes; check its current criteria against your own training and registration history.

Candidates must be registered with the GMC or with the statutory regulator in the country where they practice, without limitation on practice. FRCEM OSCE applicants must have achieved IELTS Level 7, OET, or an equivalent English standard; RCEM may request evidence. Supporting documents must be in English or accompanied by an attested and stamped English translation.

The currency rules allow seven years after completing MRCEM to pass the first FRCEM component, then a further seven years after that pass to complete the other component. Each component normally allows four attempts; after four failed attempts, a candidate may request one additional attempt, which is considered case by case. The regulations specify limited historical RCEM equivalences and no recognized equivalence for examinations from other institutions.

For the SBA

• Use the published allocation to prioritize resuscitation, stable-patient care, injured-patient care, and care of children, while also scheduling time for procedures, workplace issues, management, research, and quality improvement.
• Practice in two 90-question blocks with a one-hour break to match the paper structure. Review errors by decision point as well as by diagnosis.
• Because incorrect answers are not penalized, answer every item and use remaining time to revisit questions you flagged.

For the OSCE

• Practice timed eight-minute stations with the one-minute reading period. Use the station brief to identify the task and assessed domains before starting; RCEM says the brief includes this information.
• Give dedicated practice time to resuscitation, because passing at least one resuscitation station is required in addition to the overall standard.
• Rehearse the published range of formats, including complex stable-patient, injured-patient, pediatric, EPIC, teaching, management, and research stations. Practice spoken reasoning, focused information gathering, communication, prioritization, and leadership under time pressure.
• For the critical-appraisal station, read the journal article RCEM releases four weeks before the OSCE. Prepare to discuss internal and external validity and implications for practice. RCEM says the station is a guided discussion; candidates do not need to memorize or summarize the paper or perform calculations.

Applications are made online during RCEM’s published application window; late applications are not accepted. Use the current Exam Calendar & Fees page for dates and fees, and the application page for submission requirements. Prepare the requested qualification, registration, training, and experience documents in advance.

The SBA is delivered through Surpass Assessment, with worldwide test-center access. RCEM prefers test-center delivery; candidates who cannot travel may be considered for remote online invigilation in exceptional circumstances and must meet the technical requirements. The FRCEM OSCE is listed as taking place in London, UK. Places are limited, and an approved application does not itself guarantee an OSCE place if a sitting is oversubscribed.

International candidates planning to sit the OSCE in the UK should allow time to meet entry requirements. RCEM regulations say an allocated OSCE candidate can obtain a visa support letter after payment; the candidate remains responsible for meeting visa and entry requirements. Requests for reasonable adjustments can be made through the application process and are considered individually.