How to Pass

In this section we will cover exam preparation and technique on the day.  Although individual learning technique varies, each part of the exam requires a different approach.  We will take you through how best to prepare and pass the exams.

*Spoiler Alert - to pass the exams you will have to work hard, really hard*


How to approach the exams

FRCEM Primary

When you sit the FRCEM Primary and Intermediate exams you are usually in the early stages of your medical career.  Adapting to a busy working life can be tricky, especially if you are working a full shift rota and so it is best to plan ahead:

  • Start early - plan how you are going to prepare for each part of the exam
  • Find time - this can be difficult.  You need to work out how you work best.  Some find it easier to work in small chunks  (30 - 60 mins a day), others find they achieve more by working longer (and maybe less often).  Either way you may find that you are not be able to do all that you set out to achieve.
  • Speak to others - can you help each other
  • Make sure you take time to relax and recharge (very important)

Primary - SBAQs - Book work, lots of book work.  Use the basic sciences curriculum to understand what aspects you are expected to know and use anatomy and physiology books to consolidate your knowledge.

There are not many resources out there for the new SBAQs and so practicing MCQs is probably the best way to get an idea of what questions will be asked, we have some Part A papers on the SAQ page here or even buy an MCEM Part A book.

These are some key areas to look at that come up regularly:

  • Physiology (cardiovascular, respiratory, renal)
  • Anatomy (upper and lower limbs, nerve innervation of muscles, dermatones)
  • Surface anatomy for key structures
  • Pharmacology (drugs used commonly in the emergency department and their interactions)


SAQs - This exam is a lot more clinically based and are usually based upon questions that you would ask in day to day practice (although they will throw in a few rarer cases to keep you on your toes!!).

Practice answering SAQs as often as possible.  You can also try this under exam conditions to see how you do in the time.  We have A LOT of past papers on the SAQ page.  Remember that the MRCEM used to be the MFAEM so these papers are relevant too.  We have deliberately not split up the MRCEM and FRCEM, I would advise taking them earlier.  This will allow time to complete your portfolio and paper work and start looking for Consultant Jobs.

SJP - (Situational Judgement Paper) - The is a new part to the RCEM exams and seems to be looking for the most 'common sense' answer from a choice of 4.  The 'best' answer gets 4 marks, 'second best' 3 marks etc.  More tips on this to come.


OSCEs - "a day at the office" -  This is the practical part of your exam and can be quite stressful.  You will 16 stations and 2 rest stations and about 8 minutes to complete each.  It can cover any part of the curriculum but there are recurring themes.  Some stations are double stations and usually cover an advanced life support scenario.  Check out the OSCEs page for examples of what you might get.  You need to be successful in 14 out of 18 to pass!

Here are some handy tips to approaching the exam:

  • Doing the basics well will score you points - introduce yourself, wash your hands, use appropriate PPE, talk to patients politely etc.
  • Practice, practice, practice!! - either by yourself or in a group, practice scenarios or systems examinations.  Remember you only have 8 minutes and so make sure you are slick.  The examiners will know if you have practiced or not.
  • Get others (colleagues or supervisors) to watch what you do - this is extremely helpful and can give you some insight into how you come across to other people.  This is what this part of exam is all about.  Make sure you chose someone who can give you constructive criticism.
  • Expect the unexpected - the themes in the exam are often the same but the scenario may change.  Make sure you work out how to approach each theme so that you can be prepared.

FRCEM Finals

CTR - not all of us are good at writing or preparing academic work (I am certainly not!).  Look at the examples, choose your topic well (not too many references).  Get the topic checked by either one of your trainers or someone you respect in the academic world before you start.  Check out the EMTA guidance on preparing for the CTR.

Once you have drafted and redrafted your CTR then show it to 2 or 3 Consultants who are familiar with the requirements of the CTR before submitting.  The word count matters.  

If you are called for a viva then set up multiple mock vivas with Consultants and re-run your search before going into the viva (and be prepared to talk about any papers that you didn't include in your CTR).  Unless you are very unlucky then you will often be a lot more knowledgeable on your chosen topic than your examiner.  

The examiners have a check list of things that they need to cover and so make sure you don't stay stuck on each question for too long.  Make sure that you practice answers to some common questions (summarise your CTR in one sentence, explain why and how you did your search, what is grey literature etc).  You will often be guided to each area that needs to be covered on the mark sheet (and so listen out for clues).  If they are asking you multiple questions on the same area then they are often trying to guide you towards one of the required competencies for the marks

Critical Appraisal - use the academic section for resources on how to read and appraise papers.  Join in with your departmental or training programme journal clubs to get more experience in articulating your critique.  The College has issued some guidance on how to (and not to) answer the questions.  Remember - although you might think that you are being clever picking holes in every paper that you read, that will not always get you the marks that you need to pass the exam.  The EMTA critical appraisal section is also worth a read.

SAQ - same as MRCEM Part B (above).  There is some repetition/crossover with MRCEM so you can use the past papers for both.

OSCEs - same as MRCEM Part C

Management viva - the management section gives some great tips on approaching the viva.  In addition to your local training programme teaching sessions it is important to expose yourself to real life management scenarios in your Emergency Departments.  

Common areas to cover are: complaints, incident management (RCA), consent, mental capacity act and performance issues.

More info on the management portfolio and quality improvement project to come.

Good luck!!