Updated 30 May 2026. If you are an IMG sitting the FRCEM SBA, the first question you usually ask is: do my chances match the UK trainees in the room next to me, or do I need to plan for harder odds? This page gives you the honest numbers RCEM actually publishes, flags what they do not, and tells you what the gap looks like when you strip out the variables that drive it.
TL;DR. RCEM does not publish an IMG-vs-UK-trainee split for the FRCEM SBA specifically. The overall FRCEM SBA pass rate in 2024 was 51.1% (up from 47.0% in 2023). Across all RCEM exam diets in 2024, UK trainees passed at 79.6% versus IMG candidates at 46.0% – a roughly 34-point gap. The gap is real and largely explained by UK training exposure, first-attempt rates, work location and English-as-first-language – not ability. IMG candidates who hold UK training posts pass RCEM exams at 70.2%, which is the most useful proxy figure for what is actually achievable.
What does RCEM actually publish about FRCEM SBA pass rates by candidate type?
RCEM publishes its annual Exam Pass Rate Report each autumn. The 2024 report (released October 2025) is the most recent. It gives two things you care about:
- Pass rates per exam diet (FRCEM SBA, FRCEM OSCE, MRCEM SBA, MRCEM OSCE, MRCEM Primary).
- Pass rates across all exams broken down by trainee status, PMQ, ethnicity, gender, first language, attempt number, work location and reasonable adjustments.
What it does not publish: a per-exam × trainee-status breakdown. There is no official RCEM table showing "FRCEM SBA, UK trainees X%, IMG Y%". If you have seen that figure quoted on a forum or a course landing page, it has been estimated, not sourced. Be wary of it.
The closest defensible numbers are the cross-exam splits, which behave consistently across diets, and the FRCEM-SBA-specific overall rate. Both are below.
What is the headline FRCEM SBA pass rate right now?
| Exam diet | 2024 candidates | 2024 pass % | 2023 pass % |
|---|---|---|---|
| FRCEM SBA | 1,093 | 51.1% | 47.0% |
| FRCEM OSCE | 697 | 80.6% | 83.9% |
| MRCEM SBA | 3,101 | 30.9% | 47.0% |
| MRCEM OSCE | 1,225 | 80.0% | 86.0% |
| MRCEM Primary | 4,824 | 57.4% | 58.0% |
FRCEM SBA sits in the middle of the difficulty spread: harder than the OSCEs, easier than MRCEM SBA, comparable to Primary. The 4-point year-on-year rise (47.0% → 51.1%) was not statistically significant in RCEM’s own Z-test, so do not treat it as evidence the exam is getting kinder. Treat the long-run rate as roughly ~50%.
What is the IMG vs UK trainee gap across all RCEM exams?
This is the table RCEM does publish. It pools every diet (Primary, MRCEM SBA, MRCEM OSCE, FRCEM SBA, FRCEM OSCE) but the pattern is the strongest proxy you have for FRCEM SBA specifically.
| Trainee status | 2024 candidates | 2024 pass % | 2023 pass % |
|---|---|---|---|
| UK Trainee (in an RCEM training programme) | 1,717 | 79.6% | 86.5% |
| UK Non-Trainee (working in UK, not in programme) | 1,858 | 57.2% | 57.4% |
| ROI Trainee | 402 | 48.5% | 52.4% |
| IMG Trainee (international candidate) | 6,963 | 46.0% | 48.8% |
That is a 33.6-percentage-point gap between UK trainees and IMG candidates – and crucially, the UK trainee figure itself fell by 6.9 points year-on-year. RCEM flagged this as statistically significant. The exams got harder for UK trainees too in 2024; the gap is not widening because IMGs are doing worse, it is narrowing slightly because both groups dropped.
The same picture by primary medical qualification (PMQ):
| PMQ origin | 2024 pass % | 2023 pass % |
|---|---|---|
| UK medical school | 81.2% | 88.1% |
| EEA medical school | 57.3% | 60.9% |
| International (non-UK, non-EEA) | 46.6% | 49.9% |
Why is there a gap at all?
RCEM’s own report calls this differential attainment and ranks it "moderate" in effect size. The drivers, in roughly the order they matter:
- Clinical exposure to UK practice. The FRCEM SBA is written around the RCEM 2021 curriculum and UK guidelines (NICE, RCEM Best Practice, JRCALC, Resus Council UK). A trainee rotating through a UK ED for 4–5 years has absorbed safety-netting, FRAILTY frameworks, ECP referral pathways and trust-specific decision rules that an IMG sitting from abroad has had to learn deliberately from textbooks.
- First-attempt advantage. First-time sitters across all RCEM exams pass at 66.6%; second attempts drop to 31.4%, third to 31.3%, fourth to 31.2%. UK trainees are more likely to sit first-time-ready because their training calendar funnels them there. IMG candidates more often sit on second or third attempts – which itself drags the cohort average down.
- Work location. Candidates working within the UK passed at 68.0% in 2024; candidates working outside the UK passed at 46.1%. Same exam, same questions – very different exposure.
- English as first language. Native English speakers passed at 64.4%; non-native at 47.5%. The SBA is unforgiving on subtle wording, distractors and stem nuance.
- Question-bank and mock-exam access. UK trainees default to the same handful of question banks (FRCEM Success, FRCEMQ, FRCEMSBA.com) and free RCEM Learning content. IMG candidates often pay for them out-of-pocket from abroad and skip the formal mock days run by deanery teaching.
None of these are ability differences. They are exposure differences. That matters because exposure is the variable you can change.
What does the proxy figure for an IMG sitting in the UK look like?
Buried in Table 2(A) of the 2024 report is the most useful number for an IMG planning their attempt: IMG candidates who hold a UK training post passed RCEM exams at 70.2% in 2024 (247 passes out of 352 candidates). Compare that to:
- IMG, UK non-trainee (working in UK, not in programme): 52.7%
- IMG sitting from outside the UK: ~46% (the headline IMG figure)
That 24-point swing between IMG-in-training and IMG-from-abroad is the clearest indicator that the gap is environmental, not innate. If you can sit while working clinically in a UK ED – even as a non-training grade – your odds improve materially.
Is the FRCEM SBA gap likely the same as the cross-exam gap?
This is the honest unknown. RCEM does not publish it. Three reasons it is plausibly narrower on FRCEM SBA than on MRCEM SBA:
- The FRCEM SBA cohort is heavily filtered – almost everyone sitting has already passed the MRCEM SBA, so the weakest candidates are out.
- FRCEM SBA candidates are further into their career and have more guideline reading hours behind them.
- IMG candidates who reach FRCEM SBA have demonstrated they can pass an SBA-format exam already.
Two reasons it could be wider:
- FRCEM SBA leans harder on UK-specific operational and ethico-legal content (CQC, capacity, GMC), which IMGs see less of.
- FRCEM SBA includes management-track questions (rota, governance, complaints) that map to ST4–6 UK working life.
On balance, expect the gap on FRCEM SBA to be somewhere between the 33-point cross-exam gap and a more modest 20-point gap. There is no published figure. Treat anyone who quotes one as guessing.
What can IMG candidates do to close the gap?
The data points to five high-yield levers:
- Sit first-time-ready, not first-time-cheap. The single biggest pass-rate predictor is attempt number. A delayed first attempt with 6 months of dedicated revision is statistically far better than an early attempt followed by a re-sit. The pass rate halves on attempt 2.
- Learn UK guidelines as primary sources, not summaries. NICE NG guidelines, RCEM Best Practice (especially the Top 10 for ED), the JRCALC pre-hospital handbook, Resus Council UK ALS/APLS, NPSA alerts. Question banks are revision, not learning – you fill the curriculum from the source documents first.
- Work in a UK ED before you sit, if at all possible. A locum or non-training grade post in a UK department for even 6–12 months moves you from the 46% bucket into the 53–70% bucket. The RCEM report shows this is the single largest environmental variable.
- Do at least 3,000 SBA questions in timed conditions. The FRCEM SBA is 180 questions over 3 hours (50 seconds per question). The bottleneck for most IMG candidates who fail is not knowledge – it is timing and second-guessing. Bank-question volume builds both.
- Sit at least two full timed mocks in the final fortnight. Replicate exam-day fatigue. The FRCEM SBA is mentally exhausting in a way reading is not.
How does this compare to other Royal College exam gaps?
The IMG–UK gap is not unique to RCEM. A 2025 systematic review in BMJ Open and the GMC’s Tackling Disadvantage in Medical Education report both show a 20–35-point first-attempt pass-rate gap between UK and international graduates across MRCP, MRCS, MRCGP and Royal College specialty exams. RCEM is broadly in line, not an outlier.
That does not make it acceptable – it makes it a known phenomenon with known mitigations. RCEM’s Fairer Training Cultures programme is the College’s response, and the 2024 report is part of the published transparency commitment.
What pass rate should I actually plan around?
Three honest planning rates depending on where you sit:
- UK trainee, first attempt: ~85% (use UK trainee 79.6% × first-attempt uplift).
- IMG working in a UK training post, first attempt: ~70%.
- IMG sitting from outside the UK, first attempt: ~50–55%. Closer to 35% on second attempt, ~30% on third.
Plan financially and emotionally for the realistic figure, not the optimistic one. The FRCEM SBA costs £630 per attempt in 2026, and the cap is four attempts across the FRCEM SBA component – after that you cannot CCT through RCEM without an additional-attempts application.
FAQ
Does RCEM publish an IMG-only FRCEM SBA pass rate?
No. As of the October 2025 publication of the 2024 data, RCEM only publishes IMG vs UK splits across all exam diets pooled, not per individual exam. Anyone citing a specific FRCEM SBA IMG figure is estimating.
What was the FRCEM SBA pass rate in 2024?
51.1% overall, across 1,093 candidates. The year-on-year change from 47.0% in 2023 was not statistically significant in RCEM’s own analysis.
Is the IMG–UK gap because of ability or exposure?
Exposure. The same IMG cohort splits into 70.2% pass rate when in a UK training post and ~46% when sitting from outside the UK. The candidates are not different – the environment is. That is supported by RCEM’s own multivariate analysis.
How many attempts do I get at the FRCEM SBA?
Four. Each FRCEM component (SBA and OSCE) has a four-attempt cap. After four fails you would need to apply for additional attempts via RCEM’s formal process, which is granted case-by-case.
Will sitting the MRCEM SBA first help my FRCEM SBA odds?
Indirectly. You will be a more senior trainee, have more clinical exposure, and have already practised the SBA format. There is no published correlation, but the cohorts who reach FRCEM SBA already have higher baseline pass rates than the broader MRCEM SBA cohort.
Are female IMGs more likely to pass than male IMGs?
Across all exams in 2024, females passed at 57.4% and males at 54.8% – a small but statistically significant difference. RCEM has not published this split for IMGs specifically.
Does sitting in the UK at a UK Pearson VUE centre improve my odds compared to an overseas centre?
The exam is identical content. What matters is whether you are working in the UK in the months before, not where you sit on the day. That said, RCEM’s 2024 data shows candidates whose work location is "within UK" passed at 68.0% vs 46.1% outside UK.
Is the FRCEM SBA getting easier or harder?
Neither, statistically. Pass rates have moved between 47% and 51% over the last two reporting years with no significant trend. The Angoff standard-setting method RCEM uses is designed to hold difficulty constant.
What is the best single resource to close the gap as an IMG?
RCEM Learning (free, official, blueprinted to the curriculum) plus one paid question bank you commit to fully. Picking three banks and finishing none of them is the most common pattern in candidates who fail.
How long should I revise for if I am sitting from abroad?
Most successful IMG candidates report 5–7 months of structured revision, 2–3 hours weekday and 6–8 hours weekend, plus two full timed mocks in the last fortnight. Compressing to less than 3 months from outside the UK is the most common cause of a first-attempt fail.
If I fail, when can I re-sit?
RCEM runs FRCEM SBA diets three times a year (typically February, June and October). You can sit consecutive diets if you wish – there is no enforced gap – but RCEM advises a minimum 3-month preparation window between attempts and the data supports that.
Where to go next
If you are calibrating your FRCEM SBA preparation as an IMG candidate, start with the RCEM blueprint and a structured revision plan rather than another question bank. We cover blueprinted question sets, curriculum-mapped video teaching and full timed mocks – including a dedicated IMG study schedule – at emfinalexams.com.
Facts last verified against the RCEM Exam Pass Rate Report 2024 (PDF), the RCEM Exam Pass Rate Data 2023 (PDF), and the RCEM Additional Attempts policy. RCEM has not, as of this date, published a candidate-type breakdown for the FRCEM SBA in isolation; cross-exam pooled data is used as the closest available proxy (see also our FRCEM SBA cohort average score history).
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