How many parts the MRCEM exam has

TL;DR: The MRCEM exam has three parts, sat in a fixed order: MRCEM Primary (a 3-hour, 180-question single best answer paper on basic sciences), MRCEM SBA (180 SBA questions in two 2-hour papers covering the full ED clinical curriculum), and MRCEM OSCE (sixteen 8-minute clinical stations). Pass all three within seven years of the Primary and you are awarded Membership of the Royal College of Emergency Medicine.

If you are mapping the route to Membership for the first time — whether you are an IMG planning an OSCE trip to London or a UK trainee in ACCS — this is the short version of how the MRCEM works, what each component actually tests, and the gotchas that catch out otherwise well-prepared candidates.

How many parts does the MRCEM exam have?

The MRCEM exam has three parts: MRCEM Primary, MRCEM SBA, and MRCEM OSCE. You sit them in that order, you must pass all three to be awarded MRCEM, and the entire RCEM exam pathway from Primary to Final is the gateway to UK higher specialty training in Emergency Medicine (ST4 entry) and, eventually, to the FRCEM.

The three components are not interchangeable and you cannot leapfrog them. The College is explicit: Membership by Examination cannot be awarded without a pass in the MRCEM OSCE, and the SBA cannot be sat without a Primary pass. The structure has been stable since August 2021, when MRCEM Intermediate SBA was renamed MRCEM SBA and the Primary stopped being branded as FRCEM Primary.

What is the MRCEM Primary?

The MRCEM Primary is the first of the three MRCEM exam parts — a three-hour theory paper of 180 single best answer (SBA) questions sat at a Pearson VUE / Surpass test centre. It tests basic sciences mapped to the RCEM Basic Sciences Curriculum (June 2010 edition) and the wider RCEM 2021 Curriculum: anatomy, physiology, pharmacology, microbiology, pathology, and evidence-based medicine.

The paper is machine-marked, one mark per correct answer, no negative marking. The pass mark is set by the Angoff method and varies between diets — recent sittings have hovered around 108–112 out of 180 (60–62%). Results are released roughly 6–8 weeks after the exam date.

The Primary is the same paper formerly called the FRCEM Primary (August 2016 – July 2021) and the older MCEM Part A (August 2012 – July 2016). RCEM accepts those legacy passes as equivalent for progression.

What is the MRCEM SBA?

The MRCEM SBA is the second of the three MRCEM exam parts — a clinical theory exam of 180 single best answer questions delivered as two two-hour papers (90 questions each) with a one-hour break in the middle. It replaced the FRCEM Intermediate SAQ in August 2021 and is still informally called “the Intermediate” or “Part B” by trainees.

The SBA tests the breadth of conditions and presentations encountered in the ED, mapped to the Year 1–3 Specialty Learning Outcomes (SLOs). The blueprint weights resus, trauma, complex stable patients, paediatric EM, procedural skills, and the harder-to-prepare-for SLO7 (Complex or Challenging Situations).

Marking is machine-based, no negative marking. The pass mark uses the Angoff method plus one Standard Error of Measurement, so it varies between diets — historically around 109–114 out of 180. Results land 6–8 weeks after the exam. You can leave the test centre during the one-hour break; bring food, because invigilators will not feed you.

What is the MRCEM OSCE?

The MRCEM OSCE is the third and final MRCEM exam part — a practical clinical exam of 16 eight-minute stations plus 2 rest stations, with one minute of reading time before each station. Total running time is approximately 2 hours 42 minutes. It assesses the clinical, procedural, and communication skills expected of a doctor ready to enter UK higher specialty training in EM.

Since September 2022 the MRCEM OSCE uses domain-based marking, not the old checklist scheme — aligning it with the FRCEM OSCE. The cut score is set using borderline regression plus one Standard Error of Measurement. Results are released about five weeks after the exam, faster than the theory papers.

The OSCE is delivered in London, Kuala Lumpur (Malaysia), Chennai, and Hyderabad (India). Spaces are limited and oversubscribed — UK ST3 trainees and Irish CSTEM 3 trainees are prioritised, then NHS doctors, then anyone running out of their seven-year currency window.

How do the three MRCEM parts compare side by side?

In what order do you have to sit the MRCEM parts?

You must sit the three MRCEM parts in a fixed order: Primary first, then SBA, then OSCE. RCEM does not accept provisional applications, so you cannot apply for the SBA “pending” your Primary result, and you cannot apply for the OSCE while waiting for SBA results. Each application requires a confirmed pass in the preceding component at the point of application.

This sequencing matters when you plan study leave and rotations — a Primary fail in November pushes your SBA at least nine months and your OSCE most of a year. Build that contingency in.

Who can sit each MRCEM exam?

Eligibility tightens at each MRCEM exam part. RCEM updated the criteria for all 2025-onwards sittings, and you must meet them at the point of application, not at the point of the exam.

• MRCEM Primary: a Primary Medical Qualification (PMQ) accepted by the GMC and current medical registration (provisional or full). Suitable for FY2-equivalent doctors and brand-new IMGs.
• MRCEM SBA: PMQ, full registration with a licence to practise, two years of medical experience post-PMQ (internship counts), and a passed Primary.
• MRCEM OSCE: PMQ, full registration with a licence to practise, at least six months full-time-equivalent EM experience above Foundation level (post-full-registration), and passed Primary and SBA.

RCEM expects IELTS Level 7 (or OET/equivalent) for OSCE candidates and may ask for evidence at application.

How much does each MRCEM part cost in 2026?

The 2026 MRCEM fees range from £429 to £1,345, depending on the part, your membership status, and where you sit it. RCEM members pay less than non-members, and OSCEs delivered in India and Malaysia cost more than the London OSCE because of regional delivery costs.

To qualify for member rates, your RCEM membership must be paid up at least 24 hours before the application window opens. Pay it on the day and you will not get the discount — a common and avoidable mistake. Country-specific sales taxes may be added based on your country of residence (not where you sit the exam).

When are the 2026 MRCEM exams?

RCEM runs the Primary twice a year, the SBA twice a year, and the OSCE roughly six times a year split across London, India, and Malaysia. Application windows open at 10:00 UK time on the opening date and close at 16:00 UK time exactly seven days later.

• MRCEM Primary 2026: 22 April 2026 and 27 October 2026.
• MRCEM SBA 2026: 21 January 2026 and 16 September 2026.
• MRCEM OSCE 2026 — London: 19–30 January, 27 May–11 June, and 3–19 November.
• MRCEM OSCE 2026 — India (Hyderabad): 23–27 March 2026.
• MRCEM OSCE 2026 — India (Chennai): 20–24 July 2026.
• MRCEM OSCE 2026 — Malaysia: 21–25 September 2026.

Sign up for the RCEM email reminder list — the windows are seven days and they do not extend for forgotten applications.

How many attempts do you get at each MRCEM part?

You get a maximum of six attempts at each MRCEM exam component as standard. After six failed attempts at the same component, you can apply in writing for one additional attempt, considered case by case by the Chief Examiner — you have to explain what you will do differently. The Chief Examiner’s decision is final, and candidates who exhaust all attempts cannot restart the MRCEM journey.

Past legacy attempts after August 2016 (FRCEM Primary, FRCEM Intermediate SAQ, MRCEM Intermediate SBA) count toward your total for the equivalent current exam. The one exception: a temporary derogation means a candidate’s first attempt at an online exam format between 1 July 2020 and 31 August 2021 (during COVID) does not count.

What is the MRCEM seven-year currency rule?

You have seven years from passing the MRCEM Primary to complete all three MRCEM parts. Pass the Primary in October 2026 and your SBA and OSCE must both be banked by October 2033. The clock runs from the Primary pass date, not from the date you started studying.

If you finish MRCEM, a second seven-year clock starts: you have seven years from the MRCEM completion date to pass your first FRCEM component (FRCEM SBA or FRCEM OSCE), then another seven years to finish the second.

Extensions are possible for parental leave, long-term sick, or other exceptional circumstances — email exams@rcem.ac.uk before your currency expires. Candidates already affected by the rule change have had 24-month extensions applied automatically.

Where can you sit the MRCEM parts?

The two MRCEM theory parts (Primary and SBA) run worldwide through Surpass Assessment test centres. The MRCEM OSCE runs in four cities: London (UK), Kuala Lumpur (Malaysia), Chennai (India), and Hyderabad (India). OSCE places are limited and allocated by oversubscription criteria, not first-come-first-served.

The OSCE oversubscription order is: UK ST3 trainees first, then Irish CSTEM 3 trainees, then NHS doctors, then everyone else with candidates closest to their seven-year currency deadline prioritised. If you are an IMG sitting overseas and not in an NHS post, plan early and have a backup diet in mind.

How does MRCEM differ from FRCEM, MRCP, and MRCS?

MRCEM is the Membership exam — three parts, the gateway to ST4 entry into UK higher specialty training in Emergency Medicine. FRCEM (Fellowship) is the separate two-part exit exam you sit at the end of higher training (FRCEM SBA + FRCEM OSCE) before CCT.

Structurally, MRCEM sits between two cousins that doctorsUK trainees often discuss in the same breath. For a deeper look at how Membership compares with the Fellowship pathway, see our breakdown of FRCEM vs MRCEM examination systems. MRCP UK has three parts (Part 1 written, Part 2 written, PACES clinical) and is the medicine equivalent. MRCS has two parts (Part A written, Part B OSCE) and is the surgical equivalent. MRCEM is closer in shape to MRCP — two written papers plus a practical — but the OSCE component, station length, and curriculum are distinctly EM.

Frequently asked questions

Is MRCEM Primary the same as Part 1, Part A, or FRCEM Primary?

Yes — “MRCEM Primary”, “Part 1”, “Part A”, and the legacy “FRCEM Primary” (used between August 2016 and July 2021) all refer to the same first MRCEM exam part. “MCEM Part A” is the even older equivalent from 2012–2016. RCEM accepts those legacy passes as equivalent.

Is the MRCEM SBA the same as the MRCEM Intermediate?

Yes. The MRCEM SBA is what was called the MRCEM Intermediate SBA, and before August 2021 the FRCEM Intermediate SAQ. Many trainees and Reddit threads still call it “the Intermediate”. A pass under any of those names counts.

Do I need MRCEM to apply for UK ST4 EM training?

Yes — full MRCEM (all three parts passed) is the standard requirement for ST4 entry into UK Emergency Medicine higher specialty training. The MRCEM OSCE in particular is what RCEM treats as the marker of readiness for higher training.

Can I sit the MRCEM SBA before the Primary?

No. You must pass the MRCEM Primary before you can apply for the MRCEM SBA, and you must pass both Primary and SBA before applying for the OSCE. Provisional applications are not accepted.

Can a paramedic or physician associate sit MRCEM?

No. MRCEM eligibility requires a Primary Medical Qualification (PMQ) accepted by the GMC. The exam is restricted to medical doctors.

How long does it take to pass all three MRCEM parts?

Most candidates take 18 months to three years to complete all three MRCEM parts in real life, even though the theoretical minimum (back-to-back diets with no fails) is closer to a year. Two years is a realistic target if you are working clinically and sitting each part once. You have seven years from the Primary pass to finish, so there is room to breathe.

Is MRCEM pass/fail or graded?

MRCEM is pass/fail. There is no merit, distinction, or grade — your results letter shows your score, the pass mark for that diet, and the outcome. The score itself does not appear on any certificate and no employer or training programme asks for it.

What happens if I exhaust my attempts at one MRCEM part?

If you fail an MRCEM part six times, you can apply in writing for one additional (seventh) attempt — the Chief Examiner reviews case by case and the decision is final. If that fails too, RCEM regulations state you cannot restart the MRCEM journey. Candidates who develop a newly diagnosed condition warranting reasonable adjustments after previous unadjusted fails can apply for further attempts on that basis.

Do failed attempts show on my record or affect my training?

Failed attempts are visible to your educational supervisor and Training Programme Director if you are a UK trainee — RCEM shares trainee exam data with HEE/the relevant deanery. They do not appear on your GMC public record. In practice, multiple fails will prompt conversations at ARCP but are not a hard stop.

How much should I budget in total for MRCEM?

Budget around £1,500–£2,000 in exam fees alone if you sit each part once as a UK member (Primary £429 + SBA £429 + OSCE £586 = £1,444), more for non-members, IMGs, or anyone sitting the OSCE in India or Malaysia. Add a question bank subscription (MRCEM Success, MRCEM Expert, or RCEM Learning), Bromley OSCE course if you attend, travel and accommodation for the OSCE, and any resits. Realistic all-in for a clean run as a UK member is £2,500–£3,500.

Which question bank should I use for MRCEM?

The most-recommended question banks across r/doctorsUK and r/JuniorDoctorsUK are MRCEM Success (widely used for Primary and SBA), RCEM Learning (the only resource endorsed by the College and included in membership), and a combination of both for the SBA where MRCEM Success alone is generally not considered enough. For the OSCE, Bromley courses and the FRCEM Final 125 OSCE Stations book are the standard pairing.

Can I transfer or refund an MRCEM exam if I cannot attend?

Theory exam transfers (Primary, SBA) to the next diet are possible only in exceptional circumstances with supporting evidence (illness, bereavement, military deployment) and only if requested at least five working days before the exam. No refunds are issued for theory exams after application. OSCE withdrawals within five working days of payment incur a 30% admin fee (UK) or 50% (international); after that you forfeit the fee unless exceptional circumstances are evidenced. The full cancellation policy applies from 11 December 2025.

Facts last verified 30 May 2026 — confirm exam logistics on the RCEM site.

Next step: If you are ready to start preparing, browse curriculum-mapped question banks and OSCE practice on EM Final Exams.

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