TL;DR: The MRCEM OSCE (Membership OSCE, formerly Part C) is a fixed 16-station circuit plus two rest stations. RCEM’s published blueprint guarantees one paediatric emergency medicine (PEM) station every sitting and two “complex challenging situations” stations — the bucket where psychiatry, capacity, safeguarding and self-harm scenarios live. So a paeds station is genuinely guaranteed; a “psych” station is not guaranteed by name, but a station drawing on psychiatric/behavioural content is highly likely because SLO7 dominates that slot. Build your rotation plan around all eight SLOs, not just the two everyone fears.
If you are 4–8 weeks out from the MRCEM OSCE and trying to decide which station types absolutely must be in your weekly practice rota, this is the answer in plain terms. We will work through what RCEM publishes, what the blueprint actually mandates, where the candidate folklore is right, where it is wrong, and how to use that to build a sensible 4-week plan.
What stations always appear in the MRCEM OSCE?
Every MRCEM OSCE circuit contains 16 scored, 8-minute stations and two rest stations, blueprinted against eight Specialty Learning Outcomes (SLOs) from the 2021 Emergency Medicine curriculum. RCEM publishes the exact distribution in the MRCEM OSCE Regulations and Information Pack: three SLO1 (complex stable patient) stations, two SLO2 (answer questions / teaching), two SLO3 (resus), two SLO4 (injured patient), one SLO5 (PEM — paediatric emergency medicine), two SLO6 (procedural skills), two SLO7 (complex challenging situations) and two SLO9 (supervise & teach).
Each of those eight categories must be represented because the circuit is built from the blueprint, not assembled at random by the local centre. That is what “always appear” means in OSCE terms: not that a specific clinical scenario is fixed, but that the SLO category bucket is fixed. The case inside the bucket changes diet to diet.
So is a paediatric station guaranteed?
Yes. The RCEM blueprint allocates one station of every circuit to SLO5 (PEM). RCEM explicitly states that competence in children’s emergencies is expected “at a level delivered in a general Emergency Department” and focuses on the seriously ill or injured child and common childhood emergencies. You will get one paediatric station, and you should expect it to test either a sick child assessment, a paediatric resus scenario, a feverish/wheezy/floppy infant, or a safeguarding-flavoured paediatric presentation.
Beyond the dedicated PEM slot, paediatric content can also appear inside SLO3 (resus) and SLO4 (injured patient) stations — paediatric cardiac arrest, paediatric trauma, anaphylaxis in a child. So in practice you may face more than one paediatric scenario, but only one is mandated by the blueprint.
Is a psychiatry station guaranteed?
Not by name. There is no dedicated SLO for psychiatry in the MRCEM blueprint. Psychiatric content is examined under SLO7 (“complex challenging situations”), which has two slots per circuit. SLO7 also covers capacity assessment, deliberate self-harm risk assessment, agitated/violent patient management, intoxication, the “medically clear” mental health patient, end-of-life discussions, breaking bad news of a death, and difficult families.
So while the SLO7 bucket is guaranteed (two stations), a station that is explicitly “a psych history and risk assessment” is not guaranteed in the same way a paediatric station is. In practice, candidate experience from r/doctorsUK and the international MRCEM Telegram/WhatsApp groups suggests at least one of the two SLO7 stations in any given diet is psychiatric or behavioural in flavour — most often deliberate self-harm, acute mania, alcohol intoxication, or a Mental Capacity Act scenario. That is why the Reddit shorthand “one psych and one paeds is guaranteed” persists. It is functionally true most of the time, but it is not what the blueprint actually mandates.
What does the full MRCEM OSCE station mix look like?
Here is the published blueprint expressed as a rotation planner. Treat these as the eight buckets you must prepare for, not eight individual scripts.
| SLO | Station category | Stations per circuit | Guaranteed? | Typical content |
|---|---|---|---|---|
| SLO1 | Complex stable patient | 3 | Yes | Focused history + differential + plan; ECG-led chest pain, headache, dizziness, GI bleed, sepsis screen |
| SLO2 | Answer questions / teaching to non-clinician | 2 | Yes | Explaining a diagnosis, results, or procedure to patient/relative; consent for sedation; discharge counselling |
| SLO3 | Resuscitation | 2 | Yes | ALS, paediatric resus, anaphylaxis, major haemorrhage, septic shock; usually with a manikin and a team |
| SLO4 | Injured patient | 2 | Yes | Primary/secondary survey, ATLS-style approach, limb exam, c-spine, burns, head injury |
| SLO5 | PEM (paediatric emergency medicine) | 1 | Yes | Sick child assessment, paediatric history from a parent, NICE feverish child, BRUE, non-accidental injury suspicion |
| SLO6 | Procedural skills | 2 | Yes | Suturing, joint reduction, fracture immobilisation, lumbar puncture, chest drain, intercostal block, FAST scan |
| SLO7 | Complex challenging situations | 2 | Yes | Capacity assessment, deliberate self-harm, agitated patient, intoxication, breaking bad news of a death, angry relative, end-of-life |
| SLO9 | Supervise & teach | 2 | Yes | CDU/short-stay handover from a junior, teaching a practical skill, giving feedback, escalation conversation |
How is each station structured on the day?
Each station is eight minutes of contact time with one minute of reading time outside the door. The briefing sheet outside each station tells you the scenario, the task, the examiner’s role and the assessed domains shown as a pie chart — so if a station is 90% practical skill, do not burn five minutes taking a history. Marking is domain-based, not checklist-based (the change took effect in September 2022), and the cut score uses borderline regression plus one standard error of measurement.
There are no double (16-minute paired) stations in the MRCEM OSCE. Two of the 18 rooms are rest stations. An analogue clock is on the wall — candidates are not given a visible countdown timer and are responsible for their own time management.
Which stations do candidates find hardest?
From threads on r/doctorsUK and r/medicalschooluk, the bromleyemergency.com courses and Stemlyn’s FRCEM revision guide, three patterns come up repeatedly:
- SLO7 psychiatric/capacity stations. Candidates whose day jobs are non-UK ED report the lowest baseline confidence here. The trap is treating it as a psychiatry exam rather than an ED risk assessment — examiners want to see structured risk stratification, capacity assessed under the four-stage test, and a safety net, not a DSM-style diagnostic interview.
- SLO5 paediatric stations. The pain points are paediatric drug doses by weight, NICE feverish child traffic-light recognition, and being comfortable taking a history from a worried parent rather than the child. Candidates who only work adult ED are most exposed.
- SLO9 supervise & teach. The hidden-agenda CDU/short-stay handover catches people out because it tests rapid clinical decision-making across multiple patients simultaneously, plus identifying a junior’s learning need — there is rarely time to be thorough, only safe.
SLO6 procedural skills tend to be the highest-scoring stations for well-prepared candidates because the marking schemes are concrete — you either ran through the WHO sign-in, you either landmarked the joint correctly, or you didn’t. If you are weak elsewhere, banking marks on procedural is the most predictable route.
How should I structure 4–8 weeks of practice?
Build the week around the blueprint, not around your comfort zone. A workable rota for someone 4 weeks out:
- Monday — SLO1 + SLO2. Three complex stable cases (a chest pain, a headache, a GI bleed) followed by one “explain to the patient” station on the same diagnosis. Reuses the same clinical reasoning.
- Tuesday — SLO3 + SLO4. One ALS/paediatric resus simulation, one trauma primary survey. Do them with a partner playing nurse + patient.
- Wednesday — SLO5 PEM. One paediatric station, plus 30 minutes of paediatric weight-based dose drilling and NICE feverish child criteria.
- Thursday — SLO6 procedural. Two procedural stations end-to-end with the kit you’ll be tested on (suture pad, joint model, manikin).
- Friday — SLO7 + SLO9. One psych/capacity/self-harm station, one CDU handover. The two stations that need a real practice partner more than any of the others.
- Saturday — full mock circuit. Eight stations back-to-back, one from each SLO bucket. This is the single most predictive practice you can do.
- Sunday — review + reading. Re-read the SLO weakness from the mock, plus RCEM Learning module on the matching topic.
Repeat for four cycles. By week 4 you will have practiced every SLO bucket roughly 8–12 times. That is enough volume to make most stations feel like pattern-matching on the day.
What is the difference between MRCEM OSCE, MRCEM Part C, and Membership OSCE?
They are the same exam. MRCEM Part C was the historical name used from 2012 to 2021. Membership OSCE is the descriptive RCEM term — it distinguishes it from the FRCEM (Fellowship) OSCE, which is the higher-training variant. Since the 2021 curriculum the official name is MRCEM OSCE. Old textbooks and courses still using “Part C” are not out of date in content, only in terminology.
What about pass marks, retakes and the resus rule?
The MRCEM OSCE pass mark is set by the borderline regression method with one SEM added — there is no fixed numeric pass mark published in advance, and it shifts slightly diet to diet. Unlike the FRCEM OSCE, there is no “you must pass at least one resus station” rule in the MRCEM OSCE — that conjunctive rule applies only to FRCEM. You are allowed up to six attempts at the MRCEM OSCE; attempts at the old MRCEM Part C before August 2016 do not count.
Where does the “guaranteed” claim actually come from?
The Reddit thread phrasing “guaranteed to face at least 1 psych and 1 paeds stations” is candidate folklore that has hardened into common sense because it is broadly true diet-to-diet. The PEM half is officially correct: the RCEM blueprint guarantees one SLO5 station per circuit. The psych half is not literally guaranteed by RCEM, but candidate-reported station logs from London, Kuala Lumpur, Chennai and Hyderabad diets in 2024–2025 consistently include at least one psychiatric or behavioural-flavoured SLO7 station. Treat that as a practical guarantee built on aggregated experience, not an official one.
Frequently asked questions
How many stations are in the MRCEM OSCE in total?
Sixteen scored stations of 8 minutes each plus two rest stations, with one minute of reading time outside each station. Total exam duration is 2 hours 42 minutes.
Are there any double or paired stations?
No. RCEM has confirmed in the OSCE Exams FAQ that there are no double stations in either the MRCEM or FRCEM OSCE.
Do I have to pass a specific number of stations to pass overall?
No. The MRCEM OSCE uses domain-based marking and an overall cut score set by borderline regression plus one SEM. There is no station-by-station conjunctive rule like the FRCEM OSCE’s “must pass one resus” requirement.
Will I definitely get a paediatric resuscitation station?
Not necessarily. You will definitely get one SLO5 paediatric station, but its content varies — it could be a sick child assessment, a parent counselling station, a paediatric NAI/safeguarding scenario, or a paediatric resus. Paediatric resus could also appear inside an SLO3 slot, so paeds content sometimes hits twice.
Is the Mental Capacity Act always tested?
Not always, but capacity-flavoured scenarios fall within SLO7 and appear frequently. Know the two-stage capacity test, the four-part functional assessment (understand, retain, weigh, communicate), and how to handle a patient refusing treatment while intoxicated or post-overdose. That covers the most common SLO7 framings.
What equipment do I need to bring?
Nothing. RCEM provides everything required for each station, including stethoscopes if a station needs one. You may bring your own stethoscope if you prefer. Smart professional attire or scrubs are both acceptable.
How long after the exam do results come out?
Approximately five weeks after the exam date. Results are published to your RCEM account; the College does not release them by phone or email.
Has the marking changed recently?
Yes — from September 2022 RCEM switched the MRCEM OSCE from checklist marking to domain-based marking, mirroring the FRCEM OSCE. Older revision books that talk about checklist scoring are out of date on this point.
Can I sit the MRCEM OSCE outside the UK?
Yes. RCEM runs MRCEM OSCE diets in London, Kuala Lumpur, Chennai and Hyderabad. The blueprint is identical across centres.
Do I need to have passed MRCEM SBA before applying?
Yes. You cannot apply for the MRCEM OSCE until you have a confirmed pass in MRCEM SBA. You also need MRCEM Primary and 24 months post-foundation experience including 6 months in Emergency Medicine.
How many attempts do I get?
Six. Attempts at the old MRCEM Part C before August 2016 do not count towards the six. In exceptional circumstances candidates can apply to the Dean for an additional attempt.
Is there a critical appraisal (CLA) station like FRCEM?
No. The journal article / critical literature appraisal station is FRCEM OSCE only. MRCEM OSCE candidates do not need to prepare for it.
Next step
If you want a structured MRCEM OSCE practice plan with worked station scripts mapped to each of the eight SLOs, build your prep at emfinalexams.com. The platform’s MRCEM OSCE course is structured around the SLO blueprint above, so every practice station you do maps directly onto a scored category in the real exam.
Facts last verified . Primary source: RCEM MRCEM Exams page and the MRCEM OSCE Regulations and Information Pack. The psychiatric-station guarantee is candidate-experience evidence, not an RCEM-published guarantee.
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