FRCEM OSCE Guide: Stations, Marking Domains and the Resus Rule

The Format

• Sixteen stations of eight minutes, each with one minute of reading time, plus two rest stations — two hours and 42 minutes in all.
• Content: RCEM describes it as the complex and challenging situations faced in emergency medicine practice.
• Venue: London only. The written FRCEM SBA is taken at test centres worldwide, so the OSCE is the part that needs travel.
• Order: you can sit the FRCEM SBA and OSCE in either order.

RCEM publishes a sample journal article and questions for the FRCEM OSCE alongside its regulations and information pack — worth working through before the day.

How It Is Marked: Nine Domains

RCEM's OSCEs use domain-based marking. The FRCEM OSCE has nine domains — the seven used in the MRCEM OSCE plus two more:

• Clinical reasoning and decision making
• Practical and "pinnacle" skills
• Communication skills, including conflict
• Teaching skills
• History taking and information gathering
• Organisation and prioritisation
• Clinical examination skills
• Leadership and management (FRCEM only)
• Research and data management (FRCEM only)

Each station tests one to four domains, weighted by their importance in that station. The examiner judges your performance in each domain, from well below to well above the minimum level of competence, and those judgements convert to a score of 0 to 10 for the station — so the maximum across 16 stations is 160.

What It Takes to Pass

The pass mark is set by the borderline regression method plus one standard error of measurement. On top of that you must pass at least one of the three resuscitation stations.

From the November 2025 diet, RCEM decides pass or fail on the resus stations by borderline regression too, replacing examiner-assigned global grades. RCEM says the change does not alter how stations are marked or how candidates should prepare.

RCEM's published pass rate for the FRCEM OSCE was 80.6% in 2024 and 83.9% in 2023. More in our FRCEM pass rates article.

Before You Apply

• Eligibility is the same as for the FRCEM SBA, and you must meet it when you apply — see FRCEM eligibility.
• English: RCEM's exam regulations require FRCEM OSCE applicants to have IELTS Level 7, OET or equivalent, and you may be asked for evidence.
• Attempts: four per component, after which you may apply for one additional attempt.
• Fee: £586 for RCEM members and £695 for non-members (2026 Exam Fees). See FRCEM cost and fees.

How to Prepare

1. Practise every domain, including the two the MRCEM OSCE does not test: leadership and management, and research and data management.
2. Take the resus stations seriously — passing at least one of the three is required whatever your overall score.
3. Work to time. Eight minutes goes quickly; practise with the one-minute reading time so you start with a plan.
4. Use RCEM's material — the sample journal article and questions, and the domain-based marking guidance.

Frequently Asked Questions