The FRCEM curriculum extends the MRCEM clinical syllabus into leadership, governance, and complex decision-making. Expect questions about resource allocation, end-of-life decisions, departmental incident management, and supervising junior teams.
FRCEM SBA Curriculum
The SBA blueprint draws from the full RCEM Emergency Medicine higher-specialty curriculum. Three broad domains carry roughly equal weighting across the 180 questions.
| Domain | Weighting | Examples of high-yield content |
|---|---|---|
| Adult emergency medicine | ~40% | Major presentations at senior-decision level — sepsis bundles, complex stroke pathways, advanced toxicology, periarrest decisions |
| Paediatric emergency medicine | ~25% | Senior decision-making in paediatric resus, safeguarding leadership, complex paediatric drug calculations |
| Trauma & specialist domains | ~25% | Major trauma leadership, polytrauma, transfer principles, ICU referral thresholds |
| Leadership, governance, ethics | ~10% | Service leadership, departmental incident management, ethical decision-making, resource allocation |
Compared to the MRCEM SBA, FRCEM SBA stems are longer (often 250+ words), emphasise complex multi-pathology presentations, and frequently ask "as the senior trainee on shift, what is the most appropriate next step" rather than "what is the diagnosis".
FRCEM OSCE Curriculum
The OSCE assesses senior-trainee clinical and non-clinical skills. Its 16 assessed stations are blueprinted across these competency clusters:
- 1Resuscitation & emergency procedures
Adult and paediatric ALS leadership, advanced airway management, complex procedural skills (cricothyroidotomy, RSI, central lines), peri-arrest decision-making.
- 2Complex history-taking
Multi-system presentations, occult diagnoses, atypical presentations in older or paediatric patients.
- 3Examination & interpretation
Advanced examination technique with on-the-spot interpretation of investigations (ECGs, ABGs, imaging).
- 4Senior communication
Breaking bad news at senior level, complex consent, conflict management with relatives, end-of-life conversations, communicating uncertainty.
- 5Leadership & teaching
Leading a sim debrief, teaching juniors a complex skill, managing a stressed junior, departmental governance scenarios.
- 6Ethics & professionalism
Capacity assessments, safeguarding decisions, raising concerns about a colleague, resource-allocation dilemmas.
Stations are deliberately busier than MRCEM — multiple simultaneous demands, distractions, time pressure. Practising in this realistic style matters more than knowledge gaps in late preparation.
QIP — withdrawn from the Fellowship
RCEM's FRCEM exam regulations list the Fellowship as two exam components — the SBA and the OSCE. The FRCEM Final QIP appears among past components with no current equivalent; it was withdrawn in 2021.
How to Use the Curriculum to Plan FRCEM Revision
- Download the official RCEM Emergency Medicine higher-specialty curriculum PDF from rcem.ac.uk.
- Map each section to your existing clinical exposure — domains where you have weaker rotation history need more deliberate revision.
- Practice with curriculum-tagged FRCEM SBA questions so you're testing yourself against the actual blueprint.
- For OSCE: rehearse senior-trainee scripts — the words you use as a leader differ from the words you used at MRCEM level.
Practise for the FRCEM
Work through SLO-tagged FRCEM SBA questions — bank 1 is free — and practise OSCE stations built to RCEM's format.