The SBA is computer-delivered MCQ at a Surpass test centre, and the OSCE is a rotating-station practical exam in London. RCEM's FRCEM regulations list these as the Fellowship's two exam components.
FRCEM SBA — Structure
| Format | Computer-delivered single best answer (SBA) MCQ |
| Number of questions | 180 SBAs |
| Duration | Two 2-hour papers of 90 questions, with a 1-hour break |
| Time per question | ~80 seconds |
| Negative marking | None — answer every question |
| Venue | Surpass Assessment test centres, worldwide |
| Pass mark | Angoff method + 1 standard error of measurement; differs between exam diets |
Question style
Each FRCEM SBA stem is typically 200–300 words, presents a multi-system clinical scenario with several investigation results, and asks for the most appropriate next step from a senior-trainee perspective. The 5 options usually include several plausible answers — discrimination depends on weighing risk, severity, and resource considerations rather than basic recall.
Time strategy
At ~80 seconds per question, fatigue management matters. Aim for 60 seconds first pass, flagging difficult items, and use the final 30 minutes for flagged questions and review. Each paper is two hours, with a one-hour break between the two.
FRCEM OSCE — Structure
| Format | Rotating clinical OSCE circuit |
| Stations | 16 assessed + 2 rest stations |
| Per-station duration | 1 min reading + 8 min in-station |
| Total exam duration | 2 h 42 min (18 slots × 9 min, including the 2 rest stations) |
| Pass standard | Domain-based marking; cut score by borderline regression + 1 SEM (no fixed pass mark), and at least 1 of the 3 resus stations passed |
| Venue | London (UK only — no overseas centres) |
Practise for it: FRCEM OSCE practice — stations laid out on RCEM's blueprint, with the exam's timing, full mock circuits and self-marking by domain (a separate product).
How a typical day runs
- Arrival and ID check — within RCEM's registration window — late candidates are not admitted.
- Briefing — circuit layout, timing rules, equipment available at each station.
- The circuit — rotate through stations; bell signals each transition.
- Debrief — none. You leave when your circuit completes.
Station marking
RCEM marks each station by domain: one to four of nine domains are tested in a station, and each station is scored 0–10. The pass mark is set by borderline regression plus one standard error of measurement. You must also pass at least one of the three resuscitation stations.
RCEM sets the OSCE pass mark by borderline regression plus one standard error of measurement. For the FRCEM OSCE, RCEM also requires candidates to pass at least one of the three resuscitation stations as well as reaching the overall pass mark.
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, so there is nothing to submit, no panel review and no extra fee to plan for.
How RCEM Sets the FRCEM Pass Mark
For the SBA, RCEM uses the Angoff method rather than a fixed percentage. A panel of subject-matter experts reviews each question and estimates the proportion of "borderline pass" candidates who would answer correctly. The aggregate of those judgements becomes that paper's pass mark.
Practical implications:
- The pass mark varies between sittings based on question difficulty.
- You're not aiming for a specific percentage — you're aiming to outperform the borderline candidate.
- RCEM does not publish its pass marks as a percentage, and they differ between exam diets.
- OSCE pass standard is per-station + global — both must be cleared.
Results & Reattempts
- SBA: results about five weeks after the exam, on a date RCEM announces in advance, released to your RCEM website account.
- OSCE: results about six weeks after the sitting ends; RCEM publishes each results date on its exam calendar.
- Reattempts: each FRCEM SBA or OSCE attempt costs the full fee again.
Practise for the FRCEM
Work through SLO-tagged FRCEM SBA questions — bank 1 is free — and practise OSCE stations built to RCEM's format.