Quick answer: the MRCEM SBA exam format is a computer-based exam of 180 single best answer questions, split into two 2-hour papers of 90 questions with a 1-hour break. It covers the Year 1–3 learning outcomes of the RCEM curriculum. The pass mark is set for each sitting using the modified Angoff method plus one standard error of measurement, and you can sit it up to six times.
This guide explains how the exam is structured, how the questions are spread across the curriculum, how the pass mark works and what to expect on the day. The details come from RCEM’s MRCEM exams page and the MRCEM SBA Regulations and Information Pack.
Where the MRCEM SBA fits
MRCEM is made up of three exams, taken in order: the MRCEM Primary (basic sciences), the MRCEM SBA (clinical emergency medicine) and the MRCEM OSCE (clinical and communication skills). The SBA replaced the FRCEM Intermediate SAQ in August 2021.
MRCEM SBA exam format at a glance
| Feature | MRCEM SBA |
|---|---|
| Questions | 180 single best answer questions |
| Papers | 2 papers of 90 questions, sat on the same day |
| Time | 2 hours per paper, with a 1-hour break between them |
| Time per question | About 80 seconds |
| Delivery | Computer-based, at test centres worldwide (remote sitting only in exceptional circumstances) |
| Curriculum | RCEM curriculum, Year 1–3 specialty learning outcomes (SLOs) |
| Pass mark | Set each sitting: modified Angoff method + 1 standard error of measurement |
| Attempts | Maximum of six |
What a single best answer question looks like
Each question gives a clinical scenario, often with observations, blood results or an ECG description, followed by a set of options. RCEM describes the format like this: several answers may be partly correct or plausible, but only one is fully correct. That is what makes SBAs harder than simple recall questions. You need to choose the most appropriate next step, not just a reasonable one.
You can see exactly how this works by trying our 20 free MRCEM SBA sample questions.
How the questions are spread across the curriculum
The RCEM regulations pack sets out how the 180 questions are divided between the curriculum’s specialty learning outcomes:
| Specialty learning outcome | Questions | Share |
|---|---|---|
| SLO 1: Caring for stable adult patients with complex presentations | 55 | 31% |
| SLO 3: Resuscitation and stabilisation | 40 | 22% |
| SLO 4: The injured patient | 30 | 17% |
| SLO 5: Paediatric emergency medicine | 25 | 14% |
| SLO 6: Procedural skills | 20 | 11% |
| SLO 7: Complex and challenging situations | 10 | 6% |
Two lessons stand out. First, adult medical presentations and resuscitation make up over half the exam. Second, paediatrics and procedures together account for a quarter of the marks, so they cannot be left until the last week. This breakdown comes from the 2021 regulations pack, so check RCEM’s current documents for any updates before your sitting.
How the pass mark is set
There is no fixed pass percentage. For each sitting, a panel of examiners judges how a borderline candidate would perform on every question. This is the modified Angoff method. RCEM then adds one standard error of measurement to that cut score to reach the final pass mark. Because the questions differ between sittings, the pass mark changes too.
In practice, this means you should not aim for a particular number. Aim to score consistently well across every curriculum area in timed practice.
Results and feedback
- When: results are released 6–8 weeks after the exam. Exact dates are on the RCEM exam calendar.
- How: through your RCEM online account as a downloadable letter. Results are not given by phone or email.
- Feedback: within a week of results, you receive your score, the pass mark, the cohort average and the percentage you answered correctly in each curriculum area.
If you need to resit, that area-by-area feedback is the best starting point for your next revision plan.
Eligibility and attempts
- You must have passed the MRCEM Primary (or an accepted earlier equivalent) before sitting the SBA.
- You need a primary medical qualification recognised by the GMC and to have completed the UK Foundation Programme or equivalent.
- You have a maximum of six attempts. Previous FRCEM Intermediate SAQ attempts count towards this.
- IELTS Level 7 is the expected English standard for MRCEM.
Always confirm the current rules on RCEM’s eligibility page before you apply.
On the day
- Arrive at least 30 minutes before your exam. Late candidates are not allowed to sit and lose their fee.
- Bring valid photo ID, such as a passport or driving licence.
- Use the 1-hour break to eat, drink and reset. Don’t spend it going over questions from paper 1.
Frequently asked questions
How many questions are in the MRCEM SBA?
180 single best answer questions, split into two papers of 90 questions.
How long is the MRCEM SBA?
Four hours of exam time: two 2-hour papers with a 1-hour break between them.
What is the pass mark for the MRCEM SBA?
It is set for each sitting using the modified Angoff method plus one standard error of measurement, so it varies.
How many times can I sit the MRCEM SBA?
Up to six times, including any previous FRCEM Intermediate SAQ attempts.
Which topics carry the most marks?
Stable adult patients with complex presentations (55 questions) and resuscitation (40 questions) together make up over half the exam.
Next steps
Check the next sitting in our MRCEM exam dates 2026–27 guide, then follow our 12-week MRCEM SBA revision plan. When you are ready to practise at exam pace, the MRCEM Pass question bank has over 2,200 questions with detailed explanations, plus timed mock tests and mind maps mapped to the RCEM curriculum. View membership plans.
Information checked against RCEM’s published exam pages and regulations on 26 September 2026.