Quick answer: MRCEM is made up of three exams that must be passed in order: the MRCEM Primary (180 basic science SBAs in 3 hours), then the MRCEM SBA (180 clinical SBAs across two 2-hour papers), then the MRCEM OSCE (16 clinical and communication stations). You can sit the Primary straight after qualifying. The SBA needs Foundation training or equivalent, and the OSCE needs 24 months of experience, including six months in emergency medicine above FY1 level.
This guide explains what each exam tests, who can sit it, and how to plan the whole pathway so you are not rushing one exam while preparing for the next. The facts come from RCEM’s MRCEM exams page, its eligibility criteria and its exam FAQs.
The three MRCEM exams at a glance
| Feature | MRCEM Primary | MRCEM SBA | MRCEM OSCE |
|---|---|---|---|
| What it tests | Basic sciences for emergency medicine | Clinical knowledge across the ED | Clinical and communication skills |
| Format | 180 single best answer questions | 180 single best answer questions in 2 papers of 90 | 16 stations of 8 minutes, plus 1 minute reading time each |
| Time | 3 hours | 2 hours per paper, with a 1-hour break | About 2 hours 42 minutes, including 2 rest stations |
| Where | Computer-based test centres worldwide | Computer-based test centres worldwide | Selected centres, currently London, Kuala Lumpur, Chennai and Hyderabad |
| Pass mark | Set each sitting (Angoff method) | Set each sitting (Angoff method + 1 SEM) | Set each sitting (borderline regression + 1 SEM) |
| Results | About 6–8 weeks | About 6–8 weeks | About 5 weeks |
| Attempts | Maximum of 6 | Maximum of 6 | Maximum of 6 |
MRCEM Primary: the basic sciences
The Primary is the entry point. It tests the science behind emergency practice: anatomy, physiology, pharmacology, pathology, microbiology and evidence-based medicine, based on the RCEM basic sciences curriculum. Questions are machine-marked, with one mark for a correct answer and no negative marking, so you should never leave a question blank.
Who can sit it: anyone with a primary medical qualification recognised by the GMC. No emergency medicine experience and no Foundation years are required, which is why many doctors sit it early, while the science from medical school is still fresh.
Good to know: a Primary pass does not expire (only the old MRCEM Part A passes from before August 2012 are time-expired). The only exemption is for MRCS holders on the DRE-EM training route. MRCP does not exempt you.
MRCEM SBA: clinical emergency medicine
The SBA is where most of the clinical knowledge is tested. Its 180 questions cover the full range of conditions and presentations seen in the emergency department, mapped to the Year 1–3 learning outcomes of the RCEM curriculum. It replaced the FRCEM Intermediate SAQ in August 2021, and earlier SAQ attempts count towards your six.
Who can sit it: you must have passed the Primary and completed the UK Foundation Programme or equivalent.
For the full breakdown of papers, timing and how marks are spread across the curriculum, read our guide to the MRCEM SBA exam format.
MRCEM OSCE: putting it into practice
The OSCE tests whether you can apply your knowledge with real patients and colleagues. Its stations cover history taking, examination, practical procedures, resuscitation scenarios, and communication tasks such as breaking bad news or handling a complaint. Each station is marked across several domains, so how you communicate counts as much as what you know.
Who can sit it: you must have passed both the Primary and the SBA, completed Foundation training or equivalent, and have 24 months of experience, including six months in emergency medicine at a level above FY1.
Because it is only held at a few centres, OSCE places can be limited and you may need to travel. Check the booking window as soon as you pass the SBA.
Which exam, when? A practical timeline
There is no single right timeline, but the rules set the order and the minimum experience. A common pattern looks like this:
- During or soon after Foundation years: sit the Primary. The basic sciences are closest to what you studied at medical school, and no ED experience is needed.
- Once Foundation training (or equivalent) is complete and the Primary is passed: start preparing for the SBA. Most candidates need around 12 weeks of structured revision alongside clinical work. Our 12-week MRCEM SBA revision plan sets out a week-by-week approach.
- After the SBA, once you have 24 months of experience including six months of ED work above FY1: book the OSCE. Clinical experience in the ED is the best preparation, supported by practice with colleagues under timed conditions.
Check the next sittings and application windows in our MRCEM exam dates 2026–27 guide. Application windows close well before the exam, so plan backwards from the date you want.
Tips for international doctors
- The Primary and SBA can be taken at computer-based test centres in many countries, so you can pass both before moving to the UK.
- “Foundation training or equivalent” and the OSCE experience requirement can be met with posts outside the UK. Check with RCEM how your experience will be assessed before you apply.
- RCEM advises IELTS Level 7 as the expected standard of English for its exams.
- MRCEM is one route towards GMC registration. Check the GMC’s current requirements for your situation separately.
Summary
- Order is fixed: Primary, then SBA, then OSCE. You cannot move on until you pass the previous exam.
- Primary: basic sciences, open to any GMC-recognised graduate.
- SBA: clinical knowledge, after the Primary and Foundation training.
- OSCE: clinical and communication skills, after the SBA and 24 months of experience (six months in EM above FY1).
- Six attempts are allowed at each exam.
Frequently asked questions
Can I sit the MRCEM exams in any order?
No. RCEM requires you to pass the Primary, then the SBA, then the OSCE, and you cannot apply for the next exam until you have passed the previous one.
Do I need emergency medicine experience to sit the MRCEM Primary?
No. You only need a primary medical qualification recognised by the GMC.
How many attempts do I get at each MRCEM exam?
A maximum of six attempts at each of the Primary, SBA and OSCE.
Does my MRCEM Primary pass expire?
No. Current Primary passes remain valid. Only MRCEM Part A passes from before August 2012 are time-expired.
Where is the MRCEM OSCE held?
At a small number of centres, currently listed by RCEM as London, Kuala Lumpur, Chennai and Hyderabad. Check the RCEM exam calendar for each sitting.
Next steps
If the SBA is your next exam, start by trying our 20 free MRCEM SBA sample questions to see where you stand. When you are ready to revise in earnest, the MRCEM Pass question bank has over 2,200 questions with detailed explanations, plus timed mock tests and key facts mapped to the RCEM curriculum. View membership plans.
Information checked against RCEM’s published exam pages, eligibility criteria and FAQs on 30 September 2026.