What happens in the MRCEM exam

The MRCEM OSCE is the third and final exam for Membership of the Royal College of Emergency Medicine (MRCEM), taken after the MRCEM Primary and MRCEM SBA. It has 16 eight-minute stations, with one minute of reading time between stations and two eight-minute rest stations (2 hours 42 minutes in all), blueprinted to the Specialty Learning Outcomes (SLOs) of the emergency medicine curriculum. Examiners use domain-based marking: each station tests one to four weighted domains and is scored from 0 to 10, for a maximum of 160. The pass mark is the borderline regression cut score plus one standard error of measurement.

Checked against the official sources on 26 September 2026.

The parts, in order

How it is marked

Each station tests one to four of seven MRCEM OSCE domains: clinical reasoning/decision making; communication skills (including conflict); history taking/information gathering; clinical examination skills; practical/pinnacle skills; teaching skills; and organisation/prioritisation. Each domain is weighted by its importance within the station, and the examiner judges your competence in each domain on a range from well below to well above the minimum level of competence. These judgements are converted into a station score from 0 to 10, giving a maximum of 160 marks across the 16 stations. Marking has been domain-based rather than checklist-based since September 2022.

Passing

The cut score is set by the borderline regression method, with daily cut scores, and one standard error of measurement is added to create the pass mark. RCEM describes the standard setting as conjunctive but does not publish a fixed pass mark or a minimum number of stations that must be passed.

Worth knowing

• The three MRCEM exams must be passed in order: MRCEM Primary, then MRCEM SBA, then MRCEM OSCE. MRCEM is awarded when all three are passed.
• To apply you must hold a primary medical qualification accepted by the GMC and a current full medical registration with a licence to practise, have 6 months' full-time equivalent emergency medicine experience above Foundation training (or equivalent), and have passed the MRCEM Primary and MRCEM SBA.
• The MRCEM OSCE is held in London, Kuala Lumpur, Chennai and Hyderabad. There are no double stations, no timer is shown during stations, and an analogue clock is visible in each station.
• Candidates are allowed a maximum of six attempts at each MRCEM exam, and have seven years from passing the MRCEM Primary to complete the MRCEM exams.
• IELTS Level 7 is the expected standard of English.

Sources

• RCEM: MRCEM Exams (MRCEM OSCE FAQs)
• RCEM: Exam Regulations & Policies
• RCEM: MRCEM Exam Regulations (September 2024, for 2025 exams onwards)
• RCEM: Domain Based Marking (OSCE marking guidance)
• RCEM: MRCEM OSCE Regulations and Information Pack (July 2021; linked by RCEM as the exam blueprint)
• RCEM: OSCE Exams & FAQs
• RCEM: Exam Eligibility and Adjustments