# Practising for Emergency Med (MRCEM OSCE) with MedMock

Canonical page: https://medmock.com/exams/emergency-med-mrcem-osce

## What is the MRCEM OSCE, and how do you practise for it?

The MRCEM OSCE is the third and final part of Membership of the Royal College of Emergency Medicine, after the MRCEM Primary and MRCEM SBA, and is set at the standard for entry to higher specialty training. The real exam is sixteen 8-minute stations, each with 1 minute of reading time beforehand, plus two 8-minute rest stations (2 hours 42 minutes in all), blueprinted to the RCEM curriculum's learning outcomes. To sit it you need current full medical registration with a licence to practise, 6 months' full-time-equivalent Emergency Medicine experience above Foundation level, and passes in the MRCEM Primary and MRCEM SBA. MedMock simulates 9 station types from that 16-station exam, covering every blueprint area (procedures are talked through rather than performed), each timed at the real 8 minutes with 1 minute of reading time. MedMock lets you practise it out loud against an AI patient, with examiner-style feedback on any station you finish.

An illustrative example station, written by MedMock with example feedback, is at https://medmock.com/exams/emergency-med-mrcem-osce/example

## What happens in the real MRCEM (checked against the official source on 2026-09-26)

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.

- **Complex stable patient (three stations)** (8 minutes): Three stations blueprinted to SLO1, complex stable patient.
- **Answer questions (two stations)** (8 minutes): Two stations blueprinted to SLO2, answer questions.
- **Resus (two stations)** (8 minutes): Two stations blueprinted to SLO3, resus.
- **Injured patient (two stations)** (8 minutes): Two stations blueprinted to SLO4, injured patient.
- **PEM (one station)** (8 minutes): One station blueprinted to SLO5, PEM. Competence in children's emergencies is expected at the level delivered in a general emergency department, focusing mainly on the seriously ill and injured child or the management of common childhood emergencies.
- **Procedural skills (two stations)** (8 minutes): Two stations blueprinted to SLO6, procedural skills.
- **Complex challenging situations (two stations)** (8 minutes): Two stations blueprinted to SLO7, complex challenging situations.
- **Supervise and teach (two stations)** (8 minutes): Two stations blueprinted to SLO9, supervise and teach.
- **Rest stations (two)** (8 minutes): Two eight-minute rest stations in addition to the 16 exam stations.

Marking: 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.

Sources: https://rcem.ac.uk/mrcem-exams/ https://rcem.ac.uk/exam-regulations-policies/ https://rcem.ac.uk/wp-content/uploads/2024/11/MRCEM_Exam_Regulations_2025_V1.pdf https://rcem.ac.uk/wp-content/uploads/2025/07/Domain_Based_Marking.pdf https://rcem.ac.uk/wp-content/uploads/2023/11/MRCEM_OSCE_Regulations_and_Information_Pack.pdf https://rcem.ac.uk/osce-exams-faqs/ https://rcem.ac.uk/exam-eligibility-and-adjustments/
Full format page: https://medmock.com/exams/emergency-med-mrcem-osce/format

## How to prepare for the MRCEM (facts checked against official sources on 2026-09-27)

The MRCEM OSCE is the last of the three MRCEM exams: 16 eight-minute stations blueprinted to the emergency medicine curriculum's learning outcomes, each marked on one to four weighted domains. Prepare by working through the curriculum's year 1-3 outcomes, practising every station type aloud against an eight-minute clock, and using each station's briefing sheet, which shows the domains being assessed, to decide where your time goes.

1. **Check eligibility and your seven-year window** — You need a primary medical qualification accepted by the GMC, full registration with a licence to practise, 6 months' full-time equivalent emergency medicine experience above Foundation level, and passes in the MRCEM Primary and MRCEM SBA; you cannot apply until you have the SBA pass. You have six attempts at each MRCEM exam and seven years from passing the Primary to complete MRCEM.
2. **Work from the curriculum's year 1-3 outcomes** — RCEM strongly advises MRCEM applicants to familiarise themselves with the year 1-3 competences, and the OSCE is blueprinted to eight learning outcomes: complex stable patient, answering questions, resus, injured patient, paediatric emergency medicine, procedural skills, complex and challenging situations, and supervising and teaching. Children's emergencies are examined at the level of a general emergency department.
3. **Learn the seven domains** — RCEM tells candidates to familiarise themselves with the domains: clinical reasoning and decision making, practical skills, communication (including conflict), teaching, history taking, organisation and prioritisation, and clinical examination. Each station tests one to four of them, weighted by their importance in that station, so ask yourself before every practice station which domains carry the marks.
4. **Use the minute of reading time** — Before each station a briefing sheet gives the scenario, the task, the examiner's role and a pie chart of the domains being assessed. Practise reading a brief in under a minute and deciding how to split your eight minutes before you walk in.
5. **Practise with a clock, not a countdown** — No timer is shown during stations; an analogue clock is visible and you are responsible for your own time management, which RCEM calls a key component of the exam. Time every practice station on a wall clock or watch face so you learn to pace yourself without prompts.
6. **Rehearse every station type aloud** — Practise leading a resuscitation, assessing an injured patient, taking a history from a parent, breaking bad news, consent and complaints, teaching a junior and answering an examiner's questions on a case. Practical skills are one of the domains, so rehearse procedures hands-on in your department, and ask a senior colleague to mark you on the domains.
7. **Use RCEMLearning and the curriculum site** — RCEM suggests consulting relevant material on RCEMLearning, its online platform of curriculum-aligned clinical cases and learning sessions; some content is for members only. Check each learning outcome against the RCEM curriculum, which was updated in August 2025.
8. **Behave as you would at work, and plan the day** — Stations reflect real practice in any UK emergency department, and RCEM asks you to behave as on a normal working day, addressing everyone professionally and with courtesy. Arrive within your registration window, bring ID matching your RCEM account, and expect to surrender electronic devices; all equipment, including stethoscopes, is provided.

Official resources:

- OSCE Exams & FAQs (https://rcem.ac.uk/osce-exams-faqs/): RCEM's preparation advice, the exam-day timetable, what the station briefing sheet contains and answers to candidates' questions.
- Domain Based Marking (https://rcem.ac.uk/wp-content/uploads/2025/07/Domain_Based_Marking.pdf): RCEM's one-page explanation of the seven MRCEM OSCE domains and how station scores are built; use it to mark practice stations.
- MRCEM OSCE Regulations and Information Pack (https://rcem.ac.uk/wp-content/uploads/2023/11/MRCEM_OSCE_Regulations_and_Information_Pack.pdf): The station blueprint, showing which learning outcome each of the 16 stations samples.
- EM Curriculum (https://rcem.ac.uk/em-curriculum/): RCEM's page for the 2021 curriculum and its 2025 update, including the learning outcomes the OSCE is mapped to.
- RCEMLearning (https://rcem.ac.uk/rcemlearning/): RCEM's online learning platform with clinical cases, learning sessions and exam preparation material.
- Results, Feedback and Awarding (https://rcem.ac.uk/results-feedback-and-awarding/): How OSCE results and feedback letters work, and what they show.
- Exam Eligibility and Adjustments (https://rcem.ac.uk/exam-eligibility-and-adjustments/): The eligibility rules for each MRCEM exam, including an eligibility quiz; check before the application window.

Common mistakes examiners report:

- Spending station time on the wrong skill. RCEM's own example: if a station is 90% assessing practical skills, do not spend five minutes taking a history. (source: https://rcem.ac.uk/osce-exams-faqs/)
- Arriving after the registration window closes. Late candidates are not permitted to take the exam. (source: https://rcem.ac.uk/osce-exams-faqs/)
- Relying on a countdown. No timer is shown in the station, and RCEM makes candidates responsible for their own time management. (source: https://rcem.ac.uk/osce-exams-faqs/)

Sources: https://rcem.ac.uk/osce-exams-faqs/ https://rcem.ac.uk/exam-eligibility-and-adjustments/ https://rcem.ac.uk/mrcem-exams/ https://rcem.ac.uk/wp-content/uploads/2024/11/MRCEM_Exam_Regulations_2025_V1.pdf https://rcem.ac.uk/wp-content/uploads/2023/11/MRCEM_OSCE_Regulations_and_Information_Pack.pdf https://rcem.ac.uk/wp-content/uploads/2025/07/Domain_Based_Marking.pdf https://rcem.ac.uk/rcemlearning/ https://rcem.ac.uk/em-curriculum/ https://rcem.ac.uk/results-feedback-and-awarding/
Full guide: https://medmock.com/exams/emergency-med-mrcem-osce/prepare

Upcoming sittings: 18–29 January 2027 (London); 22–26 February 2027 (India – Chennai); 18 May – 4 June 2027 (London) (source: RCEM, checked 2026-09-23).
All MRCEM dates: https://medmock.com/exams/emergency-med-mrcem-osce#dates

## Stations you can practise

- **History Taking (Adult)** — RCEM SLO1, complex stable patient. Eight minutes with an adult who has come to the Emergency Department: take a focused history, explain your working diagnosis and agree the next steps with them.
- **Psychiatric Assessment** — RCEM SLO1, complex stable patient. Eight minutes with an adult in a mental-health crisis in the Emergency Department: assess their mental state and risk, and agree a safe plan with them.
- **Answer Clinical Questions** — RCEM SLO2, answer clinical questions. Eight minutes with an examiner, who presents an adult Emergency Department case with its observations and results and asks you focused questions about diagnosis, investigations, management and disposition.
- **Resuscitation Team Leader** — RCEM SLO3, resuscitation. Eight minutes leading the team through the resuscitation of a critically unwell patient, with the examiner telling you how the patient responds to what you do.
- **Injured Patient** — RCEM SLO4, injured patient. Eight minutes assessing and managing an injured adult: talk the examiner through your assessment, and they give you the findings as you ask for them. Decide on imaging, pain relief and referral.
- **History Taking (Paediatric via Parent)** — RCEM SLO5, paediatric emergency medicine. Eight minutes with the parent of an unwell or injured child, who is not in the room: take the history, address the parent's concerns and agree the next steps.
- **Procedure / Practical Skill** — RCEM SLO6, procedural skills. Eight minutes with an examiner: talk them through an Emergency Department procedure from the decision to perform it to aftercare. In the real exam you perform it on a manikin; here you describe each step aloud.
- **Communication / Breaking Bad News / Consent** — RCEM SLO7, complex and challenging situations. Eight minutes with a patient or relative: breaking bad news, seeking consent, or another difficult conversation such as a complaint.
- **Teaching** — RCEM SLO9, supervise and teach. Eight minutes teaching a junior colleague a focused Emergency Medicine topic or skill.

## Sample MRCEM questions

- *History Taking (Paediatric via Parent):* Speak to the mother of an 8-week-old girl who has had a temperature of 38.4°C at home and has been feeding poorly for the last day. Take a focused history, identify any red-flag features, and explain the next steps.
- *Communication / Breaking Bad News / Consent:* Tell a mother that her 19-year-old son has died following a high-speed motorcycle accident despite full resuscitative efforts.

## Example scenarios

- *Communication / Breaking Bad News / Consent:* Tell a mother that her 19-year-old son has died following a high-speed motorcycle accident despite full resuscitative efforts.
- *Resuscitation Team Leader:* You are the Emergency Medicine registrar. A 65-year-old man has arrived in resus in cardiac arrest. Lead the resuscitation.
- *Psychiatric Assessment:* A 22-year-old woman took a paracetamol overdose four hours ago and is refusing treatment. Assess her, including her capacity to refuse.
- *Answer Clinical Questions:* A 58-year-old man has had central chest pain for 40 minutes. His ECG shows ST elevation in leads II, III and aVF. What does the ECG show, and what is your immediate management?
- *Injured Patient:* A 34-year-old motorcyclist has come off his bike at 50 mph. His pulse is 124 and his blood pressure 92/60. Talk me through your assessment.

## How a practice session works

1. **Choose a station** — Pick from 9 station types drawn from the real MRCEM curriculum, or run a full mock that takes you through them as a circuit.
2. **Have the conversation** — Speak naturally, out loud. The AI patient responds in real time — with emotions, cues and unexpected turns, just like a real encounter.
3. **Get instant feedback** — The moment you finish, you get specific, examiner-style feedback and a score — what you did well, what cost you marks, and precisely what to fix before the next attempt.

## Price

Start with a one-off £5 taster: 30 credits (30 minutes of speaking practice), not a subscription. After that, or instead, £69 per month for 350 credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Cancel at any time. Full details: https://medmock.com/pricing

## Frequently asked questions

### How does the feedback work?

When you finish a station you can have it marked, and the scorecard comes back in seconds — what you did well, what cost you marks, and exactly what to work on next. Scorecards, mark schemes and model answers are included at no extra credit cost.

### Can I practise specific MRCEM stations?

Yes. You can pick any of the 9 station types to drill a weak area, or run a full mock circuit to simulate the real exam.

### How much does it cost?

You can start with a one-off £5 taster: 30 credits, which is 30 minutes of speaking practice, with no subscription. After that, or at any time, you can choose a monthly plan, which includes a monthly credit allowance. Current prices are on the pricing page.

## About MedMock

MedMock is a web app for practising the spoken parts of UK medical and dental exams and interviews out loud. The candidate talks; an AI patient, examiner or interview panel answers in real time by voice; and when the station ends MedMock marks the performance against that exam's assessment domains and shows the model answer.

It covers 104 spoken exams and interviews — OSCEs, vivas, structured oral exams, simulated consultations, and specialty-training and consultant interviews. It does not cover written or multiple-choice papers, and it is not a question bank.

It was founded by Mr Sam Nahas, MBBS BSc MEd FRCS (Tr & Orth), a practising consultant orthopaedic surgeon in the UK, with co-founder and CTO Arjan Jandu. It is operated by VirtualPatients Ltd (company no. 16303492).

Pricing: a one-off £5 taster of 30 credits to try it (not a subscription, one per account), and a monthly subscription from £20 to £129 depending on the exam (student exams cost least, fellowship exit exams and consultant interviews most), or £199 to £275 for the Intensive plans, which carry more credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Subscriptions can be cancelled at any time.

It runs in a web browser on a laptop or phone; spoken practice needs a microphone. There is no public demo: practice needs an account with credits, usually from the taster or a monthly plan.

MedMock is for adults aged 18 or over. Sign-up asks every new account to confirm it.

MedMock is a revision tool. The patients, examiners and cases are fictional and AI-generated; it is not clinical guidance and is not affiliated with or endorsed by any Royal College, the GMC, the GDC or any examining body.

Start with the £5 taster: https://medmock.com/auth/signup