What happens in the FRCEM exam
The FRCEM Final Objective Structured Clinical Examination (OSCE) is the exit clinical examination for Fellowship of the Royal College of Emergency Medicine, mapped to the Specialty Learning Outcomes (SLOs) of the 2021 Emergency Medicine curriculum. The circuit comprises 16 eight-minute stations with one minute of reading time before each station and two eight-minute rest stations. Examiners use domain-based marking to score each station out of 10 (maximum 160), and the pass mark is set by borderline regression plus one standard error of measurement.
Checked against the official sources on 24 October 2026.
The parts, in order
Eight-minute stations after one minute of reading time assessing consultant-level history, focused assessment, diagnostic reasoning and shared management of complex adult emergency presentations.
Eight-minute stations after one minute of reading time assessing supervision, real-time clinical advice and teaching for junior doctors and allied health professionals in the emergency department.
Eight-minute stations after one minute of reading time assessing leadership of adult or paediatric resuscitation, critical care stabilisation and emergency procedural skills.
Eight-minute station after one minute of reading time assessing emergency management of the seriously ill or injured child, neonatal emergencies, safeguarding and communication with parents or carers.
Eight-minute stations after one minute of reading time assessing trauma assessment, imaging interpretation, decision-making and disposition for injured patients.
Eight-minute stations after one minute of reading time assessing consultant leadership of the emergency department floor, crowding, ambulance offload delays, capacity escalation, major incidents and complex communication or ethical challenges.
Eight-minute station after one minute of reading time assessing critical appraisal of emergency medicine literature, study methodology, statistics, clinical audit and quality improvement.
Eight-minute station after one minute of reading time assessing emergency department management, patient safety incident response, statutory Duty of Candour, complaints, risk management and service governance.
How it is marked
Each of the 16 stations assesses one to four weighted RCEM 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). Examiners judge competence in each domain from well below to well above minimum competence, converted into a station score from 0 to 10 (maximum 160 marks across the 16 stations).
Passing
The FRCEM OSCE is standard set conjunctively using the borderline regression method to set daily cut scores, with one standard error of measurement (+1 SEM) added to the borderline regression cut score to calculate the pass mark.
Worth knowing
- To sit the FRCEM Final OSCE, candidates must hold full registration with a licence to practise, have passed the FRCEM SBA and met the RCEM higher specialty training experience requirements.
- There are no double stations in the FRCEM OSCE. No countdown timer is displayed inside stations; an analogue clock is visible in each station for candidates to manage their own time.
Sources
- RCEM: FRCEM Exams
- RCEM: Domain Based Marking (OSCE marking guidance)
- RCEM: OSCE Exams & FAQs
- RCEM: Exam Regulations & Policies
- RCEM: Exam Calendar & Fees
Formats change. MedMock is not affiliated with any examining body; always check the current regulations on the official site before you book.
Practise the FRCEM out loud
MedMock runs spoken FRCEM practice with AI and marks every session. Start with a £5 taster: 30 credits: 30 minutes of speaking practice. One-off payment, no subscription.
Start with the £5 taster