# Practising for Pain Medicine (FFPMRCA oral) with MedMock

Canonical page: https://medmock.com/exams/pain-medicine-ffpmrca-oral

## What is the FFPMRCA viva, and how do you practise for it?

The Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA) oral examination. The FFPMRCA comprises a written multiple-choice paper and a two-part Structured Oral Examination sat after completing Advanced Pain Training. MedMock practises the whole oral examination: the Clinical Oral (a 20-minute Long Case after 10 minutes of reading time, followed by three 10-minute Short Questions) and the 30-minute Science Oral across three 10-minute topics (pharmacology, anatomy and physiology, and psychology, epidemiology and research methods). The written MCQ paper is not practised here. MedMock lets you practise it out loud against an AI examiner, with examiner-style feedback on any question you finish.

An illustrative example station, written by MedMock with example feedback, is at https://medmock.com/exams/pain-medicine-ffpmrca-oral/example

## What happens in the real FFPMRCA (checked against the official source on 2026-10-24)

The Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA) examination has two parts: a written Multiple Choice Question (MCQ) paper and a Structured Oral Examination (SOE), taken after passing the MCQ during Advanced Pain Training. The SOE comprises a 50-minute Clinical Oral (a 20-minute Long Case after 10 minutes of reading time, followed by three 10-minute Short Questions) and a 30-minute Science Oral of three 10-minute questions. Two examiners mark each question independently, and candidates must pass both the MCQ and the SOE to be awarded the FFPMRCA.

- **Clinical Oral — Long Case** (20 minutes): After 10 minutes of preparation time to review a clinical referral packet, pain questionnaires and investigation findings, candidates spend 20 minutes with two examiners presenting a biopsychosocial formulation, differential diagnosis, red and yellow flags, examination priorities and multidisciplinary management plan.
- **Clinical Oral — Short Questions** (30 minutes): Three 10-minute short clinical pain scenarios presented verbally by two examiners across chronic non-cancer pain, neuropathic pain, cancer pain, interventional pain medicine, neuromodulation and opioid stewardship.
- **Science Oral** (30 minutes): Three 10-minute structured oral questions with two examiners covering pain pharmacology, pain neuroanatomy and neurophysiology, and pain psychology, epidemiology and research methods.

Marking: Two examiners mark each component of the Clinical Oral and the Science Oral independently against the Faculty of Pain Medicine FFPMRCA Structured Oral Examination marking criteria.

Passing: Candidates must pass the written MCQ examination before sitting the Structured Oral Examination, and both components must be passed to be awarded the FFPMRCA.

Sources: https://fpm.ac.uk/examinations-assessments/ffpmrca-examination https://fpm.ac.uk/examinations-assessments/ffpmrca-examination-dates-and-charges https://fpm.ac.uk/examinations-assessments/ffpmrca-examination/ffpmrca-examination-regulations
Full format page: https://medmock.com/exams/pain-medicine-ffpmrca-oral/format

## How to prepare for the FFPMRCA (facts checked against official sources on 2026-10-24)

The FFPMRCA Structured Oral Examination tests consultant-level pain medicine across a 50-minute Clinical Oral and a 30-minute Science Oral. Prepare by practising a 10-minute case-packet read followed by a 20-minute biopsychosocial formulation, rehearsing 10-minute short clinical vignettes aloud, and revising pain pharmacology, neurobiology and clinical trial appraisal from the Faculty of Pain Medicine syllabus.

1. **Confirm your eligibility and examination diet** — To sit the FFPMRCA Structured Oral Examination you must hold the Primary FRCA or a recognised equivalent qualification, be in an approved Advanced Pain Training post, and have passed the FFPMRCA written MCQ paper. Check the Faculty of Pain Medicine examination calendar early for the autumn oral window and application deadline.
2. **Practise the 10-minute read and 20-minute Long Case structure** — In the Clinical Oral Long Case you have 10 minutes to read a referral packet, pain questionnaires and investigation findings before 20 minutes of questioning by two examiners. Use the reading window to organise a clear biopsychosocial formulation, red and yellow flags, differential diagnosis, targeted examination priorities and a multimodal pain management plan.
3. **Rehearse 10-minute Clinical Oral Short Questions aloud** — The second part of the Clinical Oral consists of three 10-minute short clinical scenarios with no separate reading window. Practise answering concisely across chronic primary and secondary pain, neuropathic pain, Complex Regional Pain Syndrome, cancer pain interventions, neuromodulation, inpatient pain and opioid stewardship.
4. **Revise the three Science Oral domains systematically** — The 30-minute Science Oral asks three 10-minute questions covering pain pharmacology, pain neuroanatomy and neurophysiology, and pain psychology, epidemiology and research methods. Practise explaining receptor mechanisms, dorsal horn processing, descending modulation, local anaesthetic and radiofrequency physics, and trial appraisal aloud.
5. **Anchor management plans in UK pain guidelines and safety standards** — Ground your clinical answers in the Faculty of Pain Medicine Core Standards for Pain Management Services, Opioids Aware guidance on opioid risk and tapering, NICE guidelines on chronic pain, neuropathic pain and low back pain and sciatica, and fluoroscopic, radiation and anticoagulation safety checks for interventional procedures.

Official resources:

- FFPMRCA Examination — Faculty of Pain Medicine (https://fpm.ac.uk/examinations-assessments/ffpmrca-examination): The Faculty of Pain Medicine overview of the MCQ and Structured Oral Examination format, components and preparation guidance.
- FFPMRCA Examination Regulations (https://fpm.ac.uk/examinations-assessments/ffpmrca-examination/ffpmrca-examination-regulations): Official regulations setting out eligibility, attempts, marking and pass requirements for the FFPMRCA.
- FFPMRCA Examination Dates and Charges (https://fpm.ac.uk/examinations-assessments/ffpmrca-examination-dates-and-charges): Current sitting dates, application deadlines and examination fees from the Faculty of Pain Medicine.
- Opioids Aware — Faculty of Pain Medicine (https://fpm.ac.uk/opioids-aware): The Faculty of Pain Medicine resource on opioid prescribing, risk assessment, equianalgesic conversion and tapering in chronic pain.

Common mistakes examiners report:

- Presenting a purely biomedical plan in the Long Case without addressing yellow flags, psychological comorbidity, sleep, occupational function and multidisciplinary rehabilitation. (source: https://fpm.ac.uk/examinations-assessments/ffpmrca-examination)
- Running out of time across the three 10-minute Science Oral questions by giving unstructured textbook lists instead of mechanism-led explanations. (source: https://fpm.ac.uk/examinations-assessments/ffpmrca-examination)

Sources: https://fpm.ac.uk/examinations-assessments/ffpmrca-examination https://fpm.ac.uk/examinations-assessments/ffpmrca-examination/ffpmrca-examination-regulations https://fpm.ac.uk/examinations-assessments/ffpmrca-examination-dates-and-charges https://fpm.ac.uk/opioids-aware
Full guide: https://medmock.com/exams/pain-medicine-ffpmrca-oral/prepare

Dates: The Faculty of Pain Medicine runs the FFPMRCA Structured Oral Examination once a year in autumn after the written MCQ sitting; check the Faculty of Pain Medicine examination calendar for the current diet's application window and oral dates. (source: Faculty of Pain Medicine (RCoA)).
All FFPMRCA dates: https://medmock.com/exams/pain-medicine-ffpmrca-oral#dates

## Stations you can practise

- **Clinical Oral — Long Case** — 20-minute examiner-led clinical oral after 10 minutes of reading a referral letter, pain body map, BPI/HADS/PCS questionnaires and investigation reports. Present a structured biopsychosocial formulation, differential diagnosis, red and yellow flags, targeted examination priorities and a multidisciplinary pain management plan.
- **Clinical Oral — Short Questions** — 30-minute examiner-led clinical oral comprising three 10-minute short clinical scenarios across chronic non-cancer pain, cancer pain, neuropathic pain, neuromodulation, interventional pain medicine, opioid stewardship and complex inpatient pain.
- **Science Oral** — 30-minute examiner-led basic-science oral comprising three 10-minute questions: pain pharmacology (opioids, gabapentinoids, antidepressants, NMDA antagonists, local anaesthetics), pain neuroanatomy and neurophysiology (nociception, dorsal horn, central sensitisation, autonomic pathways), and pain psychology, epidemiology and evidence-based research methods.

## Sample FFPMRCA questions

- *Clinical Oral — Long Case:* A 46-year-old warehouse supervisor is referred with persistent radicular leg pain 14 months after L4/5 microdiscectomy, taking modified-release morphine 120 mg/day and pregabalin 600 mg/day. Present your biopsychosocial formulation and multidisciplinary management plan.
- *Science Oral:* Outline the cellular and synaptic mechanisms of wind-up and central sensitisation in the dorsal horn of the spinal cord, and explain how pharmacological agents target these pathways.

## Example scenarios

- *Clinical Oral — Long Case:* A 46-year-old warehouse supervisor is referred with persistent radicular leg pain 14 months after L4/5 microdiscectomy, taking modified-release morphine 120 mg/day and pregabalin 600 mg/day, with BPI interference 8.4/10 and PHQ-9 of 19. Present your biopsychosocial formulation and multidisciplinary management plan.
- *Clinical Oral — Short Questions:* A 62-year-old woman with metastatic pancreatic adenocarcinoma has refractory coeliac-distribution pain despite high-dose systemic opioids and dose-limiting delirium. Discuss your assessment and the role, anatomy, risks and evidence for neurolytic coeliac plexus block.
- *Science Oral:* Outline the cellular and synaptic mechanisms of wind-up and central sensitisation in the dorsal horn of the spinal cord, and explain how pharmacological agents target these pathways.

## How a practice session works

1. **Choose a question** — Pick from the FFPMRCA questions — all 3 that MedMock runs, or let MedMock surprise you the way exam day will.
2. **Have the conversation** — Speak naturally, out loud. The AI examiner listens, follows up and probes further, exactly like the viva.
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, £119 per month for 600 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 question 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 FFPMRCA questions?

Yes. You can pick any of the 3 questions to drill a weak area, or run a Full Mock that takes you through the questions MedMock practises, back to back.

### 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