The FRCEM OSCE is the final clinical assessment leading to Fellowship of the Royal College of Emergency Medicine. It builds on MRCEM-level skills, testing senior decision-making, leadership, and critical analysis. Candidates must have passed the FRCEM SBA before attempting the OSCE.

The FRCEM OSCE evaluates performance across Specialty Learning Outcomes (SLOs) relevant to senior registrars and future consultants:

• SLO 1 – Care of the complex stable patient

• SLO 3 – Resuscitation and stabilisation

• SLO 4 – Management of the injured patient

• SLO 5 – Paediatric emergency medicine

• SLO 7/8 – Managing complex or challenging situations (EPIC domains)

• SLO 9 – Supervise and teach

• SLO 10 – Manage the emergency department and resources

• SLO 12 – Lead, research, and improve quality

These domains encompass clinical reasoning, leadership, governance, and critical appraisal skills — reflecting consultant-level responsibilities.

(Full curriculum available via RCEM: RCEM Exams )

Four weeks before the OSCE, RCEM emails all candidates a journal article for the Critical Literature Appraisal (CLA) component.
On exam day:

• One reading station allows you to re-familiarise with the article

• One guided discussion station tests understanding of the study’s internal validity (rigour) and external validity (clinical relevance)

• No calculations are required

• From November 2025, the Borderline Regression method will be used to set the pass mark for the CLA and resus stations

• Practise literature appraisal using clinical research papers

• Review leadership and team management OSCEs

• Rehearse handover and governance discussions using SBAR and reflective frameworks

• Understand ethical and supervision-based scenarios

• Use the EM Learning Centre FRCEM OSCE Course for mock circuits, CLA coaching, and examiner marking

The EM Learning Centre  offers:

• Full coverage of FRCEM SLOs and domains

• Integrated CLA preparation with sample journal critiques

• Consultant-level leadership and management scenarios

• Examiner-led video tutorials and feedback sessions

• Regular updates to reflect RCEM assessment changes

• Arrive 45 minutes early for registration and briefing

• Leave phones and devices in the designated locker area

• Use the reading time to identify the task, patient, and domain focus

• Be structured and concise — clarity and leadership are key

• Maintain a calm and professional demeanour in all scenarios

• Remember: you must pass at least one resus station and achieve the overall pass mark

Key Links

• RCEM OSCE FAQs 

• RCEM Curriculum (2021) 

• RCEM Learning Modules 

• Domain-Based Marking Guidance PDF

• EM Learning centre

The FRCEM OSCE represents the culmination of your Emergency Medicine training. It rewards calm leadership, structured thinking, and compassion. With focused preparation and insight, you can turn every station into a demonstration of your readiness for independent consultant practice.