FRCEM SBA is a core theory exam required for Fellowship of the Royal College of Emergency Medicine (FRCEM). Together with the FRCEM OSCE, it forms the final step towards College Fellowship.

Exam Overview

• Exam Type: Theory

• Format: Multiple choice questions (MCQ) with single best answers (SBA)

• Number of Questions: 180

• Structure: Two papers (2 hours each)

• Total Duration: Four hours (with a one-hour break between papers)

• Delivery: Pearson VUE Test Centres worldwide

The FRCEM SBA is mapped to the full RCEM 2021 Emergency Medicine Curriculum. Unlike the MRCEM exams, the blueprint extends into advanced topics including:

• Clinical Emergency Medicine across all body systems

• Major trauma and critical care

• Paediatric and geriatric emergencies

• Research methods and statistics

• Quality improvement, clinical governance, and management principles

This ensures candidates demonstrate not only advanced clinical expertise, but also leadership, research awareness, and a commitment to quality improvement in practice.

You may sit the FRCEM SBA if you have obtained one of the following within the last 7 years:

• MRCEM

• FRCEM Intermediate Certificate (Intermediate SAQ and SJP)

Candidates must also meet RCEM’s minimum clinical experience requirements. Details are available on the RCEM Eligibility & Adjustments page .

Booking the Exam

• Applications must be made online during the published application window on the RCEM Exam Calendar.

• Applications close automatically at 4pm UK time on the final date – late applications are not accepted.

• The exam is delivered via Pearson VUE test centres worldwide. Candidates can select a centre near them.

Marking and Standard Setting

• Each correct answer = 1 mark

• Incorrect answers = 0 marks

• No negative marking

• Pass mark set using the Angoff method plus one Standard Error of Measurement (SEM)

This ensures fairness and consistency across exam diets.

Preparation Tips

• Use the RCEM Curriculum: This is the foundation of revision and ensures focus on examinable content.

• Balance clinical depth with breadth: SBA questions may combine knowledge recall, data interpretation, and clinical judgement.

• Practice exam technique: Time management is key — 180 questions over four hours requires pacing and focus.

• Use high-quality resources: Dedicated online revision banks such as EM Learning Centre’s FRCEM SBA course replicate the exam style and provide feedback aligned to the curriculum.

• Don’t neglect statistics & QI: Many candidates underestimate these sections, but they are increasingly weighted in the blueprint.

A 32-year-old patient presents following a road traffic collision with severe abdominal pain and hypotension. FAST ultrasound demonstrates free fluid in the abdomen.

Which of the following is the most appropriate immediate management step?

A. CT Abdomen with contrast
B. Diagnostic peritoneal lavage
C. Laparotomy
D. Angiography
E. Focused repeat FAST scan

Correct Answer: C – Laparotomy

Explanation:
In a haemodynamically unstable trauma patient with positive FAST findings, the immediate management is surgical exploration via laparotomy. CT imaging is reserved for stable patients, while angiography and DPL are adjuncts. Repeating the FAST wastes valuable time in this setting.

Key Links

• RCEM Basic Sciences Curriculum 

• MRCEM Exam Dates & Fees 

• MRCEM Overview – RCEM

• EM Learning centre

The FRCEM SBA is a rigorous test of advanced emergency medicine knowledge and judgement. Success requires both clinical mastery and a clear understanding of the RCEM 2021 Curriculum. With structured preparation, curriculum-driven study, and high-quality SBA practice, you can approach the exam with confidence.