The MRCEM Primary is the first step towards Membership of the Royal College of Emergency Medicine (RCEM). It focuses on the core basic sciences that underpin clinical emergency medicine. The exam is rigorous and requires careful preparation, particularly in anatomy and physiology, which together account for two-thirds of the paper.

• Format: 180 Single Best Answer (SBA) questions

• Duration: 3 hours

• Language: English (IELTS Level 7 recommended)

• Syllabus: RCEM Basic Sciences Curriculum

Question Distribution:

• Anatomy – 60 questions

• Physiology – 60 questions

• Pharmacology – 24 questions

• Microbiology – 17 questions

• Pathology – 9 questions

• Evidence-Based Medicine – 10 questions

(Full curriculum available via RCEM: RCEM Exams )

Preparation Strategy

• Start early: At least 6 months before the exam

• Prioritise anatomy and physiology – they form the bulk of the exam

• Use the RCEM Basic Sciences Curriculum as your roadmap

• Supplement with standard textbooks (see RCEM recommendations)

• Don’t waste time on non-required topics (e.g., unnecessary muscle attachments)

• Be disciplined with the smaller sections (microbiology, pathology, pharmacology, EBM)

• Balance revision with regular question practice to identify weak areas

• Stick with your established study methods — consistency is key

MRCEM Primary uses Single Best Answer (SBA) questions. Each has three parts:

1. Scenario or statement

2. The question

3. Answer options (one best answer)

Example SBA

A patient has suffered an injury to their arm that has damaged the inferior posterior cutaneous nerve of the arm.

Which of the following best describes the sensory area supplied by this nerve?

• The medial half of the palm

• A tapered strip of the middle portion of the posterior forearm ✅

• Part of the posterior aspect of the upper arm

• The posterior surface of the lateral three and a half digits and associated palm

• The lateral aspect of the palm

Answer: B. A tapered strip of the middle portion of the posterior forearm

Explanation: The radial nerve has four sensory branches. The posterior cutaneous nerve of the forearm specifically supplies a tapered strip in the posterior mid-forearm.

Approach to SBAs

• Read the question first, then the options, then the scenario

• Highlight key clues (abnormal findings, investigation results)

• Eliminate obviously wrong answers

• Recognise distractors — plausible but not “best” answers

• If time allows, review all questions before finishing

• In uncertain cases, trust your first instinct

Choose EM Learning Centre for its curriculum precision, data-driven feedback, and exam-style depth. Let us help you turn your study time into success.

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Textbooks + Curriculum + Question banks = best results

• Focus on application of knowledge, not rote memorisation

• Practise recalling answers before looking at options

• Be realistic: anatomy and physiology require the most hours

• Use practice tests as feedback loops to refine your weak areas

Key Links

• RCEM Basic Sciences Curriculum 

• MRCEM Exam Dates & Fees 

• MRCEM Overview – RCEM

• EM Learning centre

The MRCEM Primary is a demanding exam, but with structured preparation, consistent practice, and a clear focus on the curriculum, success is entirely achievable. Start early, concentrate on high-yield topics, and refine your skills with realistic question practice.

Good luck with your preparation!