The MRCEM SBA (Single Best Answer) exam is the second step in the Membership of the Royal College of Emergency Medicine pathway. It builds upon the scientific knowledge tested in the Primary and focuses on the clinical application of knowledge across the breadth of Emergency Medicine practice.

• Exam Type: Written theory

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

• Number of Questions: 180

• Duration: 4 hours total (split into two 2-hour sessions with a 1-hour break)

• Delivery: Pearson VUE test centres worldwide

• Language: English

📖 Full details are published by the Royal College of Emergency Medicine here: RCEM Exams

The MRCEM SBA tests your ability to recognise, investigate and manage the wide range of presentations encountered in the Emergency Department (ED).
It is case-based and reflects real-world emergency practice, covering:

• Adult emergencies

• Paediatric emergencies

• Trauma & orthopaedics

• Acute medicine

• Surgery relevant to EM

• Critical care and anaesthesia in the ED

• Psychiatry and toxicology

The exam blueprint mirrors the RCEM Intermediate Syllabus, ensuring a broad and balanced coverage of emergency conditions.

Exam Breakdown

• Total: 180 questions

• Format: All SBAs

• Sections: 2 papers (2 hours each) with a 1-hour break

• Marking: One correct answer per question, no negative marking

• Pass Mark: Standard-set using RCEM methodology

(Full curriculum available via RCEM: RCEM Exams )

SBA questions require you to choose the most appropriate answer from a set of plausible options.

Each question typically includes:

1. Clinical vignette – a short scenario describing the case.

2. Question stem – what you are asked to determine.

3. Answer options – usually 5 choices, only one is the “best” answer.

Example:
A 24-year-old man presents with sudden onset chest pain and shortness of breath. His ECG shows right axis deviation, an S1Q3T3 pattern, and tachycardia.

What is the most likely diagnosis?
A) Myocardial infarction
B) Pneumothorax
C) Pulmonary embolism
D) Pericarditis
E) Aortic dissection

Answer: C – Pulmonary embolism

Success in the MRCEM SBA requires:

• Curriculum familiarity: Read the RCEM Intermediate Syllabus carefully.

• Clinical knowledge: Focus on common and life-threatening ED presentations.

• Practice questions: Work through large volumes of high-quality SBAs.

• Exam technique: Learn to identify distractors and focus on key clinical clues.

We recommend:

• At least 4–6 months of structured preparation.

• Using past questions and high-fidelity mocks to replicate exam pressure.

• Balancing time between strong and weak topics to maximise marks.

The EM Learning Centre  offers one of the most comprehensive and exam-focused SBA question banks available:

✅ Thousands of high-quality SBA questions written by EM doctors
✅ Fully mapped to the RCEM Intermediate Syllabus
✅ Detailed explanations for every answer, including why other options are wrong
✅ Mock exams to replicate Pearson VUE conditions
✅ Updated regularly to reflect RCEM exam changes

EM Learning Centre has been trusted by hundreds of candidates worldwide to pass their MRCEM exams on the first attempt.

Tips for Exam Day

• Arrive early at the Pearson VUE centre.

• Manage your time — do not get stuck on difficult questions.

• Flag and return to uncertain questions later.

• Read the clinical scenario carefully and look for key discriminators.

• Stay calm and maintain focus — the exam is designed to test applied clinical reasoning, not obscure facts.

Key Links

• RCEM Basic Sciences Curriculum 

• MRCEM Exam Dates & Fees 

• MRCEM Overview – RCEM

• EM Learning centre

The MRCEM SBA exam is a challenging but rewarding step on your journey to Membership of the Royal College of Emergency Medicine. Success depends on structured preparation, consistent practice, and an exam-focused strategy.

By building your revision around the RCEM syllabus, mastering the SBA question style, and using high-quality resources such as the EM Learning Centre, you give yourself the strongest possible chance of passing on your first attempt.

Stay disciplined, practise regularly, and trust your preparation — the hard work will pay off on exam day.

Good luck with your MRCEM SBA journey.