The MRCEM and FRCEM Intermediate SBA exams are tough....
Success in these exams is a challenge and all Emergency Medicine doctors deserve credit for getting to this stage. Whether your passed or failed, here we'll offer some suggestions on what to do next:
I passed the MRCEM / FRCEM SBA exam
I didn't pass the MRCEM / FRCEM SBA exam
I passed the FRCEM / MRCEM SBA exam:
First things first, you deserve to celebrate and get some rest. No doubt you wherever you are, you are dealing with the coronavirus and will not be able to celebrate in the way that you would wish. But from us at IMG Connect, congratulations! Doctors who have attained full MRCEM and secured a job in the NHS tell us that the FRCEM SBA is a very tough examination, so well done! Your hard work has paid off.
Once you are feeling relaxed, this is a good time to think about what steps you need to take to complete full MRCEM. For most overseas doctors, this will mean taking the final MRCEM OSCE exam and whilst all OSCE centres are currently closed it takes most doctors at least six to nine months to prepare for the exam anyway.
So what is the MRCEM OSCE?
Like the intermediate exam, the MRCEM OSCE requires a considerable amount of revision and preparation. However, as you know the format is very different, so your preparation will change.
The MRCEM OSCE consists of 18 stations (16 patient encounters & 2 rest stations), each one lasting for about 7 minutes. The MRCEM OSCE exam will not only test your theoretical knowledge, but also your resus skills and communication skills. Even candidates who are working in an emergency medicine department (ED or ER) often find these OSCEs difficult. Even if you have strong background knowledge in Emergency Medicine the exams can still be tricky due to a heavy reliance on testing your communication skills and etiquette.
How to preparation for MRCEM OSCE?
Preparation is therefore vital for all doctors who intend to take the MRCEM OSCE exam. This can be broken down into the following:
Practical day-to-day work (colleague observations & feedback, peer groups, study groups)
Online revision resources (subscriptions, reading materials, tutorials, videos)
Courses (face to face, online)
In general, emergency medicine course tutors advise setting aside at least 2-3 months preparation in addition to your Emergency Medicine experience.
Resources, courses and revision materials:
We are often asked by Emergency Medicine doctors where they should look for resources, online revision materials, OSCE mock stations and preparation courses (online and face to face).
As such, we have compiled the best advice, tips, courses and resources suggested by Emergency Medicine doctors who have taken the MRCEM and FRCEM exams.
Where can I take the MRCEM OSCE exam?
Overseas doctors (IMGs) can sit the final MRCEM OSCE exam in three locations: the UK, India and Malaysia. However the Royal College has suspended all upcoming test dates and centres due to the COVID-19 coronavirus.
I did not pass the FRCEM SBA exam:
If you did not pass the FRCEM intermediate exam - don't worry! The overall pass rate is 35% which is roughly half of the MRCEM OSCE pass rate. This is a tough exam so don't worry too much, take some time out to relax and enjoy life. These moments where you don't succeed at the first, or second time, will only make you stronger and a better doctor in the long run. As the British say, chin up and strong upper lip!
At IMG Connect we've taken the time to prepare and collate the best preparation resources for the FRCEM Intermediate Certificate exam - we would be delighted to share these with you. Click on the buttons below to register with the IMG Connect team so we can talk you through this or request the FRCEM Intermediate resources to help you pass the next time - without fail!
If you have any questions about how to secure an NHS job in Emergency Medicine or prepare for the FRCEM Intermediate exam or MRCEM OSCE (including advice on dates, fees, courses, resources, mock scenarios, online materials and revision books) then don’t hesitate to get in touch with an IMG Consultant.
IMG Connect is keeping a very close eye on the examination schedule and will keep all our IMGs informed as soon as the College publishes some updates. You can find the updated exam schedule here.
However, this does not mean you cannot use the time to prepare for your OSCE!
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In this article we provide guidance on evidence to be supplied for an application onto the Specialist Register for Emergency Medicine, with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Emergency Medicine in the NHS?
As an Emergency Medicine doctor, attaining CESR will mean you are qualified to practice independently as an Emergency Medicine consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCEM to attain a CESR in Emergency Medicine?
Yes, Emergency Medicine is one of the few specialisms where there are no GMC-accepted equivalents to MRCEM. Any doctor wishing to attain Specialist Registration via the CCT route will attain FRCEM in addition.
What is the indicative period of training for a CCT in Emergency Medicine?
The indicative period of training for a CCT in Emergency Medicine is six years and it is very unlikely that an applicant would achieve the competencies required for a CCT in a shorter period of time.
The evidence you collect for your CESR application should reflect this period of training, which consists of:
Two years in the Acute Care Common Stem (covering areas of Emergency Medicine, Anaesthetics, Intensive Care Medicine and Acute Medicine)
Four years of training in Emergency Medicine (covering areas of Paediatric EM, EM and EM ultrasound)
CESR applicants will need to demonstrate they have achieved the competences in each of these areas.
The EM ultrasound competences (EMUS) can be shown by completing the triggered assessments outlined in the EM curriculum (level 1 or equivalent).
The assessments forms for Core Ultrasound can be found in the RCEM EMUS booklet (Appendix 2).
The first three years of training make up Core Specialty Training, the final years of training are known as Higher Specialty Training.
For complete details please refer to the Emergency Medicine Curriculum documentation.
Submitting Evidence
Do not submit original documents – this is very important.
All your copies, other than qualifications you’re getting authenticated must be accompanied by a proformas signed by the person who is attesting to the validity and accuracy of your evidence (your verifier).
It is very important that you read an explanation of how to do this in the GMC’s important notice about evidence.
How much evidence should you submit?
The GMC recognises that doctors will often not have all the evidence required for a complete CESR application, often many doctors will start their application and delay starting their application until they are able to gather all the evidence.
The evidence must cover the knowledge, skills and qualifications to demonstrate the required competencies in all areas of the Emergency Medicine Curriculum.
If evidence is missing from any one area of the curriculum, then the application will fail.
If you have a piece of evidence that is relevant to more than one domain, do not include multiple copies in your bundle. Instead, include one copy and list it in your evidence list under each relevant area, stating that the document is located elsewhere.
The GMC asks that only evidence that is strictly relevant is sent as it will help them to process the application quicker. The guidance on compiling your evidence will help you to decide what is relevant and what is not – make sure you are reading the latest version on the GMC website – here.
It is important to note that evidence that is more than five years old will be given less weight than more recent evidence, so you may not need to include it. As a general guide, an application for CESR could expect to see around 800-1000 pages of evidence.
The types of evidence are divided into four different domains, the GMC recommends that you apportion the evidence provided as per the pie chart below:
Please note, you cannot compensate for evidence lacking in one area by providing more evidence in another area.
Make sure to anonymise your evidence:
It is very important to anonymise your evidence before submitting it to the GMC.
You must remove the following:
All patient identifying details
Details of patients’ relatives
Details of colleagues that you have assessed, written a reference for, or who have been involved in a complaint you have submitted. This includes:
Names (first and last)
addresses
contact details such as phone numbers or email addresses
NHS numbers & other individual patient numbers
GMC numbers
In Summary:
If you have any questions or uncertainties, please do not hesitate to get in touch with the IMG Connect team. However, your official point of reference for any queries should the GMC – they can answer and provide the most updated information on CESR applications for overseas Emergency Medicine doctors looking to work as NHS Consultants in Emergency Medicine.
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Here we’ll take a closer look at the second stage of your FRCEM success in the examinations – FRCEM Intermediate SAQ.
We’ll consider its purpose, structure and content, eligibility, dates, exam centers and provide some revision tips to give you the best chance of passing first time and moving closer towards full Membership of the Royal College of Emergency Medicine (MRCEM).
Designed to help you prepare and sit the exam, we consider the following topics:
What is FRCEM Intermediate Certificate?
Am I eligible?
Exemptions & equivalent examinations
Where can I take the exam?
How much will it cost me?
How can I prepare for the exam?
Passed? What next?
What is the FRCEM Intermediate SAQ?
The FRCEM Intermediate Certificate is the second examination in a series of three and is mapped to the Competencies of Year 1-3 of the Emergency Medicine 2015 Curriculum (ACCS Plus).
The FRCEM Intermediate SAQ comprises of a 3-hour paper of 60, 3-mark questions.
A full break down of the blueprint is found on the FRCEM Intermediate Regulations & Information Pack.
A summarised blueprint for the SAQ can be found below.
Curriculum Category
Questions
Common Competences
7
Clinical Presentations – Core Major & Acute Presentations
18
Anaesthetic Competences CT1&2
4
ICM within ACCS
2
Acute Presentations – Additional Adult ST3
6
Paediatric Presentations – Makor & Acute Presentations
11
Practical Procedures (ACCS)
12
Total
60
Am I eligible?
To be eligible you must hold a Primary Medical Qualification (PMQ) recognised by the GMC, have completed an equivalent to the UK Foundation Programme (Internship?) and have passed FRCEM Primary Examination after 1st August 2016.
You will also be eligible if you have been granted exemption from the FRCEM Primary as a result of obtaining MRCS or MRCSI after 1st January 2012.
MRCEM Part B in place of FRCEM Intermediate SAQ
MRCEM Part B passes obtained prior to August 2012 are deemed time expired, therefore you are required to pass the FRCEM Intermediate SAQ examination.
If you passed the MRCEM Part B examination after 1 August 2012 you are deemed to have passed an equivalent examination to the FRCEM Intermediate SAQ examination.
Where and when can I take the exam? And how much will it cost me?
Examination and application dates are regularly updated by the Royal College and can be found here.
Venues and Fees for both intermediate examinations are below:
Examination
Location
Fees
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
How can I apply?
All applications are made online.
Please note, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines.
Applications submitted after the application period will not be accepted.
Links to all application forms and application windows are available here.
How do I prepare for each exam and what resources are available?
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Curriculum: Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the FRCEM examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day.
You can download this here: FRCEM Intermediate
SAQ Blueprint:
The blueprint for the Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
SJP Blueprint:
The blueprint for the new Intermediate SJP exam can be found on page 11 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College: Intermediate Certificate – sample SJP questions
Glossary of Terms:
The Royal College uses many terms that may cause confusion, so take plenty time to understand the terms and definitions using this guide.
Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Examination Report:
The Royal College recently began to publish reports on the performance of those sitting FRCEM examinations. Below is the first report published and helps to break down results for those in training and those out of training.
2018 Examination report.
Online resources:
There are lots of resources online, such as videos on YouTube, FRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
Passed? What next?
First of all, congratulations! After you have passed FRCEM Intermediate you can apply to sit the Final Examination. Take a look at our article on FRCEM Final Examination where we explore everything you need to know about how to sit the exam, including syllabus, dates, fees, results and preparation.
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To help make your MRCEM journey a success - here we’ll take a closer look at MRCEM Primary, including eligibility, dates, fees & exam centers.
We will also provide some tips to give you the best chance of passing first time - giving you MRCEM success and moving closer towards full Membership of the Royal College of Emergency Medicine (MRCEM).
Designed to help you prepare and sit the exam, we consider the following topics:
What is the MRCEM Primary?
What is the content and structure?
Can I sit the exam more than once?
What is the curriculum?
Am I eligible?
How can I apply?
Where and when can I take the exam? How much will it cost me?
How do I prepare for each exam and what resources are available?
Passed? What next?
What is the MRCEM Primary?
The MRCEM Primary Examination is the first examination in a series of three and is mapped to the Emergency Medicine 2015 Curriculum. You can find more detailed information provided in the RCEM Basic Sciences Curriculum (June 2010) which is available here or as a downloadable PDF.
The MRCEM Part A has been replaced by the MRCEM Primary exam with effect from August 2016.
Completion of the MRCEM examinations (Primary/ Intermediate/ OSCE) results in the award of membership of the Royal College of Emergency Medicine.
The Royal College strongly advises all applicants to familiarise themselves with the Basic Sciences Curriculum when preparing to sit the MRCEM Primary Examination.
General advice is to get to know the curriculum as early as possible and use it as a road map for your study plan.
What is the content and structure?
The MRCEM Primary exam consists of one 3-hour paper of 180 multiple choice, single best answer questions (SBAQs).
You must choose one best answer from a choice of five feasible answers.
The paper will examine all the domains of knowledge in the Basic Sciences Curriculum including:
Anatomy
Physiology
Pathology
Microbiology
Pharmacology
Evidence Based Medicine
Can I sit the exam more than once?
Candidates are permitted a maximum of six attempts in which to pass the MRCEM Primary Examination.
Previous attempts at the MRCEM Part A examination prior to August 2016 do not count towards the number of available attempts.
The examination is conducted in English and candidates are advised that IELTS Level 7 is the expected standard for completion of the MRCEM examinations. Remember, you will need to have a pass of 7.5 average in all areas of IELTS to complete your GMC registration.
What is the curriculum?
The blueprint for the MRCEM Primary Examination is as follows:
Category
Sub-Category
Questions
Anatomy
Upper limb
Lower limb
Thorax
Abdomen
Head and Neck
Central Nervous System Cranial Nerve Lesions
60
Physiology
Basic cellular physiology
Respiratory physiology
Cardiovascular physiology
Gastrointestinal physiology
Renal physiology
Endocrine physiology
60
Pharmacology
Gastrointestinal pharmacology
Cardiovascular system
Respiratory system
Central Nervous System
Infections
Endocrine system
Fluids and electrolytes
Muscoskeletal system
Immunological products and vaccines Anaesthesia
27
Microbiology
Principles of microbiology
Pathogen groups
18
Pathology
Inflammatory responses
Immune responses
Infection
Wound healing
Haematology
9
Evidence Based Medicine
Statistics Study methodology
Principles of critical appraisal
6
TOTAL
180
Am I eligible?
To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.
You do not need to be registered with the GMC to enter.
Don’t forget! You may need a visa to enter a different country to sit the exam. Failure to check this could prevent you from sitting the exam and your examination fee will not be refunded.
How can I apply?
All applications are made online.
Please note, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines.
Applications submitted after the application period will not be accepted.
Links to all application forms and application windows are available here.
Where and when can I take the exam? How much will it cost me?
Exam dates and locations for 2019 are currently available, these are regularly updated by the Royal College and can be found here.
Examination
Centre
Fees
MRCEM Primary
Short Answer Question Paper
London, Dublin, Edinburgh, Leeds, Cardiff
£310
Chennai, Hyderabad, New Delhi, Reykjavik, Kuala Lumpur, Muscat
£390
How do I prepare for the exam and what resources are available?
With lots of resources available online, we have discussed with IMGs the best place to start looking for materials relating to the exams. Most IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams. See below:
Curriculum:
Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.
Information Packs:
These provide detailed information for the relevant examination components so that you can best prepare for your studies and what to expect on the day:
MRCEM Primary
Sample questions:
Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
• Primary – sample questions
Glossary of Terms:
The royal college uses many terms that may cause confusion, so take plenty time to understand the terms and definitions used in this guide.
Candidates are expected to be rigorous in their use of these terms.
Glossary of terms used in RCEM exams.
Online resources:
There are lots of resources online, such as videos on YouTube, MRCEM courses and useful reading materials. We think that these are a great addition to your study plan, just be sure to check your sources.
For a useful overview of how to prepare for exams, including advice on study groups, online community support, best use of online resources & Royal College materials and courses, take a look at our blog: IMG Connects Top Tips for exam preparation
Passed? What next?
If you are completing the papers in order, the next step will be to apply for MRCEM Intermediate Certificate. For more information take a look at our blog where we explore MRCEM Intermediate and everything that you need to know about how to sit the exam, including syllabus, dates, results, fees and preparation.
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Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding a typical doctor salary in the UK and the most suitable hospital locations for you.
The MRCEM OSCE exam requires a considerable amount of revision and preparation....
And we are often asked by Emergency Medicine doctors where they should look for MRCEM OSCE resources, online revision materials, mock stations and preparation courses.
Here we compile the best advice, tips, courses and resources available for the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE exam whilst also address some understandable concerns about the effect of COVID-19 on availability of test centres and upcoming exams.
What is the MRCEM OSCE?
The MRCEM OSCE consists of 18 stations (16 patient encounters & 2 rest stations), each one lasting for about 7 minutes. The MRCEM OSCE exam will not only test your theoretical knowledge, but also your resus skills and communication skills. Even candidates who are working in an emergency medicine department (ED or ER) often find these OSCEs difficult. Even if you have strong background knowledge in Emergency Medicine the exams can still be tricky due to a heavy reliance on testing your communication skills and etiquette.
Preparation is therefore vital for all doctors who intend to take the MRCEM OSCE (part C) exam. This can be broken down into the following:
Practical day-to-day work (colleague observations & feedback, peer groups, study groups)
Online revision resources (subscriptions, reading materials, tutorials, videos)
Courses (face to face, online)
In general, emergency medicine course tutors advise setting aside at least 2-3 months preparation in addition to your Emergency Medicine experience.
How has the COVID-19 coronavirus afffected MRCEM exam centres & dates?
The Royal College of Emergency Medicine took the difficult decision to cancel all events for the months of April, May and June following the escalation of the virus. As the UK and most of the world remain in some form of lockdown, the Royal College has not announced when it is expecting to open up it's centres again. Understandably this will be tied into government advice and that of the WHO whilst most examiners involved in the OSCE examinations will be tied into urgent clinical duties.
IMG Connect is keeping a very close eye on the examination schedule and will keep all our IMGs informed as soon as the College publishes some updates. You can find the updated exam schedule here.
However, this does not mean you cannot use the time to prepare for your OSCE!
So how to get started?
The first step is to ensure you are familiar enough with the Royal College of Emergency Medicine Curriculum (2015), and to use this to create your study plan covering the whole curriculum, whilst also identifying areas of weakness to strengthen.
Take a look through Mastering Emergency Medicine – a practical guide to re-enforce your solid background in Emergency Medicine knowledge before you start approaching the stations. Note that this book was first published in 2009, and some aspects may be slightly outdated.
Familiarise yourself with the stations, techniques and format by watching online videos and tutorials - you can find both free and paid tutorials online.
YouTube has many great videos available to get you started, covering basics of examination and OSCE guides through to mock OSCE scenarios:
Mcleods Examination videos (Basics of examination)
OSCE guides - Geeky Medics
Bromley webinars and tutorials
Watching these videos before you start your practice sessions (and then repeatedly throughout your study plan) will give you a huge boost.
Resources for MRCEM OSCE
General advice is to use a variety of resources, including reading materials, online subscriptions to videos and tutorials, podcasts and videos. The following have helped IMGs on their journey to successful completion of the MRCEM OSCE:
Bromley Emergency Courses online tutorials:
Revision communication videos
Revision examination videos
Revision procedure videos
MRCEM OSCE course Podcast
Geeky Medics – Emergency Medicine
Practical work - peer groups and senior colleague observations
The best way to practice and solidify what you have learnt from your studies is to organise group sessions and observations at work.
Observations at work
Ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward. Receiving quality feedback in a formal setting is widely regarded as fundamental to your advances in emergency medicine practice.
Group sessions
When organising a peer group of Emergency Medicine OSCE aspirants, advice is to have a maximum of three/four persons per group. Three works very well because you can each play a role during role play sessions.
When conducting role plays, you may want to organise yourselves as follows:
Patient (use instructions for the actor provided in the textbooks, remember each patient has a backstory and there are many aspects the actor must show, including emotion)
Exam Candidate
Examiner (takes notes, observes, marks the checklist and gives immediate and detailed feedback on all aspects of the marking sheet)
Remember to take turns and swap roles, work as the patient, exam candidate and the examiner. Stick to the exam format, for example set a time limit of about 7 minutes which will allow you to get a clear understanding of how to pace yourself and finish before 7 minutes. Remember not to be too fast, or too slow, helping you to make every second count.
Feedback is crucial to improving your practice. As you practice together, look at the checklists after you perform each station and find out if you are missing anything.
When taking up the examiner role ensure to give detailed feedback covering all marking criteria (intro, examination, body language and winding up - the four key areas that can improve your score). Once the examiner has delivered their feedback, discuss as a group, considering how to improve in all aspects of the exam criteria.
Build stamina
Once you have a routine in place for peer group practical OSCE simulations, build up towards completing a full set of stations. This should be done for each member of your group. The exam can be tiring, which can in turn affect your performance on the day of the exam. For example, if exhausted at the final stations, it can be hard to maintain your clear communication and positive body language, so a full run through will help you to understand what it will be like on the day and what you need to do to ensure that you are consistently performing.
Record sessions
Try recording your group scenarios. IMGs who have done this repeatedly informed us that this was one of the single most important methods for seeing first-hand how to improve. We are after all our own worst critics! Take notes on the way you enter the room, move, talk, express yourself, your non-verbal cues, body language and interactions.
Take a course
There are various workshops organised by expert course tutors in Emergency Medicine designed to help you pass. You can find these online and anecdotal evidence suggests that taking a face to face course improves your chances of passing the MRCEM OSCE exam.
Speak to an IMG Consultant to check what courses might be suitable for you, if there is not a course where you live, it may be possible for us to organise one for you and your peers.
Is a course necessary?
Many overseas doctors preparing for their FRCEM or MRCEM Emergency Medicine examinations wonder if they should take a course as part of their preparation. In short, we advise that all IMGs should attend as many courses as possible. The knowledge gained on an MRCEM or FRCEM course goes well beyond the exam.
One issue is of course that courses cost a considerable amount of money, but if you consider that taking a course increases your chances exponentially of passing the examinations first time, the cost is offset by not having to pay to re-sit and all the additional costs that come with it (i.e. flights & accommodation).
Finding courses can be tricky
So take some time to work out what you specifically need help with and the stage you are at in the process. Search online to find the course that will suit your needs the most.
Speak to your peers, some may have attended a course that they felt had a positive impact on the learning and preparation.
Once you think you have found a course that suits your needs, such as an MRCEM OSCE course, check reviews posted by other IMGs to be sure of the quality of the tutoring.
If you have found a course that suits your needs, has good reviews recommendations from your peers, then it will likely be worth the investment. As a direct result you will likely pass the exams much quicker, helping you to secure the Emergency Medicine job that you want in the NHS.
On the day of exam - tips from IMGs
Passing any exam is not easy, passing the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE examination even more so. In speaking with IMGs about their journey through the MRCEM OSCE exams, we have heard many thoughts about what it takes to pass. To help IMGs preparing to take the test, here we share some tips from past examinees and OSCE course tutors.
Firstly, it is good to know that every IMG taking the test is in the same position as you, perhaps anxious about how to prepare and worried about the exam day. We are told that the exam is just an ordinary day on the ward, so why then do so many excellent practicing EM physicians struggle to pass at first attempt?
It is perhaps important to say that the advice below is not just from not just those IMGs who passed first time, but from those who had to learn from their mistakes and take the test a second or even third time.
The most common thing that we hear is that IMGs must adapt their skill set to the requirements of the NHS system as well as changing their mindset to be able to work under intense observation.
Further reasons they struggle are:
1. Anxiety
Experiencing anxiety during exams is completely natural and the fact that the OSCE stations are only 7 minutes adds to this in the Part C. The only way to combat exam anxiety is to accept that is both natural and inevitable. The best way to prepare and suppress the adrenergic surge is with practice, practice and more practice. The best way to practice is under exam conditions and if possible, this should be timed and observed by different examiners.
We are not of the opinion that this practice should be done last minute in the week before the exam, instead, your practice should start long before this point. Ask your senior colleagues in the ED to observe and comment upon your history taking and examination skills. If you can get into a routine of doing this with 3 to 5 patients per day you will be able to run through nearly all the most likely scenarios in only 12 shifts. Another great strategy is to teach OSCEs to the more junior doctors within the department. Teaching can be a powerful learning tool and has helped many aspirants with their revision.
2. Lack of practice
Make no mistake – the exam is very tough. Over 50% of candidates failed the 2016 sitting. Unless you are freakishly good at cramming you will need to set aside at least 3 months to prepare. IMGs will all study in different ways. Remember you have been through many exams all on your own. Whatever revision method works for you, stick to it. Once you know that you are going to study, make a revision plan and stick to it.
Practice in any way that you can. As above, be sure to ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward.
To practice out of work, form a small group of colleagues who are also taking the test and run through role plays, taking turns to be patient, doctor or examiner.
Pay careful attention to time keeping as it is very common for candidates to run out of time, particularly in history taking and communication skills stations.
3. Lack of familiarisation with curriculum
If you don’t know what you could be tested on, you won’t know what to prepare. The MRCEM OSCE is mapped to the competences of Year 1-3 of the Emergency Medicine 2015 Curriculum which is available on the 2015 Curriculum page. You should familiarise yourself with the Year 1-3 competences in preparation for sitting this examination.
4. Not being able to communicate effectively
Many IMGs have made the mistake of thinking that communication is only about what you say, not considering how you say it, and what you look like when you are saying it. Of course, you may be anxious, which can make you behave differently and say things in a different way. So, if you have practiced as above, make sure you incorporate practicing communicating not just focusing on what you say, but also your body language when saying it. Remember that between 70% of our communication is non-verbal!
Try to speak audibly and clearly and if at all possible, sit at the same level as the patient with an open posture. Attempt to make a connection with the patient, maintain good eye contact and give them your undivided attention. Treat actors and mannequins as if they are real patients, interact with them in the same way that you would on the EM ward.
Be direct and to the point but deliver any bad news in a sensitive and empathetic manner. Always check whether the patient has understood what you have said and ask if they have any questions.
5. Reading and deciphering the instructions
It is vitally important to read the instructions very carefully before entering a station. Easy marks are frequently lost by nervous or over-confident candidates that have overlooked key information or made assumptions by misreading. This is a mistake many IMGs have made, so learn from their mistakes and be sure to read everything carefully. Once read, make a plan of how you will approach the scenario. Once your minute is up… deep breath and smile!
If you have any questions about how to prepare for the MRCEM OSCE exam, including advice on courses, resources, mock scenarios, online materials and revision books, then don’t hesitate to get in touch with an IMG Consultant.
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One of the main reasons that overseas doctors want to work in the Emergency Medicine departments across the UK, is the excellent opportunity for access to training such as the Specialist Training Programme, career progression, including CESR, and sub-specialty development.
This short article provides useful information on the training and development available, how to access the training, the best route to becoming a consultant in the UK with entry to the specialist register, no matter what stage of your training.
Emergency Medicine Training, leading to CCT
We start with an overview of the Emergency Medicine Training in the NHS. Trainees may enter the emergency medicine training programme via:
The EM (Emergency Medicine) core training programme at ST1. This is a three-year core training programme (starting from ST1 and ending at ST3).
For the first two years, trainees will spend 6 months in EM, Intensive Care Medicine, Anaesthetics and Acute Medicine. This is followed by a further year in trauma and paediatric EM.
The start of specialty training (ST4-6) subject to having achieved the necessary competences required for completion of ST3.
Once ST6 is completed, then a doctor will be added to the specialist register for medicine and hold the title of CCT. This means that they can apply for and practice at a consultant level in the NHS.
CESR
For senior Emergency Medicine doctors (experienced specialty doctors, consultants and heads of departments) there is also the option of CESR. You can apply directly for CESR from overseas, or secure a post in the NHS with CESR support and complete your application in the UK. This is a good option for those wanting to take up their first role in the NHS as a specialty doctor (leading to consultant) or as a locum consultant.
Applying from abroad can be lengthy, and it is certainly not the quickest route towards specialist registration. Most IMGs prefer to secure a post with CESR support, so speak to your IMG Consultant to learn more about the best route to the UK for senior doctors seeking consultant jobs in Emergency Medicine.
Most senior Emergency Medicine job vacancies advertised will offer support with CESR, access to training and career progression, and senior managers will encourage you to develop your own professional interests.
Emergency medicine departments in the NHS are particularly supportive of doctors seeking to develop both personally and professionally. To find out what jobs are on offer take a look here.
If you think that a Specialty Doctor post with CESR support is suited to you, or if you are a consultant or head of department, then you can find out more information here.
For further advice on how to secure the right job for you in the NHS, take a look at our the following article.
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Many overseas doctors preparing for their FRCEM or MRCEM Emergency Medicine examinations wonder if they should take a course as part of their preparation.
In short, we advise that all IMGs should attend as many courses as possible. The knowledge gained on an MRCEM or FRCEM course goes well beyond the exam.
One issue is of course that courses cost a considerable amount of money, but if you consider that taking a course increases your chances exponentially of passing the examinations first time, the cost is offset by not having to pay to re-sit.
Finding courses can be tricky, so take some time to work out what you specifically need help with and the stage you are at in the process. Search online to find the course that will suit your needs the most.
Speak to your peers, some may have attended a course that they felt had a positive impact on the learning and preparation.
Once you think you have found a course that suits your needs, such as an MRCEM OSCE course, check reviews posted by other IMGs to be sure of the quality of the tutoring.
When purchasing the Emergency Medicine course, if you have found a course that suits your needs, has good reviews recommendations from your peers, then it will likely be worth the investment. As a direct result, you will likely pass the exams much quicker, helping you to secure the Emergency Medicine job that you want in the NHS.
If you need some advice on choosing an Emergency Medicine MRCEM or FRCEM course to help you on your journey to securing a job in the NHS, don’t hesitate to get in touch with IMG Connect.
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Passing any exam is not easy, passing the MRCEM OSCE examination, even more so.
In speaking with IMGs about their journey through the MRCEM OSCE exams, we have heard many thoughts about what it takes to pass. To help IMGs preparing to take the test, here we share some tips from past examinees and OSCE course tutors.
Firstly, it is good to know that every IMG taking the test is in the same position as you, perhaps anxious about how to prepare and worried about the exam day. We are told that the exam is just an ordinary day on the ward, so why then do so many excellent practicing EM physicians struggle to pass at first attempt?
It is perhaps important to say that we felt it was important to give advice from not just those IMGs who passed first time, but from those who had to learn from their mistakes and take the test a second or even third time.
In this article we take a broad look at some of the main reasons that good candidates have cited as contributing to their failure to pass.
The most common thing that we hear is that IMGs must adapt their skill set to the requirements of the NHS system as well as changing their mindset to be able to work under intense observation.
IMGs have told us that the main reasons they struggle are:
Nerves
Lack of practice
Lack of familiarisation with the test
Lack of understanding of the curriculum
Not being able to communicate effectively
Reading and deciphering the instructions
Anxiety
Experiencing anxiety during exams is completely natural and the fact that the OSCE stations are only 7 minutes adds to this in the Part C. The only way to combat exam anxiety is to accept that is both natural and inevitable. The best way to prepare and suppress the adrenergic surge is with practice, practice and more practice. The best way to practice is under exam conditions and if possible, this should be timed and observed by different examiners.
We are not of the opinion that this practice should be done last minute in the week before the exam, instead, your practice should start long before this point. Ask your senior colleagues in the ED to observe and comment upon your history taking and examination skills. If you can get into a routine of doing this with 3 to 5 patients per day you will be able to run through nearly all the most likely scenarios in only 12 shifts. Another great strategy is to teach OSCEs to the more junior doctors within the department. Teaching can be a powerful learning tool and has helped many aspirants with their revision.
Lack of practice
Make no mistake – the exam is very tough. Over 50% of candidates failed the 2016 sitting. Unless you are freakishly good at cramming you will need to set aside at least 3 months to prepare. IMGs will all study in different ways. Remember you have been through many exams all on your own. Whatever revision method works for you, stick to it. Once you know that you are going to study, make a revision plan and stick to it.
Practice in any way that you can. As above, be sure to ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward.
To practice out of work, form a small group of colleagues who are also taking the test and run through role plays, taking turns to be patient, doctor or examiner.
Pay careful attention to time keeping as it is very common for candidates to run out of time, particularly in history taking and communication skills stations.
Lack of familiarisation with curriculum
If you don’t know what you could be tested on, you won’t know what to prepare. The MRCEM OSCE is mapped to the competences of Year 1-3 of the Emergency Medicine 2015 Curriculum which is available on the 2015 Curriculum page. You should familiarise yourself with the Year 1-3 competences in preparation for sitting this examination.
Not being able to communicate effectively
Many IMGs have made the mistake of thinking that communication is only about what you say, not considering how you say it, and what you look like when you are saying it. Of course, you may be anxious, which can make you behave differently and say things differently. So, if you have practiced as above, make sure you incorporate practicing communicating not just focusing on what you say, but also your body language when saying it. Remember that between 70% of our communication is non-verbal!
Try to speak audibly and clearly and if at all possible, sit at the same level as the patient with an open posture. Attempt to make a connection with the patient, maintain good eye contact and give them your undivided attention. Treat actors and mannequins as if they are real patients, interact with them in the same way that you would on the EM ward.
Be direct and to the point but deliver any bad news in a sensitive and empathetic manner. Always check whether the patient has understood what you have said and ask if they have any questions.
Reading and deciphering the instructions
It is vitally important to read the instructions very carefully before entering a station. Easy marks are frequently lost by nervous or over-confident candidates that have overlooked key information or made assumptions by misreading. This is a mistake many IMGs have made, so learn from their mistakes and be sure to read everything carefully. Once read, make a plan of how you will approach the scenario. Once your minute is up… deep breath and smile!
IMG Jobs
Search and find live emergency medicine NHS doctor jobs in the UK
IMG Resources
Read more useful articles on finding an NHS trust doctor jobs, doctor salary & relocation for emergency medicine specialists
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss emergency medicine doctor job options in the NHS, including discussions regarding, CESR, a typical doctor salary in the UK and the most suitable NHS job & hospital locations for you.