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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Hospitals across the UK are offering specialty doctor job plans with opportunity for CESR programmed support, giving doctors the chance to quickly work towards specialist registration.
For experienced IMGs this is a new and quick route to your first Consultant post. By taking up a service level job as a Specialty Doctor with CESR support as part of the job plan many IMGs are securing a great start to their future career in the NHS that is suited to their senior level experience.
If you are an overseas doctor looking for a Specialty Doctor job with the chance to work towards your Certificate of Eligibility for Specialist Registration (CESR), speak to the IMG Connect team to discuss if this is a suitable route for you. We have opportunities across the UK for doctors to take advantage of the CESR programme.
You can also send your CV to info@imgconnect.co.uk or register here. It takes 30 seconds to register!
By taking such posts in NHS trusts and hospitals you can join diverse, dynamic and inspiring groups of specialty doctors and acting Consultants all on the way to achieving their CESR as part of a tailored programme. In offering such job opportunities, hospitals will provide a supportive environment with protected time to fulfill all the requirements of the CESR application, gaining career-enhancing experiences as you do.
Acting up, dedicated peer groups, coaching & mentoring, scheduled learning and study time are some of the benefits that you could receive.
In such roles you will typically receive hands on support from consultant colleague and exposure to a wide range of experience to specifically aid competency achievement for your CESR application.
In some specialty doctor jobs with CESR programme you will rotate through various departments, dependent on your required experience.
Some hospitals will also provide the following as part of the CESR programme:
Supported Professional Activity (SPAs) sessions per week
Tailored experience to your CESR portfolio
Regular clinical supervision
A CESR mentor
Involvement in academic programme and medical student teaching
Support in gaining research competencies
SAS Tutor support
CESR / SAS support forums and meetings
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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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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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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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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.
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.
For the latest news and updates on all things emergency medicine, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation.
As an IMG, what documents should you submit for your CESR application in Geriatric Medicine?
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Geriatrics or Elderly Care Medicine with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Geriatric Medicine in the NHS?
As a Geriatrician, attaining CESR will mean you are qualified to practice independently as a Geriatrics consultant in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP to attain a CESR in Geriatric Medicine?
No, but whilst it is always a benefit to attain MRCP you do not require it to attain CESR in Geriatric Medicine, though you may have already attained this depending on which route you have taken for GMC registration.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK).
What is the indicative period of training for a CCT in Geriatrics?
The indicative period of training for a CCT in Geriatric Medicine is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time.
This training consists of the following:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
AND
Five years training in Geriatrics
Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas.
For a complete list of competencies refer to the Geriatric 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 Geriatric 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 Geriatricians looking to work as NHS Consultants in Geriatrics.
Getting started
Many geriatric medicine IMGs likely haven’t completed a UK-approved training programme, but you could be eligible for Specialist Registration with the GMC via the CESR route.
If you have any further questions about Specialist Registration, your route to the UK, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Sources
https://www.jrcptb.org.uk/certificate-eligibility-specialist-registration
https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr
https://www.gmc-uk.org/-/media/documents/sat---ssg---geriatric-medicine-2010--amended-2016----dc2302_pdf-48455396.pdf
In this article we look at the specialty specific guidance on documents to be supplied in evidence for an application for entry onto the Specialist Register for Haematology with a Certificate of Eligibility for Specialist Registration or CESR.
What is CESR in Haematology in the NHS?
As a Haematologist, attaining CESR will mean you are qualified to practice at consultant level in Haematology in the NHS. Have a read through our CESR articles found in the IMG Library to understand a little more.
Do I need MRCP or FRCPath in Haematology to attain CESR in Haematology?
No, but whilst it is always a benefit to attain MRCP, or FRCPath, or both (you may have already attained either of these by ways of registering with the GMC) you do not require MRCP or FRCPath in Haematology to attain CESR.
Any doctor wishing to attain Specialist Registration via the CCT route must attain MRCP(UK) and FRCPath in Haematology.
What is the indicative period of training for a CCT in Haematology?
The indicative period of training for a CCT in Haematology is seven years and it is highly unlikely that you would achieve the competencies required for a CCT in a shorter period of time.
This training consists of the following:
2 years in Core Medical Training OR
Acute Care Common Stem (ACCS) OR
AND
Five years training in Haematology
Therefore, CESR applicants must demonstrate that they have achieved the competencies in each of these areas. For a complete list of competencies refer to the Haematology 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 Haematology 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 Haematologists looking to work as NHS Consultants in Haematology.
IMG Jobs
Search and find live NHS Pathlology jobs offering CESR in the UK
IMG Resources
Read more useful articles on finding an CESR, NHS trust doctor job, pay scales & doctor’s salary in the UK, relocation and much more!
Get in Touch
Don’t hesitate to get in touch using the buttons above (and below) to discuss doctor job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable hospital locations for you.
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!
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
If you have any questions about how to secure an NHS job in Emergency Medicine, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS:
Overseas Haematologists wanting to secure a role in the UK via the postgraduate qualificaiton route will need to attain Fellowship of the Royal College of Pathologists or FRCPath in Haematology, a sub-specialty exam of FRCPath. FRCPath is the UK Royal College qualification and the recommended route for histopathologists looking to work in the UK as a specialist or consultant.
International Medical Graduates (IMGs) from any country in the world can sit the sub-specialty FRCPath in Haemotology examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is FRCPATH in Haematology?
Eligibility for overseas doctors
FRCPath Haematology structure and format
FRCPATH in Haematology Part 1
FRCPATH in Haematology Part 2
As an overseas candidate where can I take the exams and how much will they cost me?
How do I apply?
How to prepare and what resources are available?
Passed? What next?
What is FRCPath in Haematology?
Set against the Specialty Training Curriculum for Haematology, the examinations are designed to assess a trainee’s knowledge, skills and behaviours in field of Haematology. The exams recognise haematologists close to the end of their training who can demonstrate sufficient knowledge and technique for independent practice. In other words, completion of the full set of exams (Part 1 & 2) demonstrates your ability to work at consultant level.FFRCPath, along with MRCP(UK), is a mandatory requirement for Specialist Registration in Haematology. You can read our overview on MRCP(UK) here.
The FRCPath exam is split into 2 parts:
Part 1 – two written papers sat on the same day, comprised of essay and multiple-choice questions.
Part 2 – held over three days, the exams comprise of three written components and one oral examination
Eligibility for FRCPath in Haematology:
Below we outline the eligibility for overseas doctors looking to sit both FRCPath Haematology exams. For international candidates, the eligibility criteria for FRCPath specialty examinations can be a little confusing when looking online so IMG Connect spoke to the Royal College directly to clarify this.
Time spent in haematology training is stated as a requirement of eligibilty. The Royal College do consider equivalents to NHS training programmes though there is no definitive list of countries with accepted or unaccepted training programmes. The royal college advises you should speak to your Educational Supervisor or Sponsor (if you have one) who can advise you if you are ready or eligible to sit the Examinations if you are unsure. Remember, there are many overseas doctors applying for all parts of the FRCPath exams so don’t be put off applying!
Top Tip: If you have the required months training in a recognised programme in your country for Haematology specifically, the chances are you will be eligible.
Eligibility for Part 1: You are required to have trained in a recognised training programme in haematology for a period of no less than two years.
Eligibility for Part 2: The Royal College expects you to have at least three years of specialty training specific to Haematology in your own country before applying. Furthermore, you cannot sit Part 2 examination until 12 months after successfully completing Part 1.
Structure of FRCPath Haematology:
The exam is split into 2 parts with 5 individual examinations in total. This makes it one of the more complex examinations
Structure and content for FRCPath Haematology Part 1:
The exam is split into 2 parts with 5 individual examinations in total.
Part 1 comprises two written papers, Paper 1 (Essay Paper) and Paper 2 (MCP Paper)
Part 2 comprises three written papers, and one Oral exam
Part 1, Paper 1 (essay paper) – four essay questions each addressing an important area of laboratory or clinical practice in one of the four areas:
Blood transfusion
General haematology
Haematological oncology
Haemostasis & thrombosis
Part 1, Paper 2 (MCP paper) – 125 questions of both multiple choice and extended matching format. 50 questions will be best from five whilst 75 are extended matching and examines knowledge of:
blood transfusion 25%
general haemotology 25%
haematological oncology 25%
haemostasis & thrombosis 25%
Most questions are structured around clinical or laboratory vignettes and are designed to assess clinical judgement and ability to apply, rather than just recall knowledge. Questions map to the Haematology training curriculum. The blueprint from which the questions are developed can be found on the Royal College website.
Structure and content for FRCPath Haematology Part 1:
3 written papers and 1 oral examination as below.
Morphology SAQs
Morphology, Long cases
1.5 hour
1.5 hour
12 short answer questions
3 questions long answer
Transfusion
2-hour
10 questions
Coagulation
2-hour
8 questions
Oral Examination
1 hour
8 topics
The exam is held simultaneously over 3 days in the UK only and evaluates your knowledge, skills and clinical judgement in important areas within the Haemotology. The questions in the written papers adopt a short answer format which requires you to provide a concise response, these answers can be given in short words, phrases or lists.
Top Tip: A series of questions may relate to ‘clinical vignette’ building on case information. Clinical vignettes are patient related cases and scenarios that have educational value for a wider audience.
Morphology - SAQs: This section is up to 12 questions answered in 1 hour 30 minutes. Each question requires you to examine 1-2 of either of the following:
microscope slides
flow cytometry plots
additional laboratory data
quality assurance
Morphology - Long cases: This sections comprises 3 questions answered in 1 hour 30 minutes. Each question will provide a case history and contains several parts which require either:
Interpretation of slides, lab results or other clinical investigations
Provide a report and make diagnosis
Recommend clinical investigations and interventions
Transfusion: This section consists of 10 questions answered in 2 hours. Each question will provide a case history or lab results requiring you to:
Interpret data
Make diagnosis
Recommend further investigation or treatment
Coagulation: This section consists of 8 questions answered in 2 hours. Each question will provide a case history or lab results requiring you to:
Interpret data
Make diagnosis
Recommend further investigation or treatment
Oral Examination: The oral examination assesses your ability to evaluate problems and demonstrate good clinical judgement whilst assessing your ability to communicate clearly and effectively. The exam covers 8 topics over 1 hour, with two 30-minute oral exams with two pairs of examiners.
First Exam - 2 topics in coagulation & 2 topics in transfusion medicine
Second Exam - 2 topics in general laboratory haematology & 2 topics in haematological oncology
Where can I take the exams and how much will they cost me?
FRCPath in Haematology - Part 1: In Spring 2021, the Part 1 examination will be offered using online delivery to candidates. This means you can take the exam remotely and will not need to travel overseas to sit the exam, or attend an examination centre. The College will deliver the written components of these examinations through a company called TestReach, the Oral components (including oral OSPE stations) will be delivered using a video-conferencing platform such as Zoom or Microsoft Teams and for the written examinations, candidates will be given the opportunity to trial the TestReach system to familiarise themselves with it ahead of the examination. You can read more about the new, remote examination process further here on our website. Previously, the Part 1 examination was sat in multiple overseas centres and once the pandemic is under better control globally, it is highly anticipated the Royal College will return to previous set-ups.
The FRCPath Part 1 exam costs £622. You can see how the Royal College breaks down the cost here on their website.
FRCPath in Haematology - Part 2: Haematology Part 2 is one of the few exams that can be sat overseas. Availability of overseas Part 2 examination centres will be indicated on the website and candidates should contact the Examinations Department to express their interest in taking the examination in the available centre. In 2021 no overseas Part 2 examinations will take place in the Spring session, and it is highly unlikely an overseas centre will be available for Haematology in 2021.
The FRCPath Part 2 exam costs £1,308. You can see how the Royal College breaks down the cost here on their website.
How do I apply?
Applications must be made via the Royal College of Pathologists website, with applications only available once an application window is opened by the Royal College.
How to prepare and what resources are available?
With lots of resources available online, we have discussed with consultants the best place to start looking for materials relating to the exams. Most recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
Curriculum: The content of the exam is set against the Haematology Training Curriculum. We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan.
Regulations and Guidelines: Before applying for FRCPath examinations, the Royal College recommends you read both the General & Specialty Specific regulations and guidelines:
General Regulations and Guidelines
Royal College - Haematology Regulations & Guidelines
Past papers: Test your knowledge using example questions from the current exam syllabus provided by the Royal College, see below:
Part 1 – six past papers
Part 2
MCQ/EMQ
Blueprint for MCQ Examination: The blueprint from which the MCQ questions are developed..
British Society of Haematology guidelines: Compulsory reading material for exams and day-to-day clinical practice. Make sure to read them, understand them and know the recommendations made in bold. Be aware that the guidelines are a few years old and imminently due for review.
British Society for Haematology educational resources: Click here for the British Society for Haematology edcuational resources. Morphology image bank, case reports, practice essay questions, EMQs, MCQs and tutorials. Signup and login required but you don’t need to be a member to make use of the BSH’s bank of essay questions, MCQs and EMQs
Blood Journal: How I treat articles: Click here for easy-to-read helpful overviews of most haematological conditions
Ihaematology.com: http://www.ihaematology.com/ is a great revision site created by previous candidates.
Haembase: Click here for Haembase. This is a general revision resource for those preparing for FRCPath examinations
Our on-the-day exam advice:
Part 2 – food and drink: With multiple exams taking place for Part 2 in one day bring supplies! It will be a long day and there may not be access to food.
Hiring a microscope: For Part 2 you will be required to sit examinations in the UK and will require a microscope. The examination centres will not provide equipment for any applicants so you will need to hire a microscope in advance. There are a few companies easily accessible through a web search, find a microscope and book well in advance of the exam. You can arrange for the company to drop off and pick up the microscope from the exam centre, don’t worry!
Top Tip: At IMG Connect we recommend speaking to anyone you know who has sat and passed the exam and get their personal hints and tips. We would also be happy to help you arrange anything you need for the exam day.
I passed the FRCPath Heamatology exams! What next?
First of all, congratulations! After you have passed all parts of FRCPath Haematology you can apply for a full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK and given the high standards of the FRCPath Haematology examinations, you will most likely be eligible to practice as a consultant in the NHS.
Overseas Microbiologists wanting to secure a job in the UK via the postgraduate qualificaiton route will need to attain Fellowship of the Royal College of Pathologists or FRCPath in Medical Microbiology, a sub-specialty exam of FRCPath.
International Medical Graduates (IMGs) from any country in the world can sit the sub-specialty FRCPath in Medical Microbiology examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:
What is FRCPATH in Medical Microbiology?
Eligibility for overseas doctors
FRCPath in Medical Microbiology structure and format
FRCPath in Medical Microbiology: Part 1
FRCPath in Medical Microbiology: Part 2
As an overseas candidate where can I take the exam and how much will it cost me?
How do I apply?
How to prepare and what resources are available
Passed? What next?
What is FRCPath in Medical Microbiology?
Set against the Medical Microbiology incorporating CIT curriculum, the examinations act as an early assessment of your understanding of the scientific basis of medical microbiology, virology and infectious diseases. The exams recognise microbiologists close to the end of their training who can demonstrate sufficient knowledge and technique for independent practice. In other words, completion of the full set of exams (Part 1 & 2) demonstrates your ability to work at consultant level.
The examinations are split into two parts:
Part 1 – single 3-hour paper with Multiple Choice Questions (MCQ)
Part 2 – four paper examination sat over two days
Eligibility for overseas doctors:
Below we outline the eligibility for overseas doctors looking to sit both FRCPath Microbiology exams. For international candidates, the eligibility criteria for FRCPath specialty examinations can be a little confusing when looking online so IMG Connect spoke to the Royal College directly to clarify this.
Time spent in microbiology training is stated as a requirement of eligibilty and the Royal College do consider equivalents to NHS training programmes though there is no list of countries with accepted or unaccepted training programmes. The royal college advises you should speak to your Educational Supervisor or Sponsor (if you have one) who can advise you if you are ready or eligible to sit the Examinations if you are unsure. Remember, there are many overseas doctors applying for all parts of the FRCPath exams so don’t be put off applying!
Top Tip: If you have the required months training in a recognised programme in your country for Histopathology specifically, the chances are you will be eligible.
Eligibility for Part 1: You are required to have trained in a recognised training programme in microbiology for a period of no less than 12 months.
Eligibility for Part 2: You must have passed the Part 1 examination and have had at least 3 years microbiology training in a recognised training programme in your country.
FRCPath Part 1 in Microbiology - structure and format:
The exam focuses in particular on the scientific basis of virology, microbiology and infection. The exam is set against both the medical microbiology and virology curriculum. It is a single three-hour objective MCQ examination, with computerised marking sat over one one day. Questions are in two formats:
One-best answer
Extended-matching-question
FRCPath Part 2 in Microbiology - structure and format:
Part 2 consists of four paper examinations sat over two days. The exam will be ‘closed book’ (i.e. NO textbooks, manuals, other written material or equipment
belonging to candidates may be used). Only reference material provided by the examiners may be used. These are as follows:
Paper 1 – two parts, 2.5 hours in total:
One essay from a choice of two questions, usually including laboratory management issues, antimicrobial stewardship, infection prevention or a combinatino of all.
One SAQ paper focused on clinical scenarios, infection prevention, laboratory practice and safety.
The essay is allocated one third of available marks for this paper. A closed marking scheme is used for the essay question.
Top Tip: A brief vignette with interpretation of clinical, laboratory or infection control data is a common format for SAQs.
Paper 2 - two parts, 2.5 hours in total:
Critical appraisal of a journal article
SAQ paper with similar content as Paper 1
The journal article is allocated one third of available marks for this paper
Paper 3 – one part in laboratory scenarios, 3 hours in total
Complex clinical and laboratory scenarios in microbiology and infection prevention.
Top Tip: Questions cover similar content to Paper 1&2 SAQs though the question format is longer, allowing for progression within each scenario to reflect evolving information encountered in clinical practice. Clinical and laboratory data and images may be presented, however there will be no practical manipulation of laboratory material.
Paper 4 – one part, 3 hours in total
Objective Structured Pathology Examination (OSPE) format.
Comprises of 15 stations, each of 9 minutes duration with variable rest stations.The exam allows for broad sampling of the curriculum and involves two face-to-face stations with a pair of examiners. The OSPE facilitates assessment of knowledge, application of knowledge, laboratory skills, and communication in scenarios encountered by microbiologists in clinical practice.
Pass criteria for FRCPath Microbiology Part 2 Exams:
In order to achieve an overall pass, you must achieve a pass in both combined scores for:
Papers 1+ 2
Papers 3 + 4
Failure of either of the two components will result in an overall fail. If you fail either of these two components, an overall fail result will be obtained and the entire examination will need to be taken at a future date. In other words, you cannot carry forward a pass in any part of the exam into subsequent sittings.
Where can I take the exams and how much will they cost me?
FRCPath in Medical Microbiology - Part 1:
In Spring 2021, the Part 1 examination will be offered using online delivery to candidates. This means you can take the exam remotely and will not need to travel overseas to sit the exam, or attend an examination centre. The College will deliver the written components of these examinations through a company called TestReach, the Oral components (including oral OSPE stations) will be delivered using a video-conferencing platform such as Zoom or Microsoft Teams and for the written examinations, candidates will be given the opportunity to trial the TestReach system to familiarise themselves with it ahead of the examination. You can read more about the new, remote examination process further here on our website. Previously, the Part 1 examination was sat in multiple overseas centres and once the pandemic is under better control globally, it is highly anticipated the Royal College will return to previous set-ups.
The FRCPath Part 1 exam costs £622. You can see how the Royal College breaks down the cost here on their website.
FRCPath in Medical Microbiology - Part 2:
Currently it can only be sat in the UK. Availability of overseas Part 2 examination centres will be indicated on the website and candidates should contact the Examinations Department to express their interest in taking the examination in the available centre. In 2021 no overseas Part 2 examinations will take place in the Spring session, and it is highly unlikely an overseas centre will be available for Microbiology in 2021.
The FRCPath Part 2 exam costs £1,308. You can see how the Royal College breaks down the cost here on their website.
How do I apply?
Applications must be made via the Royal College of Pathologists website, with applications only available once an application window is opened by the Royal College.
How to prepare and what resources are available?
With lots of resources available online, we have discussed with consultants the best place to start looking for materials relating to the exams. Most recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
Below we have included resources available through the Royal College and a few other resources recommend by doctors that have passed.
Curriculum: The content of the exam is set against the Curriculum for Specialty Training in Medical Microbiology. This curriculum incorporates the Combined Infection Training developed in conjunction with the Joint Royal Colleges of Physicians Training Board. Part A is set against both the medical microbiology and virology curriculum.
TOP TIP: We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan. This advice comes directly from one of the RCPath examiners/
Regulations and Guidelines: Before applying for FRCPath examinations, the Royal College recommends you read both the General & Specialty Specific regulations and guidelines:
General Regulations and Guidelines
Royal College - Medical Microbiology Regulations & Guidelines
Past papers: Test your knowledge using example questions from the current exam syllabus provided by the Royal College:
Medical Microbiology and Virology - Part 1 MCQ & EMQ
Medical Microbiology Part 2 – OSPE
Medical Microbiology Part SAQ
Medical Microbiology Part 2 – Paper 3
Medical Microbiology Part 2 – Essay
Medical Microbiology Part 2 - Journal
On-the-day Exam Advice:
Part 2 – food and drink: With multiple exams taking place for Part 2 in one day bring supplies! It will be a long day and there may not be access to food.
Hiring a microscope: For Part 2 you will be required to sit examinations in the UK and will require a microscope. The examination centres will not provide equipment for any applicants so you will need to hire a microscope in advance.
There are a few companies easily accessible through a web search, find a microscope and book well in advance of the exam. You can arrange for the company to drop off and pick up the microscope from the exam centre, don’t worry!
Top Tip: At IMG Connect we recommend speaking to anyone you know who has sat and passed the exam and get their personal hints and tips. We would also be happy to help you arrange anything you need for the exam day.
I passed the FRCPath Medical Microbiology exam! What next?
First of all, congratulations! After you have passed all parts of FRCPath in Medical Microbiology you can apply for full registration with a license to practice. Once the GMC have approved your application, you can work as a doctor in the UK.
Searching for Medical Microbiology & Virology jobs in the NHS could not be easier
If you want to find out more about the many different Microbiology roles available within the NHS - it only takes a minute to register with IMG Connect and receive expert advice and representation. We have helped many overseas Medical Mircobiologists secure consultant, specialty doctor, registrar, clinical fellow and staff grade NHS jobs, whilst offering expert guidance to many more IMGs on NHS doctor pay, FRCPath exams and English language testing. We’d be happy to help you!
Today is the day! The MRCEM OSCE results have been released...
IMG Connect wishes all emergency medicine specialists good luck with their results today - we hope you all achieve the result you deserve!
Whether your passed or failed, here we'll offer some suggestions on what to do next...
I passed the MRCEM OSCE
I didn't pass the MRCEM OSCE
I passed the MRCEM OSCE, what's next?
So, what next? First things first, you deserve to celebrate and get some relaxation in! Emergency Medicine doctors who have attained full MRCEM and secured a job in the NHS, all tell us that the MRCEM OSCE is a tough examination and it is an emotional moment when you pass. So much hard work goes into to reaching this stage, so book yourself a holiday! Or at least kick off your shoes and put your feet up :-)
You are now well on your way to being eligible to apply for an Emergency Medicine post in the UK. There are a few key steps before you're ready to go:
English language test
GMC registration
Apply for NHS jobs
English Language Test
You may be wondering whether you need to take an English exam now that you have passed MRCEM OSCE. This is a requirement for all overseas doctors and is needed for GMC registration. For doctors who have worked for at least 2 years in an English-speaking country, employer references for English can be used to demonstrate a suitable level of competence in English.
Passing your English language exams is an important next step for many Emergency Medicine doctors that pass their MRCEM. Take a look at these helpful blogs and articles from the IMG Library on OET, IELTS and preparing for English language exams, including a side-by-side comparison of the two tests.
English Language Tests - a library of all our helpful blogs and articles on English Language Testing, written specifically for international doctors.
OET - a series of blogs and articles relating to the Occupational English Test (OET)
IELTS - a library of articles and blogs and articles centered on the International English Language Testing System (IELTS)
GMC Registration
Armed with your complete MRCEM, you can now apply for full GMC registration with licence to practice. There are a few checks involved in the GMC registration process such as the verification of your medical license and obtaining a certificate of good standing, however, we are more than happy to talk you through the process with little to no worries or effort on your part. Once your application has been approved, you are eligible to work in the NHS. Nice one!
Apply for NHS Jobs
Now is also a good time to start thinking about the steps you should take in finding the right job for you in the NHS, or wherever you are considering your next role. There may be many questions running through your mind such as, do I need to take an English exam first? What grade will I be eligible for? Or perhaps most importantly, how do I find an A&E job in the UK?
To jumpstart your job search, click here for up-to-date NHS Emergency Medicine jobs.
As specialists in the recruitment of overseas MRCEM qualified A&E doctors, whether it's preparing your CV for professional representation or finding you a great role with a fantastic salary, IMG Connect is here to help.
Register your details with IMG Connect to receive a one-to-one personalised service from one of our Emergency Medicine Specialists. We have a team that helps specifically international Emergency Medicine doctors like yourself in securing work across the UK & Ireland. Register today and one of our team will get back to you immediately!
I didn't pass the MRCEM OSCE
If you did not pass the MRCEM OSCE - don't worry! The overall pass rate for those that attempt a second time is extremely high (90%+) so your hard work and dedication will pay off very soon! Take some time out to relax and enjoy life and come back stronger. These moments will only make you stronger and a better doctor in the long run so 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 OSCE - and we would be delighted to share these with you. Click on the buttons below to either register with the IMG Connect team, so we can talk you through this or request the MRCEM OSCE resources to help you pass the next time.
Getting started
If you have any questions about how to secure an NHS job in Emergency Medicine, please get in touch with us here.
Follow us on social media through the links below for regular news and updates on the Royal Colleges, relocating to the UK and working in the NHS: