FRCA - a guide for overseas anaesthetists
- May 13, 2021
One of the routes to GMC registration for an overseas anaesthetist is FRCA Primary.
IMGs from any country in the world can sit some, not all, of the FRCA examinations. Certain eligibility criteria must be met to sit primary whilst overseas doctors can only take the final part of the exams once they have started working in the NHS (UK). This is explained in further details below where we look at the following topics:
- What is FRCA?
- What is the structure and content of FRCA examinations?
- As an overseas doctor am I eligible?
- What is Temporary Exam Eligibility (TEE)?
- What is the UK IAC?
- As an overseas candidate where can I take the exam and how much will it cost me?
- How to prepare and what resources are available?
- Summary
The Royal College of Anaesthetists is the professional body responsible for the specialty of Anaesthetics throughout the UK. Among many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession.
What is FRCA?
Anaesthetists become full members of the Royal College of Anaesthetists and attain Fellowship of the Royal College, and the designation of FRCA, once they have passed the two separate exams: the Primary and Final Examinations. Each exam consists of two parts taken separately.
FRCA is one of the many routes an anaesthetist can take when looking to satisfy the GMC postgraduate criteria for full registration with a licence to practice. It is important to note that Primary FRCA will suffice for the purposes of full registration with a license to practice, and full FRCA is not essential though of course desirable.
What is the structure and content of FRCA examinations?
Primary FRCA examinations:
- Multiple Choice Question Examination (MCQ)
- The Objective Structured Clinical Examination (OSCE) and Structured Oral Examination (SOE)
Final FRCA examinations:
- Final Written exam consisting of; Multiple Choice Question exam (MCQ) and a Short Answer Question (SAQ) exam
- The Structured Oral Examination (SOE)
The FRCA examinations form an essential component of training for anaesthetists in the UK and doctors who wish to complete the FRCA route, will be required to complete the final exam after substantial experience working in the UK.
As an overseas doctor am I eligible?
It is important to note that each of the FRCA exams have different eligibility criteria.
To sit the FRCA Primary Exams, you must be a member of the College or apply for Temporary Exam Eligibility (TEE) – see below. TEE will apply to most overseas doctors.
Primary FRCA MCQ:
You are eligible to enter the Primary FRCA MCQ paper if you:
- hold national registration with an overseas Medical Council;
AND
- have successfully applied for Temporary Examination Eligibility (TEE) with the College 3 months prior to the date of the examination
Primary FRCA OSCE and SOE:
You are eligible to enter the Primary FRCA OSCE and SOE if you:
- meet the above criteria for the Primary FRCA MCQ paper
- have passed the Primary FRCA MCQ paper
- have been awarded an overseas competency in anaesthetics which is comparable to the UK IAC (see below)
Final FRCA:
You are eligible to enter the Final FRCA paper if you have:
- completed 30 months of training in anaesthesia
- at least 18 months must be spent in approved posts in the UK or Republic of Ireland – for international doctors a maximum of 12 months of overseas training in anaesthesia combined with 6 months working in an approved UK post will be accepted;
- Evidence of having completed the required training will be needed, Core Level Training Certificate
What is Temporary Exam Eligibility (TEE)?
Non-UK Trainee applicants do not qualify for any membership category of the Royal College of Anaesthetists. As such the Royal College has introduced the TEE to allow overseas anaesthetist doctors who do not work in the UK to apply for the FRCA Primary Examinations.
Applicants must submit a Temporary Examinations Eligibility form three months before any examinations are applied for.
How do I apply for TEE?
You can apply for TEE using this application form.
Documents required on your first application are:
- Proof of registration with an overseas Medical Council
- Proof of attendance at or completion of anaesthetic training, including foundation training (internship)
If you intend to take the OSCE/SOE exams, you will be asked to provide further documentation to prove you have an equivalent of the UK Initial Assessment of Competency Certificate in Anaesthesia.
The TEE application costs £90, paid by bank transfer. Once payment is confirmed you will receive a TEE number, which you will use to support your application to sit the FRCA examinations.
What is the UK IAC? And how do I demonstrate equivalence?
The initial assessment of competence (IAC) is the first anaesthesia training milestone for trainees in the Anaesthesia training programme (ACCS training for anaesthesia, acute medicine, emergency medicine and intensive care).
The purpose of the IAC is to signify that the trainee has achieved a basic understanding of anaesthesia and is able to give anaesthetics at a level of supervision matching with the individual trainee’s skills and clinical cases. The IAC is not a licence for independent anaesthetic practice. The key point is that trainees are still under the supervision of a named consultant anaesthetist.
To support an application to sit the FRCA exams you must demonstrate that you have been awarded an overseas anaesthetic competency in anaesthetics which is comparable to the UK IAC.
Overseas anaesthetic competency certificates must be provided on application and prove clinical competency comparable to the UK Initial Assessment of Competency in Anaesthetics. Certificates must be accompanied by a letter of authentication in English from a senior anaesthetic consultant or notary.
The final decision on comparability of overseas IAC certificates lies with the Chair of the Primary Examination.
How do I apply for the Primary FRCA examinations?
Applications are complete online, simply click here, register, and follow the instructions for submitting documents and completing your application.
Where can I sit the FRCA exams?
Unfortunately, IMGs cannot sit the FRCA exams overseas.
Exams are held in London, Cardiff, Birmingham, Manchester, Belfast, Sheffield and Edinburgh. You can find up-to-date exam dates here.
How much do the exams cost?
|
Primary MCQ |
£370 |
|
Primary OSCE & SOE |
£685 |
|
Primary OSCE |
£370 |
|
Primary SOE |
£340 |
|
Final Written Exam |
£545 |
|
Final SOE |
£645 |
What is the syllabus?
The syllabus for both the primary and final exams are linked to the Training Curriculum.
- The Primary FRCA Examinations are blue printed to the Core Level Training Curriculum.
- The Final FRCA examinations are blue printed to both the Core Level Training Curriculum and the Intermediate Level Training Curriculum.
*both include Intensive Care Medicine
How do I prepare?
With lots of materials online we have discussed with IMGs the best place to start looking for resources and materials relating to the exams. Most successful IMGs recommended starting with the Royal College, who have created useful resources to help you to prepare for the exams.
At IMG Connect we advise overseas candidates to be fully aware that questions used in the exam are drawn from the UK Anaesthetic Basic Level Training Curriculum. We suggest that you can use the curriculum as a road map to support your study plan.
Video series:
The exam run through video series is a useful tool to help familiarise yourself with what to expect on the exam day.
The Primary SOE support videos are designed to help trainees in preparation for exams.
The Primary FRCA examination videos also support with study for the MCQ.
More videos can be found at the College's YouTube Channel
eLearning Anaesthesia (e-LA):
The e-LA supports specialty training in anaesthesia. It provided materials for professional development of specialists seeking to refresh their knowledge.
Doctors working overseas can gain access to this resource via eIntegrity which provides a portal to all specialty e-Learning platforms.
If you are working outside the NHS, then modules are available for purchase via the eIntegrity website.
There are a number of modules available, of particular note for IMGs is Module 6: Exams Preparation.
e-LA also provides MCQ questions which are an accurate reflection of the questions included in the FRCA examinations.
Virtual Exam tours:
3D virtual exam tours have been created by the Royal College to provide a virtual experience to ensure that candidates are familiar with the process on the day.
Successful IMGs have found practice questions are a valuable part of exam preparation. Remember these should be used in conjunction with other forms of research and studies.
I attained Primary FRCA, what next?
You will simply need to prove your English Language capabilities to satisfy GMC criteria for full registration.
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Get in touch using the buttons above (and below) to discuss anaesthetics job options in the NHS, including discussions regarding CESR, a typical doctor salary in the UK and the most suitable NHS jobs & hospital locations for you.
Relevant Jobs
A leading private healthcare provider in the North West of England is seeking an experienced Consultant Anaesthetist to join their team at their state-of-the-art hospital in Merseyside. Serving over 15,000 patients annually across multiple locations, this provider is known for delivering thousands of successful cosmetic procedures each year. The Merseyside facility boasts a patient satisfaction rate exceeding 98% and has received high marks in its CQC inspection. With a multidisciplinary team of over 100 medical professionals, it offers some of the shortest waiting times for consultations and surgery in the region, making it an excellent choice for a step into the UK private sector.
Key Responsibilities:
- Deliver high-quality anaesthetic care for cosmetic surgical procedures, ensuring patient safety and comfort.
- Collaborate with multidisciplinary teams to create tailored anaesthetic plans.
- Conduct pre-operative assessments and oversee post-operative care.
- Uphold the highest standards of patient care and contribute to clinical improvements.
Eligibility Requirements:
- Full GMC registration with inclusion on the Specialist Register in Anaesthesia.
- Extensive anaesthetic experience, ideally in cosmetic or plastic surgery.
- A patient-focused approach and a commitment to clinical excellence.
- Strong communication and teamwork skills.
What’s on offer:
- Competitive salary and benefits package.
- The opportunity to work in state-of-the-art facilities with a leading private healthcare provider.
- Support for professional development and career progression.
How will IMG Connect support you?
Partnering with IMG Connect you’ll receive expert guidance throughout your recruitment and relocation journey. Our tailored support includes:
- Bespoke CV preparation with a specialist.
- Application support and NHS recruitment insights.
- At least two interview preparation sessions via video call.
- Contract and offer negotiation, including salary and relocation packages.
Once your role is secured, our relocation executives will assist with:
- Document gathering and verification.
- Sourcing short or long-term accommodation if required.
- Travel arrangements, ensuring a smooth transition to your new position.
A specialist hospital in London is looking for a Specialist Doctor in Anaesthesia and Critical Care Medicine with an interest in Paediatric Anaesthesia. The Anaesthesia department comprises a team of 34 consultants and supported by a large team of middle grade doctors. This Anaesthesia job is open to both international applications and UK-based doctors, though those with European Specialist or Royal College of Anaesthetists qualifications are most encouraged to apply.
Anyone requiring portfolio support (formally known as CESR) can have their required support discussed on a case by case basis.
JOB REQUIREMENTS AND DETAILS
Full GMC registration with a license to practice and 12 years medical experience are required for this role, and anyone with an interest in paediatric anaesthesia should apply. The salary will be between £88,364 and £119,133 dependent on experience or grade.
CORE DUTIES OF THIS ROLE
- Deliver first-class anaesthetic services and provide support for the paediatric anaesthesia service.
- On-call duty for critical care medicine covering a 3-bedded critical care unit.
- Provide leadership for the critical care outreach service in Sutton.
- Participate in audit, education, and quality improvement activities.
LIFE IN LONDON
The hospital is based in London, a vibrant and culturally rich city. Popular areas for living include urban districts like Chelsea or suburban green spaces like Sutton. London offers excellent transport links and a wide selection of schools, both public and private, ideal for families. As the UK capital, London has a significant place in British history and offers world-class museums, galleries, and cultural events.
HOW WILL IMG CONNECT SUPPORT YOU?
When applying with IMG Connect you’ll have the full support of an expert recruitment team who will be your recruitment and relocation partners throughout the process. We\'ll support you with:
- CV Preparation with a bespoke session with one of our specialists
- Application support with expert knowledge of NHS specialisms & recruitment practice
- At least two video calling interview preparation sessions
- Contract and offer negotiations for salary, relocation packages, tenure and more
- Once you have accepted your new role, you’ll then be supported and led throughout by one of our dedicated relocation executives who will guide you through all the way to starting your new role including:
- Document gathering and checking COS and Visa Application support if applicable
- Support sourcing short- and long-term accommodation
- Travel Arrangements Family support for finding schools and any other aspects of pastoral care
A leading NHS Trust is seeking to appoint a Consultant in Anaesthetics. This is an excellent opportunity to advance your medical career in the UK, with support for the CESR Portfolio Pathway. International applications from IMGs are welcome.
About the NHS Trust
This NHS Trust provides comprehensive healthcare services to a large population across multiple sites. It is known for delivering high-quality care, underpinned by a strong clinical governance structure that ensures patient safety and excellence. The Trust’s vision is to provide exceptional care delivered by a team of dedicated healthcare professionals. It offers a wide range of services, making it an exciting place for medical professionals in various specialties.
The Anaesthetics Department & Team
The Anaesthetics Department at this NHS Trust is integral to the hospital\'s operations, supporting a variety of surgical procedures. The department is staffed with experienced consultants, specialty doctors, and anaesthetic practitioners who work together to ensure patient safety and high-quality care. The team environment is collaborative and supportive, making it an excellent place for an anaesthetist looking to grow and develop their skills in a dynamic setting.
Continued Professional Development
This NHS job offers further training & accreditation within anaesthetics, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interests. The Trust is committed to fostering your professional development through a range of educational opportunities and mentorship programs, making it an ideal place to advance your medical career.
Location
The area offers a high quality of life with affordable living costs, making it an attractive option for international doctors and their families. It boasts beautiful natural landscapes, a rich cultural history, and a wide range of educational options. The region is well-connected by transport, offering easy access to other parts of the UK, including direct routes to major cities. The community is known for its safety, diversity, and welcoming nature, making it a great place to live and work.
Am I eligible for this role?
UK based candidates:
- Experience in Anaesthetics
EEA candidates:
- Experience in Anaesthetics
- European Specialist Qualification
Non-EEA candidates:
- EDAIC
- MRCP UK
- Experience in Anaesthetics
An outstanding opportunity for a motivated and enthusiastic Consultant in Anaesthetics with an interest in Intensive Care to join a very dynamic department that is supportive of opportunities for their team. The Anaesthetic Deparment offers an active training and research programmes, a strong link across Wales through various clinical networks allowing effective development of areas of subspecialty, managerial and academic interest. The Anaesthethic Department is a team of doctors that are enthusiastic and always aims to deliver high quality Critical Care to the population of Carmarthenshire.
This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
WHAT IS THE HEALTH BOARD LIKE?
The Health Board provides healthcare services to a total population of around 372,320 throughout several areas. It provides Acute, Primary, Community, Mental Health and Learning Disabilities services via General and Community Hospitals, Health Centres, GP\'s, Dentists, Pharmacists and Optometrists and other sites. It also provides a range of services for people living in nearby areas. Integrated health boards are a key first step in creating a world class NHS in Wales.
The Health Board have always aimed to provide safe and timely care for their patients. The Health Board continuously make improvements in order to be better. The Health Board partners with the local government and the third sector to improve local care services and ensure that the right care is provided in the right place, at the right time.
The Health Board shape the identity of their organisation and act as a guiding light for their employees. They aim to be an enjoyable and fulfilling place to work at.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The Department runs the Critical Care Unit and accepts admissions from all the other associated acute specialties in consultation with the on-duty Critical Care Consultant. The team is responsible for the pre-operative assessment unit and provides cover for ECT and X-ray lists, as well as running the acute and chronic pain services. The Department constitute a pivotal component of the trauma team and provide resuscitation services in emergency situations throughout the hospital. It has been the ethos of the department to be progressive and to provide state of the art anaesthetic and ICU services for our patients.
The Department has the highest quality anaesthetics machines, ventilators and monitors available, including Cardiac Output monitoring in all areas. They have a variety of ultrasound machines, with significant interest in regional anaesthesia within the department. There are new blood gas analysers in theatre and ICU as well as a ROTEM machine. They are provide a comprehensive vascular access service and support the efficient delivery of both elective and emergency anaesthesia as well as significantly enhancing the ability to provide high quality training.
The post holder will be expected to undertake their programmed activities split between Intensive Care and Anaesthetics sessions. The post holder will be expected to conduct clinical practice in accordance with contractual requirements within the parameters of the Division’s and Health Board’s agreed objectives.
WHAT IS LIFE LIKE IN THE REGION?
The Health Board is in an area wherein there are excellent choice of schools and very reasonable property prices while having a picturesque countryside view. The area is home to the Brecon Beacons, National Botanic Gardens of Wales and some of the longest and most beautiful beaches. West Wales provides wonderful lifestyle opportunities.
There are other activities such as climbing and mountain biking, as well as walking, surfing, fishing, sailing and hiking. There are also excellent road and rail connections to London and the larger cities. Wales has a low crime rate and is a safe and friendly place to live and work.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The Health Board has University status with strong links to other Universities to develop and strengthen multi-profession teaching. This initiative programme aims to engage and capture the enthusiasm and commitment of their up and coming clinicians in Wales in addressing Prudent Health Cares.
They have an 8-room Clinical Research Facility in PPH, with state of the art facilities that opened in 2012 and new initiatives involve BioBanking, EU Lead for telemonitoring at scale and new Clinical Research Fellowships.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in General Internal Medicine / Care of the Elderly
- Board Certified Specialist in General Internal Medicine / Care of the Elderly
Non-EEA Candidates:
- Experience of working in General Internal Medicine / Care of the Elderly
UK based applicants
- Experience of working in General Internal Medicine / Care of the Elderly
- Within 6 - 12 months of completing CCT