FRCA - a guide for overseas anaesthetists
- November 21, 2022
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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Relevant Jobs
An opportunity for a SAS grade Anaesthetists to work for an established NHS Trust that prides itself on delivering high quality care and services. .
This is a great opportunity for overseas Anaesthesia specialists 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 anaesthetists IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The Trust is one of the largest teaching hospital trusts in England, serving a regional, national and international population. In April 2018 the trust now has a turnover of £1.6bn, over 2,700 beds and employs more than 20,000 members of staff. It also provides the city wide vascular service including a vascular emergency service and endovascular service. A dedicated elective paediatric surgical unit for patients over the age of 1 has been set up and offers trauma, ophthalmic, ENT and general surgery.
The trust consist of 4 hospitals covering all sub-specialisms along with excellent support in their CESR pathways to develop their professional careers.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The anaesthetic department also provides a consultant led acute pain service, a pre- operative assessment service as well as support for anaesthetics in remote areas such as endoscopy and radiology. The pioneering techniques in surgery and pain control that have been developed whilst treating military patients are used for civilian surgery in the UK and elsewhere, and are progressed through the Surgical Reconstruction and Microbiology Research Centre (SRMRC).
With almost 200 Consultants based over the four main hospital sites, the trust currently provide anaesthetic and ICU cover in excess of 400 sessions/week across both the Trust and those hospitals with which we have service level agreements.
WHAT IS LIFE LIKE IN THIS AREA?
Fancied by most IMG\'s, the area has an internal airport connected to all major cities in the UK along with excellent road and train routes around the country. With low cost of living compared to all the other cities, the area has vibrant independent restaurants, shops and bars throughout the centre and popular districts.
New bars and shops open frequently as the city continues to build its youthful and unique identity. There is so much diversity and history within the area that the shops, food and venues reflect this. Old icons such as the Custard Factory host alternative shops and bars, just a short walk from the city center.
There\'s excellent schooling covering off both private and public schooling around the area with people from different cultures and backgrounds in the area.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The Trust have wellbeing groups that organise regular ‘coffee & gas’ meetings, support the trainee buddy system and raises awareness of mental health issues and support systems. They also produce a monthly newsletter featuring department news and colleague profiles and is soon to launch in-house mentoring. The Trust is committed to the development and maintenance of the highest clinical standards through individual appraisal. This will include the audit of personal and clinical practice, as well as involvement in departmental and specialty reviews. It will also involve attention to continuing professional development, in order to meet the requirements for continuing medical education as expected by the relevant Royal College.
The successful applicant would be expected to have an active interest in the areas of both teaching and research. Our junior anaesthetic training has recently been adapted to reflect the new RCOA Anaesthesia curriculum. Due to the number of specialties covered at the Trust, they are able to deliver the vast majority of the curriculum across our four sites except advanced paediatric case.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Anaesthetics
- Relevant European Qualification (recognised by GMC)
- FRCA Primary, EDAIC, or equivalent
- Experience of working in Anaesthetics
- Experience of working in Anaesthetics
- Within 6 - 12 months of completing CCT
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
An opportunity for a Consultant Anaesthetists to work for an established NHS Trust that prides itself on delivering high quality care and services. .
This is a great opportunity for overseas Anaesthesia specialists 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 anaesthetists IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The Trust is one of the largest teaching hospital trusts in England, serving a regional, national and international population. In April 2018 the trust now has a turnover of £1.6bn, over 2,700 beds and employs more than 20,000 members of staff. It also provides the city wide vascular service including a vascular emergency service and endovascular service. A dedicated elective paediatric surgical unit for patients over the age of 1 has been set up and offers trauma, ophthalmic, ENT and general surgery.
The trust consist of 4 hospitals covering all sub-specialisms along with excellent support in their CESR pathways to develop their professional careers.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The anaesthetic department also provides a consultant led acute pain service, a pre- operative assessment service as well as support for anaesthetics in remote areas such as endoscopy and radiology. The pioneering techniques in surgery and pain control that have been developed whilst treating military patients are used for civilian surgery in the UK and elsewhere, and are progressed through the Surgical Reconstruction and Microbiology Research Centre (SRMRC).
With almost 200 Consultants based over the four main hospital sites, the trust currently provide anaesthetic and ICU cover in excess of 400 sessions/week across both the Trust and those hospitals with which we have service level agreements.
WHAT IS LIFE LIKE IN THIS AREA?
Fancied by most IMG\'s, the area has an internal airport connected to all major cities in the UK along with excellent road and train routes around the country. With low cost of living compared to all the other cities, the area has vibrant independent restaurants, shops and bars throughout the centre and popular districts.
New bars and shops open frequently as the city continues to build its youthful and unique identity. There is so much diversity and history within the area that the shops, food and venues reflect this. Old icons such as the Custard Factory host alternative shops and bars, just a short walk from the city center.
There\'s excellent schooling covering off both private and public schooling around the area with people from different cultures and backgrounds in the area.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The Trust have wellbeing groups that organise regular ‘coffee & gas’ meetings, support the trainee buddy system and raises awareness of mental health issues and support systems. They also produce a monthly newsletter featuring department news and colleague profiles and is soon to launch in-house mentoring. The Trust is committed to the development and maintenance of the highest clinical standards through individual appraisal. This will include the audit of personal and clinical practice, as well as involvement in departmental and specialty reviews. It will also involve attention to continuing professional development, in order to meet the requirements for continuing medical education as expected by the relevant Royal College.
The successful applicant would be expected to have an active interest in the areas of both teaching and research. Our junior anaesthetic training has recently been adapted to reflect the new RCOA Anaesthesia curriculum. Due to the number of specialties covered at the Trust, they are able to deliver the vast majority of the curriculum across our four sites except advanced paediatric case.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Anaesthetics
- European Specialist Qualification in Anaesthetics
Non-EEA Candidates:
- FRCA Primary or Equivalent
- Experience of working in Anaesthetics
UK based applicants
- Experience of working in Anaesthetics
- Within 6 - 12 months of completing CCT
An opportunity for a SAS grade Anaesthetists to work for an established NHS Trust that prides itself on delivering high quality care and services.
This is a great opportunity for overseas Anaesthesia specialists 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 anaesthetists IMGs looking to complete CESR.
WHAT IS THE NHS FOUNDATION TRUST LIKE?
The Trust is one of the largest teaching hospital trusts in England, serving a regional, national and international population. In April 2018 the trust now has a turnover of £1.6bn, over 2,700 beds and employs more than 20,000 members of staff. It also provides the city wide vascular service including a vascular emergency service and endovascular service. A dedicated elective paediatric surgical unit for patients over the age of 1 has been set up and offers trauma, ophthalmic, ENT and general surgery.
The trust consist of 4 hospitals covering all sub-specialisms along with excellent support in their CESR pathways to develop their professional careers.
WHAT IS THE DEPARTMENT & TEAM LIKE?
The anaesthetic department also provides a consultant led acute pain service, a pre- operative assessment service as well as support for anaesthetics in remote areas such as endoscopy and radiology. The pioneering techniques in surgery and pain control that have been developed whilst treating military patients are used for civilian surgery in the UK and elsewhere, and are progressed through the Surgical Reconstruction and Microbiology Research Centre (SRMRC).
With almost 200 Consultants based over the four main hospital sites, the trust currently provide anaesthetic and ICU cover in excess of 400 sessions/week across both the Trust and those hospitals with which we have service level agreements.
WHAT IS LIFE LIKE IN THIS AREA?
Fancied by most IMG\'s, the area has an internal airport connected to all major cities in the UK along with excellent road and train routes around the country. With low cost of living compared to all the other cities, the area has vibrant independent restaurants, shops and bars throughout the centre and popular districts.
New bars and shops open frequently as the city continues to build its youthful and unique identity. There is so much diversity and history within the area that the shops, food and venues reflect this. Old icons such as the Custard Factory host alternative shops and bars, just a short walk from the city center.
There\'s excellent schooling covering off both private and public schooling around the area with people from different cultures and backgrounds in the area.
WHAT OPPORTUNITIES ARE AVAILABLE TO YOU?
The Trust have wellbeing groups that organise regular ‘coffee & gas’ meetings, support the trainee buddy system and raises awareness of mental health issues and support systems. They also produce a monthly newsletter featuring department news and colleague profiles and is soon to launch in-house mentoring. The Trust is committed to the development and maintenance of the highest clinical standards through individual appraisal. This will include the audit of personal and clinical practice, as well as involvement in departmental and specialty reviews. It will also involve attention to continuing professional development, in order to meet the requirements for continuing medical education as expected by the relevant Royal College.
The successful applicant would be expected to have an active interest in the areas of both teaching and research. Our junior anaesthetic training has recently been adapted to reflect the new RCOA Anaesthesia curriculum. Due to the number of specialties covered at the Trust, they are able to deliver the vast majority of the curriculum across our four sites except advanced paediatric case.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Anaesthetics
- Relevant European Qualification (recognised by GMC)
- FRCA Primary, EDAIC, or equivalent
- Experience of working in Anaesthetics
- Experience of working in Anaesthetics
- Within 6 - 12 months of completing CCT