MRCEM - a guide for overseas emergency medicine doctors

  • March 24, 2022

Attaining Membership of the Royal College of Emergency Medicine or MRCEM is required to attain GMC Registration and start your Emergency Medicine career in the NHS.

International Medical Graduates (IMGs) from any country in the world can sit the MRCEM examinations, provided certain eligibility criteria are met. These are summarised below along with a broad look at the following topics:

What is the Royal College of Emergency Medicine?

AnchorThe Royal College of Emergency Medicine is the professional body responsible for the specialty of Emergency Medicine throughout the UK. Amongst many other duties, its role is to set and monitor the educational curriculum for those training to enter the profession in the UK.


What is MRCEM?

Membership of the Royal College is awarded to candidates who pass three examination components. 

There have been a few changes to the MRCEM and FRCEM examination structure over the last few years, as such there are currently two routes to an accreditation in Emergency Medicine, both leading to RCEM Membership.

These two routes are:

  • Membership of the Royal College of Emergency Medicine (MRCEM)
  • Fellowship of the Royal College of Emergency Medicine (FRCEM)

MRCEM & FRCEM are one several different routes an overseas emergency medicine doctor can take full GMC registration. Read our blogs on acceptable postgraduate qualifications and PLAB if you are unsure what route to take.

For doctors who wish to take more senior roles reflective of their current practice, IMG Connect advise that MRCEM or FRCEM would be the best route to take.

Please note, aplicants that pass a specific combination of MRCEM and FRCEM examinations can still be awarded Membership of the Royal College by Examination (MRCEM). This would still satisfy postgraduate requirements for GMC registration.

MRCEM Examination route:

The alternative route, Membership by Examination (MRCEM), is offered to candidates who have passed all of the following components:

  • FRCEM Primary or (MRCEM Part A)
    • One written paper, three-hours total
  • FRCEM Intermediate SAQ (replaces MRCEM Part B)
    • Short Answer Question paper - 3 hour paper comprised of 60, 3-mark questions
    • Practical examination setting with 18, seven-minute stations 

Eligibility for MRCEM Examinations:

Eligibility for FRCEM Primary:

To be eligible you must hold a Primary Medical Qualification (PMQ) that is recognised by the GMC for registration purposes.

Eligibility for FRCEM Intermediate:

To be eligible you must hold a PMQ recognised by the GMC, have completed an equivalent to the UK Foundation Programme 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.

Eligibility for MRCEM OSCE:

To be eligible to enter the MRCEM OSCE (Part C) you must meet the following requirements:

  • Hold a medical qualification approved by the GMC and
  • Have completed the UK Foundation Programme of equivalent (electronic evidence required at point of application) and
  • Have passed the FRCEM Primary examination after 1st August 2016 or
  • Have passed the MRCEM Part A examination after 1st August 2012 and prior to 31st July 2016 and
  • Have passed the FRCEM Intermediate SAQ after 1st August 2016 or
  • Have passed the MRCEM Part B examination after 1st August 2012 and prior to 31 July 2016 and
  • Have 36 months experience including 6 months experience in Emergency Medicine at a level above Foundation Year 1 (post full registration)

Where can I take the exams & how much will they cost me?

Examination and application dates are regularly updated by the Royal College and can be found here

Please remember, applications made outside of the application period will not be accepted.




FRCEM Primary

Short Answer Question Paper



Iceland, Malaysia, Oman, India


FRCEM Intermediate Certificate




Iceland, Malaysia, Oman








How can I apply?

All applications are made online and links to all application forms and windows are available here. It is worth noting, the application can take some time to complete so it is always advisable to apply well in advance of the deadlines.

Please remember, applications submitted after the application period will not be accepted. 

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.


Applicants are tested on a range of common and important disorders in Emergency Medicine as set out in the Emergency Medicine Training Curriculum 2015.

We recommend getting to know the curriculum as early as possible and using it as a road map for your study plan. 

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:

SAQ Blueprint:

The blue print for the new Intermediate SAQ exam can be found on page 8 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, see below:

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.

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. 

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.

As ever at IMG Connect we believe in preparation. In order to succeed in the clinical exam, IMGs have told us that it is vital that you practice your clinical examinations as frequently as possible, preferably under the supervision of a senior colleague. This will give you confidence in approaching and examining patients with examiners present.

Should I take a course to prepare for the OSCE?

Whilst it is not essential to take a course when preparing for the MRCEM or FRCEM OSCEs - there is no doubt it will help your preparations both technically and mentally, and should be considered an investment towards your future career plans. Have a read of our blog on recommended MRCEM courses for Emergency Medicine doctors.

Passed? What next? 

First of all, congratulations! After you have passed all parts of FRCEM or MRCEM 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. 

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