GMC Registration can be a long and complex process. With several options available for overseas doctors to demonstrate evidence of their skills and knowledge, it might be difficult to decide the best route to take to register with the GMC.
For international doctors planning their route to the UK, the two most common and popular routes by far are the UK postgraduate qualifications (MRCEM for emergency medicine physicians) or PLAB. Here we provide a summary of both pathways and briefly consider their benefits to help you make the best choice in your journey to the UK as an IMG.
GMC Registration for Overseas Doctors
PLAB for GMC Registration
MRCEM for GMC Registration
Which is better for me as an IMG: PLAB or MRCEM?
#IMG Tips
How do I get started?
Skip ahead to the relevant section if you know what you’re looking for.
GMC Registration for Overseas Doctors
Registering with the GMC is a multi-stage process, including key timings actions and documents. To receive full registration, international doctors must provide evidence of:
What is often the most long and challenging part of the process is providing sufficient evidence of skills and knowledge, however, you can check whether you have a GMC-accepted postgraduate qualification here.
There are 5 ways in which an overseas doctor can demonstrate their skills and knowledge:
PLAB
Acceptable Postgraduate Qualification / Licensing Examination
Relevant European Qualification
Sponsorship / MTI
CESR / CESR-CP / CEGPR
Please note that only one type of evidence is required to demonstrate skills and knowledge for GMC registration.
Of these routes, the most accessible are PLAB and the Acceptable Postgraduate Qualification because they are two of the only routes that do not depend on the country you’ve trained in – the UK postgraduate exams and PLAB can be sat by doctors.
For a detailed breakdown of all the routes available to IMGs, see our blog here.
PLAB - Professional & Linguistics Assessment Board
The first and most common route we’ll be discussing, which is particularly popular among junior doctors, is PLAB.
PLAB is a two-part exam (one written and one practical element), which assesses whether a candidate is at least as capable as a doctor starting the second year of their Foundation Programme Training (FY2 or F2) and can therefore work safely as an SHO (Senior House Officer) in the NHS.
The GMC has produced a useful video summary of the PLAB exams which you can watch here, or for a more detailed overview, see our IMG Resources library.
MRCEM - UK Postgraduate Qualification for Emergency Medicine
The UK’s postgraduate qualifications are a more popular route for senior overseas doctors, and those looking to gain posts in the NHS which are reflective of their experience.
For emergency medicine, this can be done by attaining Membership of the Royal College of Emergency Medicine. The Royal College of Emergency Medicine (RCEM) is the professional body that regulates the specialism of emergency medicine in the UK, and Membership of the College of the Royal College of Emergency Medicine (MRCEM) is the full qualification attained through these examinations.
Take a look at our IMG Resources library for complete guides on MRCEM to learn more.
You can also read our interview with Dr Behzad Rashid to learn about the experience of an IMG Emergency Medicine resident going through MRCEM.
PLAB vs MRCEM
Both MRCEM and PLAB are respectable routes that demonstrate skills and knowledge and will allow an international doctor to register with the GMC and work in the UK. To decide which route of the two is best for you, you’ll need to consider the benefits of each and how they align with your needs and priorities in moving to the UK.
Seniority of Positions in the NHS
It would be difficult for an overseas emergency medicine doctor to obtain a more senior post in the NHS without either MRCEM, a GMC-approved training programme, or extensive experience from a similar English-speaking healthcare system. PLAB alone will not give overseas doctors access to senior posts in the NHS.
Training
To practice as a consultant in the UK, you must have gone through specialty training and will need a GMC-recognised postgraduate qualification to do so, whether a qualification from the country in which you completed your specialty training, or MRCEM.
Due to the more specialised nature of MRCEM, we advise emergency medicine doctors to complete MRCEM, as many NHS Trusts will list MRCEM as a requirement on job descriptions. MRCEM also allows IMGs access to more senior roles and competitive salaries.
Time
PLAB has two stages and can take anywhere between 3-9 months to prepare from start to finish.
MRCEM has three stages, the last of which must be taken after at least 24 months of postgraduate experience with at least 6 months in emergency medicine and can take anywhere between 24-36 months to prepare from start to finish.
Cost
MRCEM costs £1,115 for the three exams. Whilst the Primary and Intermediate SBA exams are delivered worldwide via computer-based testing company, the OSCE is delivered in London (UK), Kuala Lumpur (Malaysia), Chennai, Hyderabad, Mumbai and Kochi (India), so there may be the added expense of international travel.
PLAB costs £1,189, and whilst PLAB 1 can be sat in many overseas centres around the world, PLAB 2 is only delivered in the UK. You can find a list of overseas centres for PLAB 2 here.
So for both MRCEM and PLAB, candidates will have to travel to the UK, meaning that the additional cost of visas, accommodation and flights must be factored in.
It’s also important to note that these costs can rise if re-sits of the exams are necessary.
Summary
PLAB, as an exam which examines a doctor’s ability to work safely as an SHO, does not assess ability in emergency medicine specifically. For this reason, PLAB tends to be a route for junior doctors who have not already chosen their field of specialisation in medicine, I.e., emergency medicine.
PLAB allows doctors to enter the UK system much faster than other routes and for this reason alone, it is favoured by international doctors when considering their path to the UK.
MRCEM involves three more difficult examinations and takes more time to prepare for. However, for overseas doctors, attaining MRCEM will allow you to jumpstart your career in the UK, as you don't need PLAB or Core Training.
Additionally, MRCEM will facilitate the application for more senior roles in UK emergency medicine than PLAB.
#IMG Tips
Determine your priorities – your goals and timeline for relocating to the UK are important in deciding which route is best for, and this is different for everyone.
Plan well ahead – depending on the route you choose, you may be embarking on a long journey through these exams, so plan how you will fit them into your life and how best to prepare to maintain a good work-life balance at the same time.
Find a support network – once you know which exams you will sit, find a support network of others who are also preparing for the exam.
Sources
https://rcem.ac.uk/exam-mrcem/
https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab
https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/evidence-to-support-your-application
Getting started
Once you’ve decided which exams are best for you, it’s time to delve deeper into the exams and what they entail. For more useful blogs and articles on PLAB or MRCEM, registrations and qualifications to help you find your dream job in the NHS - take a look at our IMG Resources library.
Don’t hesitate to get in touch with one our recruitment specialists if you would like to discuss your options in the NHS once you have completed PLAB or MRCEM.
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.
Are you an overseas emergency medicine doctor taking the postgraduate route to GMC registration through the MRCEM exams? Are you interested in sitting the exams in the future?
As part of IMG Stories, we introduce to you Dr Behzad Rashid, an emergency medicine doctor who has recently sat and passed the MRCEM Primary exam. Dr Rashid will be sharing with you his experiences of the first of the Royal College of Emergency Medicine exams, taking you through his preparation, experience of sitting the exam and sharing some hot tips for international MRCEM aspirants.
Tell us about yourself... what should the IMG Community know about Behzad Rashid?
I am a Resident Emergency Medicine Physician, currently working in Pakistan and have worked in A&E since completing my internship. I started off as a medical officer, and then began an A&E residency programme in my country. I would say a combination of hard work and fate are the reason why I am where I am today.
What motivated you to sit the MRCEM exams?
I had booked a space on the PLAB 1 exam, however, due to COVID, it was unfortunately cancelled (three times in fact). By the third time, I’d had enough. I decided to progress my career in Pakistan because I felt I wasn’t getting anywhere with the exam bookings, and everything was very uncertain at that time.
Even though time felt like it had stopped, it was actually flying by. I therefore decided to sit the residency exam in Pakistan. I worked in A&E at the time and had heard about the MRCEM exams from my colleagues. Due to the lockdown, they had just announced that the exam could now be taken online, even within the comfort of your own home. I was ready to go all in and grind my way through both exams, so I studied and succeeded in clearing both PLAB 1 and MRCEM Primary.
At what point in your career and training did you sit the MRCEM Primary exam?
There wasn’t anything in particular that made me realise that I was ready to sit this exam, besides the fact that COVID had been ruining my plans. I was going through a difficult time, and A&E was something I dearly wanted to pursue. I saw an opportunity, and I took it.
Applications can be frustrating… how did you find the application process for the exam?
The whole process took me about 30-45 minutes to complete. The details of application and exam are available on the website, and whilst a bit tedious, it is a straightforward process. Based on the RCEM’s eligibility criteria for the first exam, you only need to have graduated with an approved medical degree in order to sit the exam.
Since I was planning to sit the exam in my own country, I was provided with some options for exam centres. There were multiple private exam centres nearby, and I did not want to sit the exam at home and risk the internet issues others had experienced. I booked my exam for 8 am, because that's when I function best, and I would recommend that everyone books whatever time of day you think you would perform best.
How far in advance did you start preparing for the MRCEM Primary?
I booked the exam 4 months in advance (around the end of October, with the exam in Dec). Everyone has their own method of studying, and for some, this may not be enough time, so whatever schedule has worked for you in the past - stick to it. In my opinion this exam requires about 3-4 months of studying if you are unemployed or have any daily commitments, and about 5-6 months if you are working or have a very busy schedule.
Often IMGs are a bit at a loss to get support... did you benefit from speaking to senior colleagues or peers about the exam? Did you study with other candidates?
I was in touch with a few individuals who had already sat the exam. They guided me through the application process and resources I could use to prepare. They were also the ones who entertained my idea in preparing for both exams at once, and they believed that I could succeed in both.
You don’t need a lot of friends, just the right ones who will push and support you in your journey.
You were preparing for PLAB at the same time as the Royal College exams...how do you feel studying for PLAB 1 compares to your experience of MRCEM Primary?
PLAB 1 and MRCEM Primary are completely different exams.
PLAB 1 focuses on the application of medical knowledge in common day-to-day scenarios that a doctor would encounter in the UK. MRCEM Primary is more of a theoretical assessment of the basics i.e. anatomy and physiology of emergency related scenarios. This became even more apparent after I’d gone over the curriculum provided by the GMC and RCEM, which is honestly the best part of the exams. I would not say that one is easier than the other – they assess different things.
I focused on the blueprint/curriculum for each exam and made sure to get in as many MCQs as possible. That gave me a better overview of what I would actually be tested on.
Emergency medicine doctors are notoriously busy...in the months leading up to the exam, how much time did you spend a week on preparation?
In my case, I had to appear for the MRCEM Primary first, and then a week later for the Pakistan Residency (FCPS I) exam. Since work was extremely hectic, and I felt that I was not able to set aside much time to prepare for both, I quit my job to study for the exams and managed my time throughout the day to study and prepare for both (around 12 hours each day).
It goes without saying that any goal without a plan is just a wish. I divided my day into 2 halves where I would wake up at 5am, and study till 12pm, take a break (which included sleeping, eating or working out), then start off again at 5pm and go at it till 10pm. The first half would be MCQS and making Anki flash cards, second half would be to review the cards I had pending for that day. I would throw in a mock exam every week to see where I stood at that point, correct my mistakes and make cards on those as well. I stuck to this routine for 3 months and by the end of the 3 months, I had a deck of about 2000 Anki flash cards, divided into two groups for the 2 exams, and that is all I would review because I was confident that is all they would test me on.
How did you manage to juggle other commitments whilst studying for the exam (without panicking)?
During COVID, I was pretty much stranded by myself in Pakistan. My family lived in a different country, and I had limited interactions with the family I did have around me. This bizarre period of isolation and confusion gave me ample time to prepare for my exams. Being alone did get frustrating at times, and anxiety would creep up on me, but the hunger to clear my exams and progress my career gave me tunnel vision and cancelled out all the other noise.
The preparation for 2 examinations was an enlightening and humbling experience. My goal is to reach out to students and help them understand what works best for them. I’d be more than happy to provide students with any resources (Including my Anki flash cards) they need. However, there isn’t a cookie cutter plan that will suit everyone - I did what was best for me in my circumstances, and you must do the same.
What resources did you use to prepare and practice for the MRCEM Primary exam?
I used the curriculum provided by the MRCEM on their website which you will find here.
Along with that I was using the MRCEM Success question bank, which I have to say is an excellent resource. The actual exam was very close to the MCQs provided, which is why I would highly recommend it.
I am also an avid user of Anki. It has helped me ace exams in med school, the MRCEM primary, FCPS I and even the PLAB 1. I have never made any notes from any textbooks, and I honestly think hardcovers will eventually become obsolete. I would highly recommend making your own cards since that allows you to work at your own pace and address any weak points. I would love to share my own deck of Anki cards as well, which covers everything provided in the MRCEM curriculum. Feel free to add more to this deck and pay it forward.
Let's face it, exams are not everyone's favourite day out... so on the day of the exam, what did you do to relax?
I woke up early and decided not to go over any cards. I’m the type of exam-taker who enjoys working out and listening to music before an exam. At that point, I know what I know, and that is all I know. So I drank a nice cup of coffee and got some cardio done while listening to music.
What was your experience like on the day?
My exam was around 8:30am, so the drive was about 5 minutes to the exam hall and I got there around 30 minutes before it started. The invigilator was friendly and after leaving my personal belongings in a small locker, they provided a sheet of paper and stationary at the centre. The computer prompted me to start once the invigilator asked me to, and everything after that went smoothly. The invigilators are ready to help you with your queries if you experience any problems during the exam as well.
What was the most challenging part of the exam?
In my honest opinion, I did not come across anything that would throw me off. After going over the curriculum, and having a plan, I just stuck to that plan and followed it till the end.
In hindsight, would you have done anything differently?
I was already taking the most extreme measures by preparing for multiple exams and taking time off work, given everything was shut down during COVID. I have no regrets and cannot think of anything I’d have done differently.
What nuggets of advice would you give to any MRCEM Primary aspirants?
The best thing about the Royal College exams is that they provide a curriculum of what you should know, and they would never ask anything more than that. I would highly recommend you go over that and familiarise yourself with the content you will be tested on. Question banks might provide extra information to give you a different perspective of the subject, however the real exam sticks to its curriculum. If you know what you are required to know, preparation for the exam becomes easier.
What are your plans going forward?
I'm planning on appearing for the PLAB 2 and the MRCEM Intermediate soon. I have already started preparing my Anki deck for the intermediate as well, so wish me luck and stay tuned for that as well.
To learn more about the RCEM exams, see our IMG Resources library.
For news and updates on all things emergency medicine, follow us on social media and join the conversation.
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 MRCEM?
MRCEM Route
Eligibility for overseas doctors
Where can I take the exams & how much will they cost me?
How do I apply?
How to prepare and what resources are available
Should I take an MRCEM course?
Passed? What next?
What is the Royal College of Emergency Medicine?
The Royal College of Emergency Medicine is the professional body responsible for the specialty of Emergency Medicine throughout the UK. Among 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 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, applicants 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 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
MRCEM OSCE
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.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
MRCEM
OSCE
UK
£450
India
£450
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.
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.
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:
FRCEM Primary
FRCEM Intermediate
MRCEM OSCE
SAQ Blueprint:
The blueprint 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:
Primary – sample questions
Intermediate - Sample SAQs are included in the Information Pack
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.
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.
Overseas doctors taking the postgraduate route to GMC registration must attain MRCEM.
International Medical Graduates (IMGs) from any country in the world can sit the Royal College of Emergency Medicine examinations (MRCEM), provided certain eligibility criteria are met. FRCEM however can only be sat once practicing in the UK, so is not a suitable route for international doctors who have not yet practiced in the NHS. To help doctors understand the FRCEM and MRCEM exams the following guide will provide you with key information covering the exams, dates, fess, eligibility, preparation and application.
These are summarised below along with a broad look at the following topics:
What is FRCEM and what is MRCEM?
FRCEM Route
MRCEM Route
Eligibility for MRCEM
Eligibility for FRCEM
Where can I take the exam & how much will it cost me?
How do I apply?
How to prepare and what resources are available
Should I take an MRCEM course?
Passed? What next?
What is the Royal College of Emergency Medicine?
The Royal College of Emergency Medicine is the professional body responsible for the specialty of Emergency Medicine throughout the UK. Among 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 FRCEM and what is MRCEM?
Membership or Fellowship 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 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.
MRCEM Examination Route
The alternative route, Membership by Examination (MRCEM), is offered to candidates who have passed all 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
MRCEM OSCE
Practical examination setting with 18, seven-minute stations
FRCEM Examination Route
The Fellowship Examinations consists of the following components:
FRCEM Primary Examination
one, three-hour written paper
FRCEM Intermediate Certificate
Short Answer Question Paper (SAQ)
Situations Judgement Paper (SJP)
FRCEM Final Examination
Critical Appraisal (Short Answer Question Paper)
Quality Improvement Project (QIP)
Clinical Short Answer Question Paper
Objective Structured Clinical Examination (OSCE)
Membership or Fellowship of the Royal College is awarded to candidates who pass three examination components, using either route above.
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)
Eligibility for FRCEM 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 FRCEM Final Examination:
To be eligible you must have FRCEM Primary and FRCEM Intermediate Certificate, attained after 1st August 2016.
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 the application period will not be accepted.
Examination
Location
Fees
FRCEM Primary
Short Answer Question Paper
UK
£310
Iceland, Malaysia, Oman, India
£390
FRCEM Intermediate Certificate
SAQ
UK
£305
Iceland, Malaysia, Oman
£385
FRCEM Intermediate Cert.
(SJP)
UK
£200
Kuala Lumpur
£200
MRCEM
OSCE
UK
£450
India
£450
FRCEM Final
Clinical SAQ
UK
£300
FRCEM Final
Critical Appraisal SAQ
UK
£240
FRCEM Final
QIP
N/A
£150
FRCEM Final
OSCE
London
£420
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, such as FRCEM Success, 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.
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.
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:
FRCEM Primary
FRCEM Intermediate
FRCEM Final Examination
MRCEM OSCE
SAQ Blueprint:
The blueprint for the new Intermediate SAQ exam can be found on page 8 of the FRCEM Intermediate examination pack, downloaded from the RCEM website here.
SJP Blueprint:
A blueprint of the new Intermediate SJP exam can be found on page 11 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:
Primary – sample questions
Intermediate Certificate – sample SJP questions
Final – successful QIP
Reducing referral rates of paediatric patients to plastic surgery
Management of fractured neck of femurs in the ED
Final – unsuccessful QIP
Critical Appraisal Questions – Advice to Candidates
Critical Appraisal – Most Frequently Offered Answers
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.
You can find a full range of articles covering MRCEM and FRCEM examinatins to help you to make a success of your preparations here.
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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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:
The MRCEM and FRCEM Intermediate SBA exams are tough....
Success in these exams is a challenge and all Emergency Medicine doctors deserve credit for getting to this stage. Whether your passed or failed, here we'll offer some suggestions on what to do next:
I passed the MRCEM / FRCEM SBA exam
I didn't pass the MRCEM / FRCEM SBA exam
I passed the FRCEM / MRCEM SBA exam:
First things first, you deserve to celebrate and get some rest. No doubt you wherever you are, you are dealing with the coronavirus and will not be able to celebrate in the way that you would wish. But from us at IMG Connect, congratulations! Doctors who have attained full MRCEM and secured a job in the NHS tell us that the FRCEM SBA is a very tough examination, so well done! Your hard work has paid off.
Once you are feeling relaxed, this is a good time to think about what steps you need to take to complete full MRCEM. For most overseas doctors, this will mean taking the final MRCEM OSCE exam and whilst all OSCE centres are currently closed it takes most doctors at least six to nine months to prepare for the exam anyway.
So what is the MRCEM OSCE?
Like the intermediate exam, the MRCEM OSCE requires a considerable amount of revision and preparation. However, as you know the format is very different, so your preparation will change.
The MRCEM OSCE consists of 18 stations (16 patient encounters & 2 rest stations), each one lasting for about 7 minutes. The MRCEM OSCE exam will not only test your theoretical knowledge, but also your resus skills and communication skills. Even candidates who are working in an emergency medicine department (ED or ER) often find these OSCEs difficult. Even if you have strong background knowledge in Emergency Medicine the exams can still be tricky due to a heavy reliance on testing your communication skills and etiquette.
How to preparation for MRCEM OSCE?
Preparation is therefore vital for all doctors who intend to take the MRCEM OSCE exam. This can be broken down into the following:
Practical day-to-day work (colleague observations & feedback, peer groups, study groups)
Online revision resources (subscriptions, reading materials, tutorials, videos)
Courses (face to face, online)
In general, emergency medicine course tutors advise setting aside at least 2-3 months preparation in addition to your Emergency Medicine experience.
Resources, courses and revision materials:
We are often asked by Emergency Medicine doctors where they should look for resources, online revision materials, OSCE mock stations and preparation courses (online and face to face).
As such, we have compiled the best advice, tips, courses and resources suggested by Emergency Medicine doctors who have taken the MRCEM and FRCEM exams.
Where can I take the MRCEM OSCE exam?
Overseas doctors (IMGs) can sit the final MRCEM OSCE exam in three locations: the UK, India and Malaysia. However the Royal College has suspended all upcoming test dates and centres due to the COVID-19 coronavirus.
I did not pass the FRCEM SBA exam:
If you did not pass the FRCEM intermediate exam - don't worry! The overall pass rate is 35% which is roughly half of the MRCEM OSCE pass rate. This is a tough exam so don't worry too much, take some time out to relax and enjoy life. These moments where you don't succeed at the first, or second time, will only make you stronger and a better doctor in the long run. As the British say, chin up and strong upper lip!
At IMG Connect we've taken the time to prepare and collate the best preparation resources for the FRCEM Intermediate Certificate exam - we would be delighted to share these with you. Click on the buttons below to register with the IMG Connect team so we can talk you through this or request the FRCEM Intermediate resources to help you pass the next time - without fail!
If you have any questions about how to secure an NHS job in Emergency Medicine or prepare for the FRCEM Intermediate exam or MRCEM OSCE (including advice on dates, fees, courses, resources, mock scenarios, online materials and revision books) then don’t hesitate to get in touch with an IMG Consultant.
IMG Connect is keeping a very close eye on the examination schedule and will keep all our IMGs informed as soon as the College publishes some updates. You can find the updated exam schedule here.
However, this does not mean you cannot use the time to prepare for your OSCE!
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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:
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.
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 a typical doctor salary in the UK and the most suitable hospital locations for you.
The MRCEM OSCE exam requires a considerable amount of revision and preparation....
And we are often asked by Emergency Medicine doctors where they should look for MRCEM OSCE resources, online revision materials, mock stations and preparation courses.
Here we compile the best advice, tips, courses and resources available for the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE exam whilst also address some understandable concerns about the effect of COVID-19 on availability of test centres and upcoming exams.
What is the MRCEM OSCE?
The MRCEM OSCE consists of 18 stations (16 patient encounters & 2 rest stations), each one lasting for about 7 minutes. The MRCEM OSCE exam will not only test your theoretical knowledge, but also your resus skills and communication skills. Even candidates who are working in an emergency medicine department (ED or ER) often find these OSCEs difficult. Even if you have strong background knowledge in Emergency Medicine the exams can still be tricky due to a heavy reliance on testing your communication skills and etiquette.
Preparation is therefore vital for all doctors who intend to take the MRCEM OSCE (part C) exam. This can be broken down into the following:
Practical day-to-day work (colleague observations & feedback, peer groups, study groups)
Online revision resources (subscriptions, reading materials, tutorials, videos)
Courses (face to face, online)
In general, emergency medicine course tutors advise setting aside at least 2-3 months preparation in addition to your Emergency Medicine experience.
How has the COVID-19 coronavirus afffected MRCEM exam centres & dates?
The Royal College of Emergency Medicine took the difficult decision to cancel all events for the months of April, May and June following the escalation of the virus. As the UK and most of the world remain in some form of lockdown, the Royal College has not announced when it is expecting to open up it's centres again. Understandably this will be tied into government advice and that of the WHO whilst most examiners involved in the OSCE examinations will be tied into urgent clinical duties.
IMG Connect is keeping a very close eye on the examination schedule and will keep all our IMGs informed as soon as the College publishes some updates. You can find the updated exam schedule here.
However, this does not mean you cannot use the time to prepare for your OSCE!
So how to get started?
The first step is to ensure you are familiar enough with the Royal College of Emergency Medicine Curriculum (2015), and to use this to create your study plan covering the whole curriculum, whilst also identifying areas of weakness to strengthen.
Take a look through Mastering Emergency Medicine – a practical guide to re-enforce your solid background in Emergency Medicine knowledge before you start approaching the stations. Note that this book was first published in 2009, and some aspects may be slightly outdated.
Familiarise yourself with the stations, techniques and format by watching online videos and tutorials - you can find both free and paid tutorials online.
YouTube has many great videos available to get you started, covering basics of examination and OSCE guides through to mock OSCE scenarios:
Mcleods Examination videos (Basics of examination)
OSCE guides - Geeky Medics
Bromley webinars and tutorials
Watching these videos before you start your practice sessions (and then repeatedly throughout your study plan) will give you a huge boost.
Resources for MRCEM OSCE
General advice is to use a variety of resources, including reading materials, online subscriptions to videos and tutorials, podcasts and videos. The following have helped IMGs on their journey to successful completion of the MRCEM OSCE:
Bromley Emergency Courses online tutorials:
Revision communication videos
Revision examination videos
Revision procedure videos
MRCEM OSCE course Podcast
Geeky Medics – Emergency Medicine
Practical work - peer groups and senior colleague observations
The best way to practice and solidify what you have learnt from your studies is to organise group sessions and observations at work.
Observations at work
Ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward. Receiving quality feedback in a formal setting is widely regarded as fundamental to your advances in emergency medicine practice.
Group sessions
When organising a peer group of Emergency Medicine OSCE aspirants, advice is to have a maximum of three/four persons per group. Three works very well because you can each play a role during role play sessions.
When conducting role plays, you may want to organise yourselves as follows:
Patient (use instructions for the actor provided in the textbooks, remember each patient has a backstory and there are many aspects the actor must show, including emotion)
Exam Candidate
Examiner (takes notes, observes, marks the checklist and gives immediate and detailed feedback on all aspects of the marking sheet)
Remember to take turns and swap roles, work as the patient, exam candidate and the examiner. Stick to the exam format, for example set a time limit of about 7 minutes which will allow you to get a clear understanding of how to pace yourself and finish before 7 minutes. Remember not to be too fast, or too slow, helping you to make every second count.
Feedback is crucial to improving your practice. As you practice together, look at the checklists after you perform each station and find out if you are missing anything.
When taking up the examiner role ensure to give detailed feedback covering all marking criteria (intro, examination, body language and winding up - the four key areas that can improve your score). Once the examiner has delivered their feedback, discuss as a group, considering how to improve in all aspects of the exam criteria.
Build stamina
Once you have a routine in place for peer group practical OSCE simulations, build up towards completing a full set of stations. This should be done for each member of your group. The exam can be tiring, which can in turn affect your performance on the day of the exam. For example, if exhausted at the final stations, it can be hard to maintain your clear communication and positive body language, so a full run through will help you to understand what it will be like on the day and what you need to do to ensure that you are consistently performing.
Record sessions
Try recording your group scenarios. IMGs who have done this repeatedly informed us that this was one of the single most important methods for seeing first-hand how to improve. We are after all our own worst critics! Take notes on the way you enter the room, move, talk, express yourself, your non-verbal cues, body language and interactions.
Take a course
There are various workshops organised by expert course tutors in Emergency Medicine designed to help you pass. You can find these online and anecdotal evidence suggests that taking a face to face course improves your chances of passing the MRCEM OSCE exam.
Speak to an IMG Consultant to check what courses might be suitable for you, if there is not a course where you live, it may be possible for us to organise one for you and your peers.
Is a course necessary?
Many overseas doctors preparing for their FRCEM or MRCEM Emergency Medicine examinations wonder if they should take a course as part of their preparation. In short, we advise that all IMGs should attend as many courses as possible. The knowledge gained on an MRCEM or FRCEM course goes well beyond the exam.
One issue is of course that courses cost a considerable amount of money, but if you consider that taking a course increases your chances exponentially of passing the examinations first time, the cost is offset by not having to pay to re-sit and all the additional costs that come with it (i.e. flights & accommodation).
Finding courses can be tricky
So take some time to work out what you specifically need help with and the stage you are at in the process. Search online to find the course that will suit your needs the most.
Speak to your peers, some may have attended a course that they felt had a positive impact on the learning and preparation.
Once you think you have found a course that suits your needs, such as an MRCEM OSCE course, check reviews posted by other IMGs to be sure of the quality of the tutoring.
If you have found a course that suits your needs, has good reviews recommendations from your peers, then it will likely be worth the investment. As a direct result you will likely pass the exams much quicker, helping you to secure the Emergency Medicine job that you want in the NHS.
On the day of exam - tips from IMGs
Passing any exam is not easy, passing the Membership of the Royal College of Emergency Medicine (MRCEM) OSCE examination even more so. In speaking with IMGs about their journey through the MRCEM OSCE exams, we have heard many thoughts about what it takes to pass. To help IMGs preparing to take the test, here we share some tips from past examinees and OSCE course tutors.
Firstly, it is good to know that every IMG taking the test is in the same position as you, perhaps anxious about how to prepare and worried about the exam day. We are told that the exam is just an ordinary day on the ward, so why then do so many excellent practicing EM physicians struggle to pass at first attempt?
It is perhaps important to say that the advice below is not just from not just those IMGs who passed first time, but from those who had to learn from their mistakes and take the test a second or even third time.
The most common thing that we hear is that IMGs must adapt their skill set to the requirements of the NHS system as well as changing their mindset to be able to work under intense observation.
Further reasons they struggle are:
1. Anxiety
Experiencing anxiety during exams is completely natural and the fact that the OSCE stations are only 7 minutes adds to this in the Part C. The only way to combat exam anxiety is to accept that is both natural and inevitable. The best way to prepare and suppress the adrenergic surge is with practice, practice and more practice. The best way to practice is under exam conditions and if possible, this should be timed and observed by different examiners.
We are not of the opinion that this practice should be done last minute in the week before the exam, instead, your practice should start long before this point. Ask your senior colleagues in the ED to observe and comment upon your history taking and examination skills. If you can get into a routine of doing this with 3 to 5 patients per day you will be able to run through nearly all the most likely scenarios in only 12 shifts. Another great strategy is to teach OSCEs to the more junior doctors within the department. Teaching can be a powerful learning tool and has helped many aspirants with their revision.
2. Lack of practice
Make no mistake – the exam is very tough. Over 50% of candidates failed the 2016 sitting. Unless you are freakishly good at cramming you will need to set aside at least 3 months to prepare. IMGs will all study in different ways. Remember you have been through many exams all on your own. Whatever revision method works for you, stick to it. Once you know that you are going to study, make a revision plan and stick to it.
Practice in any way that you can. As above, be sure to ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward.
To practice out of work, form a small group of colleagues who are also taking the test and run through role plays, taking turns to be patient, doctor or examiner.
Pay careful attention to time keeping as it is very common for candidates to run out of time, particularly in history taking and communication skills stations.
3. Lack of familiarisation with curriculum
If you don’t know what you could be tested on, you won’t know what to prepare. The MRCEM OSCE is mapped to the competences of Year 1-3 of the Emergency Medicine 2015 Curriculum which is available on the 2015 Curriculum page. You should familiarise yourself with the Year 1-3 competences in preparation for sitting this examination.
4. Not being able to communicate effectively
Many IMGs have made the mistake of thinking that communication is only about what you say, not considering how you say it, and what you look like when you are saying it. Of course, you may be anxious, which can make you behave differently and say things in a different way. So, if you have practiced as above, make sure you incorporate practicing communicating not just focusing on what you say, but also your body language when saying it. Remember that between 70% of our communication is non-verbal!
Try to speak audibly and clearly and if at all possible, sit at the same level as the patient with an open posture. Attempt to make a connection with the patient, maintain good eye contact and give them your undivided attention. Treat actors and mannequins as if they are real patients, interact with them in the same way that you would on the EM ward.
Be direct and to the point but deliver any bad news in a sensitive and empathetic manner. Always check whether the patient has understood what you have said and ask if they have any questions.
5. Reading and deciphering the instructions
It is vitally important to read the instructions very carefully before entering a station. Easy marks are frequently lost by nervous or over-confident candidates that have overlooked key information or made assumptions by misreading. This is a mistake many IMGs have made, so learn from their mistakes and be sure to read everything carefully. Once read, make a plan of how you will approach the scenario. Once your minute is up… deep breath and smile!
If you have any questions about how to prepare for the MRCEM OSCE exam, including advice on courses, resources, mock scenarios, online materials and revision books, then don’t hesitate to get in touch with an IMG Consultant.
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 a typical doctor salary in the UK and the most suitable hospital locations for you.
Many overseas doctors preparing for their FRCEM or MRCEM Emergency Medicine examinations wonder if they should take a course as part of their preparation.
In short, we advise that all IMGs should attend as many courses as possible. The knowledge gained on an MRCEM or FRCEM course goes well beyond the exam.
One issue is of course that courses cost a considerable amount of money, but if you consider that taking a course increases your chances exponentially of passing the examinations first time, the cost is offset by not having to pay to re-sit.
Finding courses can be tricky, so take some time to work out what you specifically need help with and the stage you are at in the process. Search online to find the course that will suit your needs the most.
Speak to your peers, some may have attended a course that they felt had a positive impact on the learning and preparation.
Once you think you have found a course that suits your needs, such as an MRCEM OSCE course, check reviews posted by other IMGs to be sure of the quality of the tutoring.
When purchasing the Emergency Medicine course, if you have found a course that suits your needs, has good reviews recommendations from your peers, then it will likely be worth the investment. As a direct result, you will likely pass the exams much quicker, helping you to secure the Emergency Medicine job that you want in the NHS.
If you need some advice on choosing an Emergency Medicine MRCEM or FRCEM course to help you on your journey to securing a job in the NHS, don’t hesitate to get in touch with IMG Connect.
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.
Passing any exam is not easy, passing the MRCEM OSCE examination, even more so.
In speaking with IMGs about their journey through the MRCEM OSCE exams, we have heard many thoughts about what it takes to pass. To help IMGs preparing to take the test, here we share some tips from past examinees and OSCE course tutors.
Firstly, it is good to know that every IMG taking the test is in the same position as you, perhaps anxious about how to prepare and worried about the exam day. We are told that the exam is just an ordinary day on the ward, so why then do so many excellent practicing EM physicians struggle to pass at first attempt?
It is perhaps important to say that we felt it was important to give advice from not just those IMGs who passed first time, but from those who had to learn from their mistakes and take the test a second or even third time.
In this article we take a broad look at some of the main reasons that good candidates have cited as contributing to their failure to pass.
The most common thing that we hear is that IMGs must adapt their skill set to the requirements of the NHS system as well as changing their mindset to be able to work under intense observation.
IMGs have told us that the main reasons they struggle are:
Nerves
Lack of practice
Lack of familiarisation with the test
Lack of understanding of the curriculum
Not being able to communicate effectively
Reading and deciphering the instructions
Anxiety
Experiencing anxiety during exams is completely natural and the fact that the OSCE stations are only 7 minutes adds to this in the Part C. The only way to combat exam anxiety is to accept that is both natural and inevitable. The best way to prepare and suppress the adrenergic surge is with practice, practice and more practice. The best way to practice is under exam conditions and if possible, this should be timed and observed by different examiners.
We are not of the opinion that this practice should be done last minute in the week before the exam, instead, your practice should start long before this point. Ask your senior colleagues in the ED to observe and comment upon your history taking and examination skills. If you can get into a routine of doing this with 3 to 5 patients per day you will be able to run through nearly all the most likely scenarios in only 12 shifts. Another great strategy is to teach OSCEs to the more junior doctors within the department. Teaching can be a powerful learning tool and has helped many aspirants with their revision.
Lack of practice
Make no mistake – the exam is very tough. Over 50% of candidates failed the 2016 sitting. Unless you are freakishly good at cramming you will need to set aside at least 3 months to prepare. IMGs will all study in different ways. Remember you have been through many exams all on your own. Whatever revision method works for you, stick to it. Once you know that you are going to study, make a revision plan and stick to it.
Practice in any way that you can. As above, be sure to ask senior colleagues to observe and offer feedback to you on a regular basis on the EM ward.
To practice out of work, form a small group of colleagues who are also taking the test and run through role plays, taking turns to be patient, doctor or examiner.
Pay careful attention to time keeping as it is very common for candidates to run out of time, particularly in history taking and communication skills stations.
Lack of familiarisation with curriculum
If you don’t know what you could be tested on, you won’t know what to prepare. The MRCEM OSCE is mapped to the competences of Year 1-3 of the Emergency Medicine 2015 Curriculum which is available on the 2015 Curriculum page. You should familiarise yourself with the Year 1-3 competences in preparation for sitting this examination.
Not being able to communicate effectively
Many IMGs have made the mistake of thinking that communication is only about what you say, not considering how you say it, and what you look like when you are saying it. Of course, you may be anxious, which can make you behave differently and say things differently. So, if you have practiced as above, make sure you incorporate practicing communicating not just focusing on what you say, but also your body language when saying it. Remember that between 70% of our communication is non-verbal!
Try to speak audibly and clearly and if at all possible, sit at the same level as the patient with an open posture. Attempt to make a connection with the patient, maintain good eye contact and give them your undivided attention. Treat actors and mannequins as if they are real patients, interact with them in the same way that you would on the EM ward.
Be direct and to the point but deliver any bad news in a sensitive and empathetic manner. Always check whether the patient has understood what you have said and ask if they have any questions.
Reading and deciphering the instructions
It is vitally important to read the instructions very carefully before entering a station. Easy marks are frequently lost by nervous or over-confident candidates that have overlooked key information or made assumptions by misreading. This is a mistake many IMGs have made, so learn from their mistakes and be sure to read everything carefully. Once read, make a plan of how you will approach the scenario. Once your minute is up… deep breath and smile!
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