MRCEM Primary Exam: Best Way to Prepare


Curriculum of Membership of the Royal College of Emergency Medicine (MRCEM) consists of three parts. They are MRCEM Primary, MRCEM Intermediate SBA, and MRCEM OSCE. Moreover, they test your skills, knowledge, and behaviour in training. Besides, one must complete all the three elements to enter Emergency Medicine training. Membership will be awarded only after this.

Accident and Emergency doctors need to undergo emergency medicine specialty training to work as a consultant in the UK. Furthermore, one has to complete multiple exams and components to enter the specialty program. This has to be further done at the same time as hectic training rotations, ARCP, work and personal commitment. This makes it extremely demanding. If you want to give yourself the best possible chance to clear the exam in your first attempt, read on.

Emergency Medicine Training

To get into emergency medicine training one needs a medical degree, either undergraduate or postgraduate. Two years of foundation training is further required. Besides, a trainee can start emergency training through various routes.

The first route is through the acute care common stem (ACCS) and complete core training, CT1-CT3. Higher speciality training can further follow after this. The second way is through the programme, ST1-ST6. The third option is to carry out the first 3 years in ACCS training in a different acute speciality or in surgery. In addition, you may then enter ST3 through a defined route of entry into emergency medicine (DRE-EM).

Besides, entry into ST1/CT1 is very competitive and candidates need to complete MRCEM by examination to progress into ST4 higher speciality training.

Relevance of MRCEM Exams

Trainees in UK training programs that are approved by GMC should complete the MRCEM exam. This is further essential to get into ST4 emergency medicine training. In addition, one can attempt the exams at any time from FY1. Moreover, make sure that you pass all three to progress to higher specialty training.

The GMC considers an examination pass up to date if you enter or re-enter an approved training program. In addition, this has to be done within seven years of passing the exam.

International Medical Graduates (IMGs) from any country can sit the MRCEM examinations. This will enable them to further enhance their career progression or enter EM training in the UK. Lastly, MRCEM is a requirement for those who want to pursue FRCEM in the future.

Preparation For MRCEM Primary

The MRCEM Primary is the first step towards the Royal College of Emergency Medicine (RCEM) fellowship. Read on to know about eligibility for applying, exam-style, what to read, how to prepare, how to apply, and more.

Exam Format

The MRCEM examination structure consists of the following components:

MRCEM Primary Single Best Answer (SBA), MRCEM Intermediate Single Best Answer (SBA), MRCEM Objective Structured Clinical Examination (OSCE).

The MRCEM Primary Examination is a Single Best Answer (SBA) paper. Besides, the examination consists of 180 questions. The duration is three hours. Furthermore, there will be five options in total including one correct answer and plausible alternatives. One needs to choose the best answer of the five possible options to receive one point. In addition, the exam is a test of basic sciences with a limited clinical focus.

Registering For the Exam

You can apply for the MRCEM Primary exam on the RCEM website. Online applications for all examinations will open at approximately 10 am (GMT time) on the application date listed on the exam information page, in the dates and fees section. Besides, applications close automatically at 5 pm (GMT) on the listed closing date.


A medical qualification approved by the GMC is required for registration purposes. Or else candidates registered with an international medical qualification should upload a copy of their current medical registration.

Way to Prepare

According to the consensus, the first MRCEM exam is difficult with low pass rates. Preparation is extremely important. Furthermore, the preparation entails understanding the curriculum, dedicating time on the areas where the points are weighted more heavily and practicing exam-style questions.

Understanding Curriculum

Reading the RCEM Basic Sciences Curriculum and the Emergency Medicine Curriculum is an uphill task. However, it is crucial to review this from the start of your revision. The RCEM Basic Sciences Curriculum represents the content that is found in the exam. Besides, you should structure your revision around it. Moreover, keeping the curriculum will help you to cross-reference the information you need to know and the things you don’t. This can further save you time navigating textbooks and further reading.


According to online revision guides and testimonials from doctors, three to six months are necessary to get a good understanding of the basic sciences with a focus on anatomy and physiology. Give yourself more time to prepare further to reduce the volume of revision. In addition, do your rotations alongside your revision. This will prove helpful while studying.


A good understanding of the curriculum will really help you to select further reading. Moreover, former candidates reveal that the upper and lower limb sections are more heavily weighted within the anatomy exam.

The best resources to structure your study are the following curriculum guides:

· Basic Sciences Curriculum

· RCEM Curriculum

Further Reading

· Anatomy: Teach Me Anatomy

· Physiology: Physiology at a Glance

Question Banks

High volumes of question bank practice are the best study approach for this exam. This further helps you familiarize yourself with the question style which in turn will allow you to work through them quickly. Lastly, this will allow you to clear the 180 questions in 180 minutes.


YouTube is an invaluable free study resource where you can focus on anatomy and physiology videos. Plexuses, upper and lower limb anatomy are easily accessible by searching “anatomy” or “MRCEM”.

Practice Exam

In the last month of revision, focus heavily on practice exams. This will further give you the confidence to get through the 180 questions in the set time frame.

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Top 10 Mistakes to Avoid in MRCEM Exam Preparation

Preparing for the Member of the Royal College of Emergency Medicine (MRCEM) examination requires a strategic approach. Here we discuss the top 10 mistakes to avoid during MRCEM exam preparation. By addressing these pitfalls, aspiring candidates can optimize their study efforts and improve their chances of success.

Neglecting Exam Recalls

Exam recalls are valuable resources for scoring marks in the MRCEM exam. Reviewing previous exam questions helps familiarize candidates with the exam pattern and increases the chances of encountering similar questions. Thoroughly studying past recalls can provide insights into the exam structure and boost performance.

Overcoming Exam Anxiety

Managing exam anxiety is crucial for optimal performance. Accepting anxiety as a natural response and practicing under exam-like conditions can build confidence and help candidates perform better during the MRCEM exam.

Insufficient Practice

Dedicating ample time to practice is vital for success in the MRCEM exam. With a pass rate of 50 to 60 percent, candidates must put in significant effort. Creating a structured study schedule, utilizing mentors or study guides, and practicing regularly are key components of effective preparation.

Understanding the Exam Curriculum

Familiarize yourself with the MRCEM exam curriculum, which focuses on basic sciences such as Anatomy, Physiology, Pharmacology, and more. Understanding the curriculum’s content and objectives will guide your study efforts and ensure comprehensive coverage of necessary topics.

Neglecting Revision

Regular revision is essential to retain and recall information effectively. Allocate time for revisiting the syllabus to ensure critical knowledge remains fresh in your memory. Focus on subcategories and create concise notes for quick and targeted review.

Ignoring Score Analysis

Analyzing practice scores helps identify strengths and weaknesses. Take self-assessment exams or mock tests to gauge your preparedness. Understanding score patterns and areas that require improvement allows you to adjust your study strategies accordingly.

Emphasizing Anatomy and Physiology

Anatomy and Physiology play a crucial role in the MRCEM exam. Allocate sufficient study time to these subjects, as they constitute a significant portion of the exam. Develop a strong foundation in these areas to demonstrate clinical proficiency.

Enhancing Reasoning Skills

The MRCEM exam tests logical reasoning alongside memory. Develop the ability to select the most appropriate answer option by understanding the underlying reasoning. Utilize graduation-level anatomy and physiology books for better retention and application of knowledge.

Focusing on Relevant Topics

Prioritize studying relevant topics from the basic sciences. Most MRCEM exam questions are derived from these areas. Pay attention to the significance of these topics and avoid getting distracted during the exam.

Time Allocation and Duration

Allocate an appropriate duration for MRCEM exam preparation based on your existing knowledge of basic sciences. Aim for three months if you have a strong foundation, or up to six months if additional study is needed. Dedicate at least six hours per day for preparation to adequately cover the syllabus.

By avoiding these common mistakes, candidates can optimize their MRCEM exam preparation.