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Updated: Aug 02, 2026
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RCEM FRCEM Exam Overview:
| Certification Vendor: | RCEM (Royal College of Emergency Medicine) |
| Exam Name: | RCEM MRCEM Primary Examination (Previously FRCEM Primary) |
| Exam Number: | MRCEM-PRIMARY |
| Related Certifications: | MRCEM Intermediate SBA MRCEM OSCE FRCEM SBA FRCEM OSCE |
| Exam Duration: | 180 minutes |
| Exam Format: | Single Best Answer (SBA), Computer-based |
| Available Languages: | English |
| Passing Score: | Variable (Angoff standard-setting method, no fixed percentage) |
| Certificate Validity Period: | 7 years from date of passing |
| Exam Price: | £429–£609 (varies by membership status and location) |
| Real Exam Qty: | 180 |
| Recommended Training: | RCEM Exam Regulations & Information RCEM Basic Sciences Curriculum |
| Exam Registration: | RCEM Official Registration Portal |
| Sample Questions: | RCEM FRCEM Sample Questions |
| Exam Way: | Computer-based test at global Pearson VUE / Surpass Assessment centres |
| Pre Condition: | Hold a primary medical qualification (PMQ) accepted by the GMC; hold provisional or full medical registration |
| Official Syllabus URL: | https://rcem.ac.uk/mrcem-exams/ |
RCEM FRCEM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Microbiology | 9% | - General microbiology principles - Infection control and immunity - Bacterial, viral, fungal and parasitic pathogens |
| Topic 2: Pathology | 5% | - Haematology and haemostasis - Cell injury and repair - Neoplasia and systemic pathology - Inflammation and immune response |
| Topic 3: Physiology | 33% | - Endocrine and metabolic physiology - Cellular physiology - Cardiovascular system - Gastrointestinal system - Renal and fluid balance - Respiratory system |
| Topic 4: Pharmacology | 13% | - Fluids, electrolytes and emergency drugs - Antimicrobials and anti-infectives - Principles of pharmacology - Cardiovascular drugs - Respiratory drugs - Central nervous system and analgesics |
| Topic 5: Anatomy | 33% | - Lower limb - Upper limb - Head, neck and central nervous system - Thorax - Abdomen and pelvis |
| Topic 6: Evidence-Based Medicine | 6% | - Biostatistics and data interpretation - Study design and methodology - Critical appraisal and clinical guidelines |
RCEM FRCEM Primary Examination Sample Questions:
1. A 38 year old man with an atrial septal defect complains of chest pain. On auscultation you hear a loud and split second heart sound in the second intercostal space, left parasternal region.
Closure of which structure is most likely responsible for this finding?
A) Aortic valve
B) Foramen ovale
C) Mitral valve
D) Pulmonary valve
E) Tricuspid valve
2. You are conducting a study of children presenting with febrile convulsions. As pari of your data collection you record their temperature in degrees Celsius on arrival Which is the best description of this type of data?
A) Nominal
B) Discrete
C) Ordinal
D) Ratio
E) Interval
3. A four year old boy presents with a cough and fever for the last few weeks which became worse in the last 24 hours. There is no record of his vaccination history His temperature is 38.5 °C, heart rate 135 beats per minute, and oxygen saturations are 97% He is coughing frequently and has bilateral subconjunctival haemorrhages.
Which organism is most likely to have caused his condition?
A) Bordetella pertussis
B) Respiratory syncytial virus
C) Mycobacterium tuberculosis
D) Cornebactenum diphthenae
E) Haemophilus influenzae
4. A 35 year old with an extensive history of using multiple recreational drugs but no alcohol use is diagnosed with a megaloblastic anaemia in the ED Which drug is the most likely cause of this anaemia'?
A) Cannabis
B) Heroin
C) Cocaine
D) Nitrous oxide
E) Ketamine
5. A newborn infant is brought to your ED He was born at 39 weeks gestation with low birthweight, a purpuric rash, hepatosplenomegaly and bilateral cataracts You suspect the signs are secondary to an infection acquired while khe baby was still in utero Which organism is most likely to cause this clinical presentation?
A) Cytomegalovirus
B) Toxoplasma gondii
C) Rubella
D) Treponema pallidum
E) Group B streptococcus
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: C | Question # 3 Answer: E | Question # 4 Answer: C | Question # 5 Answer: C |
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