If you’re a doctor aiming to build your career in Emergency Medicine in the UK, passing the MRCEM exam (Membership of the Royal College of Emergency Medicine) is a crucial step. But if your goal is to pass the MRCEM exam in first attempt, it’s not just about studying hard — it’s about having the right strategy, understanding the exam structure, and practising smartly. The MRCEM is challenging, and many doctors take multiple attempts before finally passing. The key difference between those who succeed on their first attempt and those who don’t often comes down to how they approach preparation.
In this blog, we’ll guide you step by step on how to pass MRCEM exam in first attempt with practical tips, resources, and a proven study plan tailored for UK doctors.
Understanding the MRCEM Exam
Before diving into preparation, it’s important to understand the exam structure. The Royal College of Emergency Medicine (RCEM) conducts this membership exam to assess whether you are ready to work as an Emergency Medicine specialist in the UK.
The exam has three parts:
- MRCEM Primary – Basic sciences: anatomy, physiology, pathology, pharmacology, microbiology.
- MRCEM SBA (Single Best Answer) – Clinical knowledge: trauma, resuscitation, toxicology, paediatrics, ECG, imaging.
- MRCEM OSCE (Objective Structured Clinical Examination) – Practical skills: communication, procedures, clinical reasoning, ethical scenarios.
Together, these parts assess your readiness to manage emergencies in real NHS environments.
Why Candidates Struggle
Even experienced doctors find the MRCEM challenging because:
- They don’t follow the UK-style approach.
- Their preparation lacks structure.
- They rely on multiple random resources.
- They don’t simulate exam conditions with mock tests.
But with a focused plan, anyone can learn how to pass MRCEM exam in first attempt successfully.
Step 1: Know the Syllabus Inside Out
Download the official MRCEM syllabus from RCEM. Knowing exactly what topics are included — and excluded — prevents wasted effort.
Key Topics:
- Primary: Anatomy, Physiology, Pathology, Pharmacology, Microbiology
- SBA: Trauma, Resuscitation, Toxicology, ECG, Paediatrics, Radiology
- OSCE: Communication, Procedures, Ethical Scenarios, Emergency Management
💡 Tip: Make a high-yield list from previous questions — many topics are repeated in exams.
Step 2: Build a Realistic Study Plan
A structured MRCEM study plan is critical. For NHS doctors, a 6-month preparation per part works well.
| Month | Focus | Goal |
|---|---|---|
| 1–2 | Build foundations | Cover core theory from standard books |
| 3–4 | Practice questions | Daily SBA question practice |
| 5 | Revise & test | Timed mock exams |
| 6 | Refine weak areas | OSCE practice and scenario drills |
Consistency matters more than cramming. Even 1–2 focused hours daily are enough if planned.
Step 3: Choose the Right Study Resources
Use trusted, updated resources:
Primary Resources:
- EM Basic Science for the MRCEM by Kate Curtis & Cliff Reid
- Oxford Handbook of Emergency Medicine
- Online question banks: Passmedicine, MRCEMExamPrep.com
SBA Resources:
- Emergency Medicine MCQs by Ffion Davies
- RCEMLearning modules
- MRCEM Success online courses
OSCE Preparation:
- RCEMLearning OSCE videos
- YouTube role-plays
- Study groups for communication and practical skills
Stick to a few reliable resources — depth matters more than quantity.
Step 4: Practice Questions and Mock Exams
Practice is the secret to success. Aim to solve 3000–4000 SBA questions before your exam and take one mock exam per week.
Review mistakes carefully. Websites like Passmedicine, MRCEMExamPrep, and RCEMLearning are ideal for this.
Step 5: Master the OSCE Format
The OSCE tests performance under pressure. Stations are about 8 minutes each and include:
- History & examination
- Procedures (e.g., suturing, chest drains)
- Communication skills
- Ethical & professional judgment
Tips:
- Always follow the ABCDE approach
- Structure answers logically
- Record or practise communication daily
- Join UK MRCEM OSCE practice groups on Facebook, Telegram, or WhatsApp
Step 6: Follow UK Guidelines
RCEM expects answers aligned with UK standards. Study:
- NICE Clinical Guidelines (Asthma, Sepsis, Head Injury, Chest Pain)
- Resuscitation Council UK Algorithms (ALS, BLS, Paediatrics)
- RCEMLearning case discussions
This ensures your answers meet the UK standard of care, increasing your chance to pass.
Step 7: Join Study Groups & Forums
Being part of a study community keeps you motivated and accountable.
- Facebook: “MRCEM Study Group UK”
- Telegram/WhatsApp: “MRCEM Primary & SBA UK Prep”
- Reddit: r/UKDoctors
Many doctors credit these communities for how they passed MRCEM exam in first attempt.
Step 8: Manage Time, Work & Stress
NHS shifts can be hectic. Tips to stay consistent:
- Set small daily goals
- Study after shifts or early mornings
- Use Notion, Trello, or Google Calendar
- Take breaks to avoid burnout
Consistency beats last-minute cramming.
Step 9: Exam Day Strategy
SBA Exam:
- Read questions carefully
- Eliminate wrong options
- Flag doubts and move on
- Time: 1 minute per question
OSCE Exam:
- Introduce yourself clearly
- Use structured communication (SBAR)
- Stay calm if a station goes wrong
- Confidence matters as much as content
Common Mistakes to Avoid
- Ignoring UK guidelines
- Over-reliance on theory without practice
- Not timing mock exams
- Avoiding OSCE communication practice
- Last-minute revision
Real Success Stories
Doctors who cleared MRCEM in one attempt share common habits:
- Start early
- Revise repeatedly
- Practice under exam conditions
- Use few, high-quality resources
Consistency and planning beat cramming every time.
Final Thoughts
Cracking the MRCEM exam in your first attempt isn’t about being the smartest — it’s about being strategic, disciplined, and focused. Follow a clear study plan, use trusted UK resources, practice SBA & OSCE, and follow UK guidelines.
With the right preparation, passing the Royal College of Emergency Medicine exam on your first try is absolutely achievable.
