All about MRCEM OSCE exam – Nov 2022 update

Once you have cleared your MRCEM primary and SBA, you will need to clear MRCEM OSCE exam to be awarded an MRCEM degree. These rules apply from Aug 2021 onwards.

If you are looking for a MOCK test and some guidance on this, Yashoda hospitals and Society for Emergency medicine India are conductind an SCE workshop as part of EMCON 2022 pre-conference workshops.

Table of Contents

What is OSCE

OSCE stands for Objective Structure Clinical Examination. You will be tested on your clinical skills while you examine a patient in front of an examiner (Live or remotely via video conference). It is somewhat similar to the STEP 2 CS of USMLE exam. Apart from clinical knowledge, it’ll also assess your communication skills.

It consists of 16 station in total. Each station will have 8 minutes of time. You will get 1 minute before each station to read the case scenario.

OSCE assesses the common competences and clinical competences required for managing adult and pediatric emergencies. Pediatric expectation – Managing a seriously ill and injured child or common childhood emergencies.

Domain based scoring

Effective Nov 2022, the RCEM has received GMC approval to change the scoring from Checklist based sheet to domain-based scoring which was being used in FRCEM OSCE already. Also, from now on, instead of 18 stations of 7 minutes each, we’ll be having 16 stations of 8 minutes each with 1 minute to read the scenario as usual. You’ll also have 4 rest stations. Read more on scoring below in the same article.

Domains tested in MRCEM OSCE

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Domain – ComponentsSLO1SLO2SLO3SLO4SLO5SLO6SLO7SLO9
1 – Professional values and behaviours
2 – Professional skills
2A – practical skills
NANA
2B – communication and interpersonal skillsNA
2C – dealing with complexity and uncertaintyNA
2D – clinical skills (history taking, diagnosis and medical management; consent; humane interventions; prescribing medicines safely; using medical devices safely; infection control and communicable disease)NANA
3 – Professional knowledge
3A – professional requirements
NANANA
3B – national legislationNANANA
3C – the health service and healthcare systems in the four countriesNANANA
4 – Capabilities in health promotion and illness preventionNANANANA
5 – Capabilities in leadership and team-workingNANA
6 – Capabilities in patient safety and quality improvement
6A – patient safety
NANANA
6B – quality improvementNANANANANANANA
7 – Capabilities in safeguarding vulnerable groupsNANANANANA
8 – Capabilities in education and trainingNANANANANANANA

Though the above table is like a broader view, the actual simplified list of domains on scoring sheet could be one or more from the following. Each station question will have a pie chart to let you know which of these domains will be tested and percentage of marks it carries.

  • Clinical reasoning / Decision making
  • Communication skills (Including conflict)
  • History taking / Information gathering
  • Clinical examination skills
  • Practical / pinnacle skills
  • Teaching skills
  • Organization / Prioritization

Eligibility for MRCEM OSCE

You must fulfill all the following criteria to be eligible to appear for an OSCE exam.

  1. Registration – Must have valid / current Medical registration approved by GMC.
  2. Foundation year – Completed the UK foundation programme or equivalent. (FY1 is house surgeonship / internship. FY2 is next year of training post)
  3. Primary – Passed the FRCEM Primary or MRCEM Part A after 1st August 2012 or MRCEM Primary SBA (2021).
  4. Intermediate – Passed the FRCEM Intermediate SAQ or MRCEM Part B after 1st August 2012 or MRCEM Intermediate SBA (2021).
  5. Experience – Must have 24 months experience post FY1 (FY-1 is 12 months. + Out of next 24 moths, minimum 6 months of Emergency medicine is a must.)
    (There was an error which said 24M including FY1 which was corrected on 5th July 2021 based on this page from RCEM)

An English knowledge of Level 7.0 (IELTS) is expected to understand and communicate well.

RCEM exam dates and Fees

MRCEM and FRCEM exam dates calendar from RCEM is available on RCEM website.

2022 exam schedule

ExaminationExam DatesCentresApplication DatesResults Date
MRCEM OSCE31 Oct–04 Nov 2022Kochi, IndiaClosedTBC
MRCEM OSCE28 Nov-07 Dec 2022LondonClosedTBC
MRCEM Primary24 Nov 2022Online *1ClosedTBC
FRCEM SBA29 Sep 2022Online *1ClosedTBC
FRCEM OSCE *307-16 Nov 2022LondonClosedTBC
Updated 23 October 2022 – Please check official RCEM page for accurate info

2023 exam schedule

ExaminationExam DatesCentresDietApplication DatesResults Date
MRCEM Primary17 May 23 Pearson VUEDiet 123 Jan – 06 Feb 2023TBC
MRCEM Primary 22 Nov 23 Pearson VUEDiet 231 Jul – 14 Aug 2023TBC
MRCEM SBA25 Apr 23 Pearson VUEDiet 104 – 16 Jan 2023TBC
MRCEM SBA 26 Oct 23Pearson VUEDiet 203 – 17 Jul 2023 TBC
MRCEM OSCE 06-17 Feb 23LondonDiet 107 – 18 Nov 2022 TBC
MRCEM OSCE 12-23 Jun 23LondonDiet 220 – 31 Mar 2023TBC
MRCEM OSCE 13-24 Nov 23LondonDiet 307 – 18 Aug 2023TBC
MRCEM OSCE 24-28 Jul 23India – ChennaiDiet 103 – 14 Apr 2023TBC
MRCEM OSCE09-13 Oct 23India – HyderabadDiet 203 – 14 Jul 2023TBC
MRCEM OSCE13-17 Mar 23Malaysia – Kuala LumpurDiet 112 – 22 Dec 2022TBC
FRCEM SBA15 Mar 23Pearson VUEDiet 121 Nov – 05 Dec 2022TBC
FRCEM SBA04 Oct 23Pearson VUEDiet 212 – 26 Jun 2023TBC
FRCEM OSCE15-26 May 23LondonDiet 113 – 24 Feb 23TBC
FRCEM OSCE16-27 Oct 23LondonDiet 217 – 28 Jul 23TBC
Updated 23 October 2022 – Please check official RCEM page for accurate info. If it says Pearson vue, it’ll be conducted in UK and internationally.

Exam fee

As on Oct 23rd, the RCEM page lists the fee as…

  • MRCEM Primary – £330
  • MRCEM (OSCE) Objective Structured Clinical Examination – £450 / £650 India / £750 (Malaysia)
  • MRCEM SBA – £335
  • FRCEM SBA – £345
  • FRCEM OSCE – £465

Apart from the online fee you pay during your application, if you are attending the exam overseas (Out of UK), you will pay some fee to the local organization that’s conducting the exam. This fee differs between countries, talk to the local body to get an idea (In India, it’s close to 20,000 INR when the entire OSCE was offline/live).

Number of attempts

You have a maximum of 6 attempts to clear the MRCEM OSCE. Attempts prior to August 2016 will not be counted

In exceptional circumstances, candidates may apply to the Dean for approval for an additional examination attempt. The Dean’s decision is final.

A pass in the MRCEM OSCE (after 1 August 2012) will remain current till further notification. If they decide to void the validity, they will provide 24 months of notice.

Oversubscription?

If the number of candidates applying for OSCE exceeds the number of available slots, the following criteria will decide who gets to attempt the exam. Ranking order :

  1. Candidates in a GMC approved UK ST3 training post
  2. Candidates in year 3 of approved Irish training programme
  3. Candidates holding an employment contract with the NHS (which covers the examination date)
  4. Candidates who were not allocated a place at the most recent sitting (on a first come, first served basis, if required)
  5. All other candidates on a first come, first served basis

Scoring

Borderline regression method is used to measure your performance.

The scoring is marked as below as per the type of domain being tested. Examiner gives a score of 0-4 based on your performance.

ZeroOneTwoThreeFour
Well below minimum competenceBelow minimum level of competenceMinimum level of competence shownAbove minimum level of competenceWell above level of competence
Very poor level of knowledge / skills displayedBelow minimum level of knowledge / skills displayedMinimum level of knowledge / skills displayedAbove minimum level of knowledge / skills displayedWell above minimum level of knowledge / skills displayed
Frequent minor errorsInfrequent minor errors onlyMinor errors identified and rectifiedSingle Minor error identified and rectifiedNo errors
Task not completedTask completed to poor standardTask satisfactorily completedTask completed to good standardTask completed to high standard

Each examiner will also have a “global score” given on a scale of 4 options.

  • Clear Pass
  • Borderline pass
  • Borderline fail
  • Clear Fail
exam_standard_setting_borderline_regression
Image courtesy : Maxinity

Passing at least one out of two resuscitation stations is mandatory. No matter how good you score in other stations, if you don’t clear at least one “Resuscitation station”, you will be failed.

As per RCEM guidelines from Aug 2021

Stations

The 16 stations have been specified by RCEM. These are mapped to the RCEM curriculum of 2021. Please check the list of domains tested in each in the beginning of this article.

Station numberStation typeSpecialty Learning Outcome
1 – 3Complex stable patientSLO-1
4 – 5Answer questionsSLO-2
6 – 7ResusSLO-3
8 – 9Injured patientSLO-4
10PEMSLO-5
11 – 12Procedural skillsSLO-6
13 – 14Complex challenging situations SLO-7
15 – 16Supervise & teachSLO-9
Division of stations for MRCEM OSCE

Results

The college will publish results on Candidate’s dashboard of RCEM website on the scheduled day by 5pm UK time.

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