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
- Domain based scoring
- Eligibility for MRCEM OSCE
- RCEM exam dates and Fees
- Number of attempts
- Oversubscription?
- Scoring
- Stations
- Results
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 – Components | SLO1 | SLO2 | SLO3 | SLO4 | SLO5 | SLO6 | SLO7 | SLO9 |
|---|---|---|---|---|---|---|---|---|
| 1 – Professional values and behaviours | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| 2 – Professional skills 2A – practical skills | ✔ | NA | ✔ | ✔ | ✔ | ✔ | ✔ | NA |
| 2B – communication and interpersonal skills | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | NA |
| 2C – dealing with complexity and uncertainty | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | NA |
| 2D – clinical skills (history taking, diagnosis and medical management; consent; humane interventions; prescribing medicines safely; using medical devices safely; infection control and communicable disease) | ✔ | ✔ | ✔ | ✔ | ✔ | NA | ✔ | NA |
| 3 – Professional knowledge 3A – professional requirements | ✔ | ✔ | ✔ | ✔ | ✔ | NA | NA | NA |
| 3B – national legislation | ✔ | ✔ | ✔ | ✔ | ✔ | NA | NA | NA |
| 3C – the health service and healthcare systems in the four countries | ✔ | ✔ | ✔ | ✔ | ✔ | NA | NA | NA |
| 4 – Capabilities in health promotion and illness prevention | ✔ | ✔ | ✔ | NA | ✔ | NA | NA | NA |
| 5 – Capabilities in leadership and team-working | ✔ | ✔ | ✔ | ✔ | ✔ | NA | ✔ | NA |
| 6 – Capabilities in patient safety and quality improvement 6A – patient safety | ✔ | ✔ | ✔ | ✔ | NA | NA | ✔ | NA |
| 6B – quality improvement | ✔ | NA | NA | NA | NA | NA | NA | NA |
| 7 – Capabilities in safeguarding vulnerable groups | NA | NA | NA | ✔ | ✔ | NA | ✔ | NA |
| 8 – Capabilities in education and training | NA | NA | NA | NA | NA | NA | NA | ✔ |
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.
- Registration – Must have valid / current Medical registration approved by GMC.
- Foundation year – Completed the UK foundation programme or equivalent. (FY1 is house surgeonship / internship. FY2 is next year of training post)
- Primary – Passed the FRCEM Primary or MRCEM Part A after 1st August 2012 or MRCEM Primary SBA (2021).
- Intermediate – Passed the FRCEM Intermediate SAQ or MRCEM Part B after 1st August 2012 or MRCEM Intermediate SBA (2021).
- 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.
2023 exam schedule
| Examination | Exam Dates | Centres | Diet | Application Dates | Results Date |
|---|---|---|---|---|---|
| MRCEM Primary | 22 Nov 23 | Pearson VUE | Diet 2 | 31 Jul – 14 Aug 2023 | TBC |
| MRCEM SBA | 26 Oct 23 | Pearson VUE | Diet 2 | 03 – 17 Jul 2023 | 4-8 Dec 2023 |
| MRCEM OSCE | 13-24 Nov 23 | London | Diet 3 | 07 – 18 Aug 2023 | TBC |
| MRCEM OSCE | 24-28 Jul 23 | India – Chennai | Diet 1 | 03 – 14 Apr 2023 | TBC |
| MRCEM OSCE | 09-13 Oct 23 | India – Hyderabad | Diet 2 | 03 – 14 Jul 2023 | TBC |
| MRCEM OSCE | 13-17 Mar 23 | Malaysia – Kuala Lumpur | Diet 1 | 12 – 22 Dec 2022 | TBC |
| FRCEM SBA | 04 Oct 23 | Pearson VUE | Diet 2 | 12 – 26 Jun 2023 | TBC |
| FRCEM OSCE | 15-26 May 23 | London | Diet 1 | 13 – 24 Feb 23 | TBC |
| FRCEM OSCE | 16-27 Oct 23 | London | Diet 2 | 17 – 28 Jul 23 | TBC |
Exam fee
As on April 13th, 2023, 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 :
- Candidates in a GMC approved UK ST3 training post
- Candidates in year 3 of approved Irish training programme
- Candidates holding an employment contract with the NHS (which covers the examination date)
- Candidates who were not allocated a place at the most recent sitting (on a first come, first served basis, if required)
- 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.
| Zero | One | Two | Three | Four |
|---|---|---|---|---|
| Well below minimum competence | Below minimum level of competence | Minimum level of competence shown | Above minimum level of competence | Well above level of competence |
| Very poor level of knowledge / skills displayed | Below minimum level of knowledge / skills displayed | Minimum level of knowledge / skills displayed | Above minimum level of knowledge / skills displayed | Well above minimum level of knowledge / skills displayed |
| Frequent minor errors | Infrequent minor errors only | Minor errors identified and rectified | Single Minor error identified and rectified | No errors |
| Task not completed | Task completed to poor standard | Task satisfactorily completed | Task completed to good standard | Task 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
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 number | Station type | Specialty Learning Outcome |
| 1 – 3 | Complex stable patient | SLO-1 |
| 4 – 5 | Answer questions | SLO-2 |
| 6 – 7 | Resus | SLO-3 |
| 8 – 9 | Injured patient | SLO-4 |
| 10 | PEM | SLO-5 |
| 11 – 12 | Procedural skills | SLO-6 |
| 13 – 14 | Complex challenging situations | SLO-7 |
| 15 – 16 | Supervise & teach | SLO-9 |
Results
The college will publish results on Candidate’s dashboard of RCEM website on the scheduled day by 5pm UK time.