MRCEM Intermediate SBA preparation resources – 2023 update

Congratulations on clearing MRCEM Primary. The next question on your mind could be, what are all the MRCEM intermediate SBA preparation resources that help you to prepare well.
In this blog post we’ll try to list ideas on How to prepare for MRCEM Intermediate SBA exam.

If all this seems overwhelming, we do offer revision classes that cover most of these topics in a short span to help you revise faster. Check the dates by clicking below

Table of Contents

Curriculum

To pinpoint your preparation, you need to be aware of the curriculum. To help us out, the RCEM has created a website “RCEM curriculum“. Frankly, the website isn’t written in a way that trainees from other countries can understand fully. You may take a look at the website anyway to get some guidance. Check the syllabus module on that website to know in which topics you are expected to be thorough. The SLO pages will tell you how what kind of knowledge is required in topics listed under the syllabus page.

Let’s go through the SLOs (SPECIALTY LEARNING OUTCOMES) one by one.

SLO-1

For SLO (Speacialty learning outcomes) – 1,

Allergy

Clinical PresentationsCondition / Issues
AP1. Acute allergyAC1. Drug allergy /severe Adverse drug reactions
AP2. Anaphylactoid reactions 
AP3. Angioedema 
AP4. Urticaria

Cardiology

Clinical PresentationsCondition / Issues
CP1. Chest painCC1. Acute Coronary Syndromes
CP2. BreathlessnessCC2. Myocardial infarction
CP3. PalpitationsCC3. Arrhythmias
CP4. Transient Loss of ConsciousnessCC4. Cardiac failure
CC5. Cardiac tamponade
CC6. Congenital heart disease
CC7. Diseases of the arteries, including aortic dissection
CC8. Diseases of myocardium
CC9. Hypertensive emergencies
CC10. Pacemaker function & failure
CC11. Pericardial disease
CC12. Sudden Cardiac Death
CC13. Valvular heart disease

Dermatology

Clinical PresentationsCondition / Issues
DP1. Dermatological manifestations of systemic illnessDC1. Common childhood exanthems (Peds)
DP2. RashesDC2. Cutaneous drug reactions
DC3. Eczema
DC4. Erythroderma
DC5. Infections of skin and soft tissues
DC6. Necrotising Fasciitis
DC7. Pressure ulcers
DC8. Purpuric rash including (Henoch Scholein Purpura – Peds)
DC9. Stevens-Johnson syndrome
DC10. Toxic-epidermal necrolysis
DC11. Urticaria

Ear, nose and throat

Clinical PresentationsCondition / Issues
EP1. ENT foreign bodiesEC1. Croup (Peds)
EP2. ENT injuriesEC2. Epiglottitis
EP3. EpistaxisEC3. Glandular Fever
EP4. Hearing lossEC4. LMN facial nerve palsy
EP5. Painful earEC5. Meniere’s disease
EP6. Sore throatEC6. Nasal fractures
EP7. VertigoEC7. Otitis externa
EC8. Otitis media
EC9. Pharyngitis
EC10. Post-tonsillectomy bleed (Peds)
EC11. Tonsillitis
EC12. Tracheostomy emergencies
EC13. Quinsy
EC14. Salivary gland disease
EC15. Vestibular neuritis

Elderly care / frailty

Clinical PresentationsCondition / Issues
ElP1. DeliriumElC1. Comprehensive geriatric assessment
ElP2.Deterioration in mobilityElC2.Acute confusion
ElP3. FallsElC3. Ceiling of care & End of life care
ElP4. Fragility fracturesElC4. Dementia – cognitive impairment
ElP5. FrailtyElC5. Fragility fractures
ElP6. HypothermiaElC6. Mobility
ElP7. IncontinenceElC7. Osteoporosis
ElP8. Increasing care needsElC8. Pharmacology considerations in the older patient
ElP9. Memory loss 
ElP10. Unsteadiness / balance disturbance 

Endocrinology

Clinical PresentationsCondition / Issues
EnP1. Addisonian CrisisEnC1. Adrenal disorders
EnP2. HyperglycaemiaEnC2. Diabetic ketoacidosis
EnP3. HypoglycaemiaEnC3. Diabetes mellitus & complications including diabetic foot
EnC4. Hyperosmolar hyperglycaemic state
EnC5. Pituitary disorders
EnC6. Thyroid emergencies

Environmental emergencies

Condition / Issues
EnvC1.Heat stroke and heat exhaustion
EnvC2. Drug-related hyperthermias
EnvC3. Hypothermia and frost bite
EnvC4. Decompression sickness
EnvC5. Near-drowning
EnvC6. Radiation exposure and safety
EnvC7. Industrial chemical incidents
EnvC8. Bites and envenomations typical for the UK
EnvC9. High altitude emergencies – cerebral and pulmonary oedema
EnvC10. Acid attacks

Gastroenterology and hepatology

Clinical PresentationsCondition / Issues
GP1. Abdominal and loin painGC1. Alcohol related liver disease including withdrawal
GP2. Abdominal swelling or massGC2. Decompensated cirrhosis
GP3. AscitesGC3. Dehydration in children (Peds)
GP4. ConstipationGC4. Functional bowel disorders
GP5. DiarrhoeaGC5. Gastrointestinal infections
GP6. Haematemesis and melaenaGC6. Hepatitis
GP7. JaundiceGC7. Inflammatory bowel disease
GP8. Anal pain and rectal bleedingGC8. Peptic ulcer disease
GP9. Nausea and vomitingGC9. Pyloric stenosis (Peds)
GP10. Dysphagia 

Haematology

Clinical PresentationsCondition / Issues
HP1. AnaemiaHC1. Anti-coagulant reversal
HP2. Bruising and spontaneous bleedingHC2.DIC
HP3. Massive haemorrhageHC3. Haemophilia
HC4. ITP
HC5. Leukaemia
HC6. Lymphoma
HC7. Marrow failure
HC8. Sickle cell disease/crisis
HC9. Transfusion reactions

Infectious diseases

Clinical PresentationsCondition / Issues
IP1. FeverIC1. Influenza
IP2. Pyrexia in travellersIC2. Infection in immunocompromised patients
IP3. SepsisIC3. Infestations
IP4. Needlestick injury/exposure to blood borne virusesIC4. Kawasaki Disease (Peds)
IC5. Notifiable diseases
IC6. Pyrexia of Unknown origin – different age groups
IC7. Malaria
IC6. HIV infection

Maxillofacial / dental

Clinical PresentationsCondition / Issues
MaP1. Dental painMaC1. Dental abscess
MaP2. Facial swellingMaC2. Facial wounds
MaP3. Avulsed or fractured teethMaC3. Post extraction complications
MaP4. Facial bone injuryMaC4. TMJ dislocation

Mental Health

Clinical PresentationsCondition / Issues
MHP1. Aggressive or disturbed behaviourMHC1. Alcohol and substance misuse
MHP2. Anxiety/PanicMHC2. Depression
MHP3. Physical symptoms unexplained by organic diseaseMHC3. Eating disorders
MHP4. Self-harmMHC4. Personality disorders
MHP5. Refusal of treatmentMHC5. Acute Psychosis including bipolar, schizophrenia
MHC6. Somatic symptom disorders
MHC7. Stress disorders
MHC8. Suicide

Musculoskeletal (non-traumatic)

Clinical PresentationsCondition / Issues
MuP1. Acute back painMuC1. Cauda equina syndrome
MuP2. Limb pain and swellingMuC2. Crystal related arthropathies
MuP3. Neck painMuC3. Septic arthritis
MuP4. Joint swellingMuC4. Limb pain and swelling: bursitis & tendonitis in the upper and lower limb including ruptured biceps, Achilles tendonitis, plantar fasciitis, metatarsalgia, carpal tunnel and other entrapment neuropathies plus sinister causes bone tumour, stress fracture
MuP5. Acute hot swollen jointMuC5. Spinal pain and radiculopathy
MuC6. Risks of rheumatological disease modifying drugs
MuC7. Spinal infections
MuC8. Torticollis (Peds)
MuC9. Limping child (Peds)
MuC10. Osteochondritis (Peds)

Nephrology

Clinical PresentationsCondition / Issues
NepP1. Electrolyte disordersNepC1. Acute kidney injury
NepP2. OliguriaNepC2. Drugs and the kidney
NepC3. Electrolyte disorders
NepC4. Fluid balance disorders
NepC5. Renal replacement therapy

Neurology

Clinical PresentationsCondition / Issues
NeuP1. Acute ConfusionNeuC1. Botulism
NeuP2. HeadacheNeuC2. Cerebral venous sinus thrombosis
NeuP3. Seizures/status epilepticusNeuC3. Febrile Convulsion (Peds)
NeuP4. Speech disturbanceNeuC4. Functional illness
NeuP5. Hemiparesis/hemiplegiaNeuC5. Guillian-Barre
NeuP6. Gait abnormalityNeuC6. Meningitis and encephalitis
NeuP7. Visual disturbanceNeuC7. Multiple sclerosis
NeuP8. Weakness/paralysisNeuC8. Myasthenia gravis
NeuP9. Dizziness and vertigoNeuC9. Parkinson’s disease and other movement disorders
NeuC10. Peripheral neuropathy (acute)
NeuC11. Subarachnoid haemorrhage
NeuC12. Stroke & TIA
NeuC13. Tetanus
NeuC14. Tumours involving the brain and spinal cord
NeuC15. VP Shunts
NeuC16. Wernicke’s Encephalopathy

Obstetrics & Gynaecology

Clinical PresentationsCondition / Issues
ObP1. Pelvic painObC1. Ante-partum haemorrhage
ObP2. Vaginal bleedingObC2. Bleeding in early pregnancy
ObP3. PregnancyObC3. Exposure to infections during pregnancy eg chickenpox
ObP4. Genital injury/AssaultObC4. Ectopic pregnancy
ObP5. Vaginal dischargeObC5. Genital injury /Female Genital Mutilation
ObP6. Foreign bodiesObC6. HELLP
ObP7. Patient in labourObC7. Heavy menstrual bleeding
ObC8. Hyperemesis Gravidaram
ObC9. Maternal Collapse
ObC10. Post-partum haemorrhage
ObC11. Pre-eclampsia/eclampsia
ObC12. Pelvic infection
ObC13. Post menopausal bleeding
ObC14. Prescribing in pregnancy
ObC15. Rhesus D prophylaxis
ObC16. Sepsis in and following pregnancy
ObC17. Thrombosis during and following pregnancy
ObC18. Trauma in pregnancy
ObC19. OHSS

Oncological Emergencies

Clinical PresentationsCondition / Issues
OncP1. Acute presentations of undiagnosed cancer that may present to the ED (including weight loss, dysphagia, pain etc)OncC1. Complications related to local tumour progression e.g. acute cord compression, upper airway obstruction, pericardial and pleural effusions, SVC compression syndrome, raised intracranial pressure
OncC2. Complications relating to cancer treatment including – neutropenic sepsis, anaemia and thrombocytopenia and immunotherapy
OncC3. Biochemical complications of malignancy- hypercalcaemia, SIADH, adrenocortical insufficiency

Ophthalmology

Clinical PresentationsCondition / Issues
OptP1. DiplopiaOptC1. Acute glaucoma
OptP2. Eye trauma including foreign bodiesOptC2. Cranial nerve palsy
OptP3. Painful eyeOptC3. Orbital & per-orbitalpreseptal or peri-orbitalcellulitis
OptP4. Red eyeOptC4. Opthalmia neonatorum (Peds)
OptP5. Sudden visual lossOptC5. Inflammatory eye disease
OptC6. Temporal arteritis

Pain & sedation

This is listed under Trauma (SLO-4) and Procedural skills and Basic anaesthesia (SLO6) also.

Condition / Issues
PC1. Analgesics
PC2. Non-pharmacological methods of pain management
PC3. Pain assessment
PC4. Sedation

Pharmacology and poisoning

Clinical PresentationsCondition / Issues
PhP1. Medication side effects/interactionsPhC1. Overdose of prescription and non-prescription medications including legal and non-legal drugs
PhP2. OverdosePhC2. Poisoning – carbon monoxide, cyanide, organo-phosphate
PhP3. Accidental PoisoningPhC3. Toxidromes
PhC4. Use of antidotes
PhC5. Batteries, household chemicals, poisonous plants

Respiratory

Clinical PresentationsCondition / Issues
RP1. Chest painRC1. Asthma
RP2. BreathlessnessRC2. Bronchiolitis (Peds)
RP3. HaemoptysisRC3. COPD
RP4. CoughRC4. Foreign body inhalation
RC5. Pertussis
RC6. Pleural effusion
RC7. Pneumonia
RC8. Pneumothorax
RC9. Pulmonary Aspiration
RC10. Pulmonary embolus
RC11. Viral induced wheeze in children (Peds)

Sexual health

Clinical Presentations Condition / Issues
SeP1. Genital discharge
SeP2. Genital lesionsSeC2. Sexual assault
SeP3. Emergency contraceptionSeC3. Sexually transmitted infections
SeP4. Post-exposure prophylaxis

Surgical emergencies

Clinical PresentationsCondition / Issues
SuP1. Abdominal painSuC1. Ano-rectal abscesses
SuP2. Abdominal swelling/massSuC2. Appendicitis
SuP3. ConstipationSuC3. Bilary colic
SuP4. DiarrhoeaSuC4. Bowel obstruction
SuP5. GI bleedingSuC5. Breast abscess
SuP6. Anal/rectal painSuC6. Cholangitis
SuP7. Nausea/vomitingSuC7. Cholecystitis
SuC8. Diverticular disease
SuC9. Haemorrhoid disease
SuC10. Hernias
SuC11. Intussusception (Peds)
SuC12. Ischaemic Bowel
SuC13. Lower gastrointestinal and rectal bleeding
SuC14. Pancreatitis
SuC15. Viscus perforation
SuC16. Volvulus

Urology

Clinical PresentationsCondition / Issues
UP1. DysuriaUC1. Epididymo-orchitis
UP2. Injury to bladder, urethra, testes or penisUC2. Renal stone disease
UP3. Urinary retentionUC3. Phimosis/Paraphimosis
UP4. Testicular pain/swellingUC4. Priapism
UP5. Loin painUC5. Testicular torsion
UP6. HaematuriaUC6. Prosatatis
UC7. UTI/Pyelonephritis

Vascular

Condition / Issues
VC1. Acute limb ischaemia
VC2. Aortic aneurysmal disease
VC3. DVT

SLO-3

Resuscitation

Clinical PresentationsCondition / Issues
RP1. Acute airway obstructionRC1. Choking
RP2. Anaphylaxis/Anaphylactoid reactionRC2. Stridor
RP3. Cardiorespiratory arrestRC3. Organ donation
RP4. Major TraumaRC4. BRUE
RP5. Respiratory failureRC5. SUDIC Protocol
RP6. Sepsis 
RP7. Shock 
RP8. Unconsciousness 

Palliative – End of life care

Clinical PresentationsCondition / Issues
PalP1. Advanced malignancy and end stage chronic diseasePalC1. Advanced care planning
PalC2. Anticipatory medications
PalC3. End stage organ failure
PalC4. Pain management
PalC5. Physical symptoms other than pain
PalC6. Psychosocial concerns including spiritual care and care of the family
PalC7. The dying patient

SLO-4

Trauma

Clinical PresentationsCondition / Issues
TP1. Head injuryTC1. Compartment syndrome
TP2. Spinal injuryTC2. Limb and joint injury including bony, musculo-tendinous and complications
TP3. Chest and lung injuryTC3. Electrical burns
TP4. Major vascular injuryTC4. Salter- Harris classification
TP5. Abdominal injuryTC5. Infection – paronychia, pulp space, flexor sheath nail bed, amputations etc.
TP6. Pelvic injuryTC6. Animal bites including human
TP7. Limb and joint injuryTC7. Injury to bladder, urethra, testes or penis
TP8. Burns
TP9. Inhalational injury
TP10. Wounds

Other clinical presentations

Condition / Issues
XC1. Major Incident Management
XC2. PHEM
XC3. Safeguarding in adults
XC4. Domestic Abuse

SLO-5

Pediatric emergencies

Apart from the neonatal topics listed underneath, Some of the sections listed above have some pediatric topics which are marked with (Peds) next to the topic. Make sure you cover them too as part of your preparation.

Neonatal emergencies

Condition / Issues
NeoC1. Delivery and resuscitation of the newborn
NeoC2. Neonatal sepsis
NeoC3. Cyanotic/ non- cyanotic congenital heart disease
NeoC4. Jaundice
NeoC5. Feeding patterns

Safeguarding and Psycho-social emergencies in children

Clinical PresentationsCondition / Issues
SaP1. Self-harm in children and adolescentsSaC1. Conditions presenting as a symptom of NAI or psychological distress, e.g. deliberate self harm, aggression or risk-taking behaviour, recurrent abdominal pain, headaches or faints, recurrent attendances in young children.
SaP2. Concerning presentationSaC2. Roles of other systems in protecting children, e.g. Social Services, the Child Protection Plan, Police Child Protection and Domestic Violence Units, SureStart, Childline, Health Visitors, School Nurses
SaC3. Mental illness in childhood including depression, anxiety, OCD, bipolar and schizophrenia
SaC4. Sexual abuse

SLO-6

Procedural skills and Basic anaesthesia

Advanced airway management

Chest drain

External pacing

Fracture/ dislocation manipulation

Lumbar puncture

Pain and sedation (Covered in SLO-4 and SLO-1 also)

POCUS (Point of care Ultrasound)

Vascular access in emergency- IO, femoral vein

Wound management

Resources

RCEM has made an amazing job here with a great list of materials to get yourself familiarize with all the procedures needed as part of SLO 6 (File updated May 2021)

SLO-7

Complex challenging situations

Legislation and legal framework

Organ/tissue donation

Information governance

Safeguarding

Evidence and guidelines

Be aware of these laws :

Consent in Adults, Adolescents and Children in Emergency Departments from RCEM

Consent, Capacity and Restraint of Adults, Adolescents and Children in Emergency Departments by RCEM best practice guideline.

The resources are not enough but should help you gain a decent insight about the curriculum. If you happen to find some helpful resources for a specific topic, do let us know to improve this article.

If you need help, please check our revision courses that cover a lot of topics in a short time.