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MRCEM Part C · Complete Exam Guide

MRCEM OSCE Exam — Complete Guide 2025

Everything you need to know about the MRCEM Objective Structured Clinical Examination — structure, fees, venues, pass rates, eligibility and proven tips to pass first time.

16Stations
~86%Pass Rate (2023)
6Venues Worldwide
3Sittings / Year
Practice 125 Free Stations → View Curriculum Guide →

What is the MRCEM OSCE?

The MRCEM OSCE is the third and final component of the Membership of the Royal College of Emergency Medicine (MRCEM) examination, awarded by the Royal College of Emergency Medicine (RCEM) in the UK. It assesses the clinical and communication skills required for higher specialty training in emergency medicine. Passing MRCEM gives doctors internationally recognised membership of a UK Royal College and is a key qualification for working in UK and Irish emergency departments.

📋 Eligibility Requirements
  • Passed MRCEM Primary
  • Passed MRCEM Intermediate SBA
  • Minimum 24 months post-FY1 clinical experience (at least 6 months in Emergency Medicine)
  • Valid GMC-approved medical qualification
  • IELTS Level 7.0 or equivalent English proficiency (where applicable)
  • Maximum 6 attempts permitted — attempts before August 2016 are not counted

Exam Structure

A single-day, in-person OSCE circuit assessed across 16 clinical stations. A video conference option is available in some exam diets.

Total stations16 assessed + 2 rest stations
Station duration8 minutes per station
Reading time1 minute before each station
Total exam timeApproximately 2 hours 42 minutes
Maximum score160 marks (10 per station)
Pass markBorderline regression method + 1 SEM
Marking systemDomain-based (since November 2022)
Critical ruleMust pass ≥1 resuscitation station
Results released~5 weeks after exam date
FormatIn-person (video conference in some diets)

The 7 Marking Domains

Up to 4 domains are tested per station, each weighted differently. The exam blueprint shows a pie chart of domain weightings for each station type.

🧠 Clinical Reasoning / Decision Making
🔧 Practical / Clinical Skills
💬 Communication Skills
📚 Teaching Skills
📋 History Taking / Information Gathering
📊 Organisation / Prioritisation
🩺 Clinical Examination Skills

Station Types

📋 History Taking 🩺 Clinical Examination 🔧 Practical Procedures 💬 Communication 📊 Data Interpretation

Exam Schedule and Application

The MRCEM OSCE runs three times per year. Demand consistently exceeds supply — applying the moment the window opens is essential.

📅Held 3 times per year — approximately January, May, and September (exact dates on RCEM exam calendar)
⏱Application window is 7 days only — opens at 10:00 UK time, closes at 16:00 UK time on closing date
🚫Late applications not accepted under any circumstances
📊If demand exceeds spaces: priority given to candidates not allocated at most recent sitting, then first-come first-served
📈160 new spaces created for 2026; over 640 additional spaces added in the past 3 years
📬Results released approximately 5 weeks after exam via RCEM candidate dashboard
⚠️ Do not miss the application window. The 7-day window closes automatically — missing it means waiting for the next sitting, typically 4 months away. Set a calendar reminder for 10:00 UK time on the opening date as soon as dates are published on the RCEM exam calendar.

Check current exam dates → rcem.ac.uk/exam-calendar-fees/

MRCEM OSCE Exam Fees

Fees vary by location and RCEM membership status. Local taxes are applied based on the candidate's country of residence — not the exam location — and are set by respective governments. Always check the official RCEM exam calendar for current fees as these are updated annually.

LocationMember FeeNon-Member Fee
🇬🇧 United Kingdom (London) ~£450 (member rate) Higher — check RCEM
🇮🇳 India (Chennai, Hyderabad, Mumbai, Kochi) Country-specific Country-specific
🇲🇾 Malaysia (Kuala Lumpur) Country-specific Country-specific

Fees above are approximate and subject to change. Local taxes may apply. Members save significantly — apply for membership before the application window. Source: RCEM Exam Calendar 2025.

💡 Membership tip: Becoming an RCEM member before sitting exams saves significantly on fees across all three MRCEM components. Apply at rcem.ac.uk at least 24 hours before the application window opens — payment must reflect in the system before you can apply at the member rate.

Exam Venues

The MRCEM OSCE is delivered internationally, making it accessible to IMGs without travelling to the UK.

🇬🇧
London
United Kingdom
🇲🇾
Kuala Lumpur
Malaysia
🇮🇳
Chennai
India
🇮🇳
Hyderabad
India
🇮🇳
Mumbai
India
🇮🇳
Kochi
India

RCEM is in active discussions about expanding to additional venues. Check rcem.ac.uk for the latest venue information.

🛂 Visa note: If your visa application is declined for an OSCE sitting, contact exams@rcem.ac.uk immediately with proof of refusal to request a refund under the cancellation policy. Transfers to a later sitting are not available.

MRCEM OSCE Pass Rates

The MRCEM OSCE has a relatively high overall pass rate compared to the Primary and Intermediate SBA components. However, pass rates vary significantly by candidate group and year.

2023 overall OSCE pass rate: ~86%  ·  Source: RCEM

2024 OSCE Pass Rate by Candidate Group

Candidate GroupPass Rate
UK Trainees79.6%
UK Non-Trainees57.2%
Republic of Ireland48.5%
International Candidates46.0%
Overall53.3%

Source: RCEM Exam Pass Rate Report 2024. The 2023 overall rate of ~86% reflects a different cohort composition. Pass rates vary by exam diet.

Key insight for international candidates: International candidates pass at 46% — less than half. The gap is not clinical knowledge but communication style, UK-specific guidelines (NICE, RCEM, BTS), and structured examination technique. This is exactly what ReviseMRCEM's 125 OSCE stations are designed to address.

10 Tips to Pass the MRCEM OSCE First Time

From consistently high-scoring candidates and RCEM examiner feedback.

01
Master the 7 marking domains
Every station is marked across up to 4 of the 7 domains. Before each station, identify which domains are tested from the blueprint pie chart and prioritise accordingly. Candidates who understand the marking framework consistently outperform those who focus only on clinical content.
02
Always pass a resuscitation station
This is a mandatory pass requirement — failing all resuscitation stations means overall failure regardless of total score. Practise ALS, paediatric resus, and major haemorrhage protocols until they are automatic. These stations reward excellent preparation.
03
Use structured frameworks every time
Examiners award marks for structure. SOCRATES for history, ABCDE for assessment, SBAR for handover, SPIKES for breaking bad news, MCA 2005 four-stage test for capacity. Practise until frameworks deploy instinctively under time pressure.
04
Know UK-specific guidelines
The exam is mapped to NICE, RCEM, BTS, RCOG, and JBDS guidelines. International candidates often know the clinical management but apply non-UK protocols. Revise NICE NG guidelines for ACS, sepsis, stroke, DKA, PE, and paediatric fever.
05
Practise communication under time pressure
8 minutes is very short. Record yourself doing stations and watch back. Most candidates speak too fast, skip introductions, or forget to summarise. Slowing down and structuring communication consistently improves marks in every cohort.
06
Introduce yourself every single station
Under exam stress candidates skip introductions. Introducing yourself, confirming the patient's name and your role, and gaining consent is worth marks in every communication and examination station. Make it an unbreakable habit.
07
Read the 1-minute brief carefully
The reading time contains everything you need. The likely diagnosis or scenario type is often signposted. Use the minute to plan your structure and identify which domains are likely tested — not just read passively.
08
Do not let one bad station affect the next
With 16 stations, candidates who dwell on a poor performance carry anxiety forward. Develop a reset routine — deep breath, focus on the new brief, approach each station fresh. The circuit is long enough for recovery.
09
Practise with a partner using real mark schemes
Solo revision is not enough for an OSCE. Find a partner, set an 8-minute timer, and score each other with mark schemes. ReviseMRCEM's 125 stations include full examiner instructions and mark schemes — designed specifically for this purpose.
10
Book early — spaces fill fast
Demand consistently exceeds supply. Apply the moment the 7-day application window opens. Set a phone alarm for 10:00 UK time on the opening date — candidates who miss the window due to time zone confusion face a 4-month wait for the next sitting.

Is the MRCEM Worth It?

A balanced view for doctors deciding whether to pursue MRCEM.

✅ Pros
•Internationally recognised UK Royal College membership
•Gateway to higher specialty training (ST4+) in Emergency Medicine in the UK and Ireland
•Required for many senior NHS ED posts and trust grade roles
•Pathway to FRCEM Fellowship for consultant-level recognition
•Demonstrates clinical competence to employers worldwide
•Recognised in Malaysia, Singapore, Hong Kong, and Gulf states for senior EM posts
•Increases earning potential and career mobility significantly
•Pass is valid indefinitely — RCEM will give 24 months notice if this changes
⚠️ Cons
•Three-component pathway (Primary + Intermediate SBA + OSCE) — time and cost intensive
•International candidates have significantly lower pass rates — requires targeted UK-specific preparation
•Limited exam spaces — demand consistently exceeds availability, particularly internationally
•Fees plus travel costs for those sitting in the UK can be significant
•Does not automatically confer the right to work in the UK — GMC registration still required separately

Frequently Asked Questions

Common questions from UK trainees and international medical graduates.

What is the MRCEM OSCE?▼
The MRCEM OSCE is the third and final component of the MRCEM examination, awarded by the Royal College of Emergency Medicine. It is an Objective Structured Clinical Examination testing the clinical and communication skills required for emergency medicine specialty training in the UK.
How many stations are in the MRCEM OSCE?▼
There are 16 assessed stations plus 2 rest stations. Each station is 8 minutes long with 1 minute of reading time beforehand. The total exam duration is approximately 2 hours 42 minutes.
What is the pass mark for the MRCEM OSCE?▼
The pass mark is set using the borderline regression method plus 1 standard error of measurement (SEM). It is not a fixed percentage and varies by exam diet. Since November 2022, marking is domain-based across 7 clinical domains.
Do I have to pass the resuscitation station?▼
Yes — this is a critical rule. Candidates must pass at least one resuscitation station to pass the overall exam. Failing all resuscitation stations results in an overall fail regardless of the total marks scored across other stations.
How long is each station?▼
Each station is 8 minutes long. There is 1 minute of reading time before each station during which candidates receive a written brief. The timer starts when the station begins.
Where is the MRCEM OSCE held?▼
The MRCEM OSCE is held at 6 international venues: London (UK), Kuala Lumpur (Malaysia), and four Indian cities — Chennai, Hyderabad, Mumbai, and Kochi. RCEM is in discussions about expanding to further venues.
How much does the MRCEM OSCE cost?▼
Fees vary by venue and RCEM membership status — members pay significantly less. Local taxes may also apply based on your country of residence. Always check the official RCEM exam calendar at rcem.ac.uk for current fees before applying, as these are updated annually.
How often is the MRCEM OSCE held?▼
The MRCEM OSCE runs 3 times per year, approximately in January, May, and September. Exact dates are published on the RCEM exam calendar when confirmed.
How do I apply for the MRCEM OSCE?▼
Applications are submitted through the RCEM candidate portal during a strict 7-day window. The window opens at 10:00 UK time and closes at 16:00 UK time on the closing date. Late applications are never accepted. You must meet all eligibility requirements and pay the relevant fee (member or non-member) before applying.
What is the pass rate for the MRCEM OSCE?▼
The 2023 overall pass rate was approximately 86%. However, 2024 data shows wide variation by group: UK trainees 79.6%, UK non-trainees 57.2%, Republic of Ireland 48.5%, and international candidates 46.0% (overall 53.3%). Pass rates vary by exam diet and cohort composition.
How long does it take to get MRCEM OSCE results?▼
Results are typically released approximately 5 weeks after the exam date via the RCEM candidate dashboard. RCEM does not release results early or informally.
How many attempts do I get for the MRCEM OSCE?▼
Candidates are permitted a maximum of 6 attempts. Attempts taken before August 2016 do not count toward this total. After 6 unsuccessful attempts, exceptional dispensation from RCEM would be required to resit.
What happens if I fail the resuscitation station?▼
Failing all resuscitation stations in the circuit results in an overall fail for the entire OSCE — even if your total marks across all other stations would have been a pass. Passing at least one resuscitation station is a mandatory requirement, not a bonus.
Can I sit the MRCEM OSCE outside the UK?▼
Yes. RCEM delivers the MRCEM OSCE in India (Chennai, Hyderabad, Mumbai, Kochi) and Malaysia (Kuala Lumpur). International candidates can complete the full examination without travelling to the UK. A video conference option is also available in some exam diets.
What is domain-based marking?▼
Introduced in November 2022, domain-based marking assesses each station across up to 4 of the 7 clinical domains — such as clinical reasoning, communication skills, and practical skills — each weighted differently. The exam blueprint shows a pie chart of domain weightings for each station type, allowing targeted preparation.
How is the MRCEM OSCE different from the FRCEM OSCE?▼
The MRCEM OSCE leads to Membership (MRCEM) and is the final stage of the membership pathway, suitable for doctors entering higher specialty training. The FRCEM OSCE leads to Fellowship (FRCEM) and is a separate, higher-level examination designed for consultants and senior trainees. They are entirely distinct qualifications with different curricula.
Is MRCEM recognised outside the UK?▼
Yes. MRCEM is recognised internationally and accepted for senior emergency medicine posts in Malaysia, Singapore, Hong Kong, the Republic of Ireland, and Gulf Cooperation Council countries. It demonstrates a UK Royal College standard of clinical competence and is valued by international employers.
What is the best way to prepare for the MRCEM OSCE?▼
Effective preparation combines structured station practice with a partner using real mark schemes, mastery of the 7 marking domains, knowledge of UK clinical guidelines (NICE, RCEM, BTS), and systematic use of clinical frameworks. ReviseMRCEM provides 125 free structured OSCE stations with full candidate briefings, examiner instructions, and mark schemes — built specifically for MRCEM Part C preparation.

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