What is the Primary FRCA examination?
The Primary FRCA examination is the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. It is a postgraduate examination in anaesthesia that assesses a candidate's competency across a range of disciplines. The Primary FRCA consists of three parts and candidates must pass all three components. Once you have passed, it is valid for seven years as part of your eligibility to the Final FRCA exam.
As we mentioned, the Primary FRCA is made up of three parts:
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Multiple Choice Question (MCQ): A computer-based exam that tests a candidate's knowledge of pharmacology, physiology, biochemistry, anatomy, physics, clinical measurement, statistics, and data interpretation.
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Objective Structured Clinical Examination (OSCE): A practical exam that assesses a candidate's clinical skills, such as patient assessment, airway management, and decision-making.
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Structured Oral Examination (SOE): A viva voce exam that assesses a candidate's communication skills, knowledge of anaesthetic techniques, and ability to apply theoretical knowledge to clinical practice.
The FRCA Primary MCQ exam
The Multiple Choice Question (MCQ) exam is the first part of the exam you will take in the FRCA process; without this one, you cannot take the subsequent two exams. This more theoretical multiple-choice exam covers the core parts of the anaesthetic training curriculum, featuring 90 single best answer (SBA) questions over 3 hours. Here’s the topics you’ll be tested on:
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Pharmacology - Drug actions, interactions, and adverse effects.
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Physiology - Cardiovascular, respiratory, renal, and neurological systems.
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Biochemistry - Metabolic processes, acid-base balance, and electrolyte disturbances.
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Anatomy - Relevant anatomical structures and their functions.
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Physics - Principles of gas laws, fluid dynamics, and medical equipment.
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Clinical measurement - Techniques and interpretation of physiological parameters.
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Statistics and data interpretation - Understanding and analysing data.
How to apply for the Primary FRCA MCQ exam
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Make sure you meet the eligibility criteria mentioned above.
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Head to the Royal College of Anaestetists website and create an account, if you haven’t already got one.
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Select the application form for the FRCA primary exam and fill in all the necessary personal information, including name, contact information, details of your training and qualifications.
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Upload a passport-style photograph of yourself and a copy of your GMC registration certificate, or equivalent.
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Submit the completed application and pay the application fee (currently £400). This fee is non-refundable and must be paid by your exam’s closing date.
How the Primary MCQ is marked
One mark will be awarded for each correct answer. There is a maximum of 90 marks on the exam. Negative marking will not be used. The pass mark is provisionally set by examiners using a modified Angoff method.
Exam dates and fees for the Primary FRCA MCQ
Exam results for the Primary FRCA MCQ
Results from the September 2024 Primary MCQ exam will be sent by email by 5pm on Tuesday 24th September 2024. No results will be given over the phone.
The FRCA OSCE exam
The FRCA Primary OSCE (Objective Structured Clinical Examination) is the practical component of the FRCA exam, designed to assess a candidate's clinical skills and ability to apply theoretical knowledge to real-world scenarios. The format of this exam comprises up to 16 live exam stations in a circuit, each one simulating a different clinical scenario, and typically lasts for two to three hours. You will be observed by an examiner and scored on your performance.
During the OSCE part of the FRCA, you may be assessed on the following stations and scenarios:
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History taking: Assessing a patient's medical history, symptoms, and allergies.
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Physical examination: Performing a physical examination, including vital signs and systemic assessments.
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Airway management: Demonstrating skills in intubation, cricothyrotomy, and airway devices.
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Drug administration: Safely administering medications, including intravenous and intramuscular injections.
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Emergency management: Handling critical situations, such as cardiac arrest or anaphylaxis.
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Communication and teamwork: Interacting with patients, relatives, and healthcare professionals.
The below is what you’ll be assessed and graded on by the examiners:
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Clinical knowledge: A candidate’s understanding of relevant medical conditions and procedures.
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Clinical skills: Proficiency in performing physical examinations, administering medications, and managing emergencies.
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Communication: Effective communication with patients, their relatives, and colleagues across a multitude of disciplines.
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Decision-making: The ability to make appropriate clinical decisions based on available information.
Structure of the FRCA OSCE
As it is more of a practical exam, the OSCE part of the FRCA exam is laid out differently. There will be around 16 stations that you will work your way through, each one lasting about five minutes. Outside of each station, guidance will be displayed, and you have one minute to read before entering. Once inside, an examiner may ask questions, you may be asked to demonstrate a technical skill, show how to use a piece, or interact with a patient (an actor). After five minutes, a bell will sound and you will move to the next station.
It’s important to remember that the above describes a typical OSCE exam, and adjustments can be made if a candidate has additional needs.
There are rest stations throughout the circuit where you will be seated and asked to wear ear defenders. Floor leads will be stationed throughout, and will inform you when you need to move to the next circuit. You are allowed to take a water bottle with you during the exam, but no paper, electronic devices, or other resources.
How the FRCA OSCE is marked
Each station is marked out of 20. The pass mark for each station is determined by the examiners prior to the exam beginning using a modified Angoff referencing. The Angoff score for each of the live stations are summed to obtain the pass mark for the whole examination.
Exam dates and fees for the Primary FRCA OSCE
Exam results for the Primary FRCA OSCE
Results from the November 2024 Primary OSC will be sent by email by 5pm on Tuesday 26th November 2024. No results will be given over the phone.
Here at Pastest, we don’t currently cover the Primary FRCA OSCE exam.
The FRCA Primary SOE exam
The FRCA Primary SOE (Structured Oral Examination) is the third and final component of the FRCA primary examination, designed to assess a candidate's communication skills, their knowledge of anaesthetic techniques, and ability to apply theoretical knowledge to clinical practice.
This last examination takes the form of a series of structured interviews with examinations, with each one lasting around 30 to 45 minutes.
To take the SOE, you will need to have passed the Primary FRCA MCQ in the last three years
During the SOE part of the FRCA, you may be assessed on the following:
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Anaesthetic techniques: General anaesthesia, regional anaesthesia, and monitored anaesthesia care.
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Patient management: This includes preoperative, intraoperative, and postoperative care.
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Clinical decision-making: Including problem-solving and decision-making in various clinical scenarios.
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Communication skills: Effective communication with patients, relatives, and healthcare professionals across a range of disciplines.
The below is what you’ll be assessed and graded on by the examiners:
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Knowledge: An understanding of anaesthetic principles, techniques, and complications.
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Clinical reasoning: The ability to apply theoretical knowledge to real-world clinical scenarios.
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Communication: Effective communication skills, including clarity, conciseness, and professionalism.
Structure of the Primary SOE
The Primary SOE is made up of two subsections:
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30 minutes of three questions in pharmacology, and three questions in physiology and biochemistry
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Followed by 30 minutes of three questions on clinical topics (including a critical incident) and three questions in physics, clinical measurement, equipment and safety.
How the Primary SOE is marked
Two examiners mark each part of the SOE. Both examiners independently mark every question. There are 12 questions, 2 marks are given for a pass, 1 mark for a borderline performance and 0 marks for a fail, giving a maximum total score of 48 marks.
Exam dates and fees for the Primary FRCA OSCE
Exam results for the Primary FRCA SOE
Results from the November 2024 Primary OSCE SOE will be sent by email by 5pm on Tuesday 26th November 2024. No results will be given over the phone.
Here at Pastest, we don’t currently cover the Primary FRCA SOE exam.
Eligibility criteria for the Primary FRCA exam
According to the Royal College of Anaesthetists (RCoA), in order to be eligible to take the Primary FRCA exam, you need to meet the following criteria:
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Be registered with the GMC or an equivalent national medical council
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NOT have failed the exam 6 times
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Be registered with the Royal College of Anaesthesia (RCoA) as a trainee in one of the following training programmes:
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Foundation Programme
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Core Anaesthetics
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Acute Care Common Stem (ACCS)
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Intensive Care Medicine
Or, in place of the final point above, you can also:
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Be registered as a trainee with the College of Anaesthetists, Ireland.
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Be registered with the RCoA in a recognised non-affiliate membership category and currently working as an anaesthetist.
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Be registered with the RCoA in a recognised non-affiliate membership category and you have previously left anaesthetic training in the UK or Ireland less than 5 years ago.
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Have successfully applied for a Temporary Examination Eligibility (TEE) with the RCoA within 3 months of the date of the exam.
Taking your exam at the college
Parts of the Primary FRCA that require you to attend in person - rather than take the exam on a computer - will take place at the Royal College of Anaesthetists. Please arrive at least 30 minutes before the first call time on your Admission Notice; late admissions are not allowed, and the earliest you will be admitted to the College is 7:30am.
Upon being admitted, report to the reception desk and present your Admission Notice and ID, where you will receive clear instructions on when and where to report for each component. You must sign in and out at reception when leaving and/or returning throughout the day.
How to prepare for the Primary FRCA exam
Pastest
Pastest’s FRCA Qbank contains more than 1,000 questions in the SBA (single best answer) format, designed to challenge you in your prep for taking the MCQ, with added dynamic explanations to 392 questions. There’s also timed tests, giving you the opportunity to answer questions against the clock to get 'exam ready'. Revise on-the-go with our mobile app!
Take a closer look at Pastest’s MCQ revision resource, and sign up for a free trial!
MedCourse
Many people prefer in-person learning. If you’re one of them, MedCourse offers a number of courses that focus purely on exam preparation. However, it’s recommended that a course like this isn’t your first step in revision or preparation, but more as the final step if you are planning to take the exam imminently.
RCoA
The Royal College of Anaesthetists offer a number of courses that can help you prepare for the Primary FRCA. Not only do they offer written revision courses specific to these exams, but they also run workshops and online conferences to keep aspiring anaesthetists updated with the latest developments in this part of the medical world.
Frequently asked questions about the Primary FRCA
How is the Primary FRCA formatted?
The FRCA primary is divided into three exams:
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A multiple-choice written (MCQ) exam which consists of multiple-choice questions and is usually held three times a year - February, September and November
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A practical (OSCE) exam
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A structured oral viva (SOE) exam
The latter two exams are taken together, and consist of 16 OSCE stations with questions provided by two examiners. These exams are usually held three times a year - May, November and January.
How many times can you take the Primary FRCA exam?
The Primary MCQ exam can be taken a maximum of six times. If you fail six times then you will need to submit evidence to an appeals process showing extenuating circumstances. You must also wait a minimum of 6 months between exam attempts, and will need to reapply and pay the exam fee each time.
What is the dress code for the exam?
For the Primary FRCA exam, you should dress the same as any other day-to-day clinical practice or contact with patients. Your form of dress should not constrain your ability to demonstrate recognised skills including effective communication with simulated patients or examiners. You will not be required to wear clinical or theatre clothing at any time. Candidates should avoid wearing forms of dress that cover the face to ensure their identity is easy to verify.
How long is the FRCA Primary valid for?
Each of the three parts of the FRCA is valid for three years. This means if you don’t pass all three exams within three years of passing your first, you may have to re-take those that have expired.
We hope this guide has told you everything you need to know about the different components of the Primary FRCA exam. With the right resources and tools at your disposal and plenty of time to prepare, we are sure you’ll be able to pass, graduate, and take the next step on your path to becoming a qualified anaesthetist.