Final FRCA 2026-27 Study Guide: Take the Last CRQ or Wait for the AKT?

The March 2027 Final Written is the last sitting with a CRQ. The current Final SOE ends in June 2027, then the RCoA plans to move to the Final AKT and FCPE, subject to GMC approval. Stage 2 trainees therefore have a real timing decision: finish under the two-paper Written and SOE they know, or wait for a shorter all-SBA written paper and a new clinical circuit?

The current Final has two components: the Final Written, itself made up of CRQ and MCQ papers on separate days, and the Final SOE. You must pass the Written before applying for the SOE. A Written pass remains valid for three years. Passing the Final SOE confers Fellowship and the FRCA post-nominals, and the complete Final allows progression to Stage 3 under the 2021 curriculum.

Final FRCA key facts

Sit the last CRQ or wait for the Final AKT?

This is not simply a choice between writing and clicking. The current route contains six hours of Written examination across two days, followed by the SOE if you pass. The planned route contains a three-hour, 100-SBA AKT and a 12-station clinical performance examination. The RCoA says the curriculum and standard do not change, so the decision is about timing, task format and your position in training rather than a lower content bar.

The current route suits a candidate who is eligible, has a realistic preparation window and is willing to build CRQ writing as a distinct skill. It also gives two Written opportunities in this final academic year, although the September 2026 application window has already closed. Waiting removes the CRQ, but the first Final AKT is not until 19 January 2028. That calendar gap is part of the decision.

The first FCPE is listed before the first Final AKT. Do not infer your own eligibility sequence from that ordering. The published rule for the current Final is that the Written must be passed before the SOE, and transition eligibility depends on the component pass you hold. Check your exact route with the RCoA rather than treating the calendar as a personal plan.

A Final Written pass remains valid for three years, and the RCoA will extend written validity by one year on request for candidates waiting for the new formats. New-format fees had not been finalised when this guide was updated, and GMC approval was still in progress. Confirm both before making a decision based on cost or format.

The current exam structure

The CRQ: 12 answers, not one essay

Every CRQ must be attempted and each is marked out of 20. That should govern your pacing. A beautifully expanded early response cannot recover marks from a blank question later. Practise recognising the task in the wording, sketching a mark-efficient structure and moving on when the allocated time has gone.

Six examiners mark the paper, with two questions each. Write so that each response stands alone: clear headings, direct answers and enough explanation to make your reasoning legible. Do not rely on an idea developed elsewhere in the script.

The MCQ: know the published balance

Half of the 90 questions are broadly general anaesthesia. The remaining half is divided between perioperative medicine, regional anaesthesia and other curriculum domains. That balance supports a broad plan, not a narrow list of fashionable clinical topics. MTF questions were removed from September 2023, and incorrect SBA answers do not attract a negative mark.

As with the CRQ, modified Angoff standard setting means there is no permanent pass percentage to chase. Track mixed-paper performance and the stability of each domain. A headline average can hide a weak area that appears repeatedly in the 25 questions from other curriculum domains.

The SOE: three different oral gears

SOE 1 moves through four short cases and linked clinical science questions across two consecutive 26-minute parts. SOE 2 begins with ten minutes to view clinical material, then moves to a two-section long case and two unrelated short cases. Your preparation needs three gears: concise short-case reasoning, deliberate clinical-science explanation and organised synthesis of the long-case material.

The 12 questions are independently marked by two examiners to a maximum of 48. The SOE is aligned to intermediate-level curriculum content: at least two topics come from the general duties unit, at least four from the six essential units, and up to one from optional units. Use that breadth to organise practice rather than trying to predict a narrow circuit.

Every 2026-27 date and application window

Applications open at 09:00 on the opening date and close at 17:00 on the closing date. The RCoA does not accept applications outside the window. The two Written papers are on separate days, so both dates need to be protected in your rota.

The result and application dates leave little administrative slack. The September Written result is published on 15 October and the November SOE application closes on 19 October. The March Written result is published on 13 April and the June SOE application closes on 16 April. If you plan to progress directly, have the non-result parts of your application process organised before result day.

The June 2027 SOE fee was unverified when this guide was updated and is listed as to be confirmed in the examination calendar. Do not assume it will match the £735 November 2026 fee. The fee for each current Written sitting is £620.

Eligibility: what is required and what is not

The Final Written requires UK GMC registration and a Primary FRCA pass or a recognised exempting qualification. The published candidate routes include UK or Irish anaesthesia trainees, an MTI-sponsored anaesthetist who has held an NHS post for six months with an appraisal, and former trainees within five years. Beyond five years, the RCoA describes routes involving Regional Adviser support or 12 months of NHS anaesthetist employment plus appraisal.

The CLTC change

A CLTC or Stage 1 Training Certificate is no longer required to sit the Final. This is worth stating plainly because older advice can persist. It does not remove the other registration, training-category and qualification conditions. Check the current eligibility wording for your own route before applying.

Training-stage guidance

The RCoA defines formal eligibility through registration category and qualifications rather than a simple CT-grade rule. In progression terms, the College recommends holding a Stage 1 Training Certificate and strongly recommends not attempting the Final clinical component until Stage 2 training has started. That recommendation and the formal entry rules answer different questions, so use both when discussing timing with your educational supervisor.

SOE entry and attempt limits

To apply for the Final SOE, you must meet the Final Written eligibility requirements and have passed the Final Written. The maximum is six attempts at the Written and six attempts at the SOE. A Written pass remains valid for three years.

What the latest pass rates tell you

The latest results available when this guide was updated are the March 2026 Written and June 2026 SOE. The RCoA reports UK first attempts, all UK attempts and all candidates separately.

One sitting does not establish a permanent hierarchy of difficulty. For context, the September 2025 Written rates were 84.54% for UK first attempts, 82.18% for all UK attempts and 73.63% for all candidates. Cohort and paper outcomes vary, while the standard-setting process applies to each examination.

The practical conclusion is modest: do not assume that reaching Stage 2 makes the Written routine, and do not read a stronger SOE percentage as permission to delay speaking practice. Compare the subgroup that matches your situation, then judge readiness from your own complete CRQ papers, mixed MCQ performance and observed oral practice.

Month-by-month plans for September 2026 and March 2027

These are editorial study plans, not RCoA requirements. They work back from both remaining current-format Written sittings. The September application window closed at 17:00 on 15 July 2026, so that plan is only relevant if you are already entered. If you are not, the March 2027 sitting is the final opportunity to take the CRQ.

September 2026 Written: compressed run-in for entered candidates

March 2027 Written: full six-month plan

Do not leave the SOE entirely until result day

The Written must be passed before SOE entry, but spoken reasoning supports both components. During Written preparation, explain difficult answers aloud and practise concise clinical-science links. Once you hold the Written pass, increase to the exact SOE timings: paired 26-minute SOE 1 parts, then the 36-minute SOE 2 sequence.

The application windows make administration urgent. A September candidate receives the Written result on 15 October before the November SOE window closes on 19 October. A March candidate receives the result on 13 April before the June window closes on 16 April. Know what evidence and account details you need before those dates.

Technique for the Written and SOE

Make CRQ practice mark-visible

After each response, separate missing knowledge from missing presentation. If you knew a point but buried it, the repair is structure. If you wrote around a gap, the repair is retrieval. If the final question was thin because the earlier ones expanded, the repair is pacing. Those are different problems and need different next sessions.

Review SBA options, not only answers

A correct choice made for the wrong reason is unstable. For every uncertain item, explain why the selected option is best and why the closest distractor is not. Tag the underlying curriculum domain, then retest the distinction later without the original wording.

Use the day between Written papers deliberately

The CRQ and MCQ are on separate days. Decide before the first paper how you will use the interval: recover, sleep and perform a limited review of familiar prompts. Trying to rebuild a major domain between Wednesday and Friday is more likely to displace recovery than repair the blueprint.

Train the SOE transitions

SOE 1 and SOE 2 require different kinds of speech. Practise moving from a short case into its linked clinical science question without losing the clinical thread. For SOE 2, use the ten-minute viewing period to organise material for the long case, then reset for two unrelated short cases. A complete rehearsal should include those transitions.

Keep one evidence trail across formats

Use one curriculum tracker with separate evidence for CRQ writing, SBA discrimination and spoken reasoning. A topic is not fully prepared because it has been read once or answered correctly once. It is stronger when you can retrieve it, apply it to an option set, organise it in writing and explain it under questioning.

How the PRIMEX methodology fits

A straight disclosure first: PRIMEX does not yet offer a Final FRCA question bank, exam simulation or viva practice, and this guide does not promise one. The relevant method is broader: spaced repetition to keep knowledge retrievable, graded practice to make missing answer elements visible, and curriculum tracking to show where coverage and performance diverge.

PRIMEX already serves UK intensive care trainees through the live Final FFICM programme. If you want to inspect the approach and see which examinations are currently covered, use the overview below. Keep your FRCA plan anchored to the RCoA syllabus and current component information unless a specific live offering is shown on the site.

Frequently asked questions

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