Final FRCA Examination Format Explained

Overall structure

Two components: the Final Written (two papers, a Constructed Response Question paper and an MCQ paper, sat on different days) and the Final SOE. Both must be passed, and the Written must be passed before applying for the SOE. There is no OSCE at the Final. Passing the SOE confers Fellowship and the FRCA post-nominals.

Components and structure

The Final FRCA Examination is assessed across the following components:

• Written: CRQ paper (CRQ) - 12 questions, 180 min. 12 Constructed Response Questions, all of which must be attempted, each marked out of 20 with a modified Angoff pass mark per question. Six examiners mark each paper, two questions each. Delivered online via TestReach.. Part of the Final Written; the Written (CRQ plus MCQ) is marked as one component and must be passed before applying for the SOE. A Written pass is valid for 3 years..
• Written: MCQ paper (MCQ) - 90 questions, 180 min. 90 Single Best Answer questions: broadly 45 general anaesthesia, 10 perioperative medicine, 10 regional anaesthesia and 25 across other curriculum domains. One mark each, maximum 90, no negative marking, modified Angoff pass mark. MTF (multiple true or false) questions were removed from September 2023. Delivered online via TestReach.. Sat on a different day from the CRQ paper; together the two papers form the Written component..
• SOE (structured oral) (viva) - 12 questions, 88 min. 12 questions in total, with two examiners marking each independently: 2 marks pass, 1 borderline, 0 fail per question, maximum 48. Standard setting is GMC-approved. Held in person at the College.. SOE 1 has parts A and B taken consecutively, each 26 minutes, each covering two clinical short cases with a linked clinical science question (13 minutes per case and question). SOE 2 is 36 minutes: 10 minutes viewing clinical material, a 13-minute two-section clinical long case, then 13 minutes on two unrelated clinical short cases. Content is aligned to the intermediate-level curriculum. Passed after the Written; passing confers Fellowship..

Pass the Written (the CRQ and MCQ papers, marked together as one component and valid for 3 years) before applying for the SOE. Both components must be passed for the Final FRCA. Passing the Final SOE confers Fellowship of the College and the FRCA post-nominals. Each component may be attempted up to 6 times.

Structure per the official examination materials: RCoA source.

Exam format glossary

Key assessment formats used in the Final FRCA Examination, defined. Each definition is general and applies across colleges.

Multiple Choice Question (MCQ)

A written item that presents a clinical or factual stem with several answer options, of which one or more are correct, marked automatically against a key.

Single Best Answer (SBA)

A multiple-choice format in which several options are plausible but the candidate must choose the single best answer for the scenario.

Viva voce

A structured oral examination in which examiners question the candidate in real time, assessing reasoning, justification and depth of understanding under pressure.

Long case

A clinical examination in which the candidate independently assesses a real patient, then presents and defends the history, findings and management plan to examiners.

Short case

A focused clinical examination of one or more patients that tests examination technique, sign elicitation and interpretation under time pressure.

What the format means for your preparation

The single most common preparation mistake is studying as if the examination only had an MCQ component. Format-aware preparation looks like this:

• MCQ components reward high question volume and pattern recognition. Read explanations, not just answers, and revisit weak domains with spaced repetition.
• Short answer / SAQ components reward a prioritised, structured response under time pressure. Practise writing complete answers in the available time, not just outlining points.
• Viva or OSCE components reward verbalised structured reasoning. Practise aloud, ideally with feedback, rather than rehearsing silently.
• Practical or image-based components reward repeated exposure under time pressure. Build a routine that includes timed slide or image interpretation.

What separates pass from fail under this format

Examiner reports and feedback consistently flag these preparation pitfalls:

• Answering at Primary basic-science level instead of applied clinical management - the Final rewards prioritised, structured perioperative decisions.
• Vague dosing: "give a vasopressor" scores poorly where a named UK drug, dose, route and titration target is expected.
• Poor time management across the twelve constructed response questions in three hours - each must be attempted and answered to its mark allocation.
• Ignoring the guideline framework a question is built around (DAS, Resuscitation Council UK, NICE, the Association of Anaesthetists) and the consent, capacity and human-factors marks.

How PRIMEX maps to the format

• A constructed response question surface at the real Final format (twelve CRQs, each marked out of twenty) with structured examiner feedback and model answers.
• Five-option single best answer bank plus a Structured Oral simulator modelled on SOE 1 and SOE 2, probing clinical management and the linked applied science.
• UK study notes across the full applied-clinical curriculum with spaced-repetition flashcards and progress analytics.

Frequently asked questions