The FRCEM SBA is the written component of the Fellowship of the Royal College of Emergency Medicine examination, and for most UK trainees it is the last major knowledge hurdle before the OSCE and CCT. It is a broad, demanding paper that samples the entire 2021 Emergency Medicine curriculum at consultant level.
This guide brings everything you need into one place: the format and logistics, the question blueprint, a realistic revision timeline, exam-day technique, and the clinical guidelines that come up again and again.
The FRCEM SBA replaced the old FRCEM Final SAQ in August 2021. Since then it has been a single-best-answer paper mapped to the RCEM 2021 curriculum rather than a short-answer paper. The exam now rewards clinical reasoning and the ability to choose the single best option from several plausible ones, rather than factual recall written out longhand.
What is the FRCEM SBA?
The FRCEM SBA consists of 180 single-best-answer questions, delivered as two papers of 90 questions, with two hours allowed for each paper and a one-hour break in between. It is machine-marked: one mark for a correct answer, with no negative marking.
Both FRCEM components — the SBA and the OSCE — must be passed independently, and there is no cross-compensation between them. You can sit them in either order.
- 180 single-best-answer questions across two papers of 90
- 2 hours per paper, with a 1-hour break in between
- Machine-marked, no negative marking — always answer every question
- Blueprinted to the full RCEM 2021 Emergency Medicine curriculum
How hard is the FRCEM SBA? Pass rates in context
The FRCEM SBA is a genuinely difficult exam, but the numbers are less frightening when you understand them. According to RCEM's "Publication of Exam Pass Rate Data 2024", the recent pass rates were:
- 2023: 47.0% (518 of 1,102 candidates passed)
- 2024: 51.1% (558 of 1,093 passed) — RCEM notes the difference between the two years was not statistically significant
UK higher specialty trainees consistently outperform other candidate groups. Across all RCEM exams in 2024, UK trainees achieved a 79.6% pass rate compared with 46.0% for international (IMG) trainee candidates — with RCEM's report stating that "UK trainees achieved the highest pass rate at 79.6%, significantly surpassing other groups."
The single biggest controllable predictor of success is structured, blueprint-led revision combined with high-volume question practice — not raw clinical experience alone.
The five things every candidate needs to get right
1. Know the format and logistics
Understand the structure, fees, dates, eligibility, attempts, and the 2026 move to a new exam delivery provider. See our full page on FRCEM SBA exam format and logistics.
2. Revise to the blueprint
The SBA samples specific SLOs in fixed proportions. Resuscitation, trauma and paediatrics dominate. Read the SBA blueprint and SLO-by-SLO revision strategy.
3. Build a realistic timeline
Most successful candidates give themselves several months of "little and often" revision. Use our page to build a study timeline.
4. Master SBA exam technique
The paper is as much a test of pace and nerve as knowledge. Learn SBA exam-day technique.
5. Revise the right guidelines
A predictable slice of marks comes from current NICE, RCEM and Resuscitation Council UK guidance. Revise the high-yield guidelines for the FRCEM SBA.
How Bolus fits into your revision
Bolus is a UK emergency medicine question bank built specifically for RCEM exams — quality-assured rather than crowd-sourced, and based on the latest relevant guidelines. Four things make it suited to the SBA:
Peer-reviewed by trainees who passed
Every question is written by a post-FRCEM trainee and independently checked by a second.
Filter by topic and SLO
Practise in exactly the proportions the blueprint uses, and track each outcome.
Reference library
Each answer links to a summary of the guideline behind it, so review doubles as revision.
Timed mock tests
Rehearse the full two-paper experience and build stamina before the day itself.
Explore the guide
Work through the five pages in order if you are early in your preparation, or jump straight to the area you want to know more about.