Why the blueprint should drive your revision
The 2021 RCEM curriculum is enormous, and you cannot revise all of it to the same depth. The single most useful thing you can do early is to map your revision to the SBA blueprint, which tells you exactly how the 180 marks are distributed across the Specialty Learning Outcomes (SLOs). Spend your time in proportion to the marks on offer.
The clinical SLOs dominate, but the non-clinical SLOs — research, quality improvement, management and leadership — are reliably tested, and are where well-prepared clinical candidates routinely lose easy marks.
The FRCEM SBA blueprint: questions per SLO
The 180 questions are distributed as follows:
Three clinical SLOs — resuscitation (SLO3), the breadth of stable presentations (SLO1) and major trauma (SLO4) — account for 110 of the 180 marks between them. Add paediatrics (SLO5) and you have 140 of 180 marks in four areas. This is why successful candidates often advise that trauma, paediatrics and resuscitation are your bread and butter.
SLO1 — Stable patients across the breadth of EM (35 questions)
SLO1 samples the entire clinical syllabus through the lens of the physiologically stable patient — cardiology, respiratory, neurology, gastroenterology, endocrinology, ENT, ophthalmology, dermatology, urology, infectious diseases, toxicology and more. This is the widest net in the exam.
Work systematically through the syllabus categories, prioritising common presentations and the conditions with clear evidence-based pathways. Filtering a question bank by topic is the most efficient way to find and close gaps across this breadth.
SLO3 — Resuscitation and stabilisation, excluding major trauma (40 questions)
The largest single block of marks. Expect:
- adult and paediatric advanced life support, and peri-arrest arrhythmias;
- the acutely unwell medical patient, sepsis and septic shock, and anaphylaxis;
- acute coronary syndromes; the crashing asthmatic and COPD patient;
- DKA and other metabolic emergencies, poisoning, and post-ROSC care.
Know the Resuscitation Council UK algorithms, alongside the relevant NICE and specialty-society guidance.
SLO4 — Injured patients and major trauma (35 questions)
Major trauma and injury. Cover:
- the primary survey and catastrophic haemorrhage control;
- traumatic brain injury and the head-injury imaging rules; c-spine assessment;
- chest and abdominal trauma; pelvic and limb injuries; burns;
- trauma in special groups (children, older people, pregnancy).
The NICE head injury and major trauma guidance is high-yield here.
SLO5 — Children and paediatric emergency medicine (30 questions)
Paediatrics is a large, distinct block and a common weak spot for adult-focused candidates. Cover:
- the febrile child and the traffic-light system; paediatric sepsis and meningococcal disease;
- bronchiolitis, croup and the wheezy child;
- paediatric DKA, and fluid and resuscitation calculations;
- non-accidental injury and safeguarding, and common paediatric injuries.
Do not leave paediatrics until the end.
SLO6 — Procedural skills (13 questions)
Know the indications, contraindications, technique, complications and aftercare for the core EM procedures:
- airway and RSI;
- chest drains;
- central and intraosseous access;
- lumbar puncture;
- joint reduction and aspiration;
- local and regional anaesthesia;
- DC cardioversion and pacing;
- procedural sedation.
Point-of-care ultrasound is frequently tested.
SLO7 — Complex and challenging situations, medicolegal (10 questions)
Expect questions on:
- capacity and consent;
- the Mental Health Act and Mental Capacity Act;
- DNACPR and end-of-life decisions;
- safeguarding for children and vulnerable adults;
- the patient in custody;
- breaking bad news and dealing with complaints;
- managing the intoxicated or aggressive patient.
RCEM guidance and the relevant legal frameworks are the source material.
SLO8 and SLO12 — Leading the ED shift and management (7 questions)
Running the shop floor:
- prioritisation, flow and crowding;
- major incident concepts and triage;
- business cases, job planning and rotas;
- the organisational side of EM.
Small in number but easy to revise from RCEM resources.
SLO10 and SLO11 — Research, data, quality and safety (10 questions)
This non-clinical block covers:
- critical appraisal and statistics — sensitivity, specificity, predictive values, likelihood ratios, relative and absolute risk, number needed to treat, p-values and confidence intervals;
- study design and evidence-based medicine;
- audit and the audit cycle, and quality improvement methodology;
- patient safety, human factors, and incident investigation.
These ten marks are very achievable with focused preparation, yet many clinically strong candidates neglect them.
Turning the blueprint into a revision plan
Translate the blueprint into a weighted plan: give the most time to SLO3, SLO1 and SLO4, schedule paediatrics as a protected block, and ring-fence dedicated sessions for statistics, QI and management so they are not crowded out.
A question bank that lets you filter by SLO as well as by topic is invaluable here, because it lets you practise in exactly the proportions the exam uses and track your performance against each outcome — one of the reasons Bolus tags every question to both topic and SLO.
Pair this page with the high-yield guidelines for the FRCEM SBA and then build your study timeline.