Fellowship of the Royal College of Emergency Medicine


Fellowship of the Royal College of Emergency Medicine is a postgraduate medical qualification in the United Kingdom and Ireland awarded by the Royal College of Emergency Medicine to doctors who have completed specialty training in emergency medicine. The exam comprises two parts, the Single Best Answer paper, and the Objective Structured Clinical Examination, which are normally taken in the latter stages of specialty training in emergency medicine while holding a position as a Specialty Registrar, having already completed the RCEM Membership exam earlier on in the training programme. Obtaining this qualification allows a doctor to become a fellow of the College, as well as entitling them to use the post-nominal letters FRCEM.

History

Emergency medicine is one of the newer medical specialties in the UK, having only been formally recognised in 1972 with its roots in earlier schemes from the 1950s. The first postgraduate qualification in emergency medicine was the Fellowship of the Royal College of Surgeons of Edinburgh in Accident & Emergency Medicine & Surgery, or the FRCS, established in 1983 and administered by the titular college with input from the Casualty Surgeon's Association established in 1967; this became the MRCS in the 1990s with the formation of the new MRCS exam to replace the FRCS for doctors in earlier core training posts. This examination would continue to be awarded until 2009.
However, with the formation of the intercollegiate Faculty of Accident & Emergency Medicine in 1993, responsibility for postgraduate training and examination of emergency medicine specialists would move to the new faculty, leading to the creation of a Fellowship of the faculty in 1996 and a Membership in 2003, although few people sat the MFAEM exam and instead earned early medical or surgical qualifications before going on to take the FFAEM. With the transfer of the FAEM and the Casualty Surgeons Association to the new College of Emergency Medicine in 2006, these exams became the MCEM and FCEM respectively, eventually becoming the MRCEM and FRCEM when the college received the "Royal" designation in 2015.
Since being established under the RCEM, the examination component sat during early specialty/core training has undergone several changes; in 2016, the MRCEM was merged into the FRCEM, creating a new three-part qualification, consisting of the FRCEM Primary, the FRCEM Intermediate, and FRCEM Final. However, this was reversed again in 2021 with the MRCEM again becoming a separate qualification, incorporating the Primary and Intermediate levels of examination.

Examinations

The FRCEM is a required part of specialist training for doctors undertaking General Medical Council approved training in the United Kingdom, but it is also taken by doctors from a variety of other countries. In particular, several parts of the examination are held in overseas examination centres in Dublin, Chennai, Hyderabad, New Delhi, Reykjavik, Kuala Lumpur, and Muscat.

FRCEM SBA

The FRCEM SBA is an examination open to doctors who have a minimum of 1 year experience in higher specialty training and have completed the MRCEM within the past 7 years. It consists of 180 single-best answer questions, divided into 2 papers of 2 hours each with an hours break in between, consisting of 35 questions on the management of various medical and surgical presentations, 40 on the resuscitation of the critically unwell patient, 35 specifically on trauma, 30 on paediatric presentations, 13 on procedural skills, 10 on ethical and medicolegal issues, 7 on leading in emergency department, and 10 on research and patient quality/safety metrics. Successful competition allows the candidate to take the FRCEM OSCE within the next 7 years if not already taken, or together with it leads to completion and award of the Fellowship.

FRCEM OSCE

The FRCEM OSCE is also open to doctors who have a minimum of 1 year experience in higher specialty training and have completed the MRCEM within the past 7 years. It consists of 16 stations where they must demonstrate a clinical skill or interpret data related to "complex and challenging situations that are faced in Emergency Medicine practice". Successful competition allows the candidate to take the FRCEM SBA within the next 7 years if not already taken, or together with it leads to completion and award of the Fellowship.

Fellowship

Those who pass the examination are admitted as Fellows by Examination of the Royal College of Emergency Medicine, and are entitled to use the postnominal FRCEM after their name. Fellowship may also be conferred by the college on those who have been recognised as making an exceptional contribution to the field of emergency medicine, known as Honorary Fellows, who may use the postnominal FRCEM. Fellowship of the college also includes a free subscription to the Emergency Medicine Journal, access to the RCEMLearning e-learning platform as well as the RCEM ePortfolio electronic portfolio platform, access to a health advice line, various discounts on goods and services, and opportunities for professional development or to apply for research grants.