MRCEM Primary vs MRCEM SBA: what each stage tests

Primary is a single paper of 180 single best answer questions in 180 minutes, five options throughout. It tests basic science — anatomy, physiology and pharmacology — but framed in a clinical shell rather than as abstract science, so a question still reads like an emergency medicine scenario even where the underlying knowledge being tested is anatomical or physiological.

Anatomy and physiology are the largest blocks, each roughly a third of Primary by RCEM's own published category-level question counts. Pharmacology is a real but smaller share.

SBA is a later, separate stage: two papers of 90 single best answer questions each in 120 minutes, five options. The content moves from basic science to emergency decision-making, tested against the RCEM curriculum's own Specialty Learning Outcomes (SLOs) — the standards a trainee is expected to meet, not a science syllabus.

By RCEM's own published SLO-level question counts, the Complex or Stable Patient outcome and Resuscitate carry the largest shares, with the Injured Patient, Paediatric Emergency Medicine and Procedural Skills outcomes each contributing a defined but smaller count.

Unlike several other exams in this set, RCEM's weighting is not an estimate. These are RCEM's own published category-level counts for Primary and Specialty Learning Outcome-level counts for SBA, taken from RCEM's regulations and information packs, so a revision plan can follow them directly rather than treating them as indicative.

• For Primary, put the bulk of your time into anatomy and physiology in rough proportion to their published share, and keep pharmacology moving rather than leaving it until last.
• For SBA, practise decision-making against the SLOs it is actually marked on — the Complex or Stable Patient and Resuscitate outcomes carry the most weight, so they earn the most time, but every SLO appears every sitting.
• For both stages, track which categories or outcomes are currently costing you marks and tilt sessions toward them.
• Bring misses back on a spacing schedule so a wrong answer returns before it is forgotten, rather than moving on for good.

The SpecialityMCQs MRCEM revision mirrors RCEM's own published weighting for both Primary and SBA, tilts each session toward whichever category or outcome is currently weakest, and brings misses back on a spacing schedule. Every answer names the reference or guideline it rests on.