Question 1

What is the structure of the Primary FRCA examination?

Accepted Answer

The Primary FRCA examination set by the Royal College of Anaesthetists (RCoA) consists of three distinct components: a written paper followed by two clinical examinations.

The Multiple Choice Question (MCQ) is a three-hour, computer-based exam featuring 90 Single Best Answer (SBA) questions with no negative marking. It tests basic sciences, divided equally into 30 questions each for Pharmacology, Physiology and Biochemistry, and Physics, Clinical Measurement, Equipment, and Statistics. Candidates must pass this written component before moving on to the practical assessments; a pass remains valid for three years.

The clinical components comprise the Objective Structured Clinical Examination (OSCE) and the Structured Oral Examination (SOE), both sat in person during the same examination week. The OSCE features a circuit of up to 16 assessed five-minute stations evaluating practical skills, resuscitation, applied anatomy, communication, and data interpretation. The SOE consists of two 30-minute viva sessions testing basic sciences, clinical scenarios, critical incidents, and equipment safety.

Both clinical parts are marked independently. If you pass one and fail the other, you retain credit for the passed section and only need to resit the failed component. Candidates are permitted up to six attempts per section.

Question 2

How many questions are in the Primary FRCA MCQ exam?

Accepted Answer

There are 90 questions in the Primary FRCA MCQ exam. All of them are Single Best Answer (SBA) questions, split evenly into:
- 30 questions in Pharmacology
- 30 questions in Physiology (including related anatomy and biochemistry)
- 30 questions in Physics, clinical measurement, equipment, and statistics/data interpretation

Question 3

How long is a pass in the Primary FRCA valid for?

Accepted Answer

A pass in the Primary MCQ remains valid for three years towards sitting the clinical components (OSCE and SOE). Once you have passed all parts of the Primary, the overall qualification is valid for seven years towards the Final FRCA.

Question 4

How should candidates prepare for the Primary FRCA?

Accepted Answer

The Royal College of Anaesthetists recommends a combination of structured reading and extensive question practice. Candidates are encouraged to complete hundreds of SBA questions, use mock examinations, practise SOE techniques under timed conditions, and attend OSCE practice sessions where possible. The College advises beginning revision at least three to four months before each examination component.

Question 5

Can I sit the Final FRCA before passing the Primary FRCA?

Accepted Answer

No. Candidates must first pass the Primary FRCA examination, or hold a recognised exemption, before being eligible to apply for the Final FRCA examination. The Final FRCA itself consists of a written examination followed by the Structured Oral Examination (SOE), and candidates must pass the written component before progressing to the oral examination.

For official examination regulations, curriculum blueprints, examination dates and candidate guidance, refer to the Royal College of Anaesthetists FRCA Examinations and the Primary FRCA Examination Page.

Question 6

Are there still Multiple True/False (MTF) questions in the Primary MCQ?

Accepted Answer

No. Since September 2023, the Primary MCQ consists entirely of 90 Single Best Answer (SBA) questions.

Question 7

How is the MCQ exam delivered?

Accepted Answer

The written paper is delivered online as a remotely invigilated, computer-based exam. You sit it on your own laptop or computer using the College’s designated testing software, with strict identity checks and environment monitoring.

Question 8

How much time do I have per question?

Accepted Answer

With 90 questions over three hours (180 minutes), you have roughly two minutes per question, leaving time for review.

Question 9

Is there negative marking?

Accepted Answer

No. One mark is awarded for each correct answer. Candidates are advised to select an answer for every single question, as unattempted questions simply score zero.

Question 10

What is the pass mark for the MCQ?

Accepted Answer

There is no fixed percentage or static score. The pass mark changes each sitting and is determined using standard-setting methods (such as the modified Angoff method) adjusted for exam difficulty and the Standard Error of Measurement (SEM). Historically, the pass mark usually sits around the 65% to 75% range.

Question 11

How many attempts am I allowed?

Accepted Answer

Under RCoA examination regulations, candidates are allowed a maximum of six attempts at each component of the exam.

Question 12

Who is eligible to sit the Primary FRCA MCQ?

Accepted Answer

You must hold full registration with the GMC (or equivalent national regulatory medical body) and be registered with the Royal College of Anaesthetists, either as a UK trainee in a recognised training programme (Core / ACCS / Stage 1) or as an eligible affiliate/trust grade member under College regulations.

Question 13

When during training should I sit the Primary MCQ?

Accepted Answer

Most trainees attempt the MCQ during their CT1/CT2 (Stage 1) years, usually after completing around 6 to 12 months in anaesthesia. Clinical familiarity makes the pharmacology, equipment, and physiology far more intuitive.

Question 14

How often does the exam run?

Accepted Answer

The Primary MCQ is typically held three times a year: usually around September, November, and February.

Question 15

How closely do your questions reflect the real exam blueprint?

Accepted Answer

All of our questions are mapped directly to the RCoA Stage 1 curriculum domains: Pharmacology, Physiology (including Anatomy and Biochemistry), and Physics, Clinical Measurement, and Statistics.

Question 16

Can I take timed mock exams?

Accepted Answer

Yes. You can test your recall through untimed subject-by-subject practice, or simulate the actual sitting using full-length, 90-question timed mocks under real 3-hour exam conditions.

Question 17

Is the curriculum or syllabus changing under the new format 2027?

Accepted Answer

No. The College has confirmed that the underlying syllabus and standard-setting principles remain identical. All questions and scenarios will still map directly to Stage 1 of the UK anaesthetic curriculum (Pharmacology, Physiology, Physics, Clinical Measurement, and Equipment). The shift only changes how knowledge and reasoning are assessed.

Question 18

Does my current SBA preparation still count towards the new AKT?

Accepted Answer

Yes, completely. Because the written paper remains an SBA assessment testing the same Stage 1 syllabus, revising with SBA question banks directly prepares you for both the current MCQ and the new Primary AKT.

Question 19

How will the transition period work between 2027 and 2028?

Accepted Answer

The College has outlined a phased rollout:
- Until June 2027: The current exam structure (MCQ, OSCE, SOE) runs as standard.
- July 2027 to June 2028 (Transition Year): First-time entrants sit the new format (AKT and CASE). Candidates with partial passes in the legacy format (e.g. passed OSCE but not SOE) can sit their remaining component during this year, or opt into the new CASE exam.
- From July 2028: The legacy OSCE and SOE are retired permanently, and all candidates sit the AKT and CASE.

Question 20

What happens if I have already passed the Primary MCQ before July 2027?

Accepted Answer

A pass in the written exam will continue to hold its standard validity period (three years) towards entering the clinical component, allowing you to book either the remaining legacy clinical sittings during the transition year or the new CASE exam

Question 21

Will my attempt count reset when CASE is introduced?

Accepted Answer

Yes. Under the College’s transition guidance, attempts at the new CASE exam are counted separately from previous attempts at the legacy OSCE or SOE, provided you have not already exhausted the maximum six-attempt rule on the legacy component before the transition.

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