The Pastest Complete Guide to the Primary FRCA Exam
Thinking of taking the Primary FRCA exam? In this guide you’ll find everything you need to know about the different components, and how to ace them.
What is the Primary FRCA examination?
The Primary FRCA examination is the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. It is a postgraduate examination in Anaesthesia that assesses a candidate's competency across a range of disciplines. The Primary FRCA consists of three parts and candidates must pass all three components. Once you have passed, it is valid for seven years as part of your eligibility to the Final FRCA exam.
The Primary FRCA is made up of three parts:
- Multiple Choice Question (MCQ): A computer-based exam that tests a candidate's knowledge of pharmacology, physiology, biochemistry, anatomy, physics, clinical measurement, statistics and equipment and safety
. - Objective Structured Clinical Examination (OSCE): A practical exam that assesses a candidate's clinical skills, such as patient assessment, airway management and decision-making.
- Structured Oral Examination (SOE): A viva voice exam that assesses a candidate's communication skills, knowledge of anaesthetic techniques and ability to apply theoretical knowledge to clinical practice.
The FRCA Primary MCQ exam
The Multiple Choice Question (MCQ) exam is the first part of the exam you will take in the FRCA process; without this one, you cannot take the subsequent two exams. This more theoretical multiple-choice exam covers the core parts of the anaesthetic training curriculum, featuring 90 single best answer (SBA) questions over three hours. These are the topics you’ll be tested on:
- Pharmacology - Drug actions, interactions and adverse effects.
- Physiology - Cardiovascular, respiratory, renal and neurological systems.
- Biochemistry - Metabolic processes, acid-base balance and electrolyte disturbances.
- Anatomy - Relevant anatomical structures and their functions.
- Physics - Principles of gas laws, fluid dynamics and medical equipment.
- Clinical measurement - Techniques and interpretation of physiological parameters.
Statistics and data interpretation - Understanding and analysing data. There will be 30 questions in pharmacology, 30 questions in physiology (including biochemistry and anatomy) and 30 questions in physics, clinical measurement, statistical methods and data interpretation.
How to apply for the Primary FRCA MCQ exam:
- Make sure you meet the eligibility criteria.
- Head to the Royal College of Anaesthetists website and create an account, if you haven’t already got one.
- Select the application form for the FRCA primary exam and fill in all the necessary personal information, including name, contact information, details of your training and qualifications.
- Upload a passport-style photograph of yourself and a copy of your GMC registration certificate, or equivalent.
- Submit the completed application and pay the application fee (currently £410). This fee is non-refundable and must be paid by your exam’s closing date.
How the Primary MCQ is marked
One mark will be awarded for each correct answer, with a maximum of 90 marks on the exam. Negative marking will not be used. The pass mark is provisionally set by examiners using a modified Angoff method.
Exam dates and fees for the Primary FRCA MCQ
Exam results for the Primary FRCA MCQ
Results from the February 2026 Primary MCQ exam will be released by 5pm on Wednesday, 18 March 2026.
Exam results will be given by email, no results will be given or confirmed by telephone.
The FRCA OSCE exam
The FRCA Primary OSCE (Objective Structured Clinical Examination) is the practical component of the FRCA exam, designed to assess a candidate's clinical skills and ability to apply theoretical knowledge to real-world scenarios. The format of this exam comprises up to 16 live exam stations in a circuit, each one simulating a different clinical scenario, and typically lasts for two to three hours. You will be observed by an examiner and scored on your performance.
During the OSCE part of the FRCA, you may be assessed on the following stations and scenarios:
· History taking and examination: focused anaesthetic history, airway assessment and targeted cardiovascular/respiratory examination.
· Airway management: airway assessment and planning, basic and advanced airway techniques and failed airway drills.
· Drug handling and administration: dose calculation, safe preparation and labelling and management of adverse drug events.
· Equipment and monitoring: anaesthetic machine checks, breathing systems and ventilators and interpretation of monitors.
· Resuscitation and emergencies: ALS algorithms, anaesthetic emergencies (anaphylaxis, MH, LAST) and crisis management.
· Communication and professionalism: consent and capacity, explaining risk and procedures, patient safety and escalation.
You will be assessed and graded on the following by the examiners:
- Knowledge: accuracy, relevance and recall under pressure.
- Practical skill: safe technique, and systematics and asepsis.
- Application and judgement: prioritisation, decision-making and safety focus.
- Communication: clarity, structure and professional manner.
- Organisation: logical flow, time management and signposting.
Structure of the FRCA OSCE
As it is more of a practical exam, the OSCE part of the FRCA exam is laid out differently. There will be around 16 stations that you will work your way through, each one lasting about five minutes. Outside of each station, guidance will be displayed, and you have one minute to read before entering. Once inside, an examiner may ask questions, and you may be asked to demonstrate a technical skill, show how to use a piece of equipment or interact with a patient (an actor). After five minutes, a bell will sound and you will move to the next station.
It’s important to remember that the above describes a typical OSCE exam, and adjustments can be made if a candidate has additional needs.
There are rest stations throughout the circuit where you will be seated and asked to wear ear defenders. Floor leads will be stationed throughout, and will inform you when you need to move to the next circuit. You are allowed to take a water bottle with you during the exam, but no paper, electronic devices or other resources.
How the FRCA OSCE is marked
Each station is marked out of 20. The pass mark for each station is determined by the examiners prior to the exam beginning using a modified Angoff referencing. The Angoff score for each of the live stations are summed to obtain the pass mark for the whole examination.
Exam dates and fees for the Primary FRCA OSCE
Here at Pastest, we don’t currently cover the Primary FRCA OSCE exam.
The FRCA Primary SOE exam
The FRCA Primary SOE (Structured Oral Examination) is the third and final component of the FRCA primary examination, designed to assess a candidate's communication skills, their knowledge of anaesthetic techniques and their ability to apply theoretical knowledge to clinical practice.
This last examination takes the form of a series of structured interviews with examinations, in two 30-minute segments of six questions each on different topics.
To take the SOE, you will need to have passed the Primary FRCA MCQ in the last three years.
During the SOE part of the FRCA, you may be assessed on the following:
- Physiology: Cardiovascular, respiratory, CNS, renal, hepatic, endocrine and applied physiology in anaesthesia and critical care.
- Pharmacology: Pharmacokinetics and pharmacodynamics, anaesthetic drugs, adjuncts and emergency drugs.
- Physics, measurement and equipment: Gas laws, electricity, fluid dynamics, anaesthetic machines, breathing systems, monitors and safety features.
- Anatomy: Airway, neuraxial and regional anaesthesia anatomy.
- Clinical anaesthesia: Pre-operative assessment and optimisation, intra-operative management and monitoring and post-operative care and pain management.
- Critical care and emergencies: Shock, hypoxia, acid–base and electrolyte disorders, airway crises, anaphylaxis and MH and ALS principles.
- Pain medicine: Acute pain, multimodal analgesia and core chronic pain principles.
- Ethics, law and professionalism: Consent, capacity, DNACPR and end-of-life care, patient safety and human factors.
This is what you’ll be assessed and graded on by the examiners:
- Knowledge: Accuracy and breadth
- Application: Linking theory to clinical practice.
- Clinical reasoning and judgement: Prioritisation, safety and decision-making
- Communication: Clear, structured, concise answers.
- Professionalism and safety: Recognition of risk and escalation.
- Organisation: Logical flow and time management.
Structure of the Primary SOE
The Primary SOE is made up of two subsections:
- 30 minutes of three questions in pharmacology, and three questions in physiology and biochemistry
- Followed by 30 minutes of three questions on clinical topics (including a critical incident) and three questions in physics, clinical measurement and equipment and safety.
How the Primary SOE is marked
Two examiners mark each part of the SOE. Both examiners independently mark every question. There are 12 questions, 2 marks are given for a pass, 1 mark for a borderline performance and 0 marks for a fail, giving a maximum total score of 48 marks.
Exam dates and fees for the Primary FRCA OSCE
Here at Pastest, we don’t currently cover the Primary FRCA SOE exam.
Exam results for the Primary FRCA SOE
Results from the Primary OSCE/SOE in January 2026 will be released by 5pm on Tuesday 17 February 2026.
All results will be sent via email, no results will be given over the phone.
Eligibility criteria for the Primary FRCA exam
According to the Royal College of Anaesthetists (RCoA), in order to be eligible to take the Primary FRCA exam, you need to meet the following criteria:
- Be registered with the GMC or an equivalent National Medical Council
- Be registered with the Royal College of Anaesthesia (RCoA) as a trainee in one of the following training programmes:
- Foundation Programme
- Core Anaesthetics
- Acute Care Common Stem (ACCS)
- Intensive Care Medicine
- Be attempting the exam for the sixth time or less; a maximum of six attempts is allowed.
Or, in place of the final point above, you can also:
- Be registered as a trainee with the College of Anaesthetists, Ireland.
- Be registered with the RCoA in a recognised non-affiliate membership category and currently working as an Anaesthetist.
- Be registered with the RCoA in a recognised non-affiliate membership category and you have previously left anaesthetic training in the UK or Ireland less than five years ago.
- Have successfully applied for a Temporary Examination Eligibility (TEE) with the RCoA within three months of the date of the exam.
Taking your exam at the college
Parts of the Primary FRCA that require you to attend in person, rather than take the exam on a computer. This will take place at the Royal College of Anaesthetists. Please arrive at least 30 minutes before the first call time on your Admission Notice; late admissions are not allowed, and the earliest you will be admitted to the College is 7:30 am.
Upon being admitted, report to the reception desk and present your Admission Notice and ID, where you will receive clear instructions on when and where to report for each component. You must sign in and out at reception when leaving and/or returning throughout the day.
How to prepare for the Primary FRCA exam
Pastest’s FRCA Qbank contains more than 1,000 questions in the SBA (Single Best Answer) format, designed to challenge you in your prep for taking the MCQ, all with explanations for each answer options. Revise on-the-go with our mobile app!
Take a closer look at Pastest’s MCQ revision resource, and sign up for a free trial!
Primary FRCA Exam Essentials Course
Introducing the Primary FRCA Exam Essentials Course
Ideal to use alongside your Primary FRCA subscription, our Primary FRCA Exam Essentials Course is designed to make FRCA revision manageable for busy trainees.
Bite-Sized, High-Yield Learning
This on-demand course features 60+ videos (5–10 minutes each) that cover the essential topics across Physiology, Pharmacology, Physics, and Equipment. Each module is structured to keep you focused, helping you tackle the notoriously broad FRCA syllabus efficiently.
High-Yield Topics and Practice Questions
The course covers key areas including; Agonist & Antagonist, Oxygen Content & Delivery, Pulse Oximetry plus many more, including Viva scenarios & High Yield notes. Pair these with the Pastest Primary FRCA Qbank to maximise your revision, track progress, and boost exam confidence.
Expert-Led by Dr. Lasith Ranasinghe
Learn from Dr. Lasith Ranasinghe, a Nuffield Medal-winning Resident Doctor in ACCS Anaesthetics at Royal London Hospital. Dr. Ranasinghe passed the FRCA OSCE/SOE with a perfect score, has shaped Pastest MRCP and PACES platforms, founded the medical education charity Make a Medic, and authored four internationally published textbooks.
Combine with Pastest MCQs for Maximum Impact
Elevate your revision by combining the course with Pastest MCQs. Watch bite-sized videos, practise targeted MCQs and viva-style questions, and track your progress across high-yield topics.
The Royal College of Anaesthetists offer a number of courses that can help you prepare for the Primary FRCA. Not only do they offer written revision courses specific to these exams, but they also run workshops and online conferences to keep aspiring anaesthetists updated with the latest developments in this part of the medical world.
Frequently asked questions about the Primary FRCA
How is the Primary FRCA formatted?
The FRCA primary is divided into three exams:
- A multiple-choice written (MCQ) exam which consists of multiple-choice questions and is usually held three times a year - February, September and November
- A practical (OSCE) exam
A structured oral viva (SOE) exam
The latter two exams are taken together, and consist of 16 OSCE stations with questions provided by two examiners. These exams are usually held three times a year - May, November and January.
How many times can you take the Primary FRCA exam?
The Primary MCQ exam can be taken a maximum of six times. If you fail six times then you will need to submit evidence to an appeals process showing extenuating circumstances. You must also wait a minimum of 6 months between exam attempts, and will need to reapply and pay the exam fee each time.
What is the dress code for the exam?
For the Primary FRCA exam, you should dress the same as any other day-to-day clinical practice or contact with patients. Your form of dress should not constrain your ability to demonstrate recognised skills including effective communication with simulated patients or examiners. You will not be required to wear clinical or theatre clothing at any time.
How long is the FRCA Primary valid for?
Each of the three parts of the FRCA is valid for three years. This means if you don’t pass all three exams within three years of passing your first, you may have to re-take those that have expired.
We hope this guide has told you everything you need to know about the different components of the Primary FRCA exam. With the right resources and tools at your disposal and plenty of time to prepare, we are sure you’ll be able to pass, graduate, and take the next step on your path to becoming a qualified anaesthetist.