Practice for the MRCEM Intermediate SBA examination — 180 clinical single-best-answer questions across two papers, with adaptive AI question selection, spaced repetition and per-distractor rationales on every question.
A growing, referenced question bank — RCEM, NICE and resuscitation guidance across the full ED case mix
📚 Every answer anchored to named guidelines — see something off? Write us and we answer with the reference.
The MRCEM Intermediate SBA is the clinical written examination of the MRCEM, administered by the Royal College of Emergency Medicine (RCEM). It tests clinical decision-making across the whole emergency department case mix, blueprinted to the Specialty Learning Outcomes (SLOs) of the RCEM 2021 Emergency Medicine Curriculum.
The format is 180 single-best-answer questions over two 90-question papers of two hours each, sat on the same day at Pearson VUE centres. There is no negative marking, and the pass mark is set by a modified Angoff method, varying slightly between sittings.
The breadth is what makes this paper demanding: adult medicine and surgery, resuscitation and the deteriorating patient, trauma, paediatric emergencies, mental health presentations, procedural skills and sedation, toxicology, and the law around consent and capacity — all in one examination, frequently with ECGs, radiographs and other images attached to the stems.
Sittings run at published dates through the year. Eligibility, fees and the exam calendar are on the official website — always confirm current details at rcem.ac.uk before applying.
180 clinical single-best-answer questions across two 2-hour papers in a single day.
Prerequisite: Candidates take the Intermediate SBA after MRCEM Primary (or an RCEM-accepted equivalent), as the second MRCEM component.
Who applies: UK and Irish emergency medicine trainees and international EM doctors pursuing the MRCEM.
Registration Steps:
Source: rcem.ac.uk. Verify details before registering.
Approximate sampling across the RCEM 2021 curriculum SLOs — RCEM publishes these as ranges, and exact sampling varies by sitting. AiMedQs coverage mirrors this distribution.
Chest pain and ACS pathways, asthma and COPD escalation, PE workup, acute abdomen, GI bleeding scores, stroke and TIA, headache red flags, DKA, sepsis, renal colic and toxicology
ALS algorithm and reversible causes, post-arrest care, anaphylaxis doses, septic shock, major haemorrhage triggers and tracheostomy emergencies
Primary survey priorities, NICE head injury imaging rules, C-spine decision rules, pelvic and limb fractures, compartment syndrome and burns
The febrile child, bronchiolitis versus croup, paediatric DKA, intussusception, the limping child, safeguarding and weight-based emergency drug doses
RSI drug choice, the difficult airway algorithm, procedural sedation, local anaesthetic dosing and toxicity, chest drains and reductions
Suicide risk assessment, acute behavioural disturbance, capacity assessment and Mental Health Act sections
Consent and capacity edge cases, Gillick competence, end-of-life decisions, confidentiality limits and mandatory reporting
Supervision, escalation and supporting colleagues as represented in the written paper
The Intermediate SBA is the second of three components. The full MRCEM runs:
For the most current pathway requirements, visit rcem.ac.uk.
An intelligent study platform built for the RCEM clinical written examination.
Question coverage mirrors the curriculum sampling — adult presentations, resuscitation, trauma, paediatrics, procedures, mental health and complex situations.
Stems ask what you do next in the resus room — immediate management, next investigation and disposition, not leisurely ward-round reasoning.
Our engine identifies your weakest SLO areas and prioritises questions there, so your study time goes where the marks are.
Answers track RCEM clinical guidance, NICE criteria (head injury, sepsis, major trauma), ALS/APLS/ATLS algorithms and BNF/BNFC dosing — the anchors the paper actually uses.
Every answer is anchored to a named guideline or algorithm. See something off? Write us and we answer with the reference.
The classic ED traps — premature discharge, imaging that the rules do not support — each get their own explanation on every question.
Missed questions return at scientifically optimised intervals, so algorithms and doses hold until exam day.
The MRCEM SBA tests emergency medicine as practised in UK departments. Generic question banks miss these critical differences:
Imaging and admission decisions follow RCEM clinical guidance and NICE criteria — head injury CT rules, sepsis recognition, VTE and major trauma pathways — not US-style defensive workups.
Resuscitation questions assume the UK and European algorithm set, including exact drug doses, shock energies and escalation sequences for adults and children.
Mental Health Act sections, Mental Capacity Act assessments, Gillick competence and UK safeguarding duties frame the mental health and complex-situation questions.
Dosing follows the BNF and BNF for Children with rINN names and SI units — paediatric emergency doses per kilogram are reliably examined.
AiMedQs questions are written for the UK emergency department — RCEM and NICE-anchored, algorithm-precise, with named references — so your preparation matches what the paper actually asks.
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The MRCEM Intermediate SBA (formerly the FRCEM Intermediate) is the clinical written examination of the MRCEM, run by the Royal College of Emergency Medicine (RCEM). It tests clinical decision-making across the emergency department case mix — adult medicine and surgery, resuscitation, trauma, paediatrics, mental health, procedures and complex situations — blueprinted to the Specialty Learning Outcomes (SLOs) of the RCEM 2021 Emergency Medicine Curriculum.
The exam consists of 180 single-best-answer questions delivered as two papers of 90 questions, each lasting two hours, sat on the same day at Pearson VUE test centres. There is no negative marking. The pass mark is set by a modified Angoff method and varies from sitting to sitting.
The paper samples across the curriculum's Specialty Learning Outcomes. The largest share concerns the care of physically presenting adult patients (around 30%), with substantial blocks for resuscitation and the deteriorating patient, trauma, and acutely presenting children (around 15% each), plus procedural skills and sedation, mental health, complex situations such as consent and capacity, and supervision themes. RCEM publishes these as approximate ranges, and sampling varies by sitting.
Primary tests mechanism — anatomy, physiology and pharmacology behind ED presentations. The Intermediate SBA tests management — what is the most appropriate next investigation, immediate treatment or disposition for the patient in front of you. Stems are medium-length clinical scenarios, frequently with ECGs, radiographs or other images attached.
Doctors pursuing the MRCEM — UK and Irish emergency medicine trainees and international EM doctors. Candidates take it after MRCEM Primary (or an accepted equivalent), as the second of the three MRCEM components. Confirm current eligibility rules and dates at rcem.ac.uk.
Recurring high-yield territory includes resuscitation algorithms (ALS and APLS, anaphylaxis doses), toxicology with its antidotes and the paracetamol pathway, NICE head injury and sepsis criteria, trauma decision rules for C-spine and imaging, paediatric emergencies with weight-based drug doses, procedural sedation and RSI drug choice, and the legal framework of capacity, consent and Mental Health Act sections.
Management answers track RCEM clinical guidance, NICE guidelines (head injury, sepsis, VTE, major trauma, self-harm), the ALS, APLS and ATLS algorithms, and the BNF and BNF for Children for dosing — especially paediatric weight-based emergency doses. AiMedQs anchors every answer to the named source.
AiMedQs provides a growing, referenced SBA question bank built around ED management decisions in the exam's format, with adaptive AI question selection that targets your weakest SLO areas, spaced repetition, per-distractor rationales and performance analytics. Every answer is anchored to a named guideline — if you think a keyed answer is wrong, write to us and we answer with the reference.
The MRCEM Intermediate SBA bank is new and growing, with referenced questions added continually across the SLO blueprint. We deliberately publish carefully sourced questions rather than inflating the count — every question carries a named reference and per-distractor explanations.
The final component of the MRCEM is the OSCE, a stationed assessment of clinical and communication skills. Completing Primary, Intermediate SBA and OSCE earns the MRCEM — the Royal College of Emergency Medicine's membership qualification, used in UK emergency medicine training and widely recognised internationally.
ED management practice questions with named references and full rationales. AI-powered. Start studying today.
Try 30 Questions FreeAiMedQs is an exam preparation tool and does not guarantee exam results. Content is for educational purposes only. AiMedQs is not affiliated with or endorsed by the Royal College of Emergency Medicine (RCEM). For official exam information, visit rcem.ac.uk.