02/10/2025
MRCEM and Career in Emergency Medicine – A Comprehensive Guide By Dr. Muhammad Asif
✅Brief Introduction
I am Dr. Muhammad Asif Nazir, currently holding MRCEM, MRCGP (UK), and CCT (UK). Over the course of my career, I have had the privilege of working in Pakistan, Saudi Arabia, the United Arab Emirates, and the United Kingdom, where I have been based for the last five years.
➡️1. What is MRCEM?
MRCEM (Membership of the Royal College of Emergency Medicine) is a postgraduate diploma in Emergency Medicine recognised worldwide. It demonstrates competence in the specialty and is particularly valued in regions where Emergency Medicine is an evolving field.
➡️2. How many exams are required for MRCEM?
MRCEM consists of three examinations:
• MRCEM Primary (Theory Exam)
◦ Format: Multiple-choice, single best answer (SBA)
◦ Number of Questions: 180
◦ Duration: 3 hours
◦ Location: Pearson Vue Test Centres worldwide
◦ Content: Based on the RCEM Basic Sciences Curriculum (June 2010)
• MRCEM Intermediate (Theory Exam)
◦ Format: Multiple-choice, SBA
◦ Number of Questions: 180
◦ Duration: 4 hours (2 × 2 hours with a 1-hour break)
◦ Location: Pearson Vue Test Centres
◦ Content: Covers a wide range of clinical conditions encountered in Emergency Medicine
• MRCEM OSCE (Practical Clinical Exam)
◦ Format: 16 Objective Structured Clinical Examination (OSCE) stations
◦ Duration: 2 hours 42 minutes (16 × 8-minute stations with 1-minute reading time; 2 rest stations)
◦ Locations: London (UK), Kuala Lumpur (Malaysia), Chennai, Hyderabad, and Kochi (India)
◦ Content: Assesses clinical skills, communication, and decision-making using simulated patient encounters
➡️3. What is the cost of MRCEM?
The total cost for all three examinations is approximately £1,579 (subject to periodic updates from RCEM).
➡️4. How should I prepare for MRCEM?
• For Primary and Intermediate exams, the best preparation is through high-quality online question banks. A dedicated period of 4–6 months of self-study is generally sufficient.
• For the OSCE, attending a structured, exam-focused preparatory course is strongly recommended, as it helps in refining communication and practical skills under exam conditions.
➡️5. What is a career in Emergency Medicine like?
Emergency Medicine is challenging, high-pressure, and highly rewarding. It requires quick decision-making, adaptability, and resilience.
• In many countries, Emergency Departments were historically run by Medical Officers (MOs), but there is now an increasing demand for formally trained Emergency Physicians.
• In the UK, Emergency Medicine is considered one of the most demanding specialties within the NHS due to its rotational shifts (day, evening, night, twilight), high workload, and responsibility of supervising junior staff. Even at senior levels, unsocial working hours are common.
• In the Middle East, Emergency Medicine specialists are in demand, but shift work and rotation remain an expectation, even at consultant level.
Working in the NHS is significantly different from practising in South Asia or the Middle East. The system is more structured but also more demanding.
➡️6. What are the benefits of MRCEM?
• MRCEM is valuable only if you intend to pursue a career in Emergency Medicine.
• In the Middle East, it can allow you to work as a Specialist in Emergency Medicine, even without formal CCT training. However, outside Emergency Medicine, it does not confer any specialist recognition.
• In the UK, MRCEM alone does not place you on the Specialist Register. You can work in Emergency Departments without MRCEM, but progression to consultant status requires structured training and CCT. Some trusts may appoint experienced doctors with MRCEM/FRCEM to locum consultant roles, but this is not the standard route.
➡️7. Should you choose Emergency Medicine as a career?
Emergency Medicine is best suited for doctors who are:
• Passionate about acute care,
• Able to work under pressure,
• Comfortable with unsocial working hours and shift patterns, and
• Motivated to handle fast-paced, unpredictable environments.
If you are unsure about committing long-term to this lifestyle, I would advise against pursuing MRCEM, as it requires considerable time, financial investment, and personal commitment.
✅8. My Guidance and Support
Over the years, I have conducted multiple online sessions guiding colleagues about the MRCEM pathway and Emergency Medicine as a career. I am always happy to share my experience and provide honest advice, free of charge, to those who genuinely seek guidance.
I strongly prefer direct conversations over calls or structured sessions, as they are far more effective than prolonged messaging.
🛑Final Thoughts
Emergency Medicine is not just a career — it is a lifestyle. If you are genuinely passionate about it, the rewards in terms of professional growth and personal fulfilment are immense. However, it is equally important to make an informed decision before embarking on this demanding but rewarding journey.
Good luck to all doctors who are working hard to shape their careers and striving for a better future.
