Clear answers to the questions anaesthetic trainees ask most about the Primary FRCA — the MCQ structure, how pharmacology, physiology and physics are weighted, how the pass mark is set, and how long to revise.
The Primary FRCA is the first examination towards Fellowship of the Royal College of Anaesthetists. It tests the basic sciences underpinning anaesthetic practice and has three components: a written MCQ examination, an Objective Structured Clinical Examination (OSCE) and a Structured Oral Examination (SOE). You must pass the MCQ before you can sit the OSCE and SOE.
The MCQ paper contains 90 questions sat over three hours — roughly two minutes per question. It is delivered as a single paper on the exam day.
Questions are split equally across the three core sciences: 30 pharmacology, 30 physiology, and 30 physics and clinical measurement questions. That equal weighting is why physics and pharmacology can't be left until last — each subject is worth exactly a third of the paper.
The MCQ is normally sat three times a year, with the OSCE and SOE following in later sittings for successful candidates. Check the RCoA website for the exact dates and application windows for your sitting before planning your revision block.
Four to six months of structured revision alongside clinical work is the most common pattern — roughly 1.5–2 hours on working days with longer sessions at weekends. Physics and clinical measurement usually need the most dedicated time because few trainees have touched them since school.
Work subject by subject: read a structured tutorial, then test it immediately with questions and review every incorrect answer before moving on. In the final six weeks switch to mixed, timed 90-question mocks so pacing across pharmacology, physiology and physics is practised as well as content.
Several thousand questions is typical, but depth of review matters more than the raw total. A candidate who completes 2,000 questions and rewrites their reasoning on every error will outperform one who rushes through 5,000 without reviewing.
It has a reputation as one of the harder first-part postgraduate exams, with pass rates that are typically around half of candidates or lower depending on the diet. The difficulty comes from precision rather than breadth: the syllabus is well defined, but answers often depend on exact mechanisms, numbers and curves.
The pass mark is set for each diet using a recognised standard-setting method rather than a fixed percentage, so it moves a little between sittings depending on paper difficulty. Results are published with the pass mark for that diet.
MCQ results are typically released a few weeks after the sitting through your RCoA online account. If you pass, you become eligible to apply for the OSCE and SOE at a later sitting.
Candidates are allowed a maximum of six attempts at the MCQ, with separate attempt limits for the OSCE and SOE. Because attempts are limited, most trainees wait until their timed mock performance is consistently above the pass standard before applying.
Passing the MCQ opens the OSCE and SOE, which are normally sat together. The MCQ pass stays valid for a defined period within which you must complete the remaining components, so plan the written and the viva/OSCE phases as one continuous campaign rather than two separate exams.
