The Final FRCA Exam
The Final Fellowship of the Royal College of Anaesthetists (FRCA) examination is the second and final stage of the FRCA qualification. Whereas the Primary FRCA focuses on the scientific principles underpinning anaesthetic practice, the Final FRCA assesses the application of that knowledge to real-world clinical anaesthesia, perioperative medicine, intensive care, pain medicine, and professional decision-making. It is aligned to Stage 2 anaesthetic training and is designed to determine whether a trainee has developed the knowledge and judgement expected of an independent registrar approaching higher specialist training.
The examination consists of two components:
- Final FRCA Written Examination
- Final FRCA Structured Oral Examination (SOE)
Candidates must pass the Written Examination before they are eligible to sit the SOE. Once passed, the written component remains valid for three years.
*Importantly, the exam is due to change substantially in Summer 2027. For more detail of the new exam, follow this link: https://www.rcoa.ac.uk/examinations/2027-launch-new-frca-exams*
Final FRCA Written
The Written Examination is intended to assess both factual knowledge and the ability to prioritise information, solve clinical problems, and make appropriate management decisions. It comprises two separate papers, usually sat on different days.
Constructed Response Question (CRQ) Paper
Unlike traditional essay questions, CRQs reward concise, targeted responses. Marks are allocated to specific answer points, and candidates are expected to provide exactly the information requested. The examination is designed to test clinical reasoning, prioritisation, and the ability to identify key issues within a scenario.
Multiple Choice Question (MCQ) Paper
The MCQ paper is a three-hour examination containing 90 Single Best Answer (SBA) questions. Each question consists of a clinical vignette or stem followed by five possible answers, of which one is considered the most appropriate. There is no negative marking.
The emphasis is less on recall of isolated facts and more on clinical application. Questions frequently require interpretation of investigations, risk stratification, decision-making, and selection of the most appropriate management strategy.
Our Final FRCA SBAs launched in May 2026. Follow this link for more information: https://teachmeanaesthetics.com/sign-up/#final-frca
Final FRCA Structured Oral Examination (SOE)
The SOE is the final component of the FRCA examination and assesses a candidate’s ability to apply knowledge in a clinical context. Examiners are interested not only in what candidates know, but also in how they think, prioritise, communicate, and justify their decisions. Successful completion of the SOE leads to the award of Fellowship by Examination.
The examination is conducted in person and consists of two separate sections: SOE 1 and SOE 2.
SOE 1
SOE 1 contains two consecutive parts (Part A and Part B). Each part lasts 26 minutes and consists of two clinical short cases, with each case linked to an applied clinical science discussion. The clinical science component may occur before or after the clinical scenario. Each candidate will answer questions on anatomy, physics, physiology and pharmacology, with each basic science component linked (sometimes closely, sometimes not) to the paired short case.
SOE 2
SOE 2 is centred around a longer clinical scenario and tests the candidate’s ability to manage more complex situations. The examination includes a clinical long case followed by two independent clinical short cases. Candidates are given time to review clinical material before discussion begins.
Topics frequently involve:
- Major perioperative complications
- Complex co-morbidity
- Intensive care medicine
- Pain management
- Ethical and professional dilemmas
- Interpretation of investigations and imaging
Examiners assess whether the candidate can synthesise information, formulate safe management plans, and adapt their approach as new information becomes available.