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The basic-sciences and core anaesthesia exam for UK anaesthesia trainees — MCQ, SAQ, OSCE and SOE assessing pharmacology, physiology, anatomy, physics, equipment and clinical anaesthesia. Mapped to the RCoA 2021 curriculum with an AI-adaptive question bank by practising UK anaesthetists.
Full Primary FRCA bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
90 single-best-answer questions · 3 hours · 30 pharmacology, 30 physiology/anatomy/biochemistry, 30 physics/clinical measurement/statistics/data interpretation.
Candidates must pass the Primary MCQ before applying for the Primary FRCA OSCE and SOE components.
Station-based assessment of applied anaesthesia, resuscitation, equipment, anatomy, communication and clinical skills.
Structured oral assessment of basic sciences and clinical anaesthesia.
RCoA publishes the exact 2026-27 exam calendar by component. The Primary MCQ fee is £410/£420 depending on sitting, and OSCE/SOE combined fee is £755.
Approximate question distribution across the RCoA 2021 curriculum for Primary FRCA. Used to drive iatroX adaptive sequencing.
Source: official Royal College of Anaesthetists (RCoA) blueprint
Drawn from the RCoA 2021 curriculum, Oxford Handbook of Anaesthesia, AAGBI/RA-UK guidelines and item density in iatroX.
Pharmacokinetics — context-sensitive half-time of remifentanil vs alfentanil vs fentanyl, volume of distribution and clearance principles, paediatric dosing differences
Volatile agents — minimum alveolar concentration (MAC) and modifying factors (age, hypothermia, opioids, pregnancy), blood-gas partition coefficient, second gas effect, halothane vs sevoflurane vs desflurane
Respiratory physiology — alveolar gas equation, V/Q matching, physiological vs anatomical dead space, oxygen dissociation curve right shift (acidosis, hypercapnia, 2,3-DPG)
Cardiovascular physiology — Starling curve, baroreceptor reflex, coronary autoregulation, factors affecting CO and SVR
Equipment — gas pipeline pressures (4 bar, 7 bar oxygen, 12 bar CO2), variable bypass vaporisers, Mapleson breathing systems (A, B, C, D, E, F) and efficiency, BIS monitoring principles
Regional anatomy — brachial plexus roots/trunks/divisions/cords/branches, neuraxial anatomy (epidural space depth, dermatomes), peripheral nerve block landmarks
Drug calculations — bolus and infusion conversions, mcg/kg/min ↔ ml/hr, dilution calculations under SOE time pressure
Resuscitation algorithms — adult ALS (2021 update), paediatric ALS, neonatal life support, anaesthetic crisis management algorithms (AAGBI/ANZCA)
Observations from UK anaesthesia trainees and recent Primary FRCA candidates. Verify against current RCoA, AAGBI and Resuscitation Council UK guidance.
Candidate-reported observations — not official guidance.
A pragmatic phased approach used by recent CT2/ST3 anaesthesia trainees.
A live item from the iatroX bank. Try it before launching a full session.
Lidocaine has a hepatic extraction ratio of approximately:
Why iatroX is built differently for Primary FRCA.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the Primary FRCA bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
Most UK anaesthesia trainees sit during CT2 (Core Training 2) or ST3 of the 2021 curriculum. There is no formal minimum requirement but most colleges advise at least 12 months of dedicated anaesthesia clinical experience before attempting. International candidates can sit at any time meeting RCoA eligibility.
Primary FRCA starts with the Primary MCQ: 90 single-best-answer questions over 3 hours. Candidates must pass the MCQ before applying for the Primary OSCE and SOE; exact component dates and fees are published in the RCoA exam calendar.
MCQ and SAQ papers are held 2-3 times per year. OSCE and SOE are typically held quarterly. Each component is booked separately. Confirm 2026 dates on the RCoA website.
No. Components can be passed across multiple sittings. Most candidates sit MCQ first, then progress to SAQ, then OSCE/SOE once written components have been passed. RCoA publishes detailed pathway rules — confirm current attempt limits.
Approximately £400 for MCQ, £600 for SAQ, £880 combined for OSCE+SOE — total around £1,900 in fees, plus revision course costs which most candidates also pay. RCoA reviews fees annually.
Primary FRCA is the earlier-training fellowship — basic sciences and core anaesthesia, typically sat in CT2/ST3. Final FRCA is the higher-training fellowship — subspecialty practice (obstetric, paediatric, cardiothoracic, neuro, vascular), typically sat in ST4-ST5. Both are required for CCT in anaesthesia.
Yes. A single iatroX subscription (£29/month or £99/year for UK users; $29/$99 elsewhere) includes the Primary FRCA bank alongside Final FRCA, FFICM and every other premium iatroX exam bank. No add-ons or per-exam fees.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.