Primary FRCA: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Pharmacology
• Physiology, related biochemistry and anatomy
• Physics, clinical measurement, statistical methods and data interpretation

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.

1. OSCE equipment stations — knowing common UK anaesthetic machines (Dräger, GE, Mindray), circuit configurations, vapouriser anatomy, monitoring standards (AAGBI 2015 onwards). Equipment varies by region.
2. Drug calculations under SOE time pressure — bolus and infusion conversions, drug pumps (TCI, syringe drivers), mcg/kg/min for adrenaline/noradrenaline. Practise these cold.
3. Physics fundamentals — vapour pressure principles, laminar vs turbulent flow (Reynolds number), critical pressure of oxygen, ultrasound physics (frequency, attenuation, artefacts).
4. Resuscitation algorithm currency — adult ALS updated 2021 (Resus Council UK), paediatric ALS, neonatal life support. Olde rrevision sources may teach outdated drug doses or sequences.
5. Communication stations — breaking bad news in the perioperative context, explaining anaesthetic plan for awake regional vs GA, consent for high-risk anaesthesia. Practise with structured frameworks (SPIKES).
6. Statistics — sample size calculations, types of error (alpha, beta), confidence intervals, power calculations. Small block but examined directly.
7. Paediatric drug calculations — weight-based dosing, paediatric ETT sizing (age/4 + 4 mm internal diameter), volume of distribution differences. Speed and accuracy matter.
8. Regional anatomy under OSCE — identifying brachial plexus structures on ultrasound vs cadaveric vs landmark anatomy. Different examiners weight different presentations.

A pragmatic phased approach used by recent CT2/ST3 anaesthesia trainees.

1. Weeks 1–6

   Foundation pass across all three MCQ science areas. 30 questions/day with the iatroX adaptive engine. Read the Oxford Handbook of Anaesthesia paired with weak topics. Drill anatomy daily — brachial plexus, neuraxial, airway.

2. Weeks 7–11

   Targeted weak-area drilling. Pharmacology mechanism + kinetics review (induction agents, volatiles, NMBs, LAs). Equipment cards review. Daily drug calculation practice under time pressure.

3. Weeks 12–14

   Timed MCQ practice each week, followed by answer review. SOE practice with a senior trainee or consultant — structured-answer technique. OSCE station practice for equipment, anatomy, communication.

4. Weeks 15–16

   Bookmark review only. Last-minute revision of resuscitation algorithms, common drug doses and OSCE communication frameworks. Confirm RCoA bookings. Sleep, hydrate, do not learn new material.

Dedicated Primary FRCA question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

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.

For 2026/27, Primary FRCA has three components: MCQ, OSCE and SOE. The MCQ contains 90 single-best-answer questions over 3 hours and must be passed before applying for the OSCE and SOE. All three components must be passed to complete Primary FRCA.

The 2026/27 RCoA calendar lists three MCQ sittings and three OSCE/SOE sessions. Check the linked official calendar for exact dates and application windows; the schedule changes with the planned new formats from July 2027.

No. Pass the MCQ before applying for OSCE and SOE. The OSCE and SOE can be passed at different sittings, subject to RCoA pass-validity and attempt-limit rules. Candidates planning sittings from July 2027 must also check the transition rules for their existing passes.

RCoA publishes the MCQ fee and the combined or single-component OSCE/SOE fees on its exam pages. Use the official fee links above for your intended sitting. Your total depends on which components you need to take and any resits.

RCoA plans to introduce the Applied Knowledge Test (AKT) and Clinical and Anaesthetic Sciences Exam (CASE) from July 2027, subject to approval. Some candidates with a valid partial OSCE/SOE pass can use the legacy format during 2027/28. Check the linked RCoA transition guidance before choosing a sitting.

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.

Full Primary FRCA bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.