Final FRCA Written examination

About the Written

The Final FRCA Written examination assesses factual knowledge and the ability to make judgements and prioritise information. It forms a gateway to the Final FRCA SOE, which assesses application of this knowledge. 

The Final FRCA Written examination is mapped to the intermediate level of the UK anaesthetic training curriculum. It is approved by the General Medical Council for meeting the required standards of assessment for this level of training and is informed by important developments in anaesthesia. It has two parts, which are sat on different days - the Final FRCA Constructed Response Question (CRQ) examination and the Final FRCA Multiple Choice Question (MCQ) examination.

Due to COVID-19, the Final Written examination will be sat online with remote invigilation. More information on this delivery method is provided in taking the written exams online - guidance

Structure of the Final Written examination

The Final FRCA CRQ 

A three hour examination in which candidates provide a written response to 12 constructed response questions.

The CRQ examination assesses the mandatory areas of the UK training curriculum. These areas may appear as stand-alone questions or as part of a question, for example pain management within a perioperative case.

In addition to specific knowledge-based competences, examination material may be developed from guidance or recommendations published by healthcare organisations such as the RCoA, AAGBI, NCEPOD, NICE, SIGN, NPSA, CEMACH. 

Candidates must attempt all 12 questions. If one or more questions is not attempted, a candidate will fail.

Changes to the CRQ paper. The March 2020 paper contained only CRQ format questions.
These questions are designed to assess a candidate's ability to think critically and prioritise information. This is assessed in the way the questions are answered and marked. Candidates should read the question instructions carefully and only give the information that is asked. For example, where a CRQ question asks for a specific number of responses e.g. 'List 4 factors contributing to X',  only the first distinct answer per line will be awarded marks. Any additional answers on that same line will not be considered.  
For more information on this change, please go to 'planned changes to the examination' .

The Final FRCA MCQ

This is a three-hour examination with two question types: Multiple True False (MTF) and Single Best Answer (SBA). Candidates answer 90 questions in total, 45 MTFs and 45 SBAs.    
Each MTF question has a question stem and five options. Candidates must decide which of these options are true and which are false.

The MTF questions comprise:

  • 15 questions on advanced sciences to underpin anaesthetic practice.
  • 15 questions on the essential general duties units.
  • 15 questions on specialist topics including both essential and optional units.

SBA questions consist of a stem, lead in question and five options, one of which will be the best response.  Each correct answer is worth 4 marks.
The 45 SBA questions are divided into:  

  • 22-23 questions on the essential general duties units.
  • 22-23 questions on specialist topics taken from both essential and optional units.

This format of this exam will be changing in 2022, please see ‘planned changes to the examination’.

How it is marked   

One mark will be awarded for each correct answer in the MTF section of the paper and four marks will be awarded for each correct answer in the SBA section. Negative marking is not used. The marks for each section of the MCQ are combined to produce the total mark. With 45 MTF and 45 SBA questions, the maximum mark obtainable for the MCQ paper is 405 marks. 

The pass mark is provisionally set by examiners using a modified Angoff method. This mark is then reduced by one Standard Error of Measurement (SEM) to give the pass mark. The core group reserve the right to remove questions from the overall marks where error or ambiguity is found. Candidates will not be disadvantaged where this occurs.

A quick eligibility check is set out below. You must:

Final Written - maximum six attempts - valid  for three years
Registered with the GMC (UK)  AND
  • currently registered as a UK trainee in Anaesthesia, or registered as a trainee in Anaesthesia with the College of Anaesthetists, Ireland, OR
  • currently sponsored under the RCoA IP MTI scheme and employed as an anaesthetist in an NHS post for six months, NHS appraisal required OR
  • currently registered with the their respective College and is a former UK trainee UK or Ireland and left training no more than five years. OR Specialty/SAS grade who left training more than five years and has RA support. OR
  • currently registered with the College; is a former trainee (more than five years) or a non-UK anaesthetic trainee who has been employed in the UK NHS as an anaesthetists for at least 12 months immediately preceding the exam date applied for. NHS appraisal required. AND
Have passed the Primary FRCA examination  or exemption qualification within last seven years  AND

Have been awarded the Core Level Training Certificate or NHS appraisal for non-UK trainee or sponsored under MTI. AND

Has not exceeded the number of attempts allowed (six) If failed at the fifth attempt must have submitted an Additional Educational Training form (AET1) at least three months before the exam applied for.  Paragraph 8, Appendix 8 of the Examination Regulations refers.

The full eligibility for this exam is listed at Section 7 Paragraph 17 of the Examination Regulations.

Final Written Examinations Calendar – August 2020 to July 2021

Application opening date

7 June

29 November 2021

Application closing date

25 July

10 January 2022

Examination date

14 September 2021 - CRQ


Thursday 16 September 2021 - MCQ

8 March 2022 - CRQ


Thursday 10 March 2022 - MCQ


Examination fees




The online application process will be open for each exam from 0900 on the exam opening date to 1700 on the exam closing date (see dates and fees in the section above).  Applications are not accepted outside the application window.

Reasonable adjustments: Any applicant who has a physical or mental disability, specific learning difficulty (SpLD) or on-going or fluctuating medical condition may be entitled to reasonable adjustments. To apply for reasonable adjustments, you should check the ‘I have a disability’ and ‘I require exam adjustment’ boxes. You must do this at the time of booking your exam. Applicants requiring reasonable adjustments should book as early as possible to ensure that there is sufficient time to put in place any specific requirements.  For more information on reasonable adjustments, please refer to the Examination Regulations.

Withdrawals: withdrawals before the closing date may receive the full fee paid. Candidates withdrawing after the closing date may be entitled to a full refund, providing the request is made within 14 days of receipt of the application. For withdrawals greater than 14 days, the refund is subject to an admin fee.  A candidate who withdraws in any other circumstance within 7 working days of an exam date, including non-issue of entry visas or failure to appear for an examination, will not be entitled to any refund of fee. Exceptional circumstances will be considered on receipt of written evidence. Fees cannot be deferred from one exam to another. 

Tax deductibility.  The College and faculties are aware that trainees who sit examinations as part of a training programme can claim tax relief on their exam fees. Whilst in a training programme trainees can also claim tax relief on membership fees.  Please visit HMRC for further information on how to claim. 

Results from the September 2021 Final written exam will be released by email at 2pm on Monday 11 October 2021. 

No results will be given or confirmed by telephone.

All candidates who pass or fail FRCA exams will receive the same feedback which will be set out on their 'results letter' this is despatched to all candidates using first class post within seven working days of the release of the pass/fail list.  A full list of the type of feedback provided for each exam component is set out in the Primary and Final FRCA examinations regulations - appendix 9 - feedback policy.

Candidates sitting the Final FRCA Multiple Choice Question (MCQ) exams are provided with a comprehensive breakdown of their question performance against the areas of the curriculum tested in the exam. This allows trainees and trainers to identify shortfalls of knowledge in the relevant areas of the syllabus, so that focussed preparation can be put in place prior to the next attempt. Where a pass result is achieved, it will provide trainees with important information on which to base further continuing professional development. 

Around 14 days after the publication of the pass/fail list, the chair of the CRQ exam will release a comprehensive report summarising question performance and areas of the exam not answered well by candidates.

A candidate who has failed any of the following examination components more than once may request a guidance interview. Guidance is limited to one interview per examination component:

  • Final CRQ
  • Final SOE

Guidance is not provided for the Final MCQ. Candidates seeking advice on the MCQ component should contact their college tutor.

Candidates are not required to attend guidance interviews up to the fifth attempt for each examination component but at the sixth attempt, guidance interviews are mandatory. 

Please note that no special consideration will be given in respect of refunds following guidance interviews.

Interviews are usually arranged locally but where this is not possible or if local trainers and examiners are not available, interviews can be arranged at the College.  To arrange a guidance interview, please contact the examinations department  

The CRQ paper

A hybrid paper of Constructed Response Questions (CRQ) and Short Answer Questions (SAQ) was used in September 2019 and a full CRQ paper was introduced in the March 2020 exam.  Timings for the exam remain the same.

The use of CRQs provides candidates with a structured format in which to answer the 12 questions and assesses a candidates ability to think critically and prioritise information.

  • Candidates should take care in the way they answer the questions. Marks for each question element are clearly stated and there is a line per question element in which to place your answer. For example, if a question element requires 5 answers, there will be 5 lines numbered from 1 to 5. You should write each answer on each line. If you need to change an answer, clearly cross it out and write the new answer on the same line. 
  • The way the question is answered is reflected in the grading. For example, where a question asks for '6 elements', only the first distinct answer per line will be awarded marks. Any additional answers on that same line will be disregarded.

The examination preparation video in our resource section can continue to be used as a reference, with an updated CRQ video available in due course.

The MCQ paper

SBAs are used in UK undergraduate and postgraduate medical assessments, and are widely used by medical colleges, faculties and the GMC. Over the next 3 years, the MCQ examination will increase the number of Single Best Answer (SBA) questions, whilst reducing the number of Multiple True False (MTF) questions. This change will not affect the exam blueprint for the MCQ and the College will continue to test the same areas of the curriculum across the exam overall.

During transition the papers will change as follows: 

  • From September 2022, papers will comprise 30 MTF and 60 SBA questions
  • From September 2023 (tbc), papers will no longer contain MTFs. The final number of questions and paper format at this stage has yet to be finalised.

Candidate resources are a consolidation of the various example questions, videos, courses and guides, any of which may guide a candidate in their preparation for the various FRCA examination components.