It is the nightmare scenario.
You walk out of the exam hall feeling confident. You knew the guidelines. You understood the clinical scenarios. Yet, when the results come out, you’ve missed the pass mark by 2%.
Why does this happen?
Often, it isn’t a lack of medical knowledge. It’s exam technique. The FRCEM is designed to punish "sloppy" thinking. The question writers insert specific traps to differentiate between a safe F2 and a Registrar ready for consultancy.
If you want to avoid repeating the cycle, you need to identify these leaks in your performance.
Here are the most common FRCEM mistakes that cost candidates marks—and exactly how to fix them.
1. The "Initial" vs. "Definitive" Trap
This is the #1 reason candidates drop marks on Single Best Answer (SBA) questions.
You read a scenario about a patient with severe sepsis. The question asks: "What is the most appropriate initial step?"
You see "IV Antibiotics" in the options and click it immediately. It’s the correct treatment, right? Wrong. The correct answer was "High-flow Oxygen."
The Mistake: You identified the correct treatment, but you ignored the chronology. In the FRCEM, "Initial" means "what happens in the first 60 seconds." "Definitive" means "what solves the underlying problem."
The Fix: Read the "lead-in" question twice. If it says "Initial," think ABCDE. If it says "Definitive," think Pathology.
2. Ignoring the "Dry" SLOs
Emergency Medicine doctors love Resus (SLO 3) and Trauma (SLO 4). We hate Management (SLO 11) and Research (SLO 12).
We previously discussed how hard the FRCEM exam is due to the massive curriculum. Many candidates subconsciously skip the "boring" topics during revision, hoping they won't come up.
The Reality: The exam blueprint is strict. You will get questions on clinical governance, audit cycles, and statistical values (p-values, sensitivity vs. specificity). Failing these sections makes it mathematically very hard to pass, even if you ace the clinical questions.
The Fix: Force yourself to study the dry topics first when your brain is fresh. Do not leave Statistics for the week before the exam.
3. Passive Reading Instead of Active Recall
We have said it before, but it bears repeating: Reading a textbook is not studying.
If you are just highlighting lines in the Oxford Handbook, you are recognising information, not retaining it. In the exam, under pressure, that passive knowledge disappears.
To pass, you need to test yourself constantly.
The Fix: Switch to active testing immediately.
Don't just read about head injury guidelines.
Try a free demo quiz here to test your application of those guidelines in a real scenario.
If you get it wrong, then read the explanation.
4. Poor Time Management (The "Spiral of Doom")
You have approximately 60 seconds per question.
A common mistake is spending 4 minutes agonising over a complex Toxicology question you don't know. This puts you behind schedule. You then rush the next 10 questions—which were easy Paediatric ones—and make silly errors because you are panicking.
This is especially common for those trying to balance revision with work. If you are struggling to fit study in, check our guide on how to study for FRCEM while working full time for advice on building stamina.
The Fix: Be ruthless. If you don't know the answer after 60 seconds, flag it, guess, and move on. Never sacrifice easy marks later in the paper for a hard mark now.
5. Over-Complicating the Scenario
"The patient has chest pain... but what if it's actually an aortic dissection presenting atypically?"*
Sound familiar? Experienced Registrars often fail because they "know too much." They look for the zebra when the exam is showing them a horse.
The Rule: Unless the question gives you a specific clue (e.g., "tearing back pain" or "unequal pulses"), assume the common presentation. The exam is not trying to trick you with unmentioned symptoms.
6. Not Having a Structured Roadmap
You cannot wing this exam. Candidates who dive into random topics without a plan often find themselves overwhelmed two weeks before the date, realising they haven't covered an entire SLO.
You need a timeline. You need to know exactly what you are covering in Month 1 vs. Month 4.
If you haven't built your schedule yet, read our step-by-step guide on how to pass the FRCEM exams on your first attempt. It breaks down the revision phases you need to follow.
Summary: How to Stop Losing Marks
Read the Lead-In: Are they asking for Initial or Definitive action?
Respect the Blueprint: Don't skip Statistics or Management.
Active Recall: Stop reading, start doing questions.
Keep Moving: Never spend more than 90 seconds on a single question.
Keep it Simple: Don't invent symptoms that aren't there.
Ready to Test Your Technique?
Knowledge is only half the battle. You need a question bank that mimics the style, difficulty, and traps of the real FRCEM exam.
At StudyFRCEM, our questions are written to expose these common mistakes before exam day, so you don't make them when it counts.
