About the exam
Final FRCA Written Exam structure
An independent study guide aligned to the current RCoA Final FRCA Written examination, Final syllabus and Stage 2 anaesthetics curriculum.
Issuer and path
Final FRCA Written Study Guide is administered through Royal College of Anaesthetists. Check official resources before booking, retesting, or relying on a stale requirement.
Final FRCA MCQ
90 scored + 0 pretest
A three-hour paper of 90 five-option Single Best Answer questions, broadly allocated across general anaesthesia, perioperative medicine, regional anaesthesia and other curriculum domains.
Final FRCA CRQ
12 scored + 0 pretest
A three-hour paper of 12 mandatory constructed-response questions, each worth 20 marks, sampling mandatory Stage 2 areas through structured clinical problems.
Confirm both papers and the transition date
Use the current RCoA calendar, Regulations, candidate guidance and direct communications to confirm eligibility, application windows, technical checks, adjustments and whether your sitting uses the legacy MCQ-plus-CRQ format or the new AKT.
Official Outline Coverage Map
Coverage is mapped to official outline item counts so content depth can be checked without hard-coding a single exam.
| Topic | Official outline items | Your questions | Your flashcards | Confidence |
|---|---|---|---|---|
| MCQ: General anaesthesia | 45 | 200 | 25 | Strong |
| MCQ: Perioperative medicine | 10 | 45 | 10 | Strong |
| MCQ: Regional anaesthesia | 10 | 45 | 10 | Strong |
| MCQ: Other curriculum domains | 25 | 111 | 20 | Strong |
| CRQ curriculum scope: Stage 2 SBA practice | 12 | 200 | 35 | Strong |
How to use this guide
How to prepare for the current Final FRCA Written
Protect breadth for the 90 SBA paper, then rehearse concise CRQ answers that follow the command, mark allocation and printed answer lines.
1. Parse the exact task
Identify the patient, procedure, phase, urgency and command. For a CRQ, note the marks, requested number and available lines.
2. Represent the problem
Summarise the dominant diagnosis, physiology, comorbidity, risks and constraints before listing interventions.
3. Prioritise threats and goals
Put immediate oxygenation, perfusion, neurological or haemorrhage threats first and define what successful management must achieve.
4. Choose and justify actions
Connect each assessment, investigation, monitor or treatment to a decision, benefit, important harm and alternative where relevant.
5. Match the item form
For SBA, choose the single option that best fits the complete lead-in. For CRQ, give distinct concise points in the number and structure requested.
6. Reassess and close the loop
State response measures, complications, escalation, postoperative destination, handover and follow-up rather than stopping after the first intervention.
Current written examination
Use one syllabus through two answer forms
The MCQ rewards breadth and single-best-answer discrimination; the CRQ rewards distinct, prioritised, applied points.
MCQ: General Anaesthesia
General anaesthesia across complex patients, airway and head and neck work, major surgery, specialist practice and the age spectrum.
Choose a topic to open below
MCQ: Perioperative Medicine
Assessment, optimisation, shared decisions, risk, enhanced recovery and safe care across the perioperative pathway.
Choose a topic to open below
MCQ: Regional Anaesthesia
Neuraxial, peripheral and fascial-plane techniques, ultrasound, local anaesthetic pharmacology and complication management.
Choose a topic to open below
MCQ: Other Curriculum Domains
Intensive care, pain, resuscitation, transfer, sedation, research, data, safety, professionalism and applied basic sciences.
Choose a topic to open below
CRQ Scope: Neuroscience SBA Practice
Five-option SBA clinical-judgement practice across neurosurgery, neuroradiology and neuro critical care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: Cardiothoracic SBA Practice
Five-option SBA clinical-judgement practice across cardiac, thoracic and cardiothoracic critical care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: Intensive Care SBA Practice
Five-option SBA clinical-judgement practice in organ support, sepsis, escalation, communication and end-of-life care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: General Duties SBA Practice
Five-option SBA clinical-judgement practice across airway, critical incidents, specialist duties, transfer, trauma and non-theatre care.
Choose a topic to open below
CRQ Scope: Obstetric SBA Practice
Five-option SBA clinical-judgement practice across maternal assessment, labour analgesia, operative delivery and emergencies.
Choose a topic to open below
CRQ Scope: Paediatric SBA Practice
Five-option SBA clinical-judgement practice across age-specific physiology, anaesthetic planning, emergencies and family-centred care.
Choose a topic to open below
CRQ Scope: Pain Medicine SBA Practice
Five-option SBA clinical-judgement practice across acute, chronic and cancer pain, interventions, risk and multidisciplinary care.
Choose a topic to open below
CRQ preparation
Rotate through all seven essential units
The College does not publish a fixed unit-level CRQ quota, so protect breadth across every mandatory area.
CRQ Scope: Neuroscience SBA Practice
Five-option SBA clinical-judgement practice across neurosurgery, neuroradiology and neuro critical care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: Cardiothoracic SBA Practice
Five-option SBA clinical-judgement practice across cardiac, thoracic and cardiothoracic critical care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: Intensive Care SBA Practice
Five-option SBA clinical-judgement practice in organ support, sepsis, escalation, communication and end-of-life care; not constructed-response simulation.
Choose a topic to open below
CRQ Scope: General Duties SBA Practice
Five-option SBA clinical-judgement practice across airway, critical incidents, specialist duties, transfer, trauma and non-theatre care.
Choose a topic to open below
CRQ Scope: Obstetric SBA Practice
Five-option SBA clinical-judgement practice across maternal assessment, labour analgesia, operative delivery and emergencies.
Choose a topic to open below
CRQ Scope: Paediatric SBA Practice
Five-option SBA clinical-judgement practice across age-specific physiology, anaesthetic planning, emergencies and family-centred care.
Choose a topic to open below
CRQ Scope: Pain Medicine SBA Practice
Five-option SBA clinical-judgement practice across acute, chronic and cancer pain, interventions, risk and multidisciplinary care.
Choose a topic to open below
Complex General Anaesthesia and Major Surgery
Anaesthesia across frailty, comorbidity, major abdominal, urological, gynaecological and orthopaedic surgery, including day-case selection and recovery.
Key rules
Rule 1
A defensible anaesthetic plan connects patient reserve, surgical burden, positioning, blood loss, postoperative destination and the patient's goals.
Exam cue: Frame each case as patient factors, procedure factors, options, chosen plan and contingency.
Rule 2
Technique choice is less important than showing how monitoring, analgesia, fluid strategy, temperature control and rescue plans address the dominant risks.
Exam cue: State how the plan changes for frailty, organ dysfunction, anticoagulation or anticipated major blood loss.
Common traps
Listing techniques without explaining why one best fits the patient and operation.
Prevention: Answer the exact lead-in or command instead of reproducing a generic essay.
Treating immediate recovery as the endpoint instead of planning ward, enhanced-care or critical-care needs.
Prevention: Answer the exact lead-in or command instead of reproducing a generic essay.
Memory anchors
What makes a major-surgery plan complete?
Assessment, optimisation, consent, monitoring, technique, analgesia, fluids and blood, complication plans and postoperative destination.
How should frailty change planning?
Use it to inform shared decisions, realistic benefit, delirium and functional risk, medication review and the level of postoperative support.
What should a blood-loss plan contain?
Anticipated loss, access and monitoring, blood availability, haemostatic strategy, warming, targets, escalation and communication.
Why plan analgesia before induction?
It allows a multimodal, procedure- and patient-specific strategy with contraindications, rescue options and follow-up considered early.
What closes the perioperative loop?
Defined recovery goals, handover, surveillance for expected complications and a clear escalation destination.
Next best moves
Quick check-up
Use a short quiz to confirm the rule pattern is actually sticking.
Check-up Questions
A frail 84-year-old with limited exercise tolerance is listed for elective hemicolectomy. Which preoperative finding most strongly supports planned postoperative critical-care admission?
During laparoscopic surgery, peak airway pressure rises immediately after steep Trendelenburg positioning. What is the most likely mechanism?
Answer all questions to submit.
Next step personalized recommendations
Open another topic next
Official resources
Verify the details with the official sources
Use these links for eligibility, scheduling, handbook rules, and issuer updates. Our guide helps you study; official sources tell you what the testing partner currently requires.
RCoA: Final FRCA Written examination
The authoritative current purpose, online delivery, MCQ and CRQ formats, scope, marking, eligibility and progression page.
RCoA: Final FRCA Syllabus v2.2
The current examination syllabus, last updated 19 January 2026, with Stage 2 capability codes and essential units.
RCoA: 2021 Curriculum learning syllabus, Stage 2
The Stage 2 learning outcomes and key-capability context to which the current Final examination is mapped.
RCoA: Final FRCA assessment strategy
The College's description of the written papers, blueprinting, expected Stage 2 standard and relationship to the SOE.
RCoA Examination Regulations, April 2026
Current component structure, eligibility, attempts, conduct, marking, successful attempts and transition governance.
RCoA: Final FRCA written resources
Official sample-paper links, chair reports and candidate preparation resources; candidates should use these without reconstructing live content.
RCoA: taking written exams online
Current technical, room, identity and remote-invigilation preparation for online written examinations.
RCoA: 2027 launch of new FRCA exams
The planned Final AKT format and transition timetable, including the January 2028 start, subject to GMC approval.
RCoA: new exam format FAQs
Current answers on the AKT timetable, 100-SBA delivery, curriculum continuity and written-pass validity.
FAQ
Common Final FRCA Written questions
Is this an official RCoA resource?
No. This is an independent study guide. The current Royal College of Anaesthetists examination pages, syllabus, Regulations, calendar and candidate communications remain authoritative.
What does the final-frca-written slug cover?
It covers the current written Final FRCA component: the MCQ and CRQ papers. It does not cover the separate Final Structured Oral Examination and does not represent the complete Fellowship examination.
What is the current Final FRCA Written format?
The current examination has two remotely invigilated papers on different days: a three-hour MCQ paper of 90 Single Best Answer questions and a three-hour CRQ paper of 12 Constructed Response Questions.
Does the MCQ still include Multiple True/False questions?
No. The RCoA removed Multiple True/False items from September 2023. The current Final MCQ consists of 90 five-option SBA questions.
How is the MCQ distributed?
The College says the paper will broadly, but not exclusively, contain 45 questions in general anaesthesia, 10 in perioperative medicine, 10 in regional anaesthesia and 25 in other curriculum domains. Applied basic sciences may appear in every section.
How does the CRQ paper work?
Candidates attempt all 12 questions. Each is worth 20 marks and is divided into structured elements with the marks and answer lines shown. The paper tests critical thinking, application, judgment, evaluation and prioritisation as well as knowledge.
How should answers be placed on CRQ answer lines?
When the question requests a stated number of responses, give one distinct response per line. The RCoA warns that only the first distinct answer on a line is considered and extra answers on the same line are not considered.
Which syllabus applies?
The current Final FRCA Syllabus v2.2, last updated 19 January 2026, maps examinable capabilities to Stage 2. The College also states that the Final examination may sample Stage 1 material, including applied basic sciences, professionalism and important recent reports or guidelines.
What are the seven essential units?
They are neuroscience; cardiothoracic anaesthesia and critical care; intensive care medicine; general duties; obstetrics; paediatrics; and pain medicine. This guide uses them to organise CRQ preparation without claiming a fixed live-paper quota for each.
How are the papers standard set?
The RCoA uses modified Angoff standard setting. The MCQ has a maximum of 90 marks. Each CRQ is worth 20 marks, for 240 total, and the question standards are combined across the paper.
Who may apply for the Final Written?
Candidates generally need an eligible registration or membership route and a pass in the Primary FRCA or an accepted exemption or equivalent route. Section 4 of the current Regulations is authoritative for the complete eligibility rules.
How many attempts are allowed?
The current Regulations allow up to six attempts at an examination component. Additional Educational Training and specified guidance or evidence requirements apply before a sixth attempt.
Does passing the Written complete the Final FRCA?
No. Passing the Written allows a candidate to apply for the Final SOE. The written pass is valid for that progression for three years under the current rules.
When is the written format expected to change?
The RCoA plans the first Final FRCA Applied Knowledge Test for January 2028, subject to GMC approval and the published transition arrangements. The planned AKT is one three-hour paper of 100 SBA questions and removes the separate CRQ paper.
Does this guide treat the future AKT as current?
No. It records the MCQ plus CRQ format as current for the 2026–2027 academic year and labels the 100-SBA AKT as a future boundary. Candidates should always confirm the format for their own sitting.
Are the 601 practice questions an official number or CRQ simulation?
No. The current examination contains 90 SBA and 12 CRQ. This independent bank contains 601 original five-option SBA questions: 401 scale the published MCQ allocation and 200 cover advanced clinical judgement across the mandatory Stage 2 areas sampled by the CRQ paper. Those 200 questions do not simulate constructed-response wording, answer lines or marking.