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There are four elements in the examination. The clinical component makes up 50% of the marks and is divided between a Short Answer Question (SAQ) paper and an Objective Structured Clinical Examination (OSCE). The management component makes up 25% of the marks, and an academic component the remaining 25% (divided equally between a Clinical Topic Review (CTR) and a Critical Appraisal of a paper from the current medical literature (usually a Randomised Controlled Trial , a Systematic Review or a diagnostic paper). The clinical component must be passed. The examination is held twice a year and the SAQ is held one month before the rest of the examination.

Those passing the examination become Fellows of the College Of Emergency Medicine and are entitled to use the letters FCEM.