Trainee anaesthetists in the United Kingdom are required to pass this examination during the first two years in a Higher Specialist Training (Specialist Registrar / SpR) post or during ST3-4 in the new Specialty Registrar training scheme otherwise completion of specialist training is delayed.
Candidates are required to have a minimum of thirty months of recognised training in anaesthesia, and have passed the Primary FRCA, before they are allowed to attempt the exam. In some circumstances, the requirement to pass the Primary FRCA is waived if the candidate holds other qualifications in anaesthesia such as the European Diploma in Anaesthesiology or Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA).
Candidates are not allowed to sit the Final FRCA examination more than six times. Guidance is provided from the Royal College of Anaesthetists to trainees who fail more than twice.
Sittings of the examination take place twice per year.
Form of the examination
The exam takes the form of a written Short-Answer Question (SAQ) paper (3 hours, 12 questions), and a Multiple-Choice Question (MCQ) paper (3 hours, 60 five stem questions covering medicine, surgery, intensive care, pain and basic sciences and 30 Single Best Answer clinical questions)  which can be attempted at several regional centres in the UK (such as Edinburgh, Belfast, Cardiff, Manchester and London). Candidates who clearly fail either the SAQ or the MCQ are not allowed to proceed further and are deemed to have failed the entire examination.
Candidates who pass both the MCQ and the SAQ (or narrowly fail one) are invited to the oral part of the examination, in Churchill House, London, the headquarters of the Royal College of Anaesthetists.
The Viva Voce (oral) component of the examination consists of two structured oral examinations: the first (clinical) consists of 10 minutes to review a prepared series of clinical data, followed by 40 minutes of questioning; the second (basic science) consists of 30 minutes of questioning.
As with the Primary FRCA exam, each quarter of the examination is marked as follows:
- 2+: outstanding pass.
- 2: clear pass.
- 1+: narrow fail.
- 1: clear fail.
To pass the examination overall, the minimum mark is 2,2,2,1+. In other words, candidates are allowed a narrow fail in one quarter of the examination. Two awards of 1+, regardless of the remaining marks, result in a fail.
Approximately half of all candidates pass the examination at each sitting.
Negative marking (the deduction of a point for an incorrect answer) has been removed from the Multiple Choice Question (MCQ) component of the examination from the October 2008 sitting. From October 2010, some MCQ questions will be set according to the "single best answer" format.
The tone of the examination is predominantly clinical. The syllabus is extensive and covers all aspects of clinical anaesthetic practice. In addition, the entire syllabus of the Primary FRCA examination (which is predominantly basic science) is included.
Those who pass the examination are admitted as Fellows of the Royal College of Anaesthetists, and are entitled to use the postnominal "FRCA" after their name.
Fellowship may also be bestowed by election from the Council of the College.
A ceremony is held annually in London at which new fellows are formally admitted. "Diplomates" are invited to attend, but are admitted as fellows whether or not they do so.
Before the College bestowed its own fellowships, anaesthetists were awarded the FFARCS: Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons, the forerunner of the Royal College of Anaesthetists.
The following are similar qualifications to the FRCA. They are not necessarily equivalent or interchangeable:
- FFARCSI: Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons in Ireland.
- FANZCA: Fellowship of the Australian and New Zealand College of Anaesthetists.
- EDA: European Diploma in Anaesthesiology (and Intensive Care).
- FCA (SA): Fellowship of the College of Anaesthetists of the Colleges of Medicine of South Africa.
- "Past Paper". Retrieved 2008-06-16.[dead link]
- "Eligibility". Retrieved 2008-06-16.
- "Examination Fees". Retrieved 2008-06-16.
- "Regulations". Retrieved 2008-06-16.
- "Forms of Exam". Retrieved 2008-06-16.
- Nightingale P. (ed) (2008). Guide to the FRCA examination: The Final. 2nd edn. London, Royal College of Anaesthetists. ISBN 1-900936-31-3.
- "Final FRCA Syllabus". Retrieved 2008-06-16.
- "Membership Catergories". Retrieved 2008-06-16.