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100+ Free FCEM(SA) Part I Practice Questions

Pass your Fellowship of the College of Emergency Medicine of South Africa — Part I (Basic Sciences) exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: FCEM(SA) Part I Exam

2 papers

Online MCQ papers (no oral for Part I)

FCEM(SA) Regulations

100 each

Questions per paper

FCEM(SA) Regulations

3 hours

Time per paper

FCEM(SA) Regulations

25%

Equal weight per basic science subject

FCEM(SA) Part I Blueprints

40%

Subminimum per paper

FCEM(SA) Regulations

R12,950

Listed Part I exam fee (SS2026/FS2027; confirm diet)

CMSA Exam Fees Schedule

6 years

Part I validity toward Part II

FCEM(SA) Regulations

100

Free practice MCQs on OpenExamPrep

OpenExamPrep

FCEM(SA) Part I is two 3-hour online MCQ papers (100 questions each) with equal Anatomy, Pathology, Physiology and Pharmacology weighting. Pass requires a standard-set average above the cut score and ≥40% on each paper. Fee listed as R12,950 on the CMSA SS2026/FS2027 schedule. This free bank has 100 practice MCQs across the four basic sciences.

Sample FCEM(SA) Part I Practice Questions

Try these sample questions to test your FCEM(SA) Part I exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During emergency cricothyroidotomy, which structure is opened to enter the airway between the thyroid and cricoid cartilages?
A.Cricothyroid membrane (median cricothyroid ligament)
B.Thyroid isthmus
C.Vocal cords
D.Recurrent laryngeal nerves
Explanation: The median cricothyroid ligament (cricothyroid membrane) spans the midline between the thyroid cartilage superiorly and the cricoid cartilage inferiorly. Opening this membrane accesses the airway below the vocal cords, which is why this landmark is preferred for emergency front-of-neck access.
2In the costal groove, which structure lies most superior within the main intercostal neurovascular bundle?
A.Intercostal nerve
B.Intercostal vein
C.Intercostal artery
D.Collateral intercostal nerve
Explanation: The main intercostal neurovascular bundle in the costal groove runs vein–artery–nerve from superior to inferior (VAN). Therefore the intercostal vein is the most superior structure, immediately under the inferior border of the rib above, which matters when inserting an intercostal drain above the rib.
3Which cranial nerve provides motor innervation to the muscles of mastication and is at risk in deep facial trauma and inferior alveolar nerve blocks?
A.Facial nerve (CN VII)
B.Glossopharyngeal nerve (CN IX)
C.Trigeminal nerve — mandibular division (V3)
D.Hypoglossal nerve (CN XII)
Explanation: The mandibular division of the trigeminal nerve (V3) supplies motor fibres to the muscles of mastication (masseter, temporalis, medial and lateral pterygoids) and carries sensory fibres including the inferior alveolar nerve. Facial nerve injury affects facial expression muscles, not mastication.
4For a femoral nerve block at the inguinal crease, the femoral nerve typically lies in which relationship to the femoral artery?
A.Medial to the femoral artery
B.Deep to the pectineus medial to the vein
C.Posterior within the femoral sheath with the vein
D.Lateral to the femoral artery
Explanation: At the inguinal ligament the order from lateral to medial is nerve–artery–vein–lymphatics (NAVL). The femoral nerve therefore lies lateral to the femoral artery, outside the femoral sheath, which guides ultrasound-guided or landmark femoral nerve blocks for femur fractures.
5Which structure forms the inferior border of the triangle of safety for intercostal drain insertion in the mid-axillary line?
A.Fifth intercostal space / horizontal nipple line level
B.Apex of the axilla
C.Lateral border of pectoralis major
D.Latissimus dorsi posterior border
Explanation: The triangle of safety is bounded anteriorly by pectoralis major, posteriorly by latissimus dorsi, and inferiorly by the fifth intercostal space (roughly nipple level in males). Inserting above this inferior border reduces risk of diaphragmatic or abdominal visceral injury.
6Occlusion of which cerebral artery most classically produces contralateral hemiparesis and hemisensory loss affecting the face and arm more than the leg, often with aphasia if dominant?
A.Anterior cerebral artery
B.Middle cerebral artery
C.Posterior cerebral artery
D.Anterior communicating artery
Explanation: The middle cerebral artery supplies the lateral hemispheric cortex including face and arm motor/sensory areas and language centres in the dominant hemisphere. ACA strokes preferentially affect the contralateral leg; PCA strokes more often cause visual-field deficits.
7Which spinal level most commonly corresponds to the iliac crest landmark used to identify a safe lumbar puncture interspace in adults?
A.L1–L2
B.L2–L3
C.L3–L4 / L4–L5 (Tuffier's line)
D.T12–L1
Explanation: A line joining the superior iliac crests (Tuffier's / intercristal line) typically crosses the L4 spinous process or L4–L5 interspace in adults. Lumbar puncture is performed at L3–L4 or L4–L5, well below the adult conus (usually ending near L1–L2).
8In the anterior triangle of the neck, which vessel lies within the carotid sheath together with the internal jugular vein and vagus nerve?
A.External jugular vein
B.Thyrocervical trunk
C.Anterior jugular vein
D.Common or internal carotid artery
Explanation: The carotid sheath contains the common/internal carotid artery, internal jugular vein and vagus nerve. This triad is critical for central venous access, trauma exploration and recognising stroke risk with carotid injury.
9Which abdominal wall layer is entered after the external oblique aponeurosis when performing an open appendicectomy gridiron incision in the right iliac fossa?
A.Internal oblique muscle fibres
B.Transversalis fascia immediately
C.Parietal peritoneum first
D.Rectus abdominis sheath
Explanation: A gridiron (McBurney) incision splits external oblique aponeurosis, then splits internal oblique and transversus abdominis in the direction of their fibres before reaching transversalis fascia and peritoneum. Knowing layer order reduces iatrogenic injury during open appendicectomy.
10Compared with the adult, the paediatric airway has which clinically important anatomical difference?
A.A relatively smaller tongue and larger mandible
B.A more cephalad (higher) and anterior larynx with a narrower cricoid relative to the glottis
C.A longer, more rigid trachea with easily palpable cricothyroid membrane
D.Vocal cords that are more horizontal and easier to visualise
Explanation: In infants the larynx is more cephalad and anterior (about C3–C4 versus C5–C6 in adults), the epiglottis is omega-shaped, and classically the narrowest portion of the airway is at the cricoid cartilage (until roughly 8 years), not the vocal cords. These differences affect tube size choice and intubation technique in paediatric emergencies.

About the FCEM(SA) Part I Exam

FCEM(SA) Part I is the basic-sciences examination of the Fellowship of the College of Emergency Medicine of South Africa. Candidates sit two online MCQ papers covering Anatomy, Physiology, Pathology and Pharmacology in equal weight, with emphasis on applying basic science to emergency care rather than abstract recall. Eligibility requires a post-internship medical qualification registered or registrable with the HPCSA. Passing Part I is a prerequisite for Part II, which must be completed within six years. This free bank offers 100 MCQs aligned to the official CMSA Part I blueprint for revision.

Assessment

Two online MCQ papers (3 hours each), 100 questions per paper with 25 questions on each of Anatomy, Pathology, Physiology and Pharmacology. No oral examination for Part I. Correct answers score 1; blank or incorrect answers score 0.

Time Limit

3 hours per paper (two papers)

Passing Score

Average above the standard-set cut score across both papers; subminimum 40% on each paper

Exam Fee

R12,950 (CMSA SS2026/FS2027 schedule; confirm for your diet) (College of Emergency Medicine of South Africa (CMSA))

FCEM(SA) Part I Exam Content Outline

25%

Clinical Anatomy

CNS, limbs, head and neck, thorax, abdomen/pelvis, paediatric and pregnant comparative anatomy, surface anatomy, tissues and structures

25%

Physiology

Cellular function, acid–base, nervous system, metabolism, endocrinology, GIT, haematology, cardiovascular, respiratory and renal physiology

25%

Pathology

Cellular injury, inflammation, haemodynamics, immunity, neoplasia, infection, environmental/ageing pathology, and major organ-system disease

25%

Pharmacology

General pharmacology, respiratory/CVS drugs, antimicrobials, CNS agents, analgesics, toxicology, fluids, extremes of age, GIT and immune drugs

How to Pass the FCEM(SA) Part I Exam

What You Need to Know

  • Passing score: Average above the standard-set cut score across both papers; subminimum 40% on each paper
  • Assessment: Two online MCQ papers (3 hours each), 100 questions per paper with 25 questions on each of Anatomy, Pathology, Physiology and Pharmacology. No oral examination for Part I. Correct answers score 1; blank or incorrect answers score 0.
  • Time limit: 3 hours per paper (two papers)
  • Exam fee: R12,950 (CMSA SS2026/FS2027 schedule; confirm for your diet)

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

FCEM(SA) Part I Study Tips from Top Performers

1Study applied basic science with an emergency lens: airway anatomy, shock physiology, acid–base, sepsis pathology, and resuscitation pharmacology.
2Use the official CMSA Part I blueprint matrices to weight Priority 1 topics (CNS, CVS, respiratory, renal, toxicology, antimicrobials) more heavily in revision.
3Practise timed mixed blocks of 25 questions per subject to mirror each official paper’s equal split.
4Link anatomy to procedures you perform (cricothyroidotomy landmarks, intercostal drain, femoral nerve, lumbar puncture).
5For pharmacology, know mechanisms, onset, contraindications and toxicology antidotes used in the emergency centre.
6Confirm fees, diet dates and online exam logistics on cmsa.co.za before applying.

Frequently Asked Questions

What is the format of FCEM(SA) Part I?

Part I consists of two online multiple-choice papers of 100 questions each, lasting 3 hours per paper, with no oral examination. Each paper covers Anatomy, Pathology, Physiology and Pharmacology equally (25 questions per subject).

What is the pass mark for FCEM(SA) Part I?

Candidates must achieve an average above the cut score determined by CMSA standard setting across both papers, and must score at least 40% on each paper. There is no negative marking.

How much does FCEM(SA) Part I cost?

The CMSA SS2026/FS2027 examination fees schedule and College of Emergency Medicine page list Part I at R12,950 (VAT inclusive). Always confirm the fee for your specific First or Second Semester diet on the current CMSA examination fees schedule.

Who is eligible to sit FCEM(SA) Part I?

Candidates must hold a post-internship qualification to practise medicine that is registered or registrable with the Health Professions Council of South Africa. CMSA may review professional and ethical standing.

How long is Part I valid before Part II?

Part II must be passed within six years of passing Part I. If this window is exceeded, Part I must be repeated.

What topics does the official blueprint emphasise?

The CMSA FCEM(SA) Part I blueprint divides questions equally among Anatomy, Physiology, Pathology and Pharmacology, prioritising topics highly relevant and frequently tested in emergency medicine practice (Priority 1–3 matrices).