FCA(SA) Part 1: The Complete Guide

The FCA(SA), Fellowship of the College of Anaesthetists of South Africa, is the specialist qualification for anaesthesiologists awarded by the Colleges of Medicine of South Africa (CMSA). Part 1, often called the primary, is the basic-sciences examination: physiology, pharmacology, and physics and clinical measurement, all as they apply to anaesthesia. It is a demanding exam with a distinctive format, and it changed significantly in recent years, so this guide explains the current structure, what to study and how to prepare.

What is the FCA(SA) Part 1?

Part 1 is the first of the two examinations for the FCA(SA). It tests whether you understand the science behind everything you do in theatre: why an inhalational agent behaves as it does, how a monitor produces its number, what happens to cardiac output under spinal anaesthesia. The emphasis is on knowledge, understanding, application and analysis of basic-science problems in a clinical anaesthetic context, rather than isolated recall.

FCA(SA) Part 1 format and structure

The College replaced the old format of three separately examined subjects with an integrated examination. The current structure, as published by the CMSA, is:

• Four papers in total: two single best answer (SBA) papers and two short answer question (SAQ) papers.
• Each paper contains integrated questions that combine three subject areas: pharmacology; anatomy, physiology, medical biochemistry and clinical pathology; and physics, clinical measurement, the anaesthetic environment and equipment.
• Marks for the four papers are aggregated, and a single overall pass mark is set by applying Cohen standard setting to the total.
• No supplementary examination is offered. Candidates who do not pass must sit all four papers again at a later examination.
• Papers are written online on the CMSA's digital examination platform.

Because the College's published documents have been updated at different times, confirm the number of questions and timing of each paper in the current regulations and notices on the CMSA website when you apply.

Who can sit FCA(SA) Part 1?

Entry to Part 1 requires a qualification to practise medicine that is registered or registrable as a medical practitioner with the HPCSA. There is no minimum period of anaesthetic training required to sit the primary, although most candidates find it far easier once they have some theatre experience to anchor the science. Part 2 must be passed within six years of passing Part 1, so it is worth timing your primary attempt with your overall training plan in mind. The CMSA Senate reviews every application, so confirm the current criteria before you register.

FCA(SA) Part 1 syllabus: where to focus

The College's blueprint lists the content areas and grades each topic by how often it is encountered in practice and by its impact on patient safety. Topics with the highest combined score receive the most emphasis, which gives you a ready-made priority list. High-yield areas include:

• Physics: the gas laws, vapour pressure and vaporisers, humidity, electrical safety and diathermy, the electromagnetic spectrum, ultrasound and the Doppler principle, and the mathematics of exponential processes.
• Clinical measurement and equipment: pressure and flow measurement, transducers and damping, gas and vapour analysis, the anaesthesia machine, breathing systems, ventilators, monitors and defibrillators.
• Pharmacology: receptor kinetics, pharmacokinetics and pharmacodynamics, then the systematic pharmacology of inhalational and intravenous agents, local anaesthetics, neuromuscular blockers, analgesics, autonomic and cardiovascular drugs, antibiotics and colloids.
• Physiology and chemical pathology: cardiovascular, respiratory, renal and acid-base physiology, the nervous system and neuromuscular junction, pregnancy, neonatal physiology, ageing and the surgical stress response.
• Basic statistics: study design, distributions, hypothesis testing and choosing the appropriate test, at the level needed to read the literature critically.

A realistic FCA(SA) Part 1 study plan

Most candidates need several months of steady preparation. Because the papers integrate all three subject areas, avoid finishing one subject completely before starting the next.

• Phase one, foundations in parallel. Rotate through physiology, pharmacology and physics each week so that none goes cold. After each topic, answer SBA questions and write at least one short answer from memory.
• Phase two, connect the subjects. Practise questions that cross boundaries, such as the physiology of one-lung ventilation alongside the physics of the oxygen analyser, because that is how integrated papers are written. Use the blueprint scores to direct extra time to the highest-impact topics.
• Phase three, simulate both formats. Sit timed SBA blocks and timed SAQ papers, mark your written answers against a structured model, and track which areas lose you marks in each format. Taper with revision, not new material.

Exam technique that earns marks

In the SBA papers, read the stem and decide your answer before looking at the options, then choose the single best response rather than one that is merely true. In the SAQ papers, structure is worth marks: use headings, short points, labelled diagrams and correctly drawn graphs, and give units for every value. Answer what the question asks, at the depth its mark allocation suggests, and move on. Because the four papers are aggregated, a weaker paper can be offset by a stronger one, so never abandon a paper that feels difficult; every mark counts towards the total.

The best way to revise for FCA(SA) Part 1

Strong primary candidates combine two habits: steady SBA practice to build breadth and speed, and regular written practice to build the ability to explain a concept clearly under time pressure. For the SBA component, a question bank that mirrors CMSA style, explains the underlying science behind each option, and shows your performance by subject area is the most efficient tool you can use.

Passmed's FCA(SA) Part 1 question bank is written by qualified doctors, mapped to the CMSA anaesthetics basic-sciences blueprint, and pairs detailed explanations with performance tracking across physiology, pharmacology and physics. Explore the FCA(SA) Part 1 question bank →

Frequently asked questions

What is the current format of FCA(SA) Part 1?

Four papers: two single best answer papers and two short answer question papers, each integrating pharmacology, physiology and related sciences, and physics with clinical measurement and equipment.

Can I pass one subject and carry it forward?

No. Under the current format the four papers are aggregated for a single pass mark, there is no supplementary examination, and unsuccessful candidates must resit all four papers.

Do I need anaesthetic experience to sit Part 1?

The regulations only require a qualification registered or registrable with the HPCSA, but clinical anaesthetic experience makes the applied questions much easier to answer.

How does the blueprint help me prioritise?

Each topic is scored for frequency in practice and impact on patient safety. Topics with the highest combined score receive the most emphasis in the examination.

Exam format details were checked against the Colleges of Medicine of South Africa (accessed October 2026). Regulations, dates and fees change, always confirm the current details on the CMSA website before you sit.