Primary exam

The primary examination (PEx) is a test of knowledge and understanding of the scientific foundations of clinical anaesthesia. Candidates are expected to demonstrate an understanding of the subject matter and show their ability to integrate the relevant information so that it is applicable to the practice of clinical anaesthesia.

Broadly, the curriculum for the primary is applied physiology, pharmacology, anatomy, measurement, equipment, quality and safety. Learning outcomes relating to maternal and paediatric physiology and pharmacology are also assessed in the primary examination.
The primary examination is taken during basic training and assesses knowledge outcomes via written and oral components. Success in the primary examination is necessary to progress to advanced training.

Learning outcomes

The learning outcomes in the ANZCA training program curriculum guide the range of content that may be assessed. Candidates cannot proceed to advanced training until they have passed the primary examination.


Regulation 37 provides further information about the primary examination.

Reading list

The latest reading list for the primary exam can be accessed through the ANZCA Library Guides.

Candidates are advised that all examination questions are based on Learning Outcomes and that the great majority of information required is contained in the recommended texts. Please note that the most recent version of each of the following texts is the recommended text. Nearly all of these text are available on-line through the ANZCA library. However, some topics are only superficially covered in the textbooks and candidates are advised to draw on many resources as they study, in order to gain a deeper understanding of those areas that relate to everyday anaesthetic practice.




In order to sit the primary examination, you must:

  • Be registered as a trainee with the College.
  • Have completed all requirements for introductory training and commenced basic training at the time of the written exam.
  • Candidates should be in approved vocational training when sitting the exam (however they may be admitted to the exam while in interrupted training providing they have been in Basic training 
  • Trainees in interrupted training who have been in approved vocational training within 52 weeks of the date of the written examination are also eligible to sit. A trainee who has been in interrupted training for over 52 weeks is not eligible to sit the examination.
  • Paid all outstanding training fees and the primary examination application fee.
  • Completed the primary examination application Form. The completed application must be received by the College by the closing date for registration.

Please check your trainee profile and outstanding documentation reports prior to submitting your application to ensure that you meet all eligibility requirements.

All applications received, will be acknowledged via email within 48 hours or two working days of receipt by the College. Late applications and late documentation will not be accepted after the closing date. All application fees are to be paid in full. No payment plans will be granted.



The examination consists of three sections: A written section consisting of a multiple-choice question paper (MCQ) and a short-answer question paper (SAQ) and vivas.

Section Format Duration Per cent total marks

1. Written (multiple-choice questions)

150 questions
Each question has a stem followed by five options. No marks deducted for incorrect answers.

It is essential to pass the MCQ in order to get an invitation to the viva.
150 minutes Pass/fail
2. Written (short-answer questions) 15 questions
A short written response for each question.

It is essential to get more than 40 per cent (20/50) in the SAQ to get an invitation to the viva.
150 minutes 50
3. Viva voce 3 vivas
You will be examined on approximately four topics during each viva. The viva is designed to assess your knowledge and ability to understand, apply, analyse and evaluate the knowledge.
20 minutes each 50

Requirements for passing the primary examination

  • You must be invited to the vivas (pass MCQ + 40 percent in your SAQ section).
  • The scores from the SAQ and viva are added together and to pass the exam you must gain a total mark of 50 per cent or more.
  • The SAQ section is marked out of 50 and viva section is also marked out of 50.

To attend the viva section of the primary examination, candidates must pass the MCQ section and obtain a mark of at least 40 per cent in the short answer sections. Each viva has mixed curriculum content and is undertaken by two examiners.

To achieve a pass in the exam, you must obtain a mark of at least 50 per cent in the sum of the short-answer (50 per cent) and viva (50 per cent) sections.
Candidates who have failed to achieve the standard in the written components of the examination will been deemed to have the failed the exam.  This will count as an unsuccessful attempt at the primary examination.
Failure of a candidate to attend the written examination (no show) after enrolling for the primary examination will be counted as an unsuccessful attempt at the primary examination.


Unsuccessful candidates will be provided with a pass/fail breakdown of their performance at each section of the examination they have attended. The ANZCA Handbook for Training provides more details on the feedback process.

Remediation interview resources

Remediation interview resources are available to clarify and support the purpose, process and conduct of the remediation interview. Click here for more information and links to resources.

Examination report

Examination reports are prepared to help candidates and their supervisors prepare for their examinations. These reports are intended neither to represent model answers nor imply that all points mentioned are necessary in order to achieve a pass. Supervisors are encouraged to discuss recent reports in detail with candidates they are preparing for future examinations.

Download recent exam reports here.

Old examination Papers

The multiple choice question paper is not published in the examination report, but to give candidates an understanding of the multiple choice question format, a physiology and pharmacology multiple choice question paper from 2008 can be accessed here: physiology and/or pharmacology.


Please contact the college.

Useful information

The Primary Examination Sub-Committee and all primary examiners strive to conduct an examination which is fair, valid, and reliable, and that continues to assess the basic sciences with a relevance to safe conduct of anaesthesia. 

The multiple-choice questions (MCQ) are answered in a GPAS sheet.

  • Other than your candidate number, do not write any other personal information on the answer sheet.
  • Record your answers in pencil only (pencils provided).
  • Do not cross out mistakes, carefully and neatly erase any mistakes (erasers provided).
  • Candidates wishing to make notes or perform calculations may do so on the question paper during writing time only. No writing, scribbling or marking is permitted during reading time.
  • The MCQ question paper is to be returned and is not allowed outside the exam room.

  The short-answer question (SAQ) is written in 15 books, which make a set.

  • Each question must be answered in a separate book as per the marking of the question number on the book.
  • Ensure that your candidate number is written on the front of each book on the top right hand corner.
  • Writing should be in the lined section of the book only. Do not write in the margins, the darkened out areas or the unlined pages.
  • Do not leave a blank page once you start writing, if you do, run a line through the page to indicate the answer continues.
  • All writing in blue or black pen only.

An example of the SAQ book is available here.

Other information

Conditions of entry to the exam:

  • All electronic devices are to be switched off / airplane mode and left either in your bag or the invigilator for safekeeping.
  • No wrist watches or time keeping devices will be allowed at the exam. Several clocks are placed around the examination room for your perusal.
  • Calculators are not allowed at the exam.
  • No food will be allowed into the exam room.
  • Water is provided and available at all times during the exam.
  • Ample paper is provided at each exam station for discussion at the vivas.
  • At the vivas you will be advised when your viva is to commence - you may be quarantined in an area with other candidates whilst waiting for your viva to commence or after the conclusion of your viva.
  • You are required to follow the instructions of the invigilators at all times during the exam.

Candidates who do not follow the conditions of the examination may face disciplinary action in accordance with the academic integrity policy.

Preparation courses

Each year ANZCA offices in Australia and New Zealand conduct courses designed to assist trainees who are preparing to sit for the primary examination. Priority is given to applicants who have registered to sit the examination. Participants must also be registered with the College as a trainee.

Information regarding course dates, course descriptions and enrolment forms are available from ANZCA’s New Zealand and Australian regional websites.

The College offers online Primary examination support resources that include invaluable study tips and advice for trainees preparing for the exam, including a series of simulated viva videos, trainees sharing their experience with the exam and ANZCA primary examiners offering advice for trainees. These can be found in the “Curriculum teaching and learning support network/Basic training” in Networks.

For further information about the primary examination, please contact the primary examination office on +61 3 9510 6299 or

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