After successful completion of FRCEM Primary, Intermediate SAQ and MRCEM OSCE, you will be informed within a month that your name has been submitted to the board for consideration of Membership by Examination. It may take 10-12 weeks for approval.
Once approved, you will be asked to pay the membership fees for that year (GBP200 for 2018) and you will then be formally recognised as a Member of the college. You may choose to receive the diploma by mail, or by attending their conferring ceremony held in November/December every year. If you choose to receive by mail, you will still be invited to the conferring ceremony, of course, so save your end-of-year leave!
In my case, I wanted the certificate earlier so they mailed it to me. They sent it rolled up in a nice plastic tube, so don’t worry about the post office folding it.
The Membership has to be renewed every year, and must be maintained if you plan for FRCEM Finals as a foreigner. Eligibility for FRCEM Finals is that you pass FRCEM Primary and Intermediate (SAQ+SJP), have 36 months experience after completion, AND be eligible for UK GMC Registration. In order to be eligible for GMC Registration, you must either have graduated from a UK medical institution, or passed PLAB, or hold a UK postgraduate diploma (ie MRCEM).
This is why most of us must go for MRCEM.