The MRCS exam consists of two parts: Part A and Part B (OSCE). Part A tests surgical knowledge through multiple choice questions. Part B tests surgical skills and knowledge through objective structured clinical examinations. The document provides details on eligibility, format, subjects covered, example questions, preparation strategies, and resources for both parts of the MRCS exam. Passing both parts proves the surgeon has the required knowledge, skills and attributes for basic surgical training.

1. Tea Talk with MRCS
Dr Samia Farhin
MBBS, MRCS (Edinburgh), PLAB (UK)

2. MRCS overview
Part A
 To test the knowledge of a surgical
trainee to a level which should
have been achieved two to three
years after qualification.
 The exam is intercollegiate,
meaning that it is common to all
Colleges (The Royal College of
Surgeons of Edinburgh, Glasgow,
England and Ireland).
Part B (OSCE)
 Test basic surgical scientific
knowledge and its application to
clinical surgery through a series of
stations reflecting in your day-to-
day clinical practice.
 Passing both part prove that a
surgeon possesses the correct
knowledge, skills and attributes to
complete basic training and to
progress to higher levels of
specialist surgical training.

3. Eligibility criteria, Pass mark and Cost
Part A
 GMC registered physician
 MBBS degree that is acceptable
to the GMC UK. Must submit
their original certificate (or an
authenticated copy)
 Pass mark: 70-78%
 Cost: 550£
Part B (OSCE)
 MRCS part A completed
 Knowledge Pass mark: 110-120
 Skill pass mark: 120-140
 Cost: 1047£

4. Exam Format
Part A
 Paper 1: Applied Basic Science
 3 hours, 90 min sections with 10 min
break
 180 MCQ question with SBA
 1 min/ question
 Paper 2: Principles of Surgery in
General
 2 hours
 120 MCQ questions
 Schedule: January, May, September
 Computer based testing centers in
partnership with Pearson Vue.
Part B (OSCE)
 17 stations, 2 preparation
station
 9 minutes in each station
 1 min to read task
 1 min to change
 Live, OSCE exam
 Applied Knowledge (8 stations)
 Applied skills & communication
(9 stations)
 20 marks in each station.

5. MRCS part A subjects
Paper 1: Applied basic science
 Applied Surgical Anatomy:
 Thorax
 Abdomen, pelvis, perineum
 Upper limb, breast
 Lower limb
 Head, neck and spine
 Central, peripheral and autonomic
nervous systems
 Surgical Physiology
 Surgical Pathology
 Clinical microbiology
 Pharmacology
 Statistics
Paper 2: Principles of Surgery
 Principles of Surgery-in-General
 Peri & post OP care
 Surgical techniques
 M/L
 Surgical Specialties
 Trauma & ER, Ortho
 Breast & endocrine
 Plastic, Skin & oncosurgery
 GIT, HBS, Colo-rectal
 Neurosurgery
 Urology
 Vascular
 Paediatrics

6. Part A example question 01
 A 40-year-old farmer sustains a deep 2 cm long laceration to the
lateral aspect of the lower leg. Physical examination shows that the
laceration is anterior to the lateral malleolus. Which of the following
structures is most at risk of being divided?
A. Peroneus (fibularis) brevis
B. Peroneus (fibularis) longus
C. Saphenous nerve
D. Superficial peroneal nerve
E. Sural nerve

7. Answer
D. Superficial peroneal nerve

8. Part A example question 02
 A 35 years old motorcyclist presents to the emergency department after being
involved in a road traffic accident. A deep lacerated wound was present on
the anterior aspect of the thigh with pain and tenderness and with an
unpleasant smell coming from the wound. A plain X-ray reveals the presence
of gas in the deep tissues. What is the best antibiotic in this condition?
A. Cephalosporin (Cefotaxime or Ceftriaxone)
B. Flucloxacillin
C. Gentamycin
D. Glycopeptide (Vancomycin or Teicoplanin)
E. Metronidazole and penicillin

9. Answer
E) Metronidazole and penicillin

10. Part A preparation and study routine
 3 months reading
 1 month revision
 7-8 hours per day
 Last month 12-14 hours per day
 Q bank, Common topics, Recalls, Fawzia sheets
 Before exam day: NO STUDY

11. MRCS part B (OSCE) subjects
Applied knowledge
 Knowledge (8 stations)
 3 surgical anatomy stations
 2 surgical pathology stations
 3 applied surgical science and
critical care stations
Applied Skill
 Skills (9 stations)
 2 history taking stations
 2 Communication stations:
 1 person communication
with a patient/relative
 1 phone call
communication with
another health professional
 3 physical examination
 2 Procedure Stations

12. OSCE example station 01
 Mr Patel has been brought in to a trauma unit following a large road traffic
accident.
 An assessment of her ABCs have been done, patient is able to talk, having
distressed breathing, has a respiratory rate of 23, sats is 88% with high flow
oxygen, is in sinus tachycardia at 130/min, and has a BP of 90/40. RBS is 6
and GCS 15.
 C-spine is clear, there is no pelvic fracture, and the chest X-ray is given. She
has a painful abdomen, with guarding on palpation.

13. Xray Chest, A/P view, showing:
 Left sided pneumothorax
 Surgical emphysema

14. CT abdomen showing, hypodense lesion over liver, possibly liver tear.

15. OSCE example station 02
 Intro, ID confirmation
 Offer help, make rapport
 Elaborate P/C
 SOCRATES
 Associated features to exclude
D/D
 Past hx
 Personal hx
 Medical hx
 Greet, Thanks
• Q. A 33 years old homeless man was referred by
GP to your surgical outdoor with the complains of
right sided painful groin swelling for some
duration.
• Swelling is red, painful and local temperature
raised. Patient is irritated due to pain. Patient has
history of Genitourinary infections.
• Considering this history taking station you are
asked to take the history of patient in order to
help him.

16.  History taking: 6 minutes
 Case presentation: 30 sec
 Cross Q & A with examiner: 2.5 min
 Prov Dx
 D/D
 Inv
 Mx plan

17. OSCE preparation plan and study routine
 Plan of study: 4-5 months
 Self study: 2.5 months
 Make a group of 4
 Practice everyday for 3 hours until exam
 Except all evaluation politely, even if that’s rude!
 Apply for VISA at least 2 months before exam.
 Buy round trip ticket as early as you receive your VISA.

18. Common mistakes during OSCE
 Taking unorganized preparations
 Do not follow treatment guidelines of UK
 Less empathetic
 Less practice
 Less Communication in English

19. Helpful Resources
 Q bank
 Oxford book series
 Netter’s Atlas of Human Anatomy
 McMinn's Clinical Atlas of Human Anatomy
 Surgical Critical Care: For the MRCS OSCE by Mazyar Kanani and Simon
Lammy
 Websites

20. Good Luck!!
Dr Samia Farhin
MBBS, MRCS (Edinburgh), PLAB (UK)