The following document was written by Mr Max Whittaker MBBS(lond) MRCS(eng) in Feb 2008. You may use the information here for personal use but if you intend to publish or present it, you must clearly credit the author and www.clinicaljunior.com
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The MRCS Examination
Since deciding on a surgical career, the prospect of completing the MRCS exams has been constantly present at the back of my mind. Despite their importance, I found little or no relevant information to guide me through the process with most of my insight gathered by word of mouth.
I have devised the following pages in an attempt to answer some basic questions and offer simple advice to help preparing for the surgical membership exams as well as dispelling some of the hype which surrounds them.
The MRCS exams are currently in a state of flux, with the old 3-part structure being phased out and replaced by a 2 part system, namely A and B.
- Anyone who has made an attempt at Part 2 by April 2007 will be able to complete their exams until September 2010
- Anyone starting their exams or who have already attempted Part A will continue on the new scheme
Part A
- 4 hour MCQ examination divided into 2 papers (2 hours each)
Paper 1: Applied Basic Science
- Paper 2: Principles of Surgery-in-General
Marks for each both papers are combined to give a total mark for Part A
Equivalent to old Parts 1 & 2 combined (see below)
Part B
- 3 Parts:
- Structured interviews
- Clinical examination
- Communication skills
- Equivalent to old Part 3 (see below)
Part 1: Applied Basic Sciences
- 3 hours
- As of January 2008 the exam will consist of 180 Single Best Answer questions
Part 2: Clinical Problem Solving
- 3 hours
- 180 Extended Matching Questions (EMQs)
- For each scenario choose the single most likely option
Tips:
These may not apply to everyone but having sat many such exams throughout medical school these seemed to have worked for me so far.
- Technique can be as important as core knowledge. Many people attempting the exam without any prior revision have scored well (although I’m not suggesting you try this purposefully!)
- No negative marking: answer all questions
- No trick questions: they are simply designed to test your knowledge therefore don’t read too much into them
- Transfer your answers to answer sheet as you progress (avoids transcription during the final minutes of the exam and associated errors)
- Work by elimination: several answers will clearly be false, leaving 2 potentials
- If unsure, your first hunch is usually right!
Revision material:
Finding the motivation to revise while working a busy schedule is not a virtue possessed by many. The greatest amount of work seems to be achieved in the final 2 weeks before exams when fear begins to outweigh laziness. For this reason I found wading through textbooks of minimal value: it is both time-consuming and tedious.
- Use practise questions to identify areas of weakness and focus your revision accordingly
- Some sources of questions include extensive feedback and this alone may provide sufficient information
Commonly used sources of practise questions include:
- Pastest MCQ and EMQ books
- www.pastest.com
- Similar but greater bank of questions on-line
- www.onexamination.com
- Large source of questions classified by topic
- Good feedback
- Offers information about your score relative to other online users undertaking same exam
Part 3 - Oral Examination
- 3 stations
- 2 x 10 minute vivas in each
- Anatomy
- Applied surgical anatomy
- Operative surgery
- Physiology
- Critical care
- Applied surgical physiology
- Pathology
- Applied surgical pathology
- Principles of surgery
- Each oral section is scored from 1-4
- Scores of 3 or above indicate satisfactory performance
- Score of 2 may be compensated for by a 4 in another section
- Score of 1, or more than one 2, results in definite failure
Revision material:
- “Applied Surgical Physiology Vivas” Mazyar Kanani, Martin Elliott
- “Surgical Critical Care” Mazyar Kanani
- “General Pathology” David Lowe
Part 3 - Clinical Examination
- 4 bays
- Head & neck, breast / axilla, skin
- Trunk and groin
- Vascular
- Orthopaedic
- 2 x 7½ minute sections in each, usually representing 1 long, and several short cases
- Each section is scored from 1-4
- Scores of 3 or above indicate satisfactory performance
- A total score of 24 is required to pass HOWEVER
- A combined sum of 4 of a pair of examiners in more than 1 bay results in definite failure
Revision material:
- “Clinical Cases and OSCEs in Surgery” M. Ramachandran, A. Poole
- “Surgical Short Cases for the MRCS Clinical Examination” C. Parchment-Smith
- Similar content
- Good photos
Part 3 - Clinical Communication Skills
- 2 stations
- 5 minutes to read information sheet explaining each scenario
- Information giving test, possible scenarios include
- Breaking bad news
- Obtaining consent
- Discussing treatment of condition
- Information taking test
Tips:
- Establish a routine as follows:
- Introduce yourself
- Obtain consent for examination
- Ask about any pain or tenderness
- Expose adequately
- Perform requested examination
- Wash hands
- Thank patient
- Assist in redressing
- Classify and sub-classify answers:
- E.g. Causes of renal failure: pre-renal, renal, post-renal
- E.g. Lumps: surgical sieve, or superficial ? deep
- Name common causes first
- Even though recent exams are more structured than the old MRCS and use preset question cards, examiners can stray from the stem question. Direct the questions to a topic you know well!
Good luck!!
For more information contact:
Royal College of Surgeons of England
35-43 Lincoln’s Inn Fields
London WC 2A 3PE
Tel: 020 7869 6281
Fax: 020 7869 6290
Other Links:
www.pastest.com
www.onexamination.com
MRCS.org.uk
BMJ careers
Another BMJ careers document
Disclaimer
The authors of this document have attempted to provide information that is medically sound and up-to-date. The authors nor Clinicaljunior.com cannot take any reponsibility for the accuracy or completeness of this article. The reader should confirm the statements made in this website before using the information outside this website.