Everything You Need to Know About MRCS

As an international medical graduate, there are several postgraduate qualifications you can use to get GMC registered, with one of them being MRCS. MRCS is an intercollegiate membership awarded to trainee surgeons to get them into higher specialty training in the NHS. It’s a very well-regarded, senior qualification that looks fantastic on your CV and can give you a great kickstart in your surgery career. 

The exam itself comes in two parts: Part A (a multiple-choice exam) and Part B (an Objective Structured Clinical Exam). As an intercollegiate membership, this exam is exactly the same regardless of the awarding body, and all exams are taken at the same time. You can choose the awarding body you take the examination with, which includes the following: 

• The Royal College of Physicians and Surgeons of Glasgow
• The Royal College of Surgeons of Edinburgh
• The Royal College of Surgeons of England
• The Royal College of Surgeons of Ireland

So, whichever awarding body you take the exam with, you’ll end up with the same membership with the same weight as any of the others. Want to learn more about MRCS, including eligibility, cost, structure, and how to prepare? If so, this guide is for you! 

Who is MRCS For?

MRCS is for any trainee surgeon who wants to practise medicine at level ST3+ in the NHS. That includes IMGs who want to get GMC registered and get into a surgery-related higher specialty training programme, such as the following: 

• Neurosurgery
• Cardiothoracic Surgery
• Plastic Surgery 
• General Surgery
• Trauma & Orthopaedic Surgery 
• Urology
• Oral & Maxillofacial 
• Vascular Surgery 
• Paediatric Surgery 

MRCS is also a prerequisite for all surgeons wanting to go into specialist training in surgery, meaning UK doctors wishing to practise surgery at ST3+ will also need to take it. By taking and passing both parts of MRCS, you prove that you have the skills, knowledge, experience, and competence to practise at a higher specialty level in surgery. 

As the completion of MRCS puts you on the same playing field as ST3 trainee surgeons, you should have at least two to three years of experience in surgery before attempting this exam. Without it, you won’t have the necessary skills and clinical competencies to pass! 

MRCS vs. FRCS 

If you are a trainee surgeon, the chances are you will have heard of FRCS. FRCS stands for Fellow of the Royal College of Surgeons, which sounds very similar to MRCS (Membership of the Royal College of Surgeons). However, they are different. In essence, MRCS is a qualification that gets you into higher specialty training (ST3+) in a surgery specialty, whereas FRCS is a professional qualification for senior surgeons. Only those at the end of their training can obtain FRCS and, with it, then get on the specialist register and practise surgery as an independent Consultant. 

Unless you have completed surgical training, MRCS is the qualification you want to be looking into. You will eventually do FRCS, but only towards the end of your surgical training. 

Who is Eligible to Take MRCS? 

Fortunately, the MRCS examinations are accessible to IMGs across the world. For overseas candidates such as yourself, you simply need a primary medical qualification that is accepted by the GMC. You can find the PMQs accepted by the GMC here. If you have a PMQ that isn’t listed there, you can get in touch with the Royal College to see if yours can be accepted. 

MRCS Exam Cost 

For both parts of the MRCS examinations, you will need to pay a fee. 

• MRCS Part A: £550 
• MRCS Part B: £1047

Keep in mind that these fees might change over the years. 

Exam Locations

As an international doctor, you will want to know where you can take these exams. The less you have to travel to get qualified, the better! The MRCS exams run three times a year and can be taken in the UK and in some places internationally. 

MRCS Part A is a more accessible exam to all, as it’s completed online in multiple locations around the world. In fact, there are 5,600 test locations where you can take MRCS Part A, including Africa, Asia, the Middle East, Central Asia, and Europe. 

MRCS Part B is a little different. As it is a practical Objective Structured Clinical Exam, there aren’t as many test centres. For 2023, here are the locations you can take it: 

• London
• Glasgow
• Cairo
• Sheffield
• New Delhi
• Kuala Lumpur

If you want to book one of the examinations, you must do so on the Royal College website for whichever awarding body you are going to take the exam with (for example, the Royal College of Surgeons of England’s website).

MRCS: Exam Structure

The MRCS exams are rigorous and designed to test your skills and clinical competencies in surgery to ensure you can progress to the ST3+ level. Familiarising yourself with the exam structure is key to helping you pass these exams. Find out what to expect from both Part A and Part B below! 

MRCS Part A

MRCS Part A is a written examination that you take on a computer, and it tests your knowledge of basic sciences and the principles of surgery. The exam spans almost a whole day at five hours and consists of two papers, with the first paper being taken in the morning and the second paper being taken in the afternoon. Each paper has 135 questions, all of which are multiple-choice single-best-answer questions. 

Paper one (the morning paper) lasts three hours and includes 45 questions on anatomy, 45 questions on physiology, and 45 questions on pathology. Paper two (the afternoon paper) lasts two hours and covers the principles of surgery in general. 

MRCS Part B: OSCE 

MRCS Part B is an Objective Structured Clinical Examination. It’s a practical exam that consists of seventeen exam stations that last nine minutes each – as a candidate, you will rotate around the stations until you have completed them all. At each station, you are tested on:

- Anatomy and Surgical Pathology

- Clinical and Procedural Skills

- Applied Surgical Science and Critical Care

- Communication Skills

Many international doctors find Part B the hardest bit of the MRCS exams, as not only does it test your knowledge and skills, but it also asks you to be an excellent verbal communicator in English. As such, preparation is crucial!

Preparing for MRCS: Tips and Tricks

Don’t assume you can pass the MRCS exams without any preparation – even if you have three years of surgical training experience, you still need to get to know these exams and practise for them. Otherwise, the chances are you won’t pass the first time, which will only cost you more money and time in the end. Remember, these exams are very challenging! To learn how to prepare properly, here are our tips and tricks: 

Familiarise Yourself with the MRCS Syllabus

Getting to know the curriculum is paramount for passing the exam, as it shows you what you need to study. By understanding the syllabus, you can tailor your study sessions to cover everything that’s on there. 

Take a Course

Preparing for such a challenging exam can be overwhelming, especially if you’re still familiarising yourself with the syllabus. One of the best ways to overcome this is to take a surgical course that will boost your studies – the Royal College of Surgeons of England has excellent courses that will support your learning, which, in turn, will increase your chances of passing MRCS the first time. 

Practise the Practical Exam

For many IMGs, one of the most nerve-wracking parts of the MRCS exams is the OSCE one. That makes sense, considering it isn’t an exam you can sit quietly while filling in the answers – instead, you need to show your competence by rotating through a series of stations. One of the best strategies for passing this part is to practise with a co-worker beforehand. Preferably, practise with someone who has marked or taken this examination before, as they will know the skills to look out for. Then, you can ask for their feedback in order to improve. 

Improve Your Time Management

For passing the MRCS exams, time management is a must. There are two reasons for this: 

1. You must manage your time properly to ensure enough revision.
2. You must know how to manage your time during the exam to answer all the questions. 

When planning revision, giving yourself enough time to cover the whole syllabus while focusing more on your weaker areas is important. Spend at least one and a half months preparing for these exams (with two to three months being preferable). Of course, that time doesn’t include the months you should also have spent in training! 

Regarding time management during the exams, you must spread your time wisely – especially when it comes to MRCS Part A, which requires you to answer lots of questions within a specific timeframe. Practising the exams is a handy way to do this, which leads to the next point...

Take Mock Exams

It doesn’t matter how much knowledge you have – if you don’t understand the framework of the exams, you won’t do as well as you could on the day. For this reason, you should take mock exams. Mock OCSE exams are particularly helpful, as you will receive feedback to boost your practical skills, and, in turn, you’ll be more likely to ace the test on the day. Mock exams of A are incredibly helpful, too, as they’ll give you a better idea of the types of questions you need to answer and how long you should spend on each question. 

Consider When to Take the Exam

As we have mentioned, you need to have surgical training behind you before taking these exams – by the end of the MRCS exams, you should have at least two to three years of training experience. For this reason, it’s important to seriously consider when to take this exam, as taking it too early in your training could result in failure. It’s better to be over-prepared! 

It’s important to note that the MRCS exams are not just about your knowledge – it’s about your clinical competence. So, while studying is a significant part of it, you should also endeavour to gain relevant experience if you want to stand a chance at passing these challenging examinations. 

Materials for Preparation

One of the most common questions IMGs have about preparing for the MRCS exams is, “What materials should I use to prepare?”. Fortunately, there are plenty of excellent resources you can use to help maximise your chances of success. We recommend the following materials, which include both courses and reading materials: 

• MRCS Bootcamp Course 
• MRCS OSCE Course (conducted by the Royal College of Surgeons) 
• Principles and Practice of Surgery by Garden OJ, Bradbury AW, Forsythe JLR, Parks RW.
• Ganong’s Review of Medical Physiology by Barrett KE, Barman SM, Boitano S, Brooks HL. 
• Grant’s Atlas of Anatomy by Agur AMR, Dailey AF.
• Basic Science for the MRCS: A revision Guide for Surgical Trainees, 4E by Michael S. Delbridge, Wissam Al-Jundi. 
• Cracking the General Surgical Interviews for ST3 by Sala Abdalla, Amber Shivarajan, Kaushiki Singh. 
• Essential Revision Notes for Intercollegiate MRCS Book 2 

Tips for On the Day 

So, what about on the day? You now know what to expect in terms of structure and syllabus, but what should you do to improve your chances of success? Here are our tips for nailing the exams:

Show Up on Time and Prepared

The worst thing you can do is show up late for your exam without the proper equipment. Even with all the studying in the world, a latecomer is unlikely to pass. For this reason, plan your route to the test centre in advance and be as prepared as possible. 

Return to the Hard Questions

For MRCS Part A, you don’t have to answer the questions in order. If you come across a really hard question, feel free to flag it and go back to it when you have time at the end. You don’t want to spend too much time on that question and lose marks on other questions that you could have answered easily! 

Take a Breath

These exams are often overwhelming, and it’s not unusual for candidates to feel so overwhelmed that it impacts their marks. Confidence is key here – especially when it comes to the practical exam – so take a deep breath and trust in your studies. You’ve got this! 

Results and Feedback

Knowing how you did on the exam can be helpful if you fail, as you can refine your studies for the next time. For MRCS Part A, you will receive a breakdown of your marks following the examination. However, you won’t receive any additional written feedback on top of that. 

Failing MRCS: What Next?

Failing can feel like the worst thing in the world, especially after putting in tons of preparation. Fortunately, failing does not mean you will never attain this qualification, as you have the chance to retake these examinations. However, there is a limit – you can only take Part A a maximum of six times and MRCS Part B a total of four times. As such, it’s important not to rush into it. 

You should also be aware that your pass in Part A is valid for seven years. If you passed Part A over seven years ago, you’ll have to retake it before doing MRCS Part B.  

Passed! What Next?

MRCS is a very in-depth and challenging examination; passing shows that you have gained a lot of knowledge and experience in surgery over the years. As such, you should congratulate yourself for passing! So, what about after that – how can you use MRCS to begin your NHS career?

Now that you have passed both parts of the exam, you should apply for a Membership of the Royal College of Surgeons. Once you have this well-regarded qualification and membership, you can begin applying for higher specialty training posts in surgery, beginning at ST3+ (the exact level will depend on your experience). This will put you on a pathway to getting on the specialist register, which you can do once you have completed all years of specialty training in surgery! 

In Summary

Becoming a surgeon for the NHS is a fantastic endeavour. However, it’s also a challenging career that involves a long and strenuous path to get there, and along the way, you’ll need to prove that you have the skills and clinical competencies. One of the ways you’ll prove that is through MRCS. 

MRCS is a rigorous exam that not only tests your memory of surgical knowledge but also how you apply it in practice. Both the multiple choice and OSCE exams will require a great deal of preparation, and you’ll need excellent communication skills to pass. Once you do so, you can use MRCS to get GMC registered and begin your career as a trainee surgeon at ST3. At that point, you’ll be on the pathway to becoming a professional surgeon on the specialist register.