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Overview of MRCS

  • May 08, 2018

The Intercollegiate Membership examination of the Royal Colleges of Surgeons (MRCS) will test your knowledge, experience and clinical competence expected of trainees at the end of their core surgical training.

The exam will grant you membership to one of the four Royal Colleges in the UK and Ireland and entry to higher specialist training.

Please note that to be eligible to sit the MRCS exam, you must hold a medical degree that is acceptable to the GMC for full registration. First-time applicants whose names do not appear on the GMC register must submit their original certificate of a medical degree acceptable to the Royal College.

The Intercollegiate MRCS Exam has two parts:

Part A: Written Paper - £526

Part A: Applied Basic Science Exam: Three-hours with 180 questions

Part B: Principles of General Surgery Exam: Two-hours with 120 questions

Part B: Objective Structured Clinical Examination (OSCE) - £953

Please note that although MRCS is divided into two parts, the written part, and the clinical examination, MRCS is a single examination and so passing Part A alone will not carry any diploma status.

MRCS Part A: Written Paper

Part A of the MRCS has two separate papers that will be taken on the same day with a break in between. The first paper is the Applied Basic Science and the second paper is the Principles of General Surgery.

The standard price is £526, however, in some non-UK centres a local administration fee is also included.

The exam uses both single-best answer multiple-choice questions and extended matching multiple-choice questions.

Please note that to achieve a pass in the MRCS Part A you will be required to demonstrate a minimum level of competence in each of the two papers, in addition to achieving or exceeding the pass mark set for the combined total mark for Part A. The mark for Paper 1 and Paper 2 will be combined to give a total mark for Part A.

Part A: Applied Basic Science

This paper will last for three-hours and will ask you 180 single-best answer questions.

What is a single-best answer question?

A single-best answer question will test your order of thinking, such as application and evaluation of knowledge, rather than a true or false style question that was previously used.

A standard single-best answer question will typically have three parts:

  1. A statement or a clinical scenario
  2. The question
  3. Five answer options, which will include one single correct answer

What is an extended-matching question?

An extended-matching question will provide you with a clinical situation and then provide you with a variable number of options, but only one option will be the most appropriate response to each clinical situation. You will have to choose the most appropriate option.

Please note that from September 2018, the Part A examination will consist of single-best answer questions only.

What will the exam test me on?

  • Basic science knowledge relevant to surgical practice
  • Common surgical conditions
  • Basic surgical skills
  • The assessment and management of the surgical patient
  • Perioperative care of the surgical patient
  • Assessment and early treatment of the patient with trauma
  • Surgical care of the paediatric patient
  • Management of the dying patient
  • Organ and tissue transplantation
  • Professional behaviour and leadership skills


The MRCS Part B Exam will take the form of an objective structured clinical examination (OSCE). The OSCE is a direct observation of clinical skills and for the assessment of knowledge which is not readily assessed in written exams.

The standard price for the MRCS OSCE exam is £953.

Whilst Part A is totally theoretical, and Part B tests your clinical skills and medical knowledge, the Part B Exam will also test your personality and how well you can work under pressure. Someone with very good medical knowledge can often have trouble passing Part B because of their communication or stress-management skills – we, therefore, advise you to practice Part B with a friend or family member prior to the exam.

Please note that after passing MRCS Part A, you are required to pass Part B of the examination within seven years. Otherwise successful MRCS Part A result will be considered as expired.

How does the OSCE work?

The OSCE Exam will comprise of several different stations in a circuit, of which candidates will rotate around. At each station, you will find different scenarios which will consist of an actor or manikin playing the patient and you will be observed by an examiner. Each station will require you to undertake a clearly defined task, this may include taking a focused history, clinical examination, interpreting an X-ray or performing a practical procedure.

Please note that the Royal College advises that at all stations candidates will be expected to introduce themselves, outline the purpose of the task, confirm the patient’s identity and check that they consent to the required task. As a normal procedure, you should always clean your hands before and after patient contact.

What is in my OSCE Exam?

The Exam will comprise of 18 examined stations and after the 9th station, you will be given a break before continuing the rest. At the beginning of each station you will be given one minute to read the instructions and then you will have nine minutes to complete the station. All stations will have an examiner, with most having one but some stations may have two examiners.

Each station is marked out of 20 marks and will carry equal marks.

The MRCS Part B tests:

  • Anatomy and Surgical Pathology
  • Applied Surgical Science and Critical Care
  • Clinical and Procedural Skills
  • Communication Skills

The individual stations are grouped into two broad content areas which are Knowledge and Skills.

Knowledge (8 stations)

1. 3 Surgical anatomy stations
2. 2 Surgical pathology stations
3. 3 Applied surgical science and critical care stations
a) 1 Generic critical care
b) 1 Generic interpretation of written data
c) 1 Generic interpretation of visual information

Skills (10 stations)

1. 4 Communication skills stations
a) 2 Generic history taking
b) 1 Generic giving information to a patient/relative
c) 1 Generic giving information to another health professional
2. 6 Clinical and procedural skills stations
a) 4 Physical examination
b) 2 Generic skills

BDI Resourcing’s Tips to taking your Intercollegiate MRCS

1. Enough Preparation Time

Deciding when to book your exam is one of the most important factors in your success. We advise that if you have a flexible work schedule which would allow you to study for at least four hours a day – then you should book your exams at least six months in advance. However, if you have a very busy work schedule and only have two to three hours free a day for study time you should book your exam a year in advance.

In addition, until you book your exam date you may be in denial about starting your exam preparation so we advise for you to book your exam date at your earliest convenience.

2. Choose your Study Resources

There is often the temptation to try and methodically work your way through the syllabus before starting practise questions. However, it is important to remember that the MRCS syllabus is vast and you probably know more than you think.

Therefore, we advise for you to start your revision off by doing a practice paper and use the results to identify which areas are your weaknesses and which are your strengths. You will then be able to strengthen your weaker areas and mix your revision up by practising multiple-choice questions and extended-matching questions.

Furthermore, do not just practice past papers - using a mix of online revision resources, textbooks and perhaps a revision course will help you keep your learning varied and thus you will be more likely to obtain the information you are learning. A lot of IMG’s find the revision website and smartphone app ‘Geeky Medics’ useful as it provides free medical student revision resources, including OSCE guides, clinical skills videos, clinical cases and MCQ / SBA quizzes – all accessible in an examination scenario.

If you are an IMG who wants to relocate to the UK and work for the NHS then send your CV to [email protected] – and one of our Specialist Advisers will be happy to guide and support you through your journey to the UK. We look forward to hearing from you!

Alternatively, head over to our Facebook Group: IMG Advisor for an online support network of IMG’s who want to relocate to the UK.


“Intercollegiate Committee for Basic Surgical Examinations” (2017) Guide to the Intercollegiate MRCS Examination. Accessed on 8th May 2018 from


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