MRCS Part A Complete Guide

The Membership Examination of the Royal Colleges of Surgeons (MRCS) assesses whether surgical trainees have the knowledge, skills, clinical competence and experience expected at the end of their core surgical training. The exam consists of two parts: a written paper (Part A) and an Objective Structured Clinical Examinations (OSCE) (Part B). This MRCS Part A complete guide provides comprehensive guidance on applying, preparing for and undertaking MRCS Part A.

As well as allowing you to progress to higher levels of specialist surgical training, passing the MRCS (both Part A and Part B) and being awarded this postgraduate diploma grants membership to one of the four Royal Colleges of Surgeons of Great Britain and Ireland.

These four Royal Colleges of Surgeons, and therefore awarding bodies of the MRCS, are:

  • 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

The MRCS is an intercollegiate exam, meaning it is a common exam across the four Royal Colleges of Surgeons in the UK and Ireland, so you will undertake the same paper regardless of which college you choose to sit it with.

Guideline

Part A of the MRCS is a five-hour multiple choice exam, consisting of two papers, which must be completed on the same day (one AM and one PM). It assesses generic surgical sciences, applied knowledge and core knowledge required in all nine speciality areas (which can be found in the MRCS Part A questions section below).

The two papers are as follows:

  • Paper 1 – applied basic sciences
    • When: AM
    • Duration: three hours – divided into two 90-minute sections with a 10 minute comfort break in between
    • Number of questions: 180
  • Paper 2 – principles of surgery in general
    • When: PM
    • Duration: two hours
    • Number of questions: 120

To pass Part A of the MRCS exam, you must demonstrate a minimum level of competence in each of the individual papers, as well as meeting or exceeding the combined pass mark for the two papers. The MRCS Part A allows six attempts at passing the exam.

Requirements for MRCS Part A

Candidates undertaking the MRCS Part A will be required to demonstrate ‘knowledge of both applied basic science and principles of surgery in general to a level that a surgical trainee should have achieved two to three years after qualification’. The focus, therefore, of the MRCS Part A is on assessing your knowledge and skills across a wide range of surgical conditions – not only the area of surgery in which you hope to train – to ensure that you have the core basic knowledge and skills which are essential for successful higher training. Note: MRCS only tests knowledge ‘at the level expected of all trainees completing core training irrespective of their chosen specialty’.

More information about the MRCS syllabus and modules can be found in the MRCS Part A questions section below.

MRCS eligibility criteria

To be eligible for the MRCS exam, you must hold a primary medical qualification which is accepted by the UK General Medical Council (GMC) for full or provisional registration or by the Medical Council in Ireland for full or temporary registration. Candidates who qualified outside of the UK or Ireland must hold a primary medical qualification which is accepted by the Councils of the colleges.

The Intercollegiate MRCS Exam website also provides further information on the eligibility requirements and how to check if your medical qualification is acceptable.

MRCS application

Applications for the MRCS Part A exam should be made through the relevant individual Royal College of Surgeons’ website – either the Royal College of Physicians and Surgeons of Glasgow; the Royal College of Surgeons of Edinburgh; the Royal College of Surgeons of England; or the Royal College of Surgeons of Ireland. The deadlines for applying for the upcoming MRCS Part A exams are listed in the section below.

MRCS Part A dates

The MRCS Part A exam is held three times per year, in January, April and September, simultaneously by each of the Royal Colleges of Surgeons. The upcoming exam dates, application deadlines and fees can be found in the table below:

MRCS Part A exam date Application closing date Exam fee
14 September 2021 2 July 2021 £550
11 January 2022 22 October 2021 TBC
26 April 2022 25 February 2022 TBC

MRCS Part A test locations

Although previously offered at various locations within the UK, Ireland and internationally, since September 2020, the MRCS Part A exam has been delivered online. Although there may be a reversal to in-person testing in the future, currently this continues to be the guidance. You can find more information and resources for preparing to undertake the exam remotely on the Intercollegiate MRCS Exam website.

MRCS Part A results

The standard for the MRCS Part A exam is set using the ‘Angoff procedure’; you can find more information about what this entails on the Intercollegiate MRCS Exam website. This same process is used to set the standard for all MRCS Part A exams and ensures that the standard required to pass the exam is consistent for all. However, as each MRCS Part A exam is different, the pass mark for individual exams will vary each time.

When you complete the MRCS Part A exam, your marks for both papers (Paper 1: applied basic science and Paper 2: principles of surgery in general) will be combined to give you a total mark for Part A of the assessment. Following the exam, you’ll receive a breakdown of your marks, but no further feedback is provided.

The date on which you’ll be able to access your results will be specified on your MRCS exam documentation or provided when you complete the exam. Results will then be published on the individual Royal College of Surgeons’ website, through which you sat the exam, on the date given. Following this, you’ll also receive written confirmation of your results.

MRCS Part A questions

To gain an understanding of the knowledge and skills assessed as part of the MRCS exam, you should familiarise yourself with the MRCS syllabus. The ‘competence based’ curriculum identifies the applied and theoretical knowledge and practical skills, and professional behaviours, you’ll be required to demonstrate within the MRCS exam.

The syllabus is divided into the following ten modules which you’ll be assessed on during the MRCS exam:

  • Module 1: basic science knowledge relevant to surgical practice
  • Module 2: common surgical conditions
  • Module 3: basic surgical skills
  • Module 4: the assessment and management of the surgical patient
  • Module 5: perioperative care of the surgical patient
  • Module 6: assessment and early treatment of the patient with trauma
  • Module 7: surgical care of the paediatric patient
  • Module 8: management of the dying patient
  • Module 9: organ and tissue transplantation
  • Module 10: professional behaviour and leadership skills

To help you to prepare for the MRCS Part A questions, the MRCS candidate guidance provides detailed information on the MRCS syllabus, including the objectives and knowledge relating to each of the modules above.

Resources

Aside from the MRCS syllabus and the recommended reading list (see below), practice questions and mock exams will be one of the most valuable resources for preparing for the MRCS exam. Using a mixture of practice questions and mock exams will ensure that you’re familiar with the types of questions you’ll be asked, have the opportunity to develop your responses and grow accustomed to dealing with the time pressure and demands of a full MRCS exam.

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MRCS books

The MRCS candidate guidance provides the following list of recommended textbooks for preparing for the MRCS exam:

Basic science textbooks

  • Agur AMR, Dailey AF. Grant’s Atlas of Anatomy, 12e. Lippincott, Williams & Wilkins, 2008.
  • Netter FH. Atlas of Human Anatomy, 5th edn. Saunders, 2010.
  • Sinnatamby CS. Last’s Anatomy: Regional and Applied, 12th edn. Churchill Livingstone, 2011.
  • Barrett KE, Barman SM, Boitano S, Brooks HL. Ganong’s Review of Medical Physiology, 23rd edn. McGraw-Hill, 2009.
  • Kumar V, Abbas AK, Fausto N, Mitchell R. Robbins Basic Pathology, 8th edn. Saunders, 2007.

Clinical textbooks

  • Garden OJ, Bradbury AW, Forsythe JLR, Parks RW. Principles and Practice of Surgery, 5th edn. Elsevier, 2007.
  • Williams NS, Bulstrode CJK, O’Connell PR, eds. Bailey and Love’s Short Practice of Surgery, 25th edn. Hodder Arnold, 2008.

5 Tips to help you revise

As with all exams, effective revision will ensure that you are prepared for the MRCS and provide you with the best possible chance of performing well on the day. The following tips will help you to get the most out of your revision time:

  1. Consider when may be the best time to undertake the exam
    Before you even book your test and begin revising, consider your current knowledge, skills and experience, and how prepared you are for the MRCS. Although you can take the MRCS earlier, provided you meet the eligibility criteria, the candidate guidance recommends that you undertake Part A in Specialty/Core Training Year 1 (ST/CT1) and Part B in Specialty/Core Training Year 2 (ST/CT2). Many people do pass Part A in their foundation years, however it’s important to ensure that you have time to fully prepare, as you may risk wasting your limited attempts at passing the exams.
  2. Familiarise yourself with the syllabus
    As mentioned above, the MRCS syllabus outlines the knowledge, skills and behaviours assessed within the exam. Therefore, you can gain an understanding of what to expect within the exam, providing a useful starting point for identifying key areas for revision.
  3. Dedicate time to the recommended reading
    The MRCS candidate guidance advises that the recommended texts provide the level of knowledge required to successfully pass the exam. Mastery of the syllabus subjects, to the depth covered in the texts, and the ability to apply this knowledge in the context of surgical practice, is essential. In addition to this, it is expected that you will read beyond the recommended reading list in your preparations for the MRCS. However, many candidates find it difficult to revise from textbooks whilst working a full time job. We’re building our adaptive MRCS Part A question bank to tackle this issue; this will contain all the resources you need to pass the exam and will use AI technology to create a personalised learning journey based on your individual strengths and weaknesses.
  4. Utilise practice questions
    While being familiar with the syllabus and recommended texts is valuable, dedicating time to completing practice questions will allow you to apply your knowledge and gain exam experience. Quality practice questions will also provide feedback, which will support you to develop your knowledge and skills, and help your revision to progress.
  5. Don’t skip practising full mock exams
    In addition to helping you become familiar with the exam format, completing full practice tests will support you to prepare for the demands of a five hour exam, which offers additional challenges. It’ll also provide you with a more realistic exam experience and expectation of what you can achieve in the given time frame and over the space of a five hour exam.

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Further reading

More tips on smashing your MRCS interview.

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By Medibuddy — 23 July 2021