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New MRCS Examination (from October 2008)

  • The new MRCS is a summative assessment for candidates in the generality of speciality training, whether in run-through programmes, core surgical training or outside a training programme. Its purpose is to determine that a trainee has acquired the knowledge skills and attributes required for completion of core training and for those trainees following the ISCP, to determine their ability to progress to higher specialist training in surgery.  Passing the MRCS is mandatory to progress from ST2/CT2 to ST3/CT3

Format of Part A

  • Part A is similar to the previous MRCS
  • There is one 4-hour examination consisting of 2 two-hour MCQ papers that are sat consecutively
  • Paper 1 tests applied basic sciences and has single best answer questions
  • Paper 2 tests principles of surgery in general and has extended matching questions
  • Candidates score one mark for each correct answer
  • To pass Part A the overall pass mark has to be met
  • The pass mark is set using a modified Angoff method
  • A score of at least 50% on each paper has to be achieved
  • Candidates can have an unlimited number of attempts at this part

Format of Part B

  • Part B is now in an OSCE format
  • There are 16 stations and 4 rest stations each of 9 mins
  • Candidates will start at different points in the circuit
  • The stations assess knowledge and skills in five main subject areas
    • Anatomy and surgical pathology
    • Surgical skills and patient safety
    • Communication skills
    • Applied surgical science and critical care
    • Clinical skills
  • 12 stations test generic knowledge and are compulsory for all candidates
  • To allow for differences in training, there are 4 speciality stations
  • Candidates select their speciality context at the time of application
  • In each of the five subject areas, six domains are tested
    • Clinical knowledge
    • Clinical skill
    • Technical skill
    • Communication
    • Decision making and problem solving
    • Organisation and planning
  • Most of the stations have surgeon examiners present
  • All examiners must complete a training course
  • The marking scheme is a matrix in which the stations are marked using several domains
  • There is a structured mark sheet for each station
  • The mark sheet includes a holistic judgement of the candidate
  • Candidates must reach the overall pass mark set for Part B
  • They must also achieve a minimum score in each of the domains
  • A variant of the contrasting groups method is used for setting the overall mark

Anatomy and surgical pathology

  • Three stations - two manned and one unmanned
  • In the manned stations there is questioning of applied anatomy
  • In the unmanned station there are prosections images and photographs

Surgical skills and patient safety

  • Two stations - both manned
  • Surgical skills will test, for example, knot tying and suturing
  • Patient safety will test hand-washing, patient positioning, use of tourniquets etc

Communication skills

  • Three stations - two manned and one unmanned
  • The manned stations examine skills such as talking with colleague and relatives
  • The unmanned station tests written communication skills such as preparing a discharge letter

Applied surgical science and critical care

  • Three stations - one manned and two unmanned
  • The manned station tests the application of pathophysiological processes
  • The two unmanned stations tests interpretation if images and results

Clinical skills

  • Five stations
  • Two manned (one generic and one speciality) for history taking
  • Three manned (one generic and two specilaity) for physical examination
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