Demystifying the MRCS Exam Structure: Your Step‑by‑Step Guide to Part A & Part B 

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Introduction 

Embarking on a career in surgery is both exhilarating and challenging. One of the major benchmarks in this journey is the Membership of the Royal College of Surgeons (MRCS) exam. Whether you’re a medical graduate in the UK or an international doctor aspiring for recognition, the MRCS is your gateway to specialty training in surgery. 

However, understanding the exam structure—especially how Part A and Part B differ in scope, format, and expectations—can be confusing for first-timers. This blog aims to demystify the MRCS exam, offering a step-by-step breakdown to help you plan, prepare, and pass with clarity. 

The MRCS (Membership of the Royal Colleges of Surgeons) is a postgraduate surgical examination conducted jointly by: 

• Royal College of Surgeons of England 

• Royal College of Surgeons of Edinburgh 

• Royal College of Physicians and Surgeons of Glasgow 

• Royal College of Surgeons in Ireland 

It assesses your ability to deliver safe and effective surgical care, and passing it is mandatory for entry into higher surgical training (ST3 level) in the UK. 

Why Take the MRCS Exam? 

• Gain recognition as a surgical professional in the UK and many Commonwealth countries. 

• Necessary for progressing into specialist surgical training pathways. 

• Builds core surgical and clinical competencies. 

• Enhances career mobility and credibility, especially for international graduates. 

MRCS Part A: The Written Test 

Format 

Part A is a five-hour multiple-choice exam split into two papers taken on the same day: 

Paper	Subject	Duration	Questions	Marks
A1	Applied Basic Sciences	3 hours	~180 MCQs	180
A2	Principles of Surgery-in-General	2 hours	~120 MCQs	120

You must pass both sections in combination to succeed in Part A. 

Syllabus Includes: 

• Anatomy, physiology, pathology 

• Pharmacology and microbiology 

• Principles of surgical practice 

• Perioperative care 

• Trauma, critical care, and common surgical conditions 

Scoring & Pass Mark 

• Combined marks from both papers 

• Pass mark typically ranges between 70–72% (subject to adjustment) 

• Results declared 4–6 weeks post-exam 

Preparation Strategy 

• Study consistently over 3–6 months 

• Use question banks like Pastest or eMRCS 

• Practice under timed conditions 

• Revise using core surgical textbooks (Bailey & Love, Gray’s Anatomy) 

4. MRCS Part B: The OSCE Exam 

Format 

Part B is an Objective Structured Clinical Examination (OSCE) comprising 18 stations, each lasting about 9 minutes (8 minutes + 1-minute reading time). 

Skills Tested: 

• Clinical examination (cardio, neuro, abdominal, etc.) 

• Communication skills (breaking bad news, obtaining consent) 

• Procedure-based skills (suturing, catheter insertion) 

• Anatomy and pathology interpretation (images, specimens) 

Scoring Criteria 

Each station is marked by trained examiners on: 

• Clinical accuracy 

• Communication ability 

• Professionalism 

• Time management 

You must pass a minimum number of stations overall and in each domain. 

Preparation Tips 

• Form a study group for mock OSCEs 

• Practice with anatomical models and real scenarios 

• Work on soft skills like empathy and clarity in communication 

• Record yourself to evaluate posture and tone 

5. Exam Timeline & Eligibility 

Eligibility: 

• You must hold a primary medical qualification recognized by the GMC. 

• You don’t need to complete Part A before booking Part B, but you must pass Part A before sitting Part B. 

Timeline: 

• Part A: Conducted 3 times a year (January, April, September) 

• Part B: Held 3–4 times a year (varies by college and location) 

6. Choosing the Right College 

While the exam content is unified, the college you register through can affect: 

• Exam location availability 

• Fees (slightly vary) 

• Membership benefits post-qualification 

You can choose between: 

• RCS England 

• RCS Edinburgh 

• RCSI (Ireland) 

• RCPS Glasgow 

Tip: International candidates often choose the RCSI for its strong overseas exam center network. 

Books: 

• Bailey & Love’s Short Practice of Surgery 

• Gray’s Anatomy for Students 

• Kentsbridge MRCS Part A Notes 

Online Platforms: 

• eMRCS 

• Pastest 

• BMJ OnExamination 

• Geeky Medics (OSCE help) 

Courses: 

• MRCS OSCE workshops 

• Clinical Premier Training Programs like Texila’s Fellowship for structured guidance 

8. Final Tips to Succeed 

• Start early: Allocate at least 4–6 months for each part. 

• Track progress: Use mock tests to assess weak areas. 

• Peer discussion: Study groups improve retention and motivation. 

• Stay calm: Manage stress with daily planning and rest. 

• Seek mentorship: Connect with past candidates or enroll in guided training programs. 

FAQs