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How I Passed MRCS Part A as an FY1

The Membership of the Royal College of Surgeons (MRCS) exam is a postgraduate exam mainly for aspiring surgeons, and those in surgical training are expected to have completed parts A and B by the time they finish their core training, ready to be a registrar.

Why take the exam as an FY1?

I am not inclined to pursue a surgical career, but taking the first part of a postgraduate exam such as MRCS/MRCP as a foundation trainee grants points towards my radiology application. Between the two, I picked the MRCS since I can take it earlier in FY1 (you need one year of clinical practice before being eligible for MRCP Part 1 i.e., in FY2), which allows further attempts in case you fail the first time round. Additionally, the anatomy knowledge I will gain by preparing for the surgically-orientated MRCS is more likely to be helpful in radiology training.

My reasoning for taking the exam is certainly not a conventional one. You should also consider the price tag of £550 (for my sitting in January *prices will likely increase over time*) and associated study materials e.g. a question bank subscription. The other main reason (and why most people take it in FY1) is: if you are planning to go into surgery anyway, it would be helpful to get it out of the way early; it helps with your application to CST, and it's one less thing to worry about during your years in core training

MRCS Part A: Eligibility and exam format (taken from website)

"To be eligible to sit the MRCS exam, you must hold a medical degree that is acceptable to the UK General Medical Council (GMC) for full or provisional registration or to the Medical Council in Ireland for full or temporary registration.

First time applicants whose names do not appear on the registers of the GMC or Medical Council (Ireland) must submit their original certificate (or an authenticated copy) of a medical degree acceptable to the councils of the four colleges.

Full details on candidate eligibility can be found on the intercollegiate MRCS exam website."

"Part A is a five-hour MCQ exam consisting of two papers, an AM paper of three hours and a PM paper of two hours duration, taken on the same day. Currently the examination will delivered remotely. The applied basic sciences paper is divided into two 90-minutes sections to allow for a 10 minute comfort break.

The papers cover generic surgical sciences and applied knowledge, including the core knowledge required in all nine specialties as follows:

  • Paper 1: applied basic sciences

  • Paper 2: principles of surgery in general

To achieve a pass in Part A, you will be required to demonstrate a minimum level of competence in each paper in addition to achieving or exceeding the pass mark set for the combined total mark for Part A. Candidates may attempt to pass Part A of the MRCS exam six times."

My preparation

I started preparing for the exam about 4 months in advance. I mainly used the question bank on Pastest as it was available for free for candidates in my trust, and highly recommend it if only for the past papers. As with most written exams, it honestly boils down to rote learning and getting used to pattern recognition. It also helps to know that Paper 1 (60% of the entire exam) focuses on basic sciences.

I rinsed and repeated the questions in the question bank and managed to get through it twice in total; first time by subspecialty (e.g. general surgery, vascular surgery, orthopaedics etc.) then the second round without any filters. The most challenging aspect was the sheer amount of anatomical knowledge that I had to recall from pre-clinical years, followed by the difficulties of studying while working shifts. I had to make do with getting several questions in during lunchbreaks, and do the bulk in the evening. I was slightly worried having night shifts the week before the exam, but as a surgical F1, the ward starts to quiet down from midnight to 6am, giving ample time for some studying and a quick shuteye.

From a technical standpoint, my concern was taking the exam remotely. Fortunately, candidates are sent a trial version of the software Examplify around 6 weeks before the exam, including a mock exam that you can take to help familiarize yourself with the interface. Some points to note:

-you will be allowed to download the exam files around 3 days prior, but they will be password-locked

-a video recording will be taken for monitoring purposes throughout the exam, so make sure there is nothing in your background or near you that could raise eyebrows

-get a secure and quiet place where you would not be disturbed; I requested an empty room in my trust education center to take the exam in peace

-whilst recommended to have stable wi-fi, you truly only need it at the start for clocking in and at the end when you upload the answer and video files; so don't panic if your wi-fi disconnects in the middle of the exam

-feel free to start as soon as you are able to, the password is available on the website 30 minutes prior to start time along with an email; there is no strict start time (as times when but there is a set time by which files must be uploaded

-I did not personally take the break between the first and second parts of the AM paper, as that was the conditions I was used to doing the past papers

-ensure you receive a confirmation email after uploading the exam files

The Outcome

The exam itself went by quite quickly but there was plenty of time to review your answers. Time pressure was not really an issue as most of the questions had really short stems. Myself and several others who took the exam found trauma/orthopaedics to be a major focus this sitting.

Pass mark for my sitting was 72.8%, and generally stays around that (although the September 2020 sitting was abnormally high at around 76.9%). This equates to getting around 219/300 questions correct. Pass rate was 37.7% for the January 2021 sitting. I scored 82.7%, which I was quite happy with.

Full details for the breakdown can be found here.


Please comment below if you have further questions about the exam, or your own experiences and useful tips for the exam.

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