In this MRCS Part A guide we want to share how to pass the MRCS Part A exam while working as a doctor and go into detail about how to prepare for the MRCS Part A.

What is the Membership of The Royal College of Surgeons (MRCS)?

So what is the MRCS? Well the MRCS stands for the membership of the royal college of surgeons. It's a postgraduate medical qualification for surgery and also a membership examination . The MRCS exam is split up into two parts, a written Part A that assesses your core knowledge and a practical MRCS Part B which is an objective structured clinical examination that assesses your clinical competence as a surgical trainee. You need to pass both mrcs exams to enter specialist surgical training in the UK and gain membership of one of the royal colleges.

It's there to ensure you have the minimum level of basic science knowledge relevant to provide surgical care.

When Can I Take The MRCS Part A?

To sit the MRCS Part A exam all you need is a primary medical qualification. You can sit the MRCS anytime after graduating and it is a mandatory requirement to progress to ST3 level in any surgical specialty.

Who is eligible for MRCS Part A?

To be eligible for the MRCS Part A 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.

What is The MRCS Part A Exam Format?

The MRCS Part A is a five-hour MCQ exam that is a written paper consisting of two papers taken on the same day. The exam is sat at a Pearson Vue test centre which is similar to any of the computer based test centres you may have used for exams.

The morning paper is three hours and uses 180 single best answer multiple choice questions to assess your knowledge of applied basic science and the afternoon paper is two hours duration and uses 120 extended matching multiple choice questions to test your knowledge of the principles of surgery.

The MRCS Part B is then a practical OSCE exam.

What Are The Dates For The MRCS Part A Exam

There are three exam sittings each year for the Part A exam in January, April and September at a Pearson vue test centre across the UK and internationally with each listing a closing date to apply by. Further information can be found

You can apply to sit the MRCS at any of the four surgical royal colleges; the royal college of surgeons England, royal college of surgeons Edinburgh, Glasgow or Ireland.

Which of the four colleges you choose is entirely down to your preference though their test centre locations are slightly different so it might be more convenient to choose one over another for travel purposes but whichever you choose for Part A you'll also need to stick with for Part B.

How Much Does The MRCS Part A Exam Cost

Regardless of which of the royal college of surgeons you sit the exam the MRCS Part A costs £550 per examination sitting. The MRCS Part B is then £1000.

What Is The MRCS Part A Pass Mark?

There are equal marks for each question on the exam and no negative marking or pass mark set. You are given a combined total mark across the two papers.

According to data from the royal college of surgeons the pass mark is roughly 70% and is calculated using something called the Angoff method which basically means that rather than the pass percentage being fixed the paper uses a group of experts to judge how difficult each item is in an exam to determine the final cut-off score.

You'll then get your results from the colleges of surgeons around 4-6 weeks later when they get emailed out to you and published online via candidate numbers.

When Should I Sit The MRCS Part A?

You can sit the MRCS anytime after graduating medical school and you get six attempts to pass the exam.

The Royal College of Surgeons recommends that you attempt Part A during your first year of core surgical training (CST) and Part B in your second year but loads of people sit the exam earlier and people worry about when they should sit it.

A research study published in the BMJ in 2017 reviewed all candidates who sat the exam over an 8-year period between 2008 and 2016 and they found that doctors who sit Part A in FY1 and Part B in CST1 are not only more likely to pass, but are also more likely to pass with a higher mark.

Most people tend to sit the Part A in April of their F1 year. This makes sense especially if you have a surgical job as your first rotation which means you have exposure to surgical principles and want to get things out of the way before the summer.

If you sit it early you also get some extra points on your core surgical training application but regardless of when you sit it you want to be confident that you'll pass.

How To Prepare For The MRCS Part A

Exam preparation for the MRCS Part A is essential and doing practice questions around your day job will help you master applied basic sciences.

The Syllabus and Questions

The first place to start when preparing for the MRCS exam is to head to the MRCS exam syllabus so you know what to revise and how the exam will be marked.

To summarise paper 1 focuses on applied basic sciences and has 180 single best answer questions broken down into:

• Applied Surgical Anatomy (75 Questions)
• Applied Surgical Physiology (45 Questions)
• Applied Surgical Pathology (37 Questions)
• Pharmacology (8 Questions)
• Microbiology (7 Questions)
• Imaging (5 Questions)
• Data interpretation (3 Questions)

Then paper 2 in the afternoon which focuses on principles of surgery and surgical practice in general has 120 extended matching questions broken down into:

• Common congenital and acquired surgical conditions (45 Questions)
• Perioperative management (surgical patient module) (35 Questions)
• Assessment and management of patients with trauma (30 Questions)
• Paediatric patient module (7 Questions)
• Medico-legal aspects of surgical care (3 Questions)

So we can immediately see core knowledge required and what is going to be tested the most.

As a quick recap there are 300 questions in the MRCS Part A across both papers so we have around a minute per question to answer.

If you're using Shiken's AI-powered question bank to revise you can set the time per question.

Finally most mrcs exam syllabuses have some sample questions to give you an idea of the type of questions and their difficulty. In the case of Part A we can see that paper one uses single best answer MCQs where each question contains five possible answers of which there is only one single best answer.

You then select which option from the list is the single best answer just like in this example shown. And we can also get a feel for the difficulty level by looking at these sample questions.

What Topics Come Up Most Often On The MRCS Exam?

We've put together a list of common topics that come up again and again across multiple different exam sittings:

• Upper limb innervation.
• Thyroid tumours.
• Testicular mass.
• Slipped upper femoral epiphysis.
• Breast cancer genetics.
• Inguinal anatomy/herniae.
• Acid base balance.
• Pulmonary embolism management.
• Pharyngeal arches embryology.

It's also worth noting that ECG and blood gas analysis questions come up quite a bit too, sometimes without the normal ranges so make sure you have a rough understanding of these.

What's The Best Way To Prepare For The MRCS Part A Exam?

The highest scoring candidates tend to use a mix of online practice questions, books and digital resources to pass.

Books and Websites

For the MRCS exam the recommended textbooks on the course syllabus are insanely long and quite outdated and you risk just being overloaded with too much information.

We asked over 100 successful candidates and they recommended the below books and resources.

Paper 1 Books

For the MRCS Part A exam paper 1 Basic Science for the MRCS by Delbridge and Rafferty is the most popular book. This covers the entire syllabus including a basic surgical skills module and generic surgical sciences. It's pretty concise with bullet points and clinical examples relevant to the surgical trainee making reading easy and although there is a lot to learn in the syllabus the information is provided in a clear and accessible way.

The generic surgical sciences, surgical practice module and basic surgical skills module provide most of the core knowledge required to pass the intercollegiate mrcs part A.

For anatomy in paper 1 the website Instant Anatomy is a great quick-reference guide that is often overlooked alongside Basic Science which has a good anatomy chapter.

Paper 2 Books

For Paper 2 which focuses on clinical surgery most people defaut to the books they used for medical finals such as Complete Revision Notes For medical and surgical finals.

You might also want to check out some of the MRCS surgical podcasts that are available especially if you are driving to work.

Past Papers & Question Banks

The Part A will likely be one of the first exams you need to study for around your day job as a doctor. For that reason it's sensible to keep reference materials to a minimum as it can get overwhelming once you dive into all the books and youtube channels and lectures and instead dive directly into past paper questions and question banks of questions. Most of which are broken down into modules mapped to basic training. These include a surgical practice module, surgical patient module, paediatric patient module, dying patient module, applied knowledge module and trauma module to help you pass the intercollegiate exam.

How Many Practice Questions Does It Take To Pass The MRCS Part A?

The advice from most successful candidates is to do roughly 2000 questions from past papers and realistic question banks and you're likely to pass. Most successful surgical trainees answer mcqs and practice questions across the two papers to ensure they have the correct knowledge before heading into the five hour mcq exam.

What Is The Best MRCS Part A Question Bank?

The most important thing to consider when investing in an online question bank is how realistic are the questions to the final exam you're sitting.

Quality is much more important than quantity of questions. You also want to make sure that the actual website, app or experience is as easy to use and navigate as possible.

So let's look at each in turn and some other options.

PasTest MRCS

PasTest has just over 4000 MRCS Part A questions to practise. Pastest also has mock exams that you can use outside of the questions under timed conditions. PasTest is quite a bit more expensive and it's probably a bit over-priced for what you get.

eMRCS

eMRCS has around 2200 questions for the MRCS Part A. It's main drawback is that there is no mobile app or offline access and the website interface is very basic. While you can set yourself a timed test and filter by questions this functionality is quite basic and there are no past papers or mock exams like PasTest and some other software. The explanations are good and there are links to appropriate resources but on some questions these were a little outdated.

Shiken AI

If you are looking for a more modern question bank with a nicer design Shiken has over 3000 questions and practice exams at an affordable price written by high scoring candidates and reviewed by consultants.

The Shiken app works on both mobile and desktop and it's gamification and AI system helps to personalize your learning and you can set a time per question and you can even play against friends to make things more fun. As it has a store you can also pick up free MRCS Part A questions so do check it out.

How Long Should You Revise For The MRCS Part A?

The general advice is that if you plan 2-hours of revision most days around work 4-months will be fine to pass. Top candidates tend to focus on getting through around 50 practise questions a day and break things up by the areas of the exam syllabus so one week they'll focus on anatomy then on physiology and you can use a question bank filtering systems to help you do this. Most people feel very well prepared after just a few months and people can pass with just 4-8 weeks revision but this is fairly intense.

How To Get Started Revising For Part A

Hopefully this guide has already given you some inspiration and you should start by looking at the syllabus then decide on which sitting you want to go for. Once you have signed up and paid you then want to grab the books and pay for a question bank and map out a quick revision timetable that fits around your clinical commitments.

How To Prepare For The MRCS Around Your Day Job

For many people revising around a busy day job with oncalls and night shifts is the biggest challenge. When you're planning your revision make sure you factor in long-shifts when you know you'll have less time to revise and don't beat yourself up about not revising on those days.

Is The MRCS Part A Difficult?

The exam focuses on basic science knowledge and basic science knowledge relevant to surgery. It is a challenging exam but provided you cover the mrcs syllabus thoroughly it is no harder than passing any medical qualification. It is also easier to prepare for than the MRCS Part B exam. Applied basic science and applied knowledge sections are often considered the toughest parts of the intercollegiate mrcs part A and the surgical patient module, dying patient module and trauma module are all challenging.

Further Information

You can find out further information from the royal colleges of surgeons websites.

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