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Cracking the MRCS Part A Exam Hurdle: How to Prepare

Membership of the Royal College of Surgeons (MRCS) is one of the oldest formal affiliations which recognise surgeons who are at an early stage of their careers. Many doctors give this exam for its worldwide recognition while others give it to gain GMC registration for their license to practice in the UK. The MRCS exam can be given in many different countries of the world which makes it more accessible to many compared to the PLAB exam.

So why do only a small number of individuals gain their membership into the Royal College of Surgeons despite all the benefits? The bottleneck is undoubtedly the MRCS Part A exam.

The MRCS Part A is a 5 hour long exam consisting of 2 papers, Paper 1 for Applied Basic Science and Paper 2 for Principles of Surgery in General.

The MRCS Part A exam has a very low pass rate of about 35%, which means that only one third of the candidates giving the exam will pass in each session.

You can make a maximum of 6 attempts to pass the MRCS Part A exam, therefore, it is crucial to give it your best attempt. In order to pass the exam, it is important to understand the exam and its marking system very well, as follows:

A. Total Marks: 300 marks

a) Paper 1: 180 marks, 180 MCQ questions

b) Paper 2: 120 marks , 120 MCQ questions

Average Pass mark range: 210-230/300

**You must get at least 50% in each paper in order to pass the exam

B. Total Time: 5 hours with a 1-2 hour break in between the two papers

a) Paper 1: 3 hours (180 minutes)

b) Paper 2: 2 hours (120 minutes) ** 1 question in 1 minute is the common rate of answering in this exam*

C. Topics: a) Paper 1: Applied Basic Science

b) Paper 2: Principles of Surgery in General

D. How to Study:

1. Select your topic alliance

You may notice while going through the topic names that Paper 1 consists of topics aligned with the early years of medical school while Paper 2 covers topics which are often seen while working as a doctor clinically. The general rule of thumb is to find your strength within the topics:

- If you are a fresh graduate, focus on getting near perfect scores in Paper 1:

I personally gave my MRCS Part A very soon after medical school: So I focused on acing Paper 1 to pull up my scores.

- If you have been working as a doctor in a surgical specialty for the last 1-2 years, Paper 2 is your friend. The questions in Paper 2 will ask you questions which you address routinely while working, so you should attempt to score nearly perfect marks in this Paper.

2. Set aside the time: Aim for spaced repetition

The MRCS Part A exam requires from 2-6 months of study time (provided you have a full time job). To effectively prepare for multiple choice questions, the best approach is to study a topic, solve the questions related to that topic, then move on to another topic. Once you cover all the topics, go through them all again (and again if required) until you score good marks on the question bank exercises.

3. Master the question banks:

As mentioned in the how to pass PLAB 1 exam ( best way to master UK based exams is to practice lots and lots of questions. The two most reliable resources are emrcs and Pastest.

emrcs has about 2000 questions, all of which are remarkably similar to the actual exam question pattern itself. I would recommend going through this at least 3 times before your exam, or until your overall score is near 90% or above, whichever comes first.

Pastest consists of about 4300 questions, however, not all of them feel as aligned to the actual exam pattern as emrcs. I would recommend going through all the common Paper 2 topics such as Orthopaedics, Urology, Vascular surgery, and Endocrine system from Pastest at least once.

4. Resources:


The only notes you will need for the MRCS Part A are those which concise the topics into retainable formats. Some of the resources which helped me a lot were:

a) REDA Notes for MRCS Part A: This note consists of the answer explanations from emrcs, concisely made into a note with plenty of images, cartoons, and tables to make it easy to study. I went through this note and emrcs simultaneously.

b) Anatomy by El-matary: This book has all you need to know about anatomy for MRCS Part A in such a neat and organised way. Alternatively, Grey’s Anatomy for Students or Netter’s Atlas can also be great resources for Anatomy.

c) Basic Science for the MRCS by Andrew Raftery: This book is great for going through the topics from Physiology and Pathology which might seem challenging.

d) Bailey and Love’s Short Practice of Surgery: This is a great textbook to look at for reference if you did not understand an answer from emrcs.

5. Past Questions:

I found out quite early in my study routine that the RCS was fond of repeating past questions. Hence, I spent quite a lot of time going through the MRCS Recalls from the various websites and Facebook revision groups. These are the questions that past candidates remembered and shared, which are priceless resources to revise through. You will see that many of the questions repeat themselves and this will save you a lot of time and unfamiliarity during the exam.

The Fawziyah sheet, similarly, consists of past questions which tend to repeat themselves over and over again, I had gone through these questions about 3 times before my exam and had about 30 questions which were IDENTICAL to the questions on this sheet.

Please do leave a comment if you have any questions, wishing you all the best!

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