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Examinations are held at two key stages: during initial training and towards the end of specialist training.


The Membership Examination of the Surgical Royal Colleges of Great Britain and in Ireland (MRCS) is designed for candidates in the generality part of their specialty training. The purpose of the MRCS is to determine that trainees have acquired the knowledge, skills and attributes required for the completion of core training in surgery and, for trainees following the Intercollegiate Surgical Curriculum Programme, to determine their ability to progress to higher specialist training in surgery. The MRCS examination has two parts: Part A (written paper) and Part B Objective Structured Clinical Examination (OSCE).

Part A (written paper)

Part A of the MRCS is a machine-marked, written examination using multiple-choice Single Best Answer and Extended Matching items. It is a four-hour examination consisting of two papers, each of two hours’ duration, taken on the same day. The papers cover generic surgical sciences and applied knowledge, including the core knowledge required in all surgical specialties as follows:

  • Paper 1 - Applied Basic Science
  • Paper 2 - Principles of Surgery-in-General

The marks for both papers are combined to give a total mark for Part A. To achieve a pass the candidate is required to demonstrate a minimum level of knowledge in each of the two papers in addition to achieving or exceeding the pass mark set for the combined total mark for Part A.

Part B (OSCE)

The Part B (OSCE) integrates basic surgical scientific knowledge and its application to clinical surgery. The purpose of the OSCE is to build on the test of knowledge encompassed in the Part A examination and test how candidates integrate their knowledge and apply it in clinically appropriate contexts using a series of stations reflecting elements of day-to-day clinical practice.

Further information can be obtained from


Otolaryngology trainees at CT1/2 level in ENT themed core surgical training posts should undertake Part A of the MRCS and the Part 2 (OSCE) of the Diploma in Otolaryngology – Head and Neck Surgery (DO-HNS) in order to acquire the Intercollegiate MRCS(ENT) Diploma. From August 2013, the MRCS(ENT) examination will be a formal exit requirement from Core Surgical Training for Otolaryngology trainees. It is also a mandatory requirement for entry into higher specialty training in ENT. The DO-HNS examination exists as a separate entity but is not a requirement for ST3 unless paired with the MRCS as explained above.

The purpose of the Diploma in Otolaryngology – Head and Neck Surgery (DO-HNS) is to test the breadth of knowledge, the clinical and communication skills and the professional attributes considered appropriate by the Colleges for a doctor intending to undertake practice within an otolaryngology department in a trainee position. It is also intended to provide a test for those who wish to practise within another medical specialty, but have an interest in the areas where that specialty interacts with the field of otolaryngology. It is also relevant for General Practitioners wishing to offer a service in minor ENT surgery.


The Intercollegiate Specialty Examination (FRCS) is a summative assessment in each of the ten surgical specialties. It is a mandatory requirement for certification and entry to the Specialist Register. It forms part of the overall assessment system for UK and Irish surgical trainees who have participated in a formal surgical training programme leading to UK certification or a Certificate of Eligibility for Specialist Registration via the Combined Programme (CESR CP) or, in the Republic of Ireland, a Certificate of Satisfactory Completion of Surgical Training (CSCST).

Section 1 is a written test composed of two multiple choice questions papers. Paper 1: Single Best Answer (SBA) and Paper 2: Extended Matching Items [EMI]. Candidates must meet the required standard in Section 1 in order to gain eligibility to proceed to Section 2.

Section 2 is the clinical component of the examination. It consists of a series of carefully designed and structured interviews on clinical topics, some being scenario-based and some being patient-based. Further information can be obtained from