What is the MRCS Part B?
The MRCS Part B exam is the second and final examination required to gain Membership of the Royal Colleges of Surgeons (MRCS) at any of the four royal colleges in England, Glasgow, Edinburgh or Ireland. The MRCS tests the knowledge, experience and clinical competence expected of trainees at the end of their core surgical training. While the MRCS Part A is a written paper, Part B is an Objective Structured Clinical Exam (OSCE) — similar to the practical OSCEs used in medical school finals — comprised of a series of stations in a circuit around which you rotate.
Eligibility criteria
Candidates must have passed Part A of the MRCS before they can take Part B, and must hold a medical degree deemed acceptable by the UK General Medical Council (GMC) or the Medical Council in Ireland. Candidates have 4 attempts in which to pass their Intercollegiate MRCS Part B OSCE and must complete this within seven years of passing their Intercollegiate MRCS Part A.
Application
Applications for Part B of the MRCS can be submitted through each of the Royal College of Surgeons websites. There are four colleges where you can apply: the Royal College of Physicians and Surgeons of Glasgow; the Royal College of Surgeons of Edinburgh; the Royal College of Surgeons of England; and the Royal College of Surgeons of Ireland.
Cost
The MRCS Part B is an expensive exam. It costs around £1,000 just to sit, and then there is the cost of online question banks and in-person mock OSCE courses which can set you back a further £500–£1,000.
Exam dates
There are usually three MRCS Part B sittings in the UK and Ireland each year — February, May and October — with international dates varying. Exams are held at hospitals and simulation centres around the world in clinical environments with real and simulated patients.
Format
The MRCS Part B OSCE consists of 17 examined stations. Each station is 9 minutes long, with an additional minute to read the task instructions and a minute to move between stations. In total the exam takes approximately 3.5 hours. You rotate clockwise around the circuit, guided by examiners, undertaking a clearly defined task at each station — taking a focused history or clinical examination, interpreting an X-ray or performing a simulated practical procedure. The stations are divided into 4 content areas across Applied Knowledge (8 stations: anatomy and surgical pathology ×5, applied surgical science and critical care ×3) and Applied Skills (9 stations: clinical and procedural skills ×5, communication skills ×4).
Scoring & pass mark
Each station is marked out of 20 on a structured mark scheme, plus a separate global rating of fail, borderline or pass. The 8 Applied Knowledge stations give a score out of 160 marks and the 9 Applied Skills stations a score out of 180. To pass you must pass both content areas; the passing mark is set after the exam based on the difficulty of your specific circuit, so it is personalised to your day rather than a fixed percentage. Around 70% of candidates pass at each sitting.
When should you sit it?
The Royal College of Surgeons suggests sitting the MRCS Part B in Core Surgical Year 2, but many sit it earlier as CST2 is when you want to focus on surgical specialty job interviews. A BMJ study (2017) of successful candidates between 2008 and 2016 showed the pass rate was highest for those sitting in core surgical year 1.
How to pass
Like any OSCE, Part B tests not just your knowledge but your practical and communication skills, which are harder to improve than revising for a written paper. Difficulty is greatly reduced by being fully prepared: a solid understanding of the syllabus, familiarity with the format, and plenty of practice. Typically it is recommended to use a mix of the MRCS syllabus, textbooks, videos, question banks and mock exams.
MRCS Part B questions
Practising realistic MRCS Part B scenarios is key for effective preparation — a mix of anatomy, applied sciences and practical and communication skills. Knowing where to start can be tough, which is why we created MRCS Part B Questions: realistic scenarios covering all stations, with questions drawn from past MRCS Part B examinations.