Top tips

Pay your fee
The cost is £1700. Bite the bullet and pay for it. This will focus your mind.

 

 

The MCQ / EMQ.

 
This part of the exam is purely a knowledge based assessment that is extracted out of your very soul under pressure. You have 2 hours to complete approximately 120-140 questions. That is 60 seconds a question.
MCQ’s ( Multiple choice questions)- They are NOT negatively marked. There are usually 5 stems and cover all aspects of the curriculum. .
   

 

 

Tips:

If I was to do it again I would read up on thyroid disease and neck lumps. I would say 10% and above is on head and neck disorders.

Do not skip a question. Go with your gut feeling. You will not have time to go back and answer the ones you missed

 

 

EMI ( Extended matching items) – these again are not negatively marked. There are approximately 120- 130 questions in 2 hours. Just over a minute a question. They give you a scenario and you have to select the bets fit answer

 

 

Tips:

Some of these questions were absolutely appalling. You have to laugh or you may just shout an expletive at the top of your voice and walk out of the exam. I almost did.

Choose the best fit and forget about it. Do not skip a question. Go with your gut feeling. You will not have time to go back and answer the ones you missed

 

 

When should I start revising?

 

 

To be absolutely honest I can say that there was very little I read that would have improved my score. Having said that you can’t just turn up on the day. Ideally you should read everything as you go. We all know that this just isn’t what happens and realistically you need to start reading about 6 months before, and work seriously for a few weeks before so you can try and recall of the stuff you always forget... e.g. stats terms like positive predictive value etc.

What should I read for the MCQ?

 

 
          I did not buy a book. I did not go on a course. I borrowed the relevant books and used the resources on the internet including wikipedia. Yes! Why pay for expensive journals and books when the information is all there in cyberspace. Links to the web sites I found useful are given where appropriate.

Some purchased many of the Companion Series to Surgical Practice, and paid for expensive courses, but to be honest you don’t need to. The key to any course and exam is, knowing what to expect, i.e. knowing the level and breath of questions you may get asked. This is not cheating, and I would give you this argument.

     To be able to learn something is like a journey. Before you start you need to know where you are going (map / curriculum), and have a means to get there ( transport / information).

Therefore this web site gives you a feel for the type of questions to expect in the MCQ, viva's and clinicals. This is what you perceive a course offers you when you pay upward of £1000. What is the mystery behind passing the exam? Knowing the breath and extend of questions is all you need so you can target your reading to that level.

You don't need a fancy course or the up to date journals. The information you require is what knowledge you already have but simulated into some order. The questions aim to pick this out ( well that's what they should do)

Example: A 70yr old man presents with pain in both legs that is eased by rest, worse when he walks down a silght incline. The most likely cause is?

  1. Intermittent claudication from aorto iliac disease
  2. Venous insufficiency
  3. Spinal claudication
  4. Spondyloarthropathy
  5. Diabetic Lumbosacral Plexopathy

What the question is asking is if YOU were to take a history could you ask the relevant questions and be able to differentiate the above?

When you start remembering literature to support your BASIC answer you have probably done enough.

 

 

What should I read for the Viva's?

 

 
See the list of questions and be guided by selective reading on these subjects. I would strongly recommend you read the Companion series to surgical practice. This doesn’t mean you have to buy them, and I have used them to summaries the relevant chapters on the web site.

 

 

Tips:

Be prepared to give a 2-3 min presentation of each topic you read. This will encourage you to recite what you know in a structured way.

See common questions you may be asked and say what you would do in your practice. Do not start reciting a paper you read last month!

If you can revise in a group it does spur you on to read.

 

So what will I get asked?

Example: This is how it may go......

How can gallstones present?

This is an opener....can you dribble out something sensible and structured. ( i.e. your 2 minute summary of a topic may help you out here)

How would you manage a 49 year-old woman who presents with acute pancreatitis?

This really is asking you about your emergency care thought patterns, and they may be interested or example to know what test you would do next....USS, MRCP, ERCP and can you justify them?

Or they may take you into initial immediate management and the role of antibiotics and when a necrosectomy may be indicated.

This is the type of banter a viva will take. Start simple and build up to a discussion of more complex gray areas, just to see if you can hold a sensible discussion on the management of YOUR patient. To say I am not an upper GI surgeon will not win brownie points.

Try this link for clues http://www.wmsurgeons.com/kb/entry/168/

Suggested reading:

 

 

  1. Read your specialty companion series and the Emergency Surgery one.
  2. The ATLS book. Be familiar with the principles, even the smaller topics e.g. Burns etc
  3. Ccrisp. Be familiar with the principles and have a few physiological facts you can easily recall about each system and try and put them in context (see topics under the viva section of this web site)
  4. A good critical care book is Surgical Critical Care Viva's by Mazyar Kanani. You do not need to buy it! Just borrow it from the library and read it.
  5. Any general articles from the last 6 months of the BJS.  (see academic viva section)

For the clinicals

 

 
You cannot really do any work for these but people fail on common problems such as groin and scrotal lumps, neck lumps, lap cholecystectomies. For example...
  • Could you consent for a Lap chole? You do it everyday but do you really know the risk of CBD injury?
  • Do you have a systematic plan for examining a hernia? Worth teaching the medical students to see how it should be done. You tend to loose the basics after a few years, and it is the basics they want.
  • They last time I had to make a differential on a neck lump was 7 years ago at the MRCS exam. However the view form the Royal College is that that this should be part of the 'general exam'. As a colorectal surgeon this is something I would revisit for nostalgic purposes when I see one in a clinic, or to teach medical students on the ward. It is not something I would ever contemplate taking on in my practice.
    BE WARNED they love this for some reason. One of the last bastions of the general surgeon. Know how to do a medical student type exam of a lump in the neck and have an idea on investigation and even management.
What are they looking for?
  • Perform systematic examination
  • Eliciting signs and formulating a differential diagnosis
  • Discuss investigation and management in light of the patients age and co morbid conditions
  • Have you got any sort of bedside manner

 

 

 

Future collaboration

 

 
Everyone has to sit this exam in the current state of training. This web site is not about reproducing a textbook, but about giving you insight into what questions you may get asked. Experience of other and a short summary of topics of pertinent interest will help your colleagues avoid paying huge amounts of cash out on textbooks or to re-sit the exam. If you would like to contribute your experience please drop me an e-mail admin@wmsurgeons.com