MRCS Part A Exam Guide

What is MRCS Part A?

The MRCS — Membership of the Royal Colleges of Surgeons — is the intercollegiate examination for core surgical trainees in the UK and Ireland. It is delivered by the Intercollegiate Committee for Basic Surgical Examinations (ICBSE) on behalf of the four surgical Royal Colleges of Great Britain and Ireland: England, Edinburgh, Glasgow and Ireland. It is a single intercollegiate examination: every candidate, wherever they sit, takes the same paper on the same day.

The examination has two parts. Part A is written: two single best answer (SBA) papers on one day. Part B is an Objective Structured Clinical Examination (OSCE). Passing Part A alone carries no diploma status; the MRCS is awarded only when both parts have been passed. Part A comes first.

It is sat by core surgical trainees in CT1 and CT2, by foundation doctors sitting early, by trust-grade doctors applying to core training and by international medical graduates.

Format

Part A is two SBA papers sat on the same day, with a break between them. Paper 1, Applied Basic Sciences, has 180 questions in 3 hours. Paper 2, Principles of Surgery in General, has 120 questions in 2 hours. That is 300 questions and five hours of examination, and a minute per question in each paper.

Every question has five options and exactly one single best answer. Each question carries equal marks and there is no negative marking, so there is never a reason to leave a question blank. Both papers are computer-based and delivered at Pearson test centres in the UK and internationally; every candidate worldwide sits the same paper on the same day.

How Part A is marked

To pass Part A you must reach a minimum level of competence in each paper and the combined pass mark for Part A as a whole. The pass mark is set by standard setting for each sitting, so it varies from one diet to the next and is not a fixed percentage. A strong Paper 2 does not rescue a weak Paper 1, or the other way round.

The level

The ICBSE guide describes Part A as testing “knowledge of both applied basic science and principles of surgery in general to a level that a surgical trainee should have achieved two to three years after qualification.” That calibration explains the style of the questions: they are applied, not preclinical. The anatomy is the anatomy you need to operate safely and interpret a clinical sign; the physiology and pathology are the ones that explain a surgical patient’s course.

Eligibility

You need a primary medical qualification acceptable to the General Medical Council or the Medical Council of Ireland. International graduates need a qualification from a school listed on the World Directory of Medical Schools. The published criterion is your qualification rather than your post, which is how foundation doctors and trust-grade doctors come to sit Part A before applying to core training. The regulations are updated from time to time, so read the current version on the ICBSE website before you apply.

Attempts

RCS England’s Part A page (2026) allows six attempts at Part A. The ICBSE regulations also govern how long a Part A pass remains valid for the purpose of sitting Part B; that rule, like the attempt limit, can change, so check the current regulations rather than relying on a figure from a third-party site, including this one.

Dates, deadlines and fees

Part A runs three times a year, in January, April/May and September. The next sitting still open for applications is 29 April 2027; applications close on 25 February 2027. The published dates for 2026–27 are:

Applications close well before the examination, so the deadline is the date to plan around. Results are emailed about four weeks after the exam. The fee is £670 at the time of writing, per RCS England. Dates, deadlines and fees change; the Colleges’ own pages are the only authoritative source for the current ones.

What Part A tests: the blueprint

The syllabus is drawn from the ISCP Core Surgical Training curriculum, and the ICBSE publishes a blueprint for Part A that states how many of the 300 questions come from each content area. It is the examiners’ own guide to the weighting of the papers, and it is the basis for the syllabus on this site and for the proportions of our question bank.

Anatomy in detail

Anatomy is the largest single block in the examination, a quarter of all 300 questions. The blueprint breaks its 75 questions down further: 63 on regional anatomy, 8 on surgically related embryology and 4 on surface and imaging anatomy. The regional questions are shared out as follows:

• Upper limb and breast: 8
• Lower limb: 7
• Thorax: 6
• Abdomen, pelvis and perineum: abdominal wall and cavity 6, viscera 6, vessels 3, pelvis 4, perineum 2
• Head, neck and neuroanatomy: head 5, neck 5, brain 6, autonomic nervous system 2
• Spine: 3, alongside embryology 8 and surface and imaging anatomy 4

The rest of Paper 1 is applied surgical physiology, applied surgical pathology and pharmacology, microbiology and imaging. Paper 2 is common surgical conditions, perioperative management, trauma and critical care and children and medico-legal practice. Every line of the blueprint has its own page on the syllabus, with its question count.

What the questions look like

The ICBSE guide publishes sample questions, and they set the style. Stems are short clinical scenarios: a patient, a few findings, sometimes a result. The lead-in asks for the structure most likely injured, the most likely diagnosis, the mechanism that explains the finding or the most appropriate next step. The five options come from the same category — five nerves, five vessels, five causes of a raised potassium — so the question cannot be answered by eliminating options of the wrong type. One option is best; the others are plausible, and often right for a different patient.

How to use the Paper 1 and Paper 2 mocks

Because the two papers differ in length and content, our mock exams reproduce them separately and together:

• Paper 1 on its own: 180 questions in 3 hours, drawn only from the Applied Basic Sciences domains in blueprint proportion. Sit this once you have covered anatomy, physiology and pathology.
• Paper 2 on its own: 120 questions in 2 hours, from the Principles of Surgery in General domains. Sit this once you have covered surgical conditions, perioperative care and trauma.
• The full mock: Paper 1, a break, then Paper 2, as on the day. Save this for the final weeks, when the point is stamina and pacing as much as knowledge.
• Shorter papers: a 20-question quickfire, a 60-question standard mock across the whole blueprint, a 40-question anatomy focus and a hard-questions-only paper for final polishing.

Every mock runs at the real pace of one minute per question, with a navigator and flagging, and review opens only after you submit. The breakdown afterwards is by domain and topic, so a weak Paper 1 shows up as weak anatomy or weak physiology rather than as a single number. The 12-week revision plan says when to sit each one.

How to prepare

Start with questions, not textbooks. A timed block shows where you are weak, and reading then fills those specific gaps.

• Follow a structure: the 12-week revision plan is proportioned to the blueprint and can be compressed or stretched.
• Sample the style: free questions from every domain, with full referenced explanations.
• Know the scope: the syllabus lists every blueprint line with its question count, and every topic our questions are mapped to.
• Learn the anatomy in three dimensions: the interactive models cover the regions that are hardest to picture from a page.
• Fill gaps with short reads: the learning library covers recurring principles across anatomy, physiology, pathology and perioperative care.
• Rehearse the day: sit at least one full two-paper mock exam under exam timing before the real thing.