Sooner or later, no matter how long we all put it off, every aspiring surgeon will have to confront the MRCS Part A...

It can feel like an insurmountable task – from mountains of detailed surgical topics to the dark depths of the recommended biochemistry reading, there is a vast amount to cover. All this alongside the demands of foundation or core trainee life can leave you bewildered as to how to even start revising for this challenging exam. In this blog I will show you how ditching the microbiology and pathology textbooks and focusing instead on anatomical knowledge will help you sail through the MRCS Part A exam.

MRCS Part A Exam Format

The largest paper in the exam, accounting for 180 questions and two-thirds of the total, is Paper 1 - Applied Basic Sciences. This section is mostly made up of anatomical questions. So by scoring highly in the anatomy sections, you will ensure that you can manage to pass, even if other areas let you down on the day. Anatomy is the key to success and underlies almost the entire curriculum.

Anatomical knowledge can also be applied to a range of questions in Paper 2 – Principles of Surgery in General. These can be found in sections such as the Assessment and Management of Trauma, which includes fractures and dislocations, wounds and soft tissue injuries, and much more. Overall, anatomy can account for over a quarter of the entire MRCS Part A exam, so it’s crucial that you commit to learning this properly. Through a combination of committed study and Pastest’s helpful resources I managed to score 89% in the anatomy sections and, thanks to that high score, pass the exam comfortably with an overall mark of 84%.

Revising anatomy is a daunting prospect. I’m going to break down the revision process for you into six simple(ish) steps:

Prof Ellis Videos

The first step in your MRCS revision adventure is to learn from the best. The renowned anatomist and retired surgeon Professor Ellis has made teaching videos exclusively for Pastest subscribers, going through the anatomy of the entire human body. These videos are pitched at the level of MRCS candidates and I can’t stress how important they were in the run-up to my revision. With over 200 videos available, this is a one-stop-shop to cover all you need to know anatomically. I watched each video before starting any questions and made a set of notes on each topic. This was invaluable when starting questions on anatomy as I had helpful references to consolidate my learning as I progressed towards the exam.

TeachMeAnatomy Images

Recently, Pastest joined forces with the anatomy encyclopedia TeachMeAnatomy, and has integrated 250 helpful images into their questions to aid anatomical understanding. Using this resource really gives you a solid grip on the more complicated anatomical relationships. This will also help bridge the gap with clinical practice and give you a better foundation of knowledge when your consultant starts to quiz you in theatre!

Practise Your Questions (no, seriously)

Scientific studies have shown that success in the MRCS is directly related to the amount of questions completed. There is no way around this – if you do enough questions you will pass the exam. Most sources quote 3000-4000 questions as enough to get you a pass, but at over £500 for a retake, I played it safe and probably did 5000-6000 questions in total. Research from Pastest suggests that successful candidates answered over 4000 questions on average for the September 2019 diet.

Consolidate Your Knowledge – Other Resources

Continuous testing and consolidation in revision will give you the best chance of passing. Alongside question banks, I found Andrew T Raftery’s ‘Basic Sciences for the MRCS’ to be a particularly helpful resource. This provided a fantastic overview of Anatomy (and Physiology).

If you are getting questions wrong the best plan is to:

1. Read the question vignette thoroughly afterwards
   
   
2. Look up your previous notes on the topic (from Prof Ellis videos etc.)
   
   
3. Consult ‘Basic Sciences for the MRCS’ for further detail/extra information

Before you know it, you’ll be hitting high marks in the key topics!

Strategic revision

Using the resources available, you can build a pretty robust knowledge base using a few simple tricks:

• Identify your weak spots – if you’re consistently struggling on a certain area of questions (my area of weakness was always Head and Neck anatomy) make sure you repeatedly test yourself in these areas, tailor questions and read up until you feel more comfortable
  
  
• Choose the ‘difficult’ setting – even if you are unable to answer questions correctly, pushing yourself during revision will help the answers come more easily on the day
  
  
• Time your questions – towards the end of your revision period, start putting time pressures on yourself when revising to help mimic the exam

And last of all (but possibly the most important…)

Keep to a strict revision schedule and give yourself enough time

It may seem obvious but dedicating yourself to a thorough understanding of anatomy will take time and there is no point in rushing. Many resources suggest that you give yourself a solid three months to revise for the exam. However, if you are feeling a bit rusty with anatomy (as I was before my revision period), why not give yourself a few extra weeks for the Professor Ellis videos? Then you can hit the ground running with questions and not waste time going back over things. Include regular checkpoints in your schedule to ensure you are hitting a realistic amount of questions.

Good luck!

No matter how smart you are, the MRCS Part A will take a huge amount of work and time. But if you put the hours in and follow the points above you’ll be sure to get that all-important pass.


This article was authored by Henry Conchie, who recently completed his Foundation training in London, and is now working in Australia gaining additional trauma experience before continuing his surgical career back in the UK. Henry attended the University of Bristol Medical School, and is committed to a future career in Trauma and Orthopaedic Surgery.