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MRCS Part A: Preparation Strategies - I

Leonardo da Vinci’s famous drawing “Vitruvian Man” is a beautiful amalgamation of art and mathematics.

He described it as cosmografia del minor mondo which translates to “cosmography of the microcosm” and believed that workings of the human body to be an analogy for workings of the universe. An astute understanding of this microcosm is the base one can build upon to succeed in passing MRCS Part A.

Part A covers generic surgical sciences and applied knowledge, including the core knowledge required in all nine specialties. It consists of two sub-sections:

Paper 1 - Applied Basic Sciences MCQ

Paper 2 - Principles of Surgery-in-General MCQ

This article will deal with Paper 1 of the section.

This paper consists of 180 questions and is conducted over 3 hours. The syllabus is broadly divided into:

1. Applied Surgical Anatomy- 75 questions

🎯 Regional Anatomy 63 questions, of which:

Thorax: 6

✶ Abdomen: 15

✶ Pelvis: 4

✶ Perineum: 2

✶ Upper, lower limb; Breast: 15

✶ Spine: 3

✶ Head & neck: 10

✶ Brain: 6

✶ Autonomic nervous system: 2

🎯 Surgically related embryology and development 8 questions, of which:

✶ Thorax at least: 1

✶ Perineum at least: 1

✶ Head & neck at least: 1

🎯 Surface and imaging anatomy 4 questions


2. Applied Surgical Physiology - 45 questions

🎯 General physiological principles - 15

🎯 The physiology of specific organ systems relevant to surgical practice- 30

✶ Cardiovascular system: 5

✶ Respiratory system: 5

✶ Gastrointestinal system: 5

✶ Urinary system: 5

✶ Endocrine system: 5

✶ Neurological system: 5


3. Applied Surgical Pathology- 37 questions

🎯 General pathological principles: 9

🎯 Surgical immunology: 2

🎯 Surgical haematology: 2

🎯 Surgical clinical chemistry: 2

🎯 Principles of neoplasia & oncology: 2

The pathology of specific organ systems relevant to surgical care, including congenital anomalies include the following distribution

✶ Cardiovascular system: 2

✶ Respiratory system: 2

✶ Digestive system: 2

✶ Genitourinary system: 2

✶ Central and peripheral neurological systems: 2

✶ Skin cancer: 2

✶ Lymphoreticular system: 2

✶ Musculoskeletal system: 2

✶ Pathology of the breast: 2

✶ Pathology of the endocrine glands: 2

4. Pharmacology as applied to surgical practice- 8 questions

5. Microbiology as applied to surgical practice- 7 questions

6. Imaging- 5 questions

7. Data interpretation and audit- 3 questions

Top tips for Applied Basic Sciences:

🔰 Plan ahead:

Be realistic when planning a schedule. Whether you are working or solely preparing for the exam, set realistic goals and try to stick to it.

Understand your weakest points and focus on them. There is no one glove fits all strategy when it comes to the timing but a good 3-4 months is advised by most candidates who have been successful.


There are many resources that can be availed to help with your preparation.

✏️ Question Banks:

✶ e-MRCS

✶ Pastest

✶ BMJ OnExamination

These are most commonly used and help a lot in revision as well as sensitising you to questions similar to the examination.

These question banks give you the option to reset your answers so you can always review them afresh and it is recommended to do so at spaced intervals to refresh your concepts.

✏️ Online/Face-to-face classes:

There are many classes which can be accessed online or you can attend in person in some countries. They provide a structured method of studying and will keep you on your toes by conducting regular mock tests and may provide you with the newer updates.

✏️ Free resources:

There are a lot of Facebook/Telegram groups with active members who discuss/solve questions and prove to be very helpful.


The famous adage “practice makes a man perfect” stands true when it comes to any

examination and specially for MRCS Part A.

It is recommended that one practices more and more questions from the question banks. Always note down the answers you marked wrong and revisit the questions later. Knowing the answer is not enough, Try to find out why the other options are not.

The more you practice questions, the better you will understand the question types and better at recalling the theory.

🔰 Mocks:

It is highly advisable to start doing mocks at least one month before the exam. Space them out so that you have time to work on your mistakes and improve your score in the subsequent mocks.

🔰 Preparation of different topics

Each topic has a different approach and

✏️ Anatomy:

A lot of candidates will tell you that conquering this one segment is half the battle one as it forms the basis of your examination. It is recommended to read your notes along with the images from the anatomy atlas/Google search as the visualisation of the topic helps reinforce your learning better.

✏️ Physiology:

A lot of YouTube videos will help clear the concepts.

✏️ Pathology, Microbiology, Pharmacology:

This can be studied in conjunction with topics from Paper 2, Principles of Surgery-in-General, specially when revising the topics system wise.

✏️ Imaging:

Focus mainly on principles, advantages and disadvantages of various diagnostic and interventional imaging methods.

🔰 Relax:

Sometimes the most productive thing you can do is relax. The exam itself may be daunting and trying to master the basic sciences might sometimes seem formidable but it helps to wind down when needed to maximise your efficiency.

"Looking in detail at human anatomy, I'm always left with two practically irreconcilable thoughts: our bodies are wonderful, intricate masterpieces; and then - they are cobbled-together, rag-bag, sometimes clunking machines." - Alice Roberts.

Whichever way you choose to look at the human anatomy, the process of learning it is always going to be enjoyable.

Good Luck 👍 Keep an eye on Part B - to be released soon.

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