Paper 1
Applied Basic Sciences
180 questions3 hours
The science underlying surgical practice, applied to clinically relevant problems.
The candidate’s guide
MRCS Part A
The format, the syllabus and a thoughtful approach to preparation. Know what you are working towards before you start revising.
- Questions in total
- 300
- Papers in one day
- 2
- Total answering time
- 5 hours
- Options per SBA
- 5
What is Part A?
Part A is the written knowledge component of the intercollegiate Membership of the Royal Colleges of Surgeons examination. It assesses applied basic sciences and principles of surgery at the level expected of a surgical trainee. Part B is a separate clinical examination.
In a single-best-answer question, a question or clinical scenario is followed by five options, with one best answer. Several options may seem plausible; your task is to identify the one that best answers the question. The published intercollegiate candidate guide also describes extended-matching questions; confirm the question formats in the guidance for your sitting.
The two papers are taken on the same day at Pearson VUE test centres. Published intercollegiate exam-day guidance specifies a scheduled one-hour break between papers; check your current candidate instructions and booking confirmation for the arrangements for your sitting.
Paper 2
Principles of Surgery in General
120 questions2 hours
The assessment and management principles that underpin safe surgical care.
What to study
Two papers. A broad surgical foundation.
The summaries below are a revision overview, not the complete official syllabus or a claim that every topic has equal weighting. Use the official content guide to plan comprehensive coverage.
Applied Basic Sciences
- Anatomy
- Regional and surgical anatomy, including the limbs, thorax, abdomen, pelvis, head and neck, and neuroanatomy.
- Physiology
- Normal function and responses to illness: cardiovascular, respiratory, renal, endocrine and gastrointestinal physiology.
- Pathology
- Cell injury, inflammation, healing, infection and neoplasia, alongside the mechanisms of surgical disease.
- Pharmacology
- Drug actions and adverse effects relevant to surgery, including analgesics, antimicrobials and anticoagulants.
- Microbiology
- Clinically important organisms, surgical infections, antimicrobial principles and infection prevention.
- Imaging
- Basic imaging principles and the interpretation of anatomy and pathology relevant to surgical practice.
Principles of Surgery in General
- Common surgical conditions
- Presentation, investigation and principles of management of common surgical disease.
- Perioperative care
- Assessment and optimisation, fluid balance, nutrition, thromboprophylaxis and postoperative complications.
- Trauma
- Initial assessment, resuscitation and the principles of managing injured patients.
- Surgical care of children
- Important paediatric surgical presentations and age-specific considerations.
- General surgical principles
- Safe surgical practice, wounds, tissue handling and the principles underpinning surgical care.
Timing & marking
One minute per question, on average
Both papers allow an average of 60 seconds per question. This is an overall pace, not a separate time limit on each question: straightforward questions can leave time for more demanding ones.
Know the marking instructions
Read the current candidate instructions for scoring and how unanswered questions are handled. When uncertain, work through the options systematically rather than relying on a familiar keyword.
Both papers matter
To pass, candidates must demonstrate a minimum level of competence in each paper and achieve or exceed the pass mark for the combined total. Do not assume a universal fixed pass percentage. A score on a practice bank is not a prediction or guarantee of an examination result.
On Incisive: timed practice uses the same average of one minute per question. Untimed mode is a study option here, not an option in the official examination. Our shorter mock sets are not full-length official papers.
Prepare with purpose
Practical study suggestions—not official examination rules or a promise of a pass.
- 01
Revise from the syllabus, not just your favourites
Map your revision to the official content guide. Give weaker areas planned study time rather than repeatedly answering familiar topics.
- 02
Use questions to learn the reasoning
After each question, explain why the best answer fits and why the alternatives do not. Keep a short error log of knowledge gaps and recurring mistakes.
- 03
Space your revision
Revisit difficult concepts over several sessions. Mix topics once you have built a foundation, so that you practise recognising problems without a topic label.
- 04
Build stamina as well as speed
Start with untimed practice, then introduce timed sets at one minute per question. Include longer sessions to practise concentration and pacing.
- 05
Read the exact question being asked
Pay attention to qualifiers such as most likely, initial and definitive. Use the clinical details to distinguish plausible options rather than answering from a keyword alone.
- 06
Protect your time on exam day
If you are stuck, choose your best answer and move on; return if the examination software allows. Check your appointment, identification requirements and travel arrangements in advance.
Official resources
Always use the examining college’s current regulations and candidate instructions for definitive information on eligibility, dates, fees, adjustments and examination arrangements.
RCSI — MRCS Part A format and information RCS England — examination and pass requirements Intercollegiate MRCS examination guidance Candidate guide and syllabus overview (2021 PDF) Pearson VUE exam-day procedures (2022 PDF)
Sources checked: 17 October 2026. The detailed candidate guide and exam-day procedures linked above are older publications; your current sitting-specific instructions take precedence.
Incisive is an independent revision resource and is not affiliated with or endorsed by the Royal Colleges of Surgeons.
Put your knowledge into practice.
Start with free questions, then review the reasoning.