What is the FRCS?
The specialty fellowship examinations of the surgical Royal Colleges — formally the Intercollegiate Specialty Examinations, universally “the FRCS” — are run by the Joint Committee on Intercollegiate Examinations (JCIE) on behalf of the four surgical Royal Colleges of the UK and Ireland: England, Edinburgh, Glasgow and Ireland.
There is one examination for each of the ten surgical specialties, each overseen by its own Intercollegiate Specialty Board. Passing it is a requirement for the Certificate of Completion of Training (CCT) for surgeons in UK and Irish training programmes, and the standard is that of a day-one consultant in the specialty. Success brings eligibility for fellowship of the college of your choice, and post-nominals such as FRCS (Tr & Orth) or FRCS (Plast).
The intercollegiate exams are the ones regulated by the General Medical Council. A separate international examination, the Joint Surgical Colleges Fellowship Examination (JSCFE), exists for surgeons trained outside the UK and Ireland; it is not the same qualification.
How the exam is structured
Every specialty’s exam has two sections, taken in order: you must pass Section 1 to become eligible for Section 2.
| Section | What it is | Format |
|---|---|---|
| Section 1 | The written examination | Two single best answer papers of 120 questions, 2 h 15 min each, on one day |
| Section 2 | The clinical and oral examination | Structured oral examinations on clinical topics and clinical examinations, by specialty |
At the time of writing, candidates have two years from their first attempt, with a maximum of four attempts, to pass Section 1 (pro rata for less-than-full-time trainees), and a maximum of four attempts at Section 2. Regulations change — check the JCIE’s current rules before you apply.
Section 1: the written paper
Since January 2021, Section 1 in every specialty has been two papers of 120 single best answer (SBA) questions, each 2 hours 15 minutes, sat on the same day. It is computer-based and delivered at Pearson VUE test centres across the UK and Ireland.
Each question is a short clinical scenario with five options and one best answer. The other four are usually plausible — often right for a different patient — so the paper tests judgement and discrimination rather than recall. Questions are blueprinted against the specialty syllabus, and the pass mark is standard-set by examiners for each paper rather than fixed in advance.
Before 2021 the second paper used extended matching items (EMIs). The JCIE phased them out because they discriminated between candidates less well than SBAs and were harder to write well — worth knowing if you are working from an older book.
At 135 minutes for 120 questions you have about 67 seconds per question. Most candidates find the time adequate if they keep moving, and short if they deliberate on every stem — which is why full timed mocks matter.
Section 2: clinicals and orals
Section 2 is the clinical component: a series of structured oral examinations on clinical topics, together with clinical examinations. The exact format differs by specialty, and the JCIE publishes the details for each.
FRCS.app focuses on Section 1. Section 2 rewards a different kind of practice: talking through cases out loud with colleagues and examiners. Our explanations are written so the reasoning transfers, but they are not a substitute for viva practice.
The ten specialties
| Specialty | Qualification | On FRCS.app |
|---|---|---|
| Cardiothoracic Surgery | FRCS (C-Th) | Coming soon |
| General Surgery | FRCS (Gen Surg) | Live on frcsgensurg.app |
| Neurosurgery | FRCS (Neuro.Surg) | Coming soon |
| Oral & Maxillofacial Surgery | FRCS (OMFS) | Coming soon |
| Otolaryngology (ENT) | FRCS (ORL-HNS) | Coming soon |
| Paediatric Surgery | FRCS (Paed Surg) | Coming soon |
| Plastic Surgery | FRCS (Plast) | Live on frcsplast.app |
| Trauma & Orthopaedics | FRCS (Tr & Orth) | Live on frcsorth.app |
| Urology | FRCS (Urol) | Coming soon |
| Vascular Surgery | FRCS (Vasc) | Coming soon |
Each specialty has its own syllabus blueprint on the JCIE website, built from the specialty curriculum of the Intercollegiate Surgical Curriculum Programme (ISCP).
Before the FRCS: the MRCS
The MRCS — Membership of the Royal Colleges of Surgeons — is the examination of core surgical training, common to every specialty and run by the Intercollegiate Committee for Basic Surgical Examinations (ICBSE). It has two parts:
- Part A, the written exam: Paper 1, Applied Basic Sciences, 180 questions in 3 hours, and Paper 2, Principles of Surgery in General, 120 questions in 2 hours, on one day.
- Part B, the OSCE, which tests clinical and communication skills.
The MRCS Part A is the first written gate, and our largest bank: mrcs.app has 3,000 questions weighted to the ICBSE blueprint. See the ICBSE for official details.
How to prepare for Section 1
There is no secret syllabus and no shortcut, but there is good evidence about how people learn. Six principles, all built into every FRCS.app site:
