Now please note, these stations are just to help give you an idea of what kind of topics could

come up in the exam. There is no guarantee that they will come up again or even if they do the format maybe different as the exam structure has recently changed. MRCS OSCEs are designed to test your core surgical knowledge and ability. If you revise the theoretical stuff and ensure that you get experience in going to a variety of outpatient clinics as well as scrubbing in regularly in the OR then you should not have any problems.

Hope these are useful and good luck!

Clinical Skills and History Taking

1. Examine this ladies neck I started peripherally with a thyroid status exam, but the examiner prompted me to go directly to the neck. She was an afrocarribean lady with what I thought was bilateral parotid enlargement:

Q's Causes of symmetrical bilateral parotid enlargement What is most likely cause in her (sarcoidosis) He asked me about other manifestations outside the neck

2. Examine this lump on a man's back:

Large lipoma- I examined including assessing for fixity to muscle, transillumenence, draining lymph nodes etc

Q's What muscle was it overlying What is blood supply and lymph drainage of that muscle (was Lat Dorsi) To describe how you would excise this lipoma Consent patient for procedure

3. HISTORY:

Very simple history for likely colorectal Ca,

Q's RF for colorectal ca Difference in presentation for IBD and colorectal ca --> why is this change in bowel habit Crohns or UC How you would investigate him Why CT pneumocolon is inferior to colonoscopy (you can biopsy with latter)

4. CVS Exam:

Patient had AS

Q's Other causes of ESM --Hypertrophic cardiomyopathy How to investigate to see if fit for surgery- ECHO to look at EF and gradient across valve Any important considerations for anaesthesia? No epidural, cause hypotension which can be compensated in AS due to fixed output state

5. Hx and brief resp exam

Completely normal exam, history of long-standing panic disorders

Q's Would you pass this lady in pre-assessment for an elective cholecystectomy What are the ASA gradings? - what would she be? Can you think of ways to optomise her - SSRI trial

Anatomy (3):

1. Upper limb, prosection, live patient and skeleton all in one: Rapid fire 20 questions e.g- where is the insertion of supraspinator, (demonstrate on skeleton), demonstrate pronation and supination (live pt) point out long head of biceps (pro-section)

2. Unmanned prosection of mediastinum and thorax in saggital section. Lots of flags- just had to identify the structures - was v hard !

3. Manned station- very easy, lower GI/ Hepatobillary -prosection of bowels- asked blood supply, significance of water shed area and marginal artery of drummond. Also was given a colonoscopy picture of bowel ca and asked to identify it. Then asked dukes classification. Then hepatobillary anatomy on another prosection Skills

(2): Taking blood cultures Important points: patient was there- there were marks for interacting.

If you spoke to her, she told you she was IVDU and Hep +ve, so u had to take appropriate cautions-eye protection, and noting it on the form for the lab. Change needles before you fill bottles, and fill aerobic first. Offer to label them. Also they had an obs chart and it said she was Pen allergic. They said she had a new murmur, and was spiking on obs chart and asked for a differential. I said that I wld query infective endocarditis, they asked organism, I said staph, and they asked me if I want to write up Abx- I did, VANC--> she was penn allergic which was the trick of the station.

Scrubbing Self explanatory

Other stations:

Critical Care: Definitions of sepsis, septicaemia, septic shock etc. Asked for intepretation of a HDU chart, and generally where and how to ressucitate a patient in shock, ABCDE...

Comm skills- Calming an eratic mother whose son had been in accident in playground and was on the table for an emergency splenectomy. Had to tell her risk and complications, long term e.g immunizations. and she was questioning why he was taken to surgery without consent, so u had to to know the legislation that the doc act in interest of child if no consenting adult is available in an emergency Comm skillsDischarge summary.

Information Giving- Polytrauma patient, needed to read notes in prep station and call trauma surgeon at home who is on call. He just asked questions to see if you knew the ATLS guidelines, and about

management of open fractures.

Information Receiving (written stations) ECG: AF with fast ventricular response- asked to inteprate rate/ rhythm, about reversible causes, and treatment CT- Bilateral pleural effusions in a pancreatitic- asked about ARDS, and glasgow scoring Erect Chest X-Ray- Perforated viscus
POSTED BY I WANT TO BE A SURGEON AT 23:12 2 COMMENTS LABELS: ANATOMY, CRITICAL CARE, EXAMS, MRCS, REVISE,ROYAL COLLEGE OF SURGEONS

RXPGONLINE10/2012 MRCS B stations Took in Southampton, no running commentary allowed in any examination stations. Most examiners were nice. Stations had in order:

1. Preparation for station 2. 2. Communication. Speak to a cardiothoracic consultant in a nearby hospital, to refer a RTA guy whose X ray showed widened mediastinum. CT broken in your hospital. 3. Preparation for station 4. 4. Communication. Speak to a patient whose arthroscopy was cancelled for the 2nd time. 5. Pre-op examination. Had a pace maker. 6. Submandibular gland examination. 7. Inguinal hernia examination. 8. Spine examination. Disc prolapse. 9. Impotence history taking. 10. Assess capacity of a confused woman who is due to have TKR. 11. Tryroidism history taking. 12. Critical care. Hypothyroidism. 13. Critical care. hypothemia. 14. Critical care. Pancreatitis. 15. Pathology. Parathyroid adenoma. 16. Anatomy: upper limb.

17. Anatomy: lower limb. 18. Anatomy: lung and heart. 19. Procedure: FNA. 20. Procedure: knots and suturing.

Good luck guys, you can do it!

vivas have six bays 1 critical care and applied physiology 2 surgical principles and surgical pathology 3 applied anatomy and operative surgery (?????? older)

MRCS ORTHO PARTBones I studied in details are= 1.Base of the skull 2.Clavicle 3.Ribs(typical rib/first rib) 4.Sternum 5.Vertebra(typical/features of cervical,thoracic,lumber vertebra/intervertebral disc/disc prolapse)(I got this one in my viva) 6.Hip bone 7.Sacrum 8.Humerus 9.Radius 10.Ulna 11.Scapula 12.Articulated hand(I got this one in my viva) 13.Femur 14.Tibia 15.Fibula 16.Articulated foot 17.Define and classify joints with examples. 18.Features of synovial joint 19.Type/bones forming/movements/muscle causing those movements for= A.shoulder B.hip C.knee D.ankle 20.Which joint take part in supination/pronation and eversion/inversion

. Anatomy: lower limb (thigh injury while riding horse), great vessels of thorax, solid organs of abdomen

Clinical pathology: ca stomach viva, Scenario viva on ? TB cervical lymph node

Procedure: catheterization, knot tying techniques

Clinical skill: abdomen (Ac cholecyctitis), Respiratory system, knee jt, submandibular gland swelling

Communication skills: phone call to consultant regarding deteriorating post op patient, counselling patient regarding his desire to get self discharged on day 2 pancreatitis, taking consent from a mentally challenged patient for THR, diagnosing the cause for impotence by history only, history for chronic back pain

Critical care: ECG showing hyperkalemia with scnenario on rhabdomylosis, perforation peritonitis scenario, EDH CT Scan

Total 19 stations out of which 1 was fake. Which one??? I don't know.

Apart from this we had 2 rest stations staged in between and 2 preparatory stations staged before phone call and self discharged ones...