About

This four-day preparatory course will provide the attendee with a thorough understanding of the topics on which to focus and the areas to prepare for the MRCS OSCE. The course will be delivered through a robust method of small group teaching, individual OSCEs and interactive discussions, all of which aim to guide the attendee to prepare for each component of the exam (all stations will be covered during the four days). This course is only suitable for those who have done a good amount of prior revision and are preparing to sit the exam 2 to 3 weeks later.

Day 1 will focus on the knowledge component, with emphasis primarily placed on surgical anatomy and surgical pathology. Day 2 will be divided into a morning session that covers clinical and procedural skills and an afternoon session that covers applied surgical sciences and critical care. Day 3 will consist of small group teaching using anatomical prosections, relevant pathological specimens, and osteology. A mock OSCE will take place during the afternoon. Day 4 will consist of clinical examination stations in the morning and communication skills stations in the afternoon.

The programme and the teaching sessions will reflect any changes introduced to the exam due to the COVID-19 pandemic.

Topics Covered:

Anatomy:

• Brachial plexus and upper limb nerve injuries
• Shoulder and back
• Arm, ante-cubital fossa and forearm
• Wrist and hand
• Skull base, foramina and cranial nerves
• Circle of Willis and dural venous sinuses
• Autonomic nervous system
• Face, mandible and parotid gland
• Neck, larynx and pharynx
• Thorax, mediastinum, heart and lung
• Diaphragm
• Anterior abdominal wall, inguinal region and external genitalia
• Peritoneum, lesser sac, epiploic foramen and greater sac
• Small and large intestine
• Rectum, anal canal, pelvic floor and perineum
• Femoral triangle
• Gluteal region
• Adductor canal
• Popliteal fossa
• Lower leg, compartments, ankle and foot
• Lower limb nerve injuries
• Vascular anatomy of the neck, abdomen, and upper and lower limbs

Surgical Pathology:

• Cancers of the testis
• Cancers of the thyroid
• Malignant melanoma
• Cutaneous malignancies
• Colorectal malignancies
• Cancer of the breast
• Cancer of the oesophagus
• Cancers of the salivary glands
• Carcinoid tumour
• MEN syndromes
• Pheochromocytoma
• Vascular pathologies
• Diverticular disease
• Inflammatory bowel diseases

Applied Surgical Sciences and Critical Care Physiology:

• Acid-base imbalance (metabolic and respiratory acidosis/alkalosis) and their management
• Fluid balance and fluid replacement therapy
• Bleeding and coagulation
• Management of sepsis and septic shock
• Homeostasis and thermoregulation
• Ionotropes
• Normal ventilatory cycle
• Causes and management of post-operative respiratory failure
• Intermittent positive pressure ventilation
• Acute (adult) respiratory distress syndrome
• Applied critical care physiology during the peri-operative period
• Thyroid hormones, hypothyroidism and hyperthyroidism
• Parathyroid hormones, their disorders and calcium metabolism
• Function of the pituitary and adrenal glands
• Renal autoregulation
• Renin-angiotensin system
• Cerebral autoregulation
• Space-occupying lesions
• Head Injuries and management
• Assessment, pathophysiology and principles of management of burns
• Principles of epidural anaesthesia/assessment
• Pain pathways
• Resuscitation, temperature regulation and hypothermia
• Principles in the management of long bone fractures and pelvic trauma
• Compartment syndrome

Clinical and Procedural Skills:

• Surgical scrubbing
• Safe use of local anaesthesia
• Knot tying (Reef, Surgeon’s, tying at depth, instrument tie)
• Suturing techniques (simple, mattress, continuous, subcuticular)
• Figure of ‘8’ haemostatic stitch
• Surgical excision of a cutaneous lesion
• Urinary catheterisation
• Cannulation and venepuncture of high-risk patients
• Lumbar puncture
• Performing an FNA
• Insertion of a chest drain
• Organising a theatre list and theatre list prioritisation

Clinical Examination Topics:

• Examination of the abdomen and abdominal organs
• Examination of hernia
• Examination of varicose veins and leg ulcers
• Examination of peripheral vascular disease
• Examination of lumps and lymph nodes
• Examination of cranial nerves
• Examination of cardiorespiratory system
• Examination of the hip and knee
• Examination of the shoulder and back
• Examination of the neck and thyroid

Clinical Consultation Skills:

• Information giving and information gathering
• Challenging situation/patient
• Difficult consultation
• Breaking bad news
• Explaining a diagnosis or discussing management options
• Consent in surgery
• Telephone communication