FRCS (Gen Surg) Section 1 Exam Guide

What is FRCS (Gen Surg) Section 1?

The Intercollegiate Specialty Examination in General Surgery leads to the FRCS (Gen Surg), the specialty fellowship examination for general surgeons in the UK and Ireland. It is run by the JCIE on behalf of the four surgical Royal Colleges and is taken in two sections: Section 1 is written, Section 2 is clinical and oral.

The naming causes confusion. The JCIE calls the written component Section 1. Candidates usually call it Part 1. All of these describe the same two written papers.

Format

Section 1 is two single best answer (SBA) papers, Paper 1 and Paper 2, sat on the same day. Each paper has 120 questions and lasts 2 hours 15 minutes, which is a little over a minute per question. Both papers are computer-based and delivered at Pearson VUE test centres. This has been the JCIE format for all Section 1 examinations since 1 January 2021, when extended matching items were dropped.

Each question has five options and one best answer. The four options that are not best are usually plausible, and often right for a different patient, so the paper tests discrimination rather than recall.

The standard

The examination is set at the standard of a day-one consultant in the generality of general surgery. That phrase explains two things about the paper. It is broad: a colorectal surgeon is expected to answer questions on breast, endocrine, oesophago-gastric, HPB, transplant and paediatric surgery, because every consultant general surgeon is on the emergency take. And it is practical: questions ask what a competent consultant would recognise, do next or refer, rather than for the detail a subspecialist would know. Your special interest is examined in Section 2.

Section 1 and Section 2

Section 1 tests knowledge and judgement on a screen. Section 2 tests the same judgement face to face, in clinical and oral examinations. Under the JCIE’s regulations a candidate must be successful in Section 1 before proceeding to Section 2.

The overlap is deliberate. The scoring systems, staging, operations and guidelines you learn for Section 1 are what you will be asked to apply aloud in Section 2, so thorough Section 1 revision is not wasted.

Eligibility, attempts, dates and fees

We do not quote these. Eligibility criteria, the number of attempts allowed and the period in which they must be taken, the dates of each sitting, application windows and fees are all set by the JCIE and are revised from time to time. Read the current regulations and the examination calendar on jcie.org.uk before you plan around a sitting, and arrange your references early.

What the paper tests

The scope of the examination is the general surgery curriculum. The JCIE’s General Surgery Syllabus Blueprint 2023 lists the topics that may be assessed. Our question bank is mapped to that blueprint in eleven domains:

• Principles and evidence: perioperative care, nutrition, oncology and genetics, statistics, research, consent, ethics and patient safety
• Emergency general surgery: the acute abdomen, obstruction, GI bleeding, emergency laparotomy and vascular emergencies
• Trauma: resuscitation and damage control, abdominal and pelvic injury, and the head, chest and vascular injuries a general surgeon must manage
• Oesophago-gastric and bariatric surgery: reflux and motility, perforation, oesophageal and gastric cancer, peptic ulcer and obesity surgery
• Hepatopancreatobiliary surgery: gallstones and the bile duct, acute and chronic pancreatitis, pancreatic and liver tumours, portal hypertension
• Colorectal surgery: polyps and screening, colon, rectal and anal cancer, inflammatory bowel disease, diverticular disease, proctology and the pelvic floor
• Breast surgery: triple assessment, screening and family history, benign disease, breast cancer surgery, reconstruction and adjuvant therapy
• Endocrine surgery: neck swellings, thyroid, parathyroid, adrenal and neuroendocrine disease
• Abdominal wall and hernia: groin, umbilical and incisional hernia, mesh and abdominal wall closure
• Transplantation and dialysis access: immunology, organ donation, kidney, pancreas and liver transplantation and dialysis access
• Paediatric general surgery: the child with abdominal pain or vomiting, the groin and scrotum, trauma and safeguarding

The blueprint gives no number of questions per area, so be wary of anyone who quotes exact weightings. The grouping into eleven domains and the number of questions our bank holds on each are our editorial judgement, not an official weighting. Breadth is the safe assumption.

How the questions are written

The JCIE publishes sample questions with reasoning, and they show the style. Stems are lean clinical vignettes. The lead-in usually asks for the most likely diagnosis or the most appropriate next step. The options come from the same category — five operations, five investigations, five drugs — so you cannot eliminate by type. Some of the JCIE’s sample questions include an exhibit such as a plain radiograph.

How to choose a question bank

Every bank describes itself as comprehensive. These are things you can check in ten minutes, before you pay:

Our own answers are set out on the editorial standards page, including the fact that specialist review of our content is still pending.

How to use the bank

Start with questions, not textbooks: a timed block shows where you are weak, and reading then fills those specific gaps.

• Follow a structure: the 14-week revision plan maps weeks to the eleven domains and can be compressed or stretched.
• Sample the style: free questions with full explanations, no account needed.
• Know the scope: the syllabus lists every topic and subtopic our questions are mapped to.
• Rate your confidence on every answer, and review the confident wrong answers first: they are the misconceptions you would otherwise carry into the exam.
• Fill gaps with short reads: the learning library covers recurring topics such as acute pancreatitis and safe cholecystectomy.
• Rehearse the day: sit at least one full two-paper mock exam under exam timing before the real thing.