A 14-Week FRCS (Gen Surg) Revision Plan

Who this is for

Registrars with a Section 1 sitting three to four months away who are working a full rota. It assumes you have several years of general surgery and the emergency take behind you and need to turn clinical experience into exam-ready judgement across the whole specialty — including the special interests you have not worked in since core training, which Section 1 examines at consultant level.

Principles

Question-first revision

Answer a timed block on a topic before you read about it. The questions you get wrong, or right for the wrong reason, define what you read. That is faster than reading a chapter end to end, and closer to what the paper asks of you.

Time in proportion to breadth

The JCIE publishes no question weightings, so no plan can match the paper exactly. This one gives each domain time in proportion to its breadth in our map of the syllabus: emergency general surgery is the largest and takes two weeks; colorectal surgery takes two; principles and evidence, oesophago-gastric and HPB surgery take about a week and a half each; trauma, breast and endocrine surgery take about a week; paediatric surgery, the abdominal wall and transplantation are smaller. If your own experience is thin in one area — often breast, endocrine or transplant for a gastrointestinal trainee, and the reverse — move time towards it.

Spaced repetition

Return to every area at widening intervals: a few days, then a week or two, then a month. A topic covered once in week 2 and never again will have faded by the exam, so each week below includes a review block of questions from earlier weeks.

Confidence rating

Rate your confidence before each answer. A wrong guess is a gap. A wrong answer you were sure of is a dangerous misconception: a belief you would act on in the exam and in clinic. Review those first, every week.

Timed practice

Each paper allows a little over a minute per question. Pace is a skill learned only against the clock, so do timed blocks from week 1 and full papers from week 8.

Revising around a rota

Plan for the weeks that go wrong. A short daily habit — ten questions on the commute, or the five-question Daily Five between cases — survives nights and on-calls, and frees rest days for longer blocks and mocks.

The plan at a glance

Weeks 1–5: the emergency take, trauma and the principles

The emergency take is the core of the examination's standard — a day-one consultant who is on call for everything — and the principles underpin every other domain: an HPB question is often really about sepsis, nutrition or consent. Secure them first and keep them warm with review blocks for the rest of the plan.

• Week 1: emergency general surgery. Assessment and imaging of the acute abdomen; appendicitis, including antibiotic-first management and appendicitis in pregnancy; perforation and peritonitis; acute gynaecological causes of pain; small and large bowel obstruction, pseudo-obstruction and volvulus.
• Week 2: upper and lower GI bleeding and bleeding on anticoagulants; emergency laparotomy, risk scoring and the frail older patient; anastomotic leak, abdominal compartment syndrome, the open abdomen and enterocutaneous fistula; ruptured aneurysm, mesenteric ischaemia and the acutely ischaemic limb.
• Week 3: trauma — the primary survey, haemostatic resuscitation and damage control; liver, spleen, kidney, pancreatic, duodenal, bowel and perineal injury; penetrating trauma; the head, chest and vascular injuries a general surgeon must recognise. Then the abdominal wall: groin and ventral hernia, mesh and closure. Read the inguinal canal.
• Week 4: principles — preoperative assessment and enhanced recovery, nutrition and intestinal failure, sepsis and fluids, thromboprophylaxis, anticoagulation and blood products; cancer biology and staging, systemic and radiotherapy, hereditary cancer syndromes.
• Week 5: statistics and data presentation, study design and bias, critical appraisal; consent, capacity, safeguarding and the law; patient safety, audit and supervision; skin lesions and melanoma, necrotising infection, the spleen and lymph nodes.

Weeks 6–10: upper GI, HPB and colorectal

• Week 6: oesophago-gastric surgery. Reflux and hiatus hernia; achalasia and motility; oesophageal perforation; Barrett's and early neoplasia; staging and treatment of oesophageal, junctional and gastric cancer; GIST and lymphoma; peptic ulcer and its complications; reconstruction after gastrectomy.
• Week 7: obesity and metabolic surgery — selection, procedures and their complications, including the bariatric patient on the emergency take. Then HPB: gallstones and cholecystitis, bile duct stones, cholangitis and ERCP, bile duct injury. Read Calot's triangle and safe cholecystectomy.
• Week 8: acute pancreatitis, its severity and complications, and chronic pancreatitis — read acute pancreatitis; pancreatic and periampullary cancer and cystic neoplasms; colorectal liver metastases, primary liver and biliary cancers, benign liver lesions and portal hypertension. Sit a timed 120-question paper at the end of the week.
• Week 9: colorectal surgery. Polyps and polyposis syndromes; bowel cancer screening and surveillance; colon cancer; rectal cancer staging, surgery, neoadjuvant therapy and organ preservation; recurrent disease and anal cancer.
• Week 10: ulcerative colitis, acute severe colitis and Crohn's disease; ischaemic, infective and radiation colitis; diverticular disease and stomas; haemorrhoids, fissure, anorectal sepsis and fistula, pilonidal disease; faecal incontinence, prolapse and constipation.

Weeks 11–12: breast, endocrine, transplant and paediatric surgery

• Week 11: breast surgery. Triple assessment and imaging; the screening programme and family history; benign disease and breast sepsis; pathology and prognosis; breast-conserving surgery, mastectomy and the axilla; oncoplastic surgery and reconstruction; adjuvant, neoadjuvant and endocrine therapy; advanced disease. Sit an emergency and trauma focus paper to keep the take warm.
• Week 12: endocrine surgery — neck swellings, thyroid nodules and cancer, goitre and thyrotoxicosis, thyroidectomy and its complications, hyperparathyroidism, the adrenal, phaeochromocytoma, neuroendocrine tumours and MEN; then transplantation and dialysis access, and paediatric general surgery: the vomiting child, intussusception, the groin and scrotum, trauma and safeguarding. Sit a second timed 120-question paper.

Weeks 13–14: mocks and repair

Sit the first full two-paper mock exam early in week 13, on a rest day, under exam conditions: both papers, 2 hours 15 minutes each, with a break between them. Then spend longer reviewing it than you spent sitting it.

• Sort every wrong answer into gap (did not know), misread (knew, but missed a detail in the stem) or misconception (confidently wrong). Each needs a different fix.
• Rework your three weakest domains with targeted blocks, not with re-reading.
• Sit the second full mock early in week 14, so there are days left to act on it.
• In the last few days, revise the numbers that discriminate — scoring-system thresholds, staging cut-offs, guideline timings — and then rest. Fatigue costs more marks than a missed topic.

Shorter and longer variants

Eight weeks

Pair the weeks: the emergency take and trauma in two weeks, the principles in one, oesophago-gastric with HPB in one, colorectal in one, breast with endocrine in one, transplant and paediatric surgery folded into review blocks, and one week of mocks. Keep the daily habit and both full mocks; cut reading, not questions.

Six months

Give each week of the plan two weeks, at about half the weekly question count. Use the extra time for a second pass through the bank in mixed, timed blocks from month four, and for a third full mock.