MRCS Part B OSCE: Anatomy Jeremy Lynch, Susan Shelmerdine, Vishy Mahadevan
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1MRCS Part B OSCE: Anatomy
23MRCS Part B OSCE: Anatomy
Jeremy LynchMBChB MRCS (Eng) Specialist Registrar in General Surgery, Royal Sussex County Hospital, Brighton, UK Susan ShelmerdineMBBS BSc (Hons) MRCS (Eng) Specialty Registrar in Clinical Radiology, St. George's Hospital, London, UK Vishy MahadevanMBBS PhD FRCS (Ed & Eng) Professor of Surgical Anatomy and Barbers’ Company Professor of Anatomy, The Royal College of Surgeons of England, London, UK
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5Preface
The MRCS Part B OSCE Examination is a highly structured, standardised and comprehensive assessment of a surgical trainee's competence in a wide variety of surgical subjects and skills. These include the applied basic sciences, verbal communication, history taking, clinical examination of patients and manual procedures.
The anatomy component of the exam is often the most feared, due to the seeming magnitude of the knowledge required. Whilst there are many excellent anatomy textbooks, it can be a difficult subject to learn by reading alone. The purpose of this book is to provide a more stimulating method of learning and consolidating anatomical knowledge. It is more than just a few practice stations to be attempted in the remaining few days before the exam (although it can be used as such). It aims to be wide-ranging and can be dipped into during stolen moments in the working day and evening. This is a key advantage, since study leave is usually limited to a short period of time.
The exam is not designed to trick candidates and the knowledge required for the anatomy component is not arcane. It is anatomy that is encountered in the operating theatre and the emergency department. To mirror the anatomy component of the MRCS exam, the majority of specimens, radiological images, and surface anatomy pictures in this book depict normal anatomy. We have based each station around a specific anatomical region so that trainees can develop knowledge of these parts of the body in depth. All stations in the exam are manned by examiners, and working through this book with a colleague (preferably one due to sit the same exam) will make revision more realistic, rewarding and enjoyable.
We have aimed to cover the entire MRCS anatomy syllabus in depth. At times, the questions may seem harder than those likely to be encountered in the exam and this is because we feel that it is better for you to be stretched during revision, not during the exam. For this reason, do not be disheartened if some of the questions seem beyond your reach – we have made every effort to include detailed explanations to prepare you for the real thing.
Good luck!
Jeremy Lynch
Susan Shelmerdine
Vishy Mahadevan
October 2012
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About the exam
The aim of the MRCS Part B OSCE Examination is to determine whether or not trainees have acquired the knowledge, skills and attributes commensurate with the completion of core training in surgery.
Structure of the exam
As of February 2013, the nature, format, and marking scheme will be significantly different from that employed in previous diets of the MRCS OSCE examination. This book is written in keeping with the new changes. There are 18 examined stations in the OSCE circuit and candidates must complete each station within nine minutes. The 18 stations cover applied basic surgical sciences, clinical and procedural skills, communication skills, and history taking.
To summarise, out of a total of 18 stations, three shall be anatomy stations, two will be pathology stations, three will be given to applied surgical sciences and critical care, four will be devoted to communication skills and history taking, and finally, two stations will assess procedural skills and four stations clinical examination technique.
Each station is scored out of 20 marks.
For more details on the marking and further information regarding the MRCS Part B OSCE, we recommend that you read the Candidate Instructions and Guidance Notes provided on the MRCS exam website.
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Tips and tricks
We have come up with a few tips and hope this knowledge will help you achieve success.
  1. In the weeks before the exam, try to gauge those areas in anatomy in which you feel your knowledge is inadequate, and attempt to rectify this. For example, if you find radiological images confusing then arrange an afternoon sitting in with a radiologist. Candidates in the UK may consider visiting the Wellcome Museum of Anatomy and Pathology at the Royal College of Surgeons of England, where various specimens and prosections are on display. Alternatively your nearest medical school may let you visit their dissection laboratory.
  2. Arrive early for the exam and remember to carry all the necessary identification documents.
  3. Dress appropriately and bring the right equipment. Be smart, bare below the elbows, with hair tied back if it is long. You may bring your own stethoscope and other similar equipment. Do not under any circumstance carry your mobile phone to the OSCE circuit as this will certainly disqualify you from the exam.
  4. Whilst waiting outside the anatomy station in the exam, read the instruction sheet carefully. Although the questions that will be asked will not be listed on this sheet, it will give you a clue about the anatomical theme in which you will be examined. This will prevent you rushing into the station feeling completely in the dark.
  5. Listen to the question! Answer each question clearly, concisely and confidently, making eye contact with your examiner. Do ensure that your answers are well structured and presented in a systematic manner. Feel free to ask for the question to be repeated if you do not understand or hear the question the first time.
  6. If the answer to a particular question escapes you at the time, do not panic. Instead ask the examiner whether you can return to the question later. This will be allowed and you can save time and perhaps gain confidence by answering other questions you are more familiar with than wasting time on a question you do not know. If there is time at the end of the station, you will be able to have another go at answering the missed question.
  7. Many of the prosections used in the exam will have been carefully prepared and arranged for the candidates to inspect. Do not disturb the specimens, unless asked by the examiner to point out relevant anatomy.
  8. If asked to point out anatomical features on a prosection, ensure gloves are worn and use a pointer (these are provided in the station). Do not touch the specimens with bare hands. This sounds like common sense but it can be easily forgotten in the heat of the moment.
  9. It is an oft-observed phenomenon that a candidate who does poorly in a station proceeds to perform sub-optimally in subsequent stations too, presumably owing to a loss of confidence. Remember that each new station is a chance to start afresh, so move on and give yourself a chance to prove what you really know.
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Acknowledgments
The authors gratefully acknowledge the generosity of the trustees of the Royal College of Surgeons of England for allowing the use of anatomical specimen images from the Wellcome Museum of Anatomy and Pathology.
We are deeply indebted to John Carr of the Photography Department at the Royal College of Surgeons for his outstanding and immensely skilful help with many of the images in the book.
We would also like to thank Mandeep Gill Sagoo, Anatomist at St George's, University of London, for allowing us to photograph the prosections of the inguinal canal and right iliac fossa.
We would like to thank our parents, families and friends for their support and encouragement.
JL, SS, VM
October 2012
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Image sources
The Anatomical Department of the Royal College of Surgeons of England.
By permission from The Visible Human Project of the US National Library of Medicine, Bethesda, MD, USA.
Surface anatomy images were originally published in Pocket Tutor Surface Anatomy (© 2012 JP Medical Ltd) and are reproduced courtesy of Sam Scott-Hunter, London.
The Anatomical Department of St George's, University of London and reproduced courtesy of Mandeep Gill Sagoo.
The Otolaryngology Department of the Royal Sussex County Hospital, Brighton and reproduced courtesy of Ketan Desai.