MRCS Examinations

The MRCS examination is an intercollegiate examination run jointly with the other Colleges of Surgeons in Great Britain and Ireland.

Award of the Diploma of Membership of the Royal College of Surgeons indicates that a candidate has enhanced his or her knowledge, understanding, experience and clinical competence well beyond primary qualification level.

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The MRCS exam aims to assess trainee surgeons in the breadth of both basic sciences and the principles of surgery. It is an intercollegiate exam, hence, the syllabus, format and content are common to all surgical Royal Colleges in the UK and Ireland. The MRCS is fully-recognised by both the Irish Medical Council and the General Medical Council (UK).

  • MRCS – Part A is held three times per year, in January, April, and September. RCSI offers this exam in 11 centres: Dublin, Belfast, Malta, Al-Khobar, Amman, Bahrain, Dubai, Kochi, Kuala Lumpur, Kota Kinabalu and Penang.
  • MRCS – Part B is held three times per year, in Dublin (February, May, and October); twice per year in Bahrain (March and November); twice per year in Penang (January and August); and once a year in Dubai (June).

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Membership of the Royal Colleges of Surgeons Diploma

Membership of the Royal College of Surgeons (MRCS) is an intercollegiate exam for surgical trainees who wish to become a member of one of the four surgical royal colleges in the UK and Ireland.

Award of this postgraduate diploma indicates that you have the necessary knowledge, experience and clinical competence to complete core training and progress to specialty training.


Our members

We provide education, assessment and development to nearly 30,000 surgeons, dental surgeons and members of the wider surgical and dental teams at all stages of their career.

As one of the best-known professional membership organization in the world, we enable our members to drive the profession forward and achieve our vision of excellent surgical care for everyone.


If you have completed, nearly completed or left surgical training – but remain in surgical practice – there may be a number of professional issues for you to consider.

Our section for SAS grades provides information about specialty doctor, staff grade and associate specialist posts, as well as how you can develop your own career and how the College can support you.

In addition to this, we provide information about aspects of practicing as a surgeon that are common to all surgeons not-in-training. This covers both preparing for your first senior role and how to approach retirement.

International Surgeons

The Royal College of Surgeons of England (RCS) is committed to providing comprehensive information about the choices available to medical graduates and doctors wishing to train and work in the UK.

Whether training or working as a surgeon in the UK, you will need to consider three main factors:

  • GMC registration
  • appropriate visas/permission to work
  • securing a post

Information about all of these is provided in this section. However, we strongly recommended that you obtain advice on immigration and visa requirements directly from the Home Office as all applications are determined on a case-by-case basis.

You should also visit our International section which includes further details on both the support we provide for international surgeons wishing to work here, and our work around the world. 

Work Permits and Immigration

The Home Office now requires all international doctors who are not UK or EEA nationals wishing to train or work in the UK to have a work permit. Under the new immigration rules being introduced in order to appoint an IMG a UK employer must show that there is no suitable resident worker (e.g. UK, EU etc) that can take the post.

Information on the new points based system (PBS) is available from the Home Office Border Agency where you will able to find information about which tier is most appropriate for your needs.



The MRCS Part A

The standard for the MRCS Part A paper is set using the Angoff procedure, where a team of practicing surgeons, specialist basic scientists, trainers, trainees and a patient representative consider each question of an assessment and estimate the performance of a notional benchmark candidate. An observer from the regulator, in this case the GMC, may additionally oversee the process.

The Angoff process is completed on a regular basis particularly where there has been a notified change to the assessment process. However, it is not completed before each examination diet.

A number of ‘marker’ questions – 20% of the total questions – taken from a previous examination are included in each Part A paper and are used to maintain the standard and consistency of the examination, recognizing the standard defined by the Angoff procedure.

Following every examination, the performance of candidates on each question is scrutinised together with their performance on the test overall. A range of statistical measures are used to evaluate the quality of the examination.

It is at this stage that candidate feedback on the examination is considered and taken into account, along with statistical analysis of individual questions to identify any outlying performance statistics. The panel then review every identified question in detail and decide whether or not to exclude that specific question from the overall examination.

The performance of candidates on the marker questions is reviewed together with other statistical data from the present and previous examinations, and considered in relation to the benchmark Angoff exercise. After consideration of all the available data, the panel set the pass/fail cut-off mark.

In practice, this means that:

  • As each MRCS Part A exam is different, the pass mark will be different each time.
  • As different cohorts of candidates take each MRCS Part A exam, the pass rate will be different each time.
  • The process to set the pass mark for the MRCS Part A is the same for every exam.
  • The standard required to pass the exam remains constant for all MRCS Part A exams.

Standard Setting in the MRCS Part B (OSCE)

An MRCS Part B candidate will attend the exam and be assessed across 17 different stations in a specific ‘circuit’ at an exam venue. For standard setting purposes, this circuit is identical across all exam centres in the UK and Ireland running on a particular day. Additionally, a specific circuit may
be repeated on a subsequent day within the same exam diet.

Each individual station in the MRCS OSCE is assessed in two ways:

  • Using a structured mark sheet a mark is awarded for each domain using generic descriptors to identify and guide examiners in allocation of the marks. There is a standardised distribution of marks across the broad content areas.
  • In addition, an overall judgement is made on the candidate’s performance at the station as a whole (Pass, Borderline or Fail).

Thus for each station the candidates will have a mark out of 20 and an overall judgement of their performance. The marks and global ratings are then employed in order to construct the overall pass mark for each station using a recognised approach known as borderline regression methodology. Further information relating to Borderline Regression can be found on Page 11 of the Guidance for Standard Setting document published by the Academy of Medical Royal Colleges.

The standard setting process involves calculating the total mark for each individual scenario over all UK diets going back to February 2013. If the total number of occasions that the scenario was used was greater than 500, only the most recent 500 results were considered in the calculation.

Only scenarios that had not been significantly altered during this period were included in the calculation. The pass mark for each circuit is therefore generated by compiling the pass marks of the individual scenarios in each circuit. Pass marks are therefore generated for both ‘knowledge’ and ‘skills’ scenarios and the Standard Error of Measurement (SEM) is added.

There is not an overall pass mark for the OSCE as a whole. Candidates must pass each of the two sections of the OSCE – Knowledge and Skills – in a single sitting. Failing one of these sections does not mean that a candidate can ‘bank’ the section passed and only resit the failed section.

There is 0.84 SEM added to the calculated pass marks for both Knowledge and Skills in order to maintain the standard of the exam. It may be noted that, because both Knowledge and Skills have to be passed at the same sitting, the SEM added for the OSCE as a whole may be considered to be in excess of the 1.0 value widely accepted as the desirable minimum.

A different pass mark is generated (using the current borderline regression methodology) for each circuit, rather than for the examination as a whole. This means that, though the pass mark will be similar for different circuits, it is unlikely to be identical. This will reflect the variation in the relative difficulties of the scenarios that make up any given circuit. The consequences of doing so have been modelled and found to yield a very similar overall pass rate.