The Complete Guide to FRCS Trauma and Orthopaedics Exam for Overseas Doctors

But first, you need to conquer the hurdle: FRCS (Fellowship of the Royal Colleges of Surgeons) in Trauma & Orthopaedics.

Here’s a simple guide to help you understand the exam:

What is the FRCS Trauma & Orthopaedics?

Consider it your passport to practicing as a Consultant Trauma & Orthopaedic Surgeon overseas. It's a rigorous two-part exam designed to assess your knowledge, surgical skills, and overall competence in managing a wide range of musculoskeletal injuries and conditions.

Who Needs It?

It is a requirement for anyone who wants to become a Consultant Surgeon in Trauma & Orthopaedics. This encompasses a wide range of subspecialties, including:

• Fragility fractures
• Sports and Accident injuries
• Fractures
• Lower-limb joint reconstruction surgery (hip, knee, foot and ankle.)
• Sports and Exercise surgery
• Spine
• Paediatric orthopaedics
• Upper limb (hands, elbow, shoulder)
• Bone tumours
• Research

When to Take It?

The FRCS exam is typically taken towards the end of your surgical training pathway. In the UK system, this usually occurs around ST8 (Specialist Training year 8). However, for overseas doctors, the timeline might differ depending on your prior experience and qualifications. You do need to meet the eligibility criteria.

Eligibility:

To be eligible for the FRCS Trauma & Orthopaedics, you'll need to meet a few key criteria:

• You’re six years medically qualified: If you’re an International Medical Graduate, you’ll need to give the Joint Surgical Colleges’ Fellowship Examinations (JSCFE) FRCS instead of the Joint Committee on Intercollegiate Examinations FRCS which is only for the UK and Ireland. And to appear for it, you need to have 3 years of Ortho residency and then 3 years of work experience after that, totalling to 6 years.
• Passed the MRCS exam: As per the regulations passed in 2020, the MRCS or Membership of the Royal Colleges of Surgeons (MRCS) has been mandated for all new FRCS applicants.
  
  
• Completed a recognised surgical training program: Finish a recognised surgical training program, which shows a solid foundation in general surgical principles. This could be through an MRCS program or an equivalent.
  
  
• Proven specialist-level competence: Demonstrate your competence by submitting your Curriculum Vitae in a Word document or PDF format while registering for the examination.(Guidance Notes for Applicants )
  
  For this, maintain a detailed surgical logbook, undergo regular assessments (DOPS, CBDs, MSF), complete workplace-based evaluations, pass annual ARCP reviews, and gain diverse experience through Specialist Registrar rotations.
  
  If you’re an overseas surgeon in any specialty with more than 18 months of experience after internship, you will be overqualified for the CCT route and instead can take the CESR-CP or CESR pathways.
  
  
• Provided required references: As an applicant, you have to submit references of competency from:
  
  - Principal Referee: Applicant’s current Head of Department or Head of the Recognised Training Programme. 
  - Second Referee: Senior clinician who has worked with the applicant within the last two years and knows their specialty work
  - Third Referee: Another senior clinician with knowledge of the applicant's specialty work within the last two years.

Exam details

FRCS Trauma and Orthopaedics exam has two sections- 

• Section 1 is a written test, with two Single Best Answer(SBA) papers. Both papers have 120 SBA questions and are of 135 minutes each. The papers are delivered via computer based testing at pre-selected world-wide Pearson VUE Test Centres.
• Section 2 is clinical scenario-based and consists of a series of carefully designed and structured interviews. This section is further divided into two parts:
  
                 - Clinical examinations: Clinical Intermediate Case where 1 case will be discussed in 20 minutes, and Clinical Short Cases where 4 cases will be discussed in 20 minutes. 
                 - Oral examinations: Four 30 minute orals in Adult elective orthopaedics including spine, Trauma including spine, Children’s orthopaedics / Hand and upper limb, Applied basic sciences related to orthopaedics, including anatomy and surgical approaches, pathology, biomechanics, audit, methodology and outcome based medicine.

Preparing for FRCS

Passing the FRCS is a challenge, but with the right preparation, you can achieve it. Here's what you can do:

• Develop a strategic study plan: Tailor your studies to the FRCS curriculum.
• Utilise a variety of resources: Supplement the Royal College's materials with surgical textbooks, mock exams, etc.
• Consider additional resources: Explore exam prep services or online courses offered by reputable institutions.
  
  
  

Examples:

Surgery

• BJM On Exam 

MCQs

• Orthopass 

Viva Question Bank

• FRCS Ortho – fantastic resource with hundreds of questions relevant to the FRCS Tr & Orth

General

• Miller Orthopaedic Review Course, UK
• FRCS Orth Viva Course for Orthopaedic Surgeons (Royal College of Surgeons of England Accredited)
• 5th Preparation for FRCS (Tr&Orth;) Course (RCS Accredited)

Clinical

• Norwich Clinical and Viva course
• Chesterfield/Sheffield FRCS (Tr & Orth) Clinical Course
• Oswestry Clinical and Viva Course for FRCS
• Wrightington FRCS Course
• Luton FRCS Clinical and viva course
• BBiOrth VIVA Course

Basic science

• ORUK – The Cambridge Basic Science FRCS (Orth) Course
• Stanmore – Preparation in Basic Sciences for the FRCS (T&O)

Sub-Specialist courses:

  - Paediatrics:

• Alder Hey
• ORUK Great Ormond Street Course
• Spine – Cardiff Spinal Surgery Course for FRCS ORTH and FRCS SN

Final Thoughts

The FRCS Trauma & Orthopaedics might seem daunting, but with the right preparation, you can conquer it. So, start planning your study strategy, embrace the challenge, and get ready to embark on the next exciting chapter of your surgical journey!

If you’ve read this far, do try Medlogbook to log your medical experiences. I’ve created this to organise your competencies which could help with moving abroad. You can be better prepared for submitting work evidence, a requirement in most countries for practising.