Membership Of The Royal College Of Surgeons Research Articles

John Hatton's manuscript record of the surgical and pathological lectures given by Joseph Jordan, FRCS, in 1837-1838.

John Hatton, LSA MRCS FRCS MD (1817-1871), was apprenticed from 1833 to Joseph Jordan, MRCS FRCS (1787-1873), a well-known Manchester surgeon. Jordan, who had been teaching anatomy since 1814, closed his Mount Street Medical School in 1834 and was elected as surgeon to the Manchester Royal Infirmary in 1835. He continued to lecture on surgery and surgical pathology at the Infirmary, and sometimes at the Pine Street Medical School run by Thomas Turner, LSA FRCS (1793-1873). During 1837-38 Hatton transcribed and illustrated these lectures in a bound manuscript and also added notes and drawings in his personal copy of The Dublin Dissector. He gained his Licentiate of the Society of Apothecaries (LSA) in 1836 and Membership of the Royal College of Surgeons (MRCS) in 1839 and set up in Manchester as surgeon from around 1840. This paper is based on three previously unrelated documents in the University of Manchester Archives: a handwritten catalogue of specimens in Jordan's Anatomy Museum, Hatton's annotated copy of The Dublin Dissector and his manuscript record of Jordan's lectures. These documents provide a valuable insight into medical education during the 1830s.

Does the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination predict 'on-the-job' performance during UK higher specialty surgical training?

The Intercollegiate Membership of the Royal College of Surgeons (MRCS) is a mandatory examination to enter higher surgical specialty training in the UK. It is designed to help to ensure that successful candidates are competent to practice as higher surgical trainees. The annual review of competence progression (ARCP) assesses trainees' competence to progress to the next level of training and can be interpreted as a measure of 'on-the-job' performance. We investigated the relationship between MRCS performance and ARCP outcomes. All UK medical graduates who passed MRCS (Parts A and B) from 2007 to 2016 were included. MRCS scores, attempts and sociodemographics for each candidate were crosslinked with ARCP outcomes (satisfactory, unsatisfactory and insufficient evidence). Multinomial logistic regression was used to identify potential independent predictors of ARCP outcomes. A total of 2570 trainees underwent 11,064 ARCPs; 1589 (61.8%) had only satisfactory outcomes recorded throughout training; 510 (19.9%) had at least one unsatisfactory outcome; and 471 (18.3%) supplied insufficient evidence. After adjusting for age, gender, first language and Part A performance, ethnicity (non-white vs white, OR 1.36, 95% CI 1.08 to 1.71), Part B passing score (OR 0.98, 95% CI 0.98 to 1.00) and number of attempts at Part B (two or more attempts vs one attempt, OR 1.50, 95% CI 1.16 to 1.94) were found to be independent predictors of an unsatisfactory ARCP outcome. This is the first study to identify predictors of ARCP outcomes during higher surgical specialty training in the UK and provides further evidence of the predictive validity of the MRCS examination.

Predictors of success in the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination

Introduction The Intercollegiate Membership of the Royal College of Surgeons (MRCS, Parts A and B) is designed to safeguard patients and ensure high standards for trainees wishing to pursue a surgical career. We investigated which factors predict Part A and B success. Methods UK graduates who had attempted both parts of MRCS from September 2007 to February 2016 were included. Pearson correlation coefficients were used to examine the linear relationship between each part of MRCS and logistic regression analysis to identify potential independent predictors of MRCS pass/fail outcome. Results A positive correlation between Part A and B score was identified (r = 0.41, P < 0.01). In Part A, males had higher pass rates than females (odds ratio, OR, 2.78, 95% confidence interval, CI, 1.83-4.19), white candidates were more likely to pass than black minority and ethnic doctors (OR 1.70, 95% CI 1.52-1.89), foundation year 1 doctors had higher pass rates than all other grades (e.g. core surgical year 2 trainees vs. foundation year 1 doctors, OR 0.50, 95% CI 0.32-0.77) and younger graduates were more likely to pass than older graduates (OR 2.60, 95% CI 1.81-3.63). In addition to ethnicity and stage of training, Part A performance (number of attempts and score) was an independent predictor for Part B. Conclusions Part A performance is related to Part B score. Many independent predictors of MRCS success were identified, but only stage of training and ethnicity were found to be common predictors of both parts. This article summarises the findings of our most recent MRCS study which was published in The Surgeon (online) in October 2017. 1.

Which factors predict success in the mandatory UK postgraduate surgical exam: The Intercollegiate Membership of the Royal College of Surgeons (MRCS)?

BackgroundThe Membership of the Royal College of Surgeons examination (MRCS, Parts A and B) is one of the largest postgraduate surgical exams in the world, but little is known about the factors that affect candidate performance. We describe the relationship between both parts of MRCS and several independent predictors of MRCS success. MethodsPearson correlation coefficients were used to examine the linear relationship between MRCS Part A and B and logistic regression analysis to identify potential independent predictors of MRCS success. We included all UK medical graduates who attempted either part of MRCS between 2007 and 2016. Results7896 candidates made 11,867 attempts at Part A and 4310 made 5738 attempts at Part B. A positive correlation was found between Part A and B first attempt score (r = 0.41, P < 0.001). Gender (male vs. female, odds ratio (OR) 2.78, 95% confidence interval (CI) 1.83–4.19), ethnicity (white vs. Black Minority and Ethnic, OR 1.70, 95% CI 1.52–1.89), stage of training (e.g. Core Surgical Year 2 trainees vs. Foundation Year 1 doctors, OR 0.50, 95% CI 0.32–0.77) and maturity (young vs. mature graduates, OR 2.60, 95% CI 1.81–3.63) were all found to be independent predictors of Part A success. In addition to ethnicity and stage of training, Part A performance (number of attempts and score) was also identified as an independent predictor for Part B. The odds of passing each part of the MRCS decreased by 14% (OR 0.86, 95% CI 0.80–0.92) for Part A and 30% for Part B (OR 0.70, 95% CI 0.61–0.81) with each additional attempt that was made. ConclusionsSeveral independent predictors of MRCS success were identified, but only ethnicity and stage of training were found to be common predictors of both Part A and B.

Does the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination Predict Performance in the General and Vascular Higher Surgical Training Selection Process?

Does the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination Predict Performance in the General and Vascular Higher Surgical Training Selection Process?

Which Factors Predict Performance in the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination?

Which Factors Predict Performance in the Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination?

Impact of performance in a mandatory postgraduate surgical examination on selection into specialty training.

BackgroundThe Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is undertaken by large numbers of trainees in the UK and internationally as a mandatory step within surgical training. Unlike some high‐stakes medical examinations, the MRCS is yet to be validated. A quantitative study was undertaken to assess its predictive validity by investigating the relationship between MRCS (Parts A and B) and national selection interview scores for general and vascular surgery in the UK.MethodsPearson correlation coefficients were used to examine the linear relationship between each assessment, and linear regression analyses were employed to identify potential independent predictors of the national selection score. All UK medical graduates who attempted the interview in 2011–2015 were included.ResultsSome 84·4 per cent of the candidates (1231 of 1458) were matched with MRCS data. There was a significant positive correlation between the first attempt score at Part B of the MRCS examination and the national selection score (r = 0·38, P < 0·001). In multivariable analysis, 17 per cent of variance in the national selection first attempt score was explained by the Part B MRCS score and number of attempts (change in R 2 value of 0·10 and 0·07 respectively; P < 0·001). Candidates who required more than two attempts at Part B were predicted to score 8·1 per cent less than equally matched candidates who passed at their first attempt.ConclusionThis study supports validity of the MRCS examination, and indicates its predictive value regarding entry into specialist training.

When is the best time to sit the MRCS examination?

Duncan Scrimgeour, Jennifer Cleland, Amanda Lee, and Peter Brennan shed some light on when to sit the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination

Changing Objective Structured Clinical Examinations Stations at Lunchtime During All Day Postgraduate Surgery Examinations Improves Examiner Morale and Stress

Human factors are important causes of error, but little is known about their possible effect during objective structured clinical examinations (OSCE). We have previously identified stress and pressure in OSCE examiners in the postgraduate intercollegiate Membership of the Royal College of Surgeons (MRCS) examination. After modifying examination delivery by changing OSCE stations at lunchtime with no demonstrable effect on candidate outcome, we resurveyed examiners to ascertain whether examiner experience was improved. Examiners (n = 180) from all 4 surgical colleges in the United Kingdom and Ireland were invited to complete the previously validated human factors questionnaire used in 2014. Aggregated scores for each of 4 previously identified factors were compared with the previous data. Unit-weighted z-scores and nonparametric Kruskal-Wallis methods were used to test the hypothesis that there was no difference among the median factor z-scores for each college. Individual Mann-Whitney-Wilcoxon tests (with appropriate Bonferonni corrections) were used to determine any differences between factors and the respective colleges. 141 Completed questionnaires were evaluated (78% response rate) and compared with 108 responses (90%) from the original study. Analysis was based on 26 items common to both studies. In 2014, the college with the highest candidate numbers (England) was significantly different in 1 factor (stress and pressure), compared with Edinburgh (Mann-Whitney-Wilcoxon: W = 1524, p < 0.001) and Glasgow colleges (Mann-Whitney-Wilcoxon: W = 104, p = 0.004). No differences were found among colleges in the same factor in 2016, Kruskall-Wallis: (χ2 (3) = 1.73, p = 0.63). Analysis of responses found inconsistency among examiners regarding mistakes or omissions made when candidates were performing well. After making changes to OSCE delivery, factor scores relating to examiner stress and pressure are now improved and consistent across the surgical colleges. Stress and pressure can occur in OSCE examiners and examination delivery should ideally minimize these issues, thereby improving morale is also likely to benefit candidates.

Development, validation and initial outcomes of a questionnaire to examine human factors in postgraduate surgical objective structured clinical examinations.

Human factors including stress, repetition, burnout and fatigue are associated with possible sources of error. Objective structured clinical examinations (OSCEs), where examiners concentrate for long periods, would benefit from a human factors approach to see whether these factors affect consistency of examiner behaviour, attitude and marking. Little has been published for OSCEs, in part due to the lack of a validated tool for collecting data in this setting. A 46-item questionnaire was developed based on the Human Factors Analysis and Classification System (HFACS) domains and completed by examiners in the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination. To refine the questionnaire, an initial analysis focused on response patterns of each item. Cronbach's α was used to assess internal consistency, and a factor analysis was performed to uncover different domains emerging from the data. A total of 108 examiners completed the questionnaire (90·0 per cent response rate). The questionnaire, refined to 38 items based on an initial analysis of response patterns, showed good reliability for internal consistency (Cronbach's α = 0·76) and test-retest reliability (r = 0·85, n = 48, P < 0·001). Four factors had a close themed resemblance to the original HFACS domains, but were associated with different items, suggesting that the four human-factor domains might be linked to different behaviours and attitudes in an examination setting. Analyses according to sex, professional background and experience highlighted additional stress levels in examiners from one of the surgical Royal Colleges (P <0·001), matching evidence from the situation in that College at the time of this study. The recognition and further investigation of human factors in OSCEs is needed to improve examiner experience and behaviour in order to influence delivery, candidate experience and quality assurance of these examinations.

Providing a specialty trainee teaching programme over long distances

Today's teaching programmes must be interesting, relevant to the surgical curriculum, as defined in the UK by the Intercollegiate Surgical Curriculum Programme (ISCP), and attractive enough to the trainee so that they encourage attendance without compromising operative experience. Our aim was to achieve the objectives of the ISCP and to provide high-quality teaching to the trainees. We devised a 2-year rolling programme of events to cover the knowledge and skills required for general surgical training for both the Membership of the Royal College of Surgeons (MRCS) and Fellowship of the Royal College of Surgeons (FRCS) examinations. For the trainees unable to attend because of on-call commitments, we developed online course material, creating our own virtual learning environment (VLE). Attendance at training days, website use and exam pass rates were monitored. We surveyed trainees annually to identify whether the teaching was meeting their needs. There were 100 per cent pass rates for FRCS clinical and viva examinations, with 16 out of the 16 candidates passing on their first attempt and one gold medal awarded. Our attendance rates show that it is possible to provide well-attended sessions despite modern working patterns. The production of a yearly teaching plan with identified topics and dates allowed trainees to maximise their attendance.

RCS international surgical examinations

The Royal College of Surgeons of England (RCS) has a proud history of delivering a large portfolio of dental and surgical examinations. We take particular care to ensure that our candidates receive a professional and efficient service. The College offers its examinations both within and outside the UK. In particular, the Membership of the Royal College of Surgeons (MRCS) examinations are available in an increasing number of centres internationally. The Joint Surgical Colleges' Fellowship Examination (JSCFE), success in which leads to eligibility to apply for Fellowship of the Royal College of Surgeons (FRCS), is also now available outside the UK.

The 2013 MRCS examination: an update

The Intercollegiate Committee for Basic Surgical Examinations (ICBSE) has, with the approval of the General Medical Council (GMC), driven the continued evolution of the Membership of the Royal College of Surgeons (MRCS). Since the introduction in September 2008 of the objective structured clinical examination (OSCE) – Part B of the MRCS – there have been a number of changes and the first diet of the latest version was held in February 2013.

MRCS to become formal exit requirement for core surgical training

Successful completion of the membership of the Royal College of Surgeons (MRCS) examination will become a formal exit requirement …

Doctors Academy revision course for the DOHNS part B exam

The course is aimed at those taking their diploma of otolaryngology—head and neck surgery (DOHNS) part B exam. These may include surgical trainees and general practitioners who have an interest in ear, nose, and throat surgery (ENT). The DOHNS qualification is now considered essential for those applying for a national training number (specialty training level 3 in ENT). Those completing their membership of the Royal College of Surgeons (MRCS) part A and DOHNS part B examinations will be given MRCS (ENT) accreditation by the college. I did my DOHNS as a second year surgical core trainee and attended this course before the part B examination. The course is run by the Doctors Academy (UK), a not for profit organisation that provides a range of educational activities and clinical skills …

Anatomy Demonstration in the Era of 'Run-Through' Training: An Integrated Approach Trialled in the Oxford Deanery

An accurate knowledge of anatomy is a cornerstone of safe surgical intervention. Anatomy is therefore a key component of all stages of the Membership of the Royal College of Surgeons (MRCS) examinations. Partly for this reason, many trainees have traditionally spent a period of time attached to a university anatomy department relearning their anatomy and assisting in its teaching to undergraduate students.

Anatomy on tour: Postgraduate surgical training in a mobile teaching unit

Candidates for postgraduate surgical exams now have to learn much of their anatomy de novo rather than simply revise what they learned as medical students. A number of short courses have developed that help candidates prepare for the Intercollegiate Membership of the Royal College of Surgeons (MRCS). Unfortunately these courses tend to be centralised and trainees incur high travel and accommodation costs when attending them. Trainees are also absent from their hospitals for long periods, which can disrupt clinical services.

Postgraduate diploma in aesthetic surgery

Aesthetic surgery forms an important part of the curriculum for training in plastic surgery; however, exposure to patients with cosmetic problems is limited in the NHS. Traditionally, training in cosmetic surgery has been obtained by doing fellowships near the end of training, which commonly last for three months. The Royal College of Surgeons has also started specialised courses in aesthetic surgery, including cadaveric dissection. To deal with the problem of limited training in aesthetic surgery the University of London has established a diploma course in aesthetic surgery to provide a core curriculum for surgeons. It targets established surgeons and surgical or medical trainees and leads to a postgraduate degree from the University of London—PGDipAesSurg. Qualification requirements for the course are MB BS and part 2 membership of the Royal College of Surgeons (MRCS) or equivalent. The course is a two year, part time, web based distance learning programme starting in October. It consists of structured distance e-learning, DVD or …

Master of Science (MSc) in orthopaedic engineering

FURTHER INFORMATION Cardiff School of Engineering, Cardiff University, Cardiff CF24 3AA. www.cardiff.ac.uk/engine; tel: 029 2087 4421. Orthopaedic surgeons. In 2003, after completing my MRCS (Membership of the Royal College of Surgeons). To increase my understanding of the biomechanical principles involved in trauma and orthopaedics. The course fees were £2000 a year for two years. …

... preparing for the MRCS part 3 exam

The intercollegiate exam for membership of the Royal College of Surgeons (MRCS) has three parts. The third and most challenging part has a viva to test clinical and communications skills. Here are some tips to help you prepare.