104+ Free FSEM MSK Diploma Practice Questions

Pass your Diploma in Musculoskeletal Injury Management (ICGP/FSEM Joint Programme) exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: FSEM MSK Diploma Exam

4 workshops

Teaching Weekends

ICGP course structure

1 year

Course Duration

ICGP/FSEM

~20%

GP Consultations MSK

ICGP course materials

May

Final Examination

ICGP workshop schedule

ICGP + FSEM

Joint Accreditation

FSEM Ireland

100

Practice Questions

OpenExamPrep

The ICGP/FSEM MSK Diploma is a one-year GP course with four teaching weekends plus a May examination. Workshop modules cover shoulder, spine, hip, knee, and ankle. This free practice bank offers 100 MCQs on MSK assessment, injury management, and primary care referral decisions for Irish GPs preparing for the diploma.

Sample FSEM MSK Diploma Practice Questions

Try these sample questions to test your FSEM MSK Diploma exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 104+ question experience with AI tutoring.

1A 52-year-old office worker presents with gradual onset of bilateral shoulder stiffness and night pain. Passive and active range of motion are equally limited in all planes. What is the most likely diagnosis?

A.Adhesive capsulitis (frozen shoulder)

B.Rotator cuff tear

C.Glenohumeral osteoarthritis

D.Subacromial impingement syndrome

Explanation: Global restriction of both active and passive shoulder movement with a painful stiffening phase is characteristic of adhesive capsulitis. The capsular contracture limits motion in all planes, distinguishing it from isolated cuff or impingement pathology where passive range is often preserved.

2During examination of a patient with suspected subacromial impingement, the clinician flexes the shoulder to 90 degrees, flexes the elbow to 90 degrees, and forcibly internally rotates the humerus. Reproduction of anterolateral shoulder pain indicates which special test?

A.Speed's test

B.Hawkins-Kennedy test

C.Apprehension test

D.Drop-arm test

Explanation: The Hawkins-Kennedy test compresses the supraspinatus tendon and subacromial bursa beneath the coracoacromial arch by internal rotation in forward flexion. Pain during this maneuver supports subacromial impingement, though specificity is limited and findings must be interpreted with the clinical picture.

3A 45-year-old painter reports insidious right shoulder pain worse when reaching overhead. Empty-can testing (thumb-down abduction to 90 degrees against resistance) elicits pain and mild weakness. Which structure is most likely affected?

A.Long head of biceps

B.Deltoid muscle

C.Supraspinatus tendon

D.Subscapularis tendon

Explanation: The empty-can (Jobe) test isolates supraspinatus function by resisting abduction in the scapular plane with internal rotation. Pain or weakness suggests supraspinatus tendinopathy or partial tear, a common cause of painful overhead activity in manual workers.

4A 28-year-old rugby player feels the shoulder "slip out" when tackling. On examination, apprehension is elicited with the arm abducted and externally rotated. What is the most appropriate initial primary care management step?

A.Six months of complete shoulder immobilization in a sling

B.Oral corticosteroids as first-line definitive treatment

C.Immediate surgical stabilization without further assessment

D.Activity modification, physiotherapy referral, and discussion of specialist opinion if recurrent

Explanation: First-time or infrequent glenohumeral instability in primary care is managed with education, activity modification, rotator cuff and scapular stabilizer rehabilitation, and referral for imaging or orthopaedic review if recurrent or if structural injury is suspected. Surgery is reserved for persistent instability or significant structural lesions.

5Which finding on shoulder examination most strongly suggests a full-thickness rotator cuff tear rather than tendinopathy alone?

A.Inability to actively elevate the arm with a positive drop-arm sign

B.Mild crepitus on passive glenohumeral rotation

C.Localized tenderness over the acromioclavicular joint

D.Painful arc between 60 and 120 degrees of abduction

Explanation: A positive drop-arm sign—failure to smoothly lower the arm from full abduction—indicates loss of active elevation from a significant cuff tear. Painful arc is nonspecific and occurs in impingement and partial tears. AC joint tenderness suggests AC pathology rather than cuff rupture.

6A 35-year-old cyclist falls onto an outstretched hand and reports pain at the point of the shoulder. There is step-off deformity at the acromioclavicular joint with the arm unsupported. According to the Rockwood classification, complete rupture of both acromioclavicular and coracoclavicular ligaments with 25–100% clavicular elevation corresponds to which type?

A.Type II

B.Type III

C.Type VI

D.Type I

Explanation: Rockwood Type III AC separation involves complete disruption of both AC and coracoclavicular ligaments with clavicular displacement of 25–100% relative to the acromion. Type I is AC sprain only; Type II is AC rupture with CC sprain; Type VI is inferior displacement.

7A GP assesses a 60-year-old with shoulder pain. Which feature would most strongly prompt urgent specialist referral rather than routine physiotherapy?

A.Mild weakness on resisted abduction with preserved passive range

B.Night pain disturbing sleep for two weeks

C.History of trauma with acute severe pain and inability to move the shoulder after age 50

D.Gradual onset pain worse with overhead reaching over three months

Explanation: Acute severe shoulder pain with inability to move the joint after trauma in an older adult raises concern for fracture or significant soft-tissue disruption requiring urgent imaging. Night pain alone is common in rotator cuff disease. Gradual mechanical symptoms often suit conservative primary care management initially.

8A patient with subacromial pain syndrome has completed a structured physiotherapy programme without improvement over 12 weeks. There is no red-flag history. What is the most appropriate next step in primary care?

A.Open subacromial decompression without trial of injection

B.Permanent work cessation without further assessment

C.Immediate MRI of the shoulder for all patients

D.Consider subacromial corticosteroid injection and re-evaluation of diagnosis; discuss orthopaedic referral if persistent

Explanation: After failed conservative care for subacromial pain, GPs may offer ultrasound-guided or landmark-based subacromial corticosteroid injection while reassessing for alternative diagnoses. MRI is not required for every case but referral is appropriate if symptoms persist or mechanical signs suggest structural tear.

9Which rotator cuff muscle is primarily responsible for initiating the first degrees of shoulder abduction and centring the humeral head in the glenoid?

A.Supraspinatus

B.Teres minor

C.Subscapularis

D.Infraspinatus

Explanation: Supraspinatus initiates abduction and compresses the humeral head into the glenoid before deltoid becomes the prime mover. It is the most commonly injured rotator cuff tendon in degenerative and overuse presentations seen in general practice.

10A 40-year-old manual worker has lateral elbow pain worsened by resisted wrist extension with the elbow extended. What is the most likely diagnosis?

A.Medial epicondylitis

B.Lateral epicondylitis (tennis elbow)

C.Olecranon bursitis

D.Radial head fracture

Explanation: Lateral epicondylitis produces pain over the common extensor origin, aggravated by resisted wrist extension and gripping. It is common in repetitive manual work, not only tennis players. First-line care is activity modification, ergonomic advice, and progressive loading exercises.

About the FSEM MSK Diploma Exam

The ICGP/FSEM Joint Diploma in Musculoskeletal Injury Management is a one-year, part-time programme for general practitioners in Ireland. Delivered through weekend workshops covering shoulder and elbow, cervical and thoracic spine with wrist and hand, lumbar spine and sacroiliac joint with hip and pelvis, and knee and ankle, the course prepares GPs to recognise, assess, and manage the musculoskeletal presentations that comprise approximately one in five GP consultations. Students sit an end-of-year written examination in May at the final workshop weekend.

Assessment

End-of-year written assessment following four instructional weekend workshops

Time Limit

Final examination at fifth workshop weekend (May); one-year part-time course

Passing Score

Pass standard set by ICGP/FSEM course examination board

Exam Fee

Included in ICGP course fee (contact ICGP for current amount) (Irish College of General Practitioners and Faculty of Sports and Exercise Medicine (RCPI/RCSI, Ireland))

FSEM MSK Diploma Exam Content Outline

25%

Shoulder & Elbow

Rotator cuff and impingement assessment, instability, frozen shoulder, AC joint injury, epicondylitis, olecranon bursitis, and nerve compression at the elbow

25%

Cervical & Thoracic Spine, Wrist & Hand

Cervical radiculopathy, red flags, whiplash, carpal tunnel, De Quervain, trigger finger, scaphoid fracture, and inflammatory vs degenerative hand disease

25%

Lumbar Spine, SI Joint, Hip & Pelvis

Mechanical back pain, cauda equina red flags, sciatica, spinal stenosis, SI dysfunction, hip OA, trochanteric pain, and pelvic girdle pain

25%

Knee & Ankle

ACL and meniscal injury, patellofemoral pain, knee OA, Ottawa rules, Achilles tendinopathy and rupture, ankle sprains, and plantar fasciitis

How to Pass the FSEM MSK Diploma Exam

What You Need to Know

Passing score: Pass standard set by ICGP/FSEM course examination board
Assessment: End-of-year written assessment following four instructional weekend workshops
Time limit: Final examination at fifth workshop weekend (May); one-year part-time course
Exam fee: Included in ICGP course fee (contact ICGP for current amount)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

FSEM MSK Diploma Study Tips from Top Performers

1Learn shoulder special tests (Hawkins-Kennedy, empty can, apprehension) and link each to the structure being stressed

2Memorise spinal red flags requiring emergency referral: cauda equina symptoms, progressive neurology, fever with focal spinal tenderness

3Practice differentiating hip from lumbar referred pain using internal rotation and groin-localised symptoms

4Know Ottawa knee and ankle rules to decide when radiographs are indicated in primary care trauma

5Understand load-management principles for tendinopathy (Achilles, patellar, lateral epicondyle) rather than prolonged rest

6Review when subacromial or carpal tunnel corticosteroid injection is appropriate after failed conservative care

7Study common GP presentations: frozen shoulder in diabetes, De Quervain in new parents, plantar fasciitis in obese patients

8Use timed MCQ practice to simulate examination conditions before the May assessment weekend

Frequently Asked Questions

What is the ICGP/FSEM Diploma in Musculoskeletal Injury Management?

It is a one-year, part-time diploma run jointly by the Irish College of General Practitioners and the Faculty of Sports and Exercise Medicine (RCPI/RCSI). The course uses weekend workshops to teach GPs how to assess and manage common musculoskeletal conditions presenting in Irish general practice, culminating in an end-of-year written examination in May.

Who is the MSK diploma designed for?

The programme is designed for GPs and GP trainees who wish to increase their competence in musculoskeletal medicine. The ICGP states the course has been developed for GPs in practice in Ireland, though it is run in partnership with FSEM Ireland.

How is the course structured?

Students attend four instructional weekend workshops during the academic year covering shoulder and elbow; cervical and thoracic spine with wrist and hand; lumbar spine and sacroiliac joint with hip and pelvis; and knee and ankle. Pre-reading and eLearning content is available online before each workshop. The fifth weekend in May includes the final examination.

Is this the same as the FSEM UK Diploma in Musculoskeletal Medicine?

No. FSEM Ireland (fsem.ie) and FSEM UK (fsem.ac.uk) are separate bodies. The ICGP/FSEM joint diploma is an Ireland-specific GP training course, whereas the UK DipMSK is a standalone examination for multi-professional candidates. Curricula overlap in MSK topics but administration, fees, and entry routes differ.

What topics should I focus on for the examination?

Workshop modules define the core syllabus: upper limb (shoulder, elbow, wrist, hand), spinal disorders with red-flag recognition, hip and pelvic girdle pain, and lower limb (knee and ankle) including ligament injury, tendinopathy, and primary care imaging decisions such as Ottawa ankle and knee rules.

How can I apply for the course?

Places are advertised by ICGP, typically in May or June for a September or November intake. Application is through the ICGP courses portal. For current fees and closing dates, visit the ICGP Diploma in Musculoskeletal Injury Management course page or contact the ICGP Education Department.