PracticeVideosBlogFlashcardsEspañol
All Practice Exams

Free Practice Questions for PGIM CSE Surgical Specialties

Exam-style questions and explanations by OpenExamPrep.

✓ No registration✓ No credit card
Exam pass rate: Merit-based; the July/August 2026 Ministry of Health allocation was 25 places in Surgery, 12 in Orthopaedic Surgery, 5 in Otorhinolaryngology and 0 in Ophthalmology.
100+ Questions
100% Free

Loading practice questions...

Same family resources

Explore More Postgraduate Institute of Medicine Selection Examinations (PGIM Sri Lanka)

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

PGIM Selection Examination for MD in Anaesthesiology

Practice Questions

PGIM Selection Examination for MD in Community Medicine

Practice Questions

PGIM Selection Examination for MD in Family Medicine

Practice Questions

PGIM Selection Examination for MD in Medicine

Practice Questions

PGIM Selection Examination for MD in Obstetrics and Gynaecology

Practice Questions

PGIM Selection Examination for MD in Paediatrics

Practice Questions
Exam Review

Key Facts: PGIM CSE Surgical Specialties Exam

4

Surgical specialty tracks

50%

Pass mark in each MCQ part

12

OSCE stations (6 basic science, 6 clinical)

Rs. 107k

Full fee (state sector)

The PGIM Common Selection Examination for Surgical Specialties is the single route into MD training in Surgery, Ophthalmology, Orthopaedic Surgery and Otorhinolaryngology in Sri Lanka. It has MCQ Parts I and II, each requiring 50%, followed by a 12-station OSCE of six Basic Sciences and six Clinical Skills stations marked on the PGIM close-mark scale.

Sample PGIM CSE Surgical Specialties Practice Questions

Try these sample questions to review concepts for the PGIM CSE Surgical Specialties exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During an open repair of an indirect inguinal hernia, which anatomical structure constitutes the primary floor of the inguinal canal?
A.Incurving margin of the inguinal ligament
B.Aponeurosis of the external oblique muscle
C.Transversalis fascia reinforced by the conjoint tendon
D.Pectineal (Cooper's) ligament
Explanation: The floor of the inguinal canal is formed mainly by the grooved superior surface of the incurving margin of the inguinal ligament (Poupart's ligament) and is reinforced medially by the lacunar ligament (Gimbernat's ligament). The posterior wall, by contrast, is formed by the transversalis fascia and conjoint tendon. Recognizing this distinction is vital when inspecting the canal during anterior tissue or mesh repairs.
2In the modern surgical definition of the hepatobiliary triangle (triangle of Calot), what constitutes the superior boundary, and what critical vascular structure lies within it?
A.Inferior visceral surface of liver segment V; cystic artery
B.Right hepatic artery; right branch of portal vein
C.Falciform ligament; middle hepatic vein
D.Transverse fissure of the liver; common hepatic artery
Explanation: In modern surgical terminology, the hepatobiliary triangle (Calot's triangle) is bounded superiorly by the inferior visceral surface of the liver (specifically segments IVb and V), laterally by the cystic duct, and medially by the common hepatic duct. The cystic artery and Calot's lymph node (Lund's node) typically lie within this triangle. Calot originally defined the superior boundary as the cystic artery, but modern operative safety guidelines use the inferior liver margin to avoid misidentification during dissection.
3A surgeon makes a lower midline Pfannenstiel incision. Below the arcuate line (linea semicircularis of Douglas), what directly forms the posterior wall of the rectus sheath?
A.Aponeurosis of the internal oblique and transversus abdominis
B.Transversalis fascia and extraperitoneal connective tissue
C.Posterior lamella of the internal oblique aponeurosis alone
D.Transversus abdominis aponeurosis and anterior parietal peritoneum
Explanation: Below the arcuate line, all three aponeuroses (external oblique, internal oblique, and transversus abdominis) pass anterior to the rectus abdominis muscle to form the anterior rectus sheath. Consequently, there is no aponeurotic posterior rectus sheath; the posterior wall consists solely of the transversalis fascia, extraperitoneal connective tissue, and parietal peritoneum. This anatomical arrangement accounts for the lack of strong fascial resistance deep to the rectus muscle in low abdominal incisions.
4A patient undergoing gastroduodenectomy requires devascularization of the duodenum. The vascular arcade of the head of the pancreas and duodenum represents an important embryological watershed between which two parent arteries?
A.Left gastric artery and splenic artery
B.Coeliac trunk and superior mesenteric artery
C.Common hepatic artery and inferior mesenteric artery
D.Gastroduodenal artery and left gastroepiploic artery
Explanation: The duodenum and head of the pancreas receive dual blood supply from the superior pancreaticoduodenal artery (a branch of the gastroduodenal artery from the coeliac trunk) and the inferior pancreaticoduodenal artery (the first branch of the superior mesenteric artery). This arcade forms the crucial vascular anastomosis bridging the embryological foregut and midgut at the level of the second part of the duodenum. This dual supply protects the duodenum against ischaemia during arterial embolisation or selective ligation.
5During normal human embryological development, the midgut loop herniates into the extraembryonic coelom and undergoes rotation. What is the total rotation undergone by the midgut and around which vascular axis does it occur?
A.180 degrees clockwise around the coeliac axis
B.270 degrees counterclockwise around the superior mesenteric artery
C.90 degrees clockwise around the inferior mesenteric artery
D.360 degrees counterclockwise around the vitelline vein
Explanation: The physiological midgut herniation occurs at approximately the 6th gestational week, rotating 90 degrees counterclockwise around the axis of the superior mesenteric artery (SMA). Upon returning to the abdominal cavity during the 10th to 11th weeks, the midgut completes an additional 180 degrees of counterclockwise rotation, yielding a total rotation of 270 degrees counterclockwise. Arrest or failure of this rotation predisposes to malrotation, midgut volvulus, and extrinsic duodenal obstruction by Ladd's bands.
6During placement of a 10 mm laparoscopic trocar in the left lower quadrant, the inferior epigastric artery is inadvertently lacerated. What is the origin and initial trajectory of this vessel?
A.Originates from the internal iliac artery and ascends within the retroperitoneal pelvic fat
B.Originates from the external iliac artery just proximal to the inguinal ligament and ascends along the medial border of the deep inguinal ring
C.Originates from the femoral artery below the inguinal ligament and pierces the cribriform fascia
D.Originates from the obturator artery and travels along the obturator canal
Explanation: The inferior epigastric artery arises from the external iliac artery immediately proximal to the inguinal ligament. It curves anteriorly in the extraperitoneal fat, ascending along the medial margin of the deep (internal) inguinal ring within the lateral umbilical fold, before piercing the transversalis fascia to enter the rectus sheath. Transillumination and placement of lateral ports lateral to the rectus abdominis muscle prevent iatrogenic injury to this vessel.
7Which nerve traverses the superficial inguinal ring alongside the spermatic cord without having entered the deep inguinal ring?
A.Genital branch of the genitofemoral nerve
B.Ilioinguinal nerve
C.Iliohypogastric nerve
D.Lateral cutaneous nerve of the thigh
Explanation: The ilioinguinal nerve (L1) pierces the internal oblique muscle to enter the inguinal canal between the internal and external oblique layers. It travels within the canal anterior to the spermatic cord and emerges through the superficial inguinal ring to supply sensation to the upper medial thigh and anterior scrotum or labium majus. Crucially, it does not enter the canal through the deep ring, unlike the genital branch of the genitofemoral nerve.
8A direct inguinal hernia protrudes through Hesselbach's triangle. What anatomical structures define the superolateral and medial boundaries of this triangle?
A.Inferior epigastric vessels superolaterally; lateral border of the rectus abdominis medially
B.Deep inguinal ring superolaterally; conjoint tendon medially
C.Inguinal ligament superolaterally; medial umbilical ligament medially
D.Testicular vessels superolaterally; linea alba medially
Explanation: Hesselbach's triangle (the medial inguinal fossa) is bounded superolaterally by the inferior epigastric vessels, medially by the lateral margin of the rectus abdominis muscle (linea semilunaris), and inferiorly by the inguinal ligament (Poupart's ligament). Direct inguinal hernias push directly forward through the attenuated transversalis fascia in the floor of this triangle, medial to the inferior epigastric vessels.
9During pancreaticoduodenectomy (Whipple procedure), dissection behind the head of the pancreas reveals an aberrant replaced right hepatic artery. From which parent vessel does this anomalous artery most commonly arise, and where does it course?
A.Superior mesenteric artery; courses posterior to the portal vein
B.Left gastric artery; courses through the fissure for ligamentum venosum
C.Gastroduodenal artery; courses anterior to the common bile duct
D.Inferior mesenteric artery; courses anterior to the inferior vena cava
Explanation: A replaced right hepatic artery is the most frequent arterial variation in hepatobiliary surgery (present in ~10-15% of patients) and arises from the superior mesenteric artery (SMA). It ascends towards the liver behind the head of the pancreas and posterolateral to the portal vein in the hepatoduodenal ligament. Surgeons must recognize this variant during pancreatic head mobilization and retroperitoneal dissection to avoid catastrophic devascularization of the right hepatic lobe.
10Excessive circumferential skeletonisation of the common bile duct during cholecystectomy risks ischaemic stricture. What is the anatomical basis of the arterial supply to the extrahepatic bile ducts?
A.Axial longitudinal arteries running along the 3 o'clock and 9 o'clock positions supplied from below and above
B.A rich circumferential transmural network arising exclusively from the cystic artery
C.Segmental perpendicular perforating branches derived directly from the splenic artery
D.A single dorsal axial artery derived solely from the gastroduodenal artery
Explanation: The extrahepatic bile duct is supplied primarily by two longitudinal axial arteries that run along its lateral margins at the 3 o'clock and 9 o'clock positions. These channels are fed from below predominantly by the gastroduodenal and retroportal arteries and from above by the right hepatic artery. Extensive skeletonisation or circumferential stripping of adventitia disrupts these delicate axial channels, predisposing to ischaemic necrosis and subsequent benign biliary stricture.

About the PGIM CSE Surgical Specialties Exam

The Common Selection Examination (CSE) for Surgical Specialties is the single entry examination conducted by the Postgraduate Institute of Medicine, University of Colombo, for medical officers seeking training leading to the MD in Surgery, MD in Ophthalmology, MD in Orthopaedic Surgery and MD in Otorhinolaryngology. It replaced the separate specialty selection examinations and is set and sat in English.

Exam sponsor: Postgraduate Institute of Medicine, University of Colombo. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Component 1 is an MCQ examination in two parts (Part I and Part II). Candidates scoring 50% or more in each part proceed to Component 2, a 12-station OSCE made up of three Basic Sciences station pairs (surgical anatomy; clinical physiology & critical care; surgical pathology) and three Clinical Skills station pairs (communication skills; data interpretation; medical duties & procedures).

Time Limit

Durations are not published by the PGIM; the MCQ papers are held first and the OSCE on later scheduled dates.

Passing Score

50% or more in each MCQ part is required to sit the OSCE. The OSCE requires a cumulative non-rounded average close mark of at least 3 across the 12 stations, a close mark of 3 in four of the six Basic Sciences stations, a close mark of 3 in four of the six Clinical Skills stations, and a close mark of 3 in at least one station of each pair. Both components must be passed.

Exam / Certification Fees

Rs. 107,000 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 80,000 examination fees); Rs. 61,500 is payable with the application and the Rs. 45,500 balance only after the MCQ papers are passed. Non-state-sector candidates pay 50% more.

Exam sponsor website

Reported exam pass rate: Merit-based; the July/August 2026 Ministry of Health allocation was 25 places in Surgery, 12 in Orthopaedic Surgery, 5 in Otorhinolaryngology and 0 in Ophthalmology.. The PGIM publishes merit lists and pass index numbers per sitting rather than percentage pass rates. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

MCQ + 2 OSCE stations

Surgical Anatomy

Topographical and applied anatomy of the abdomen, thorax, head and neck, limbs and pelvis, surgical planes, vascular and neural territories, and applied embryology.

MCQ + 2 OSCE stations

Clinical Physiology & Critical Care

Fluid and electrolyte balance, shock and haemodynamics, acid-base disturbance, transfusion and coagulation, surgical nutrition, the metabolic response to trauma, sepsis and ventilation.

MCQ + 2 OSCE stations

Surgical Pathology

Wound healing, surgical infection and antimicrobial therapy, neoplasia and molecular carcinogenesis, thrombosis and thromboprophylaxis, and perioperative pathology.

MCQ + 6 Clinical Skills OSCE stations

Principles of Surgery, Data Interpretation & Emergency Management

Preoperative assessment and consent, acute abdomen, trauma and ATLS principles, burns, surgical oncology, postoperative complications, interpretation of imaging and investigations, and communication skills.

Preparing for the PGIM CSE Surgical Specialties Exam

What You Need to Know

  • Passing score: 50% or more in each MCQ part is required to sit the OSCE. The OSCE requires a cumulative non-rounded average close mark of at least 3 across the 12 stations, a close mark of 3 in four of the six Basic Sciences stations, a close mark of 3 in four of the six Clinical Skills stations, and a close mark of 3 in at least one station of each pair. Both components must be passed.
  • Assessment: Component 1 is an MCQ examination in two parts (Part I and Part II). Candidates scoring 50% or more in each part proceed to Component 2, a 12-station OSCE made up of three Basic Sciences station pairs (surgical anatomy; clinical physiology & critical care; surgical pathology) and three Clinical Skills station pairs (communication skills; data interpretation; medical duties & procedures).
  • Time limit: Durations are not published by the PGIM; the MCQ papers are held first and the OSCE on later scheduled dates.
  • Exam / certification fees: Rs. 107,000 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 80,000 examination fees); Rs. 61,500 is payable with the application and the Rs. 45,500 balance only after the MCQ papers are passed. Non-state-sector candidates pay 50% more. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

PGIM CSE Surgical Specialties: Suggested Study Strategy

1Master high-yield surgical anatomy topics including the inguinal canal, femoral triangle, biliary tree, and brachial plexus.
2Review fluid and electrolyte resuscitation protocols, Parkland formula for burns, and transfusion guidelines.
3Thoroughly study the physiological classification and initial resuscitation of hypovolaemic, septic, and cardiogenic shock.
4Focus on principles of surgical oncology, staging terminology, and safe surgical margins.
5Practice interpreting emergency clinical scenarios involving trauma, acute abdomen, and bowel obstruction.

Frequently Asked Questions

What is the PGIM Common Selection Examination for Surgical Specialties?

It is the single entrance examination run by the Postgraduate Institute of Medicine, University of Colombo, for medical officers entering surgical specialty training. It has an MCQ component in two parts and a 12-station OSCE, and replaced the separate selection examinations previously held for each surgical specialty.

What specialties does the PGIM Surgical Common Selection Examination govern?

Passing the CSE is the route into MD training in Surgery, Ophthalmology, Orthopaedic Surgery and Otorhinolaryngology. Candidates declare their specialty preferences in order from 1st to 4th before the allocation meeting.

What is the passing score for the MCQ component?

A candidate must score 50% or more in each MCQ part to sit the OSCE, then meet the OSCE close-mark requirements: an average close mark of at least 3 across the 12 stations, a close mark of 3 in four of six Basic Sciences stations, a close mark of 3 in four of six Clinical Skills stations, and a close mark of 3 in at least one station of each pair.

What are the eligibility requirements for the examination?

An SLMC-registered medical degree, a recognised internship, one year of post-internship practice in Sri Lanka acceptable to the PGIM by the closing date, six months of surgical experience (General Surgery or Obstetrics & Gynaecology) at HO or SHO level, and a consultant physician's certificate of mental and physical fitness.

Are these official PGIM questions?

No. These are independent practice questions developed by OpenExamPrep to assist candidates preparing for the PGIM Common Selection Examination for Surgical Specialties.

Is there a separate selection examination for MD Surgery?

No. Since 2024 the PGIM has run a single Common Selection Examination for Surgical Specialties covering MD Surgery, MD Ophthalmology, MD Orthopaedic Surgery and MD Otorhinolaryngology. The maximum number of attempts at the CSE is six, counted together with past attempts at the superseded individual specialty selection examinations.

Does this practice bank simulate the official PGIM examination format?

No. The official CSE combines MCQ Parts I and II with a 12-station OSCE marked on a close-mark scale. This is an independent English-language, four-option MCQ study bank by OpenExamPrep covering the same surgical sciences; it is not an official paper, a format simulation, or a substitute for OSCE practice.