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Key Facts: Certificación en Cirugía General Exam

MXN 4,500

2027 first-time certification fee (MXN 3,500 for 2027 graduates)

CMCG convocatoria Certificación 1ª vez 2027

9–30 Jan 2027

Online theoretical exam dates (9, 16, 23 and 30 January)

CMCG convocatoria Certificación 1ª vez 2027

32 units

Official knowledge areas listed for Cirugía General and SRS

CMCG Áreas del conocimiento

≥8 points

Clinical-phase pass requirement, plus sufficiency from every examiner

CMCG examen clínico

5 years

Certification validity before renewal

CONACEM / CMCG

The CMCG General Surgery certification has an online theoretical phase (January 2027 dates) followed by an online clinical phase of written answers to clinical scenarios; the 2027 fee is MXN 4,500 (MXN 3,500 for 2027 graduates).

Sample Certificación en Cirugía General Practice Questions

Try these sample questions to review concepts for the Certificación en Cirugía General exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 104+ question experience with AI tutoring.

1A 23-year-old previously healthy man presents to the emergency department with a 14-hour history of periumbilical pain that migrated to the right lower quadrant, accompanied by anorexia and low-grade fever. Physical examination reveals tenderness at McBurney's point with localized peritoneal signs and a positive Rovsing sign. Vital signs: temperature 38.1°C, pulse 94 bpm, blood pressure 122/76 mmHg. Laboratory studies show a leukocyte count of 13,800/mm³ with 82% neutrophils. His Alvarado score is calculated as 9. According to the WSES (Jerusalem) guidelines, which of the following is the most appropriate next step in management?
A.Proceed directly to prompt appendectomy without additional abdominal imaging
B.Perform an abdominal ultrasound to confirm appendiceal wall thickening >6 mm
C.Order a contrast-enhanced abdominal CT scan before surgical consultation
D.Admit for 24 hours of intravenous antibiotic therapy and serial physical examinations
Explanation: In an adult male presenting with classic migratory right lower quadrant pain, localized peritoneal signs, fever, and leukocytosis yielding a high Alvarado score (≥7-9), clinical diagnosis of acute appendicitis is established with high diagnostic accuracy. According to international surgical consensus (WSES guidelines), adult male patients with high-probability acute appendicitis should undergo prompt appendectomy without the delay or expense of routine preoperative cross-sectional imaging, which is reserved for equivocal presentations, atypical demographics, female patients of childbearing age, or suspected masses.
2A 52-year-old woman presents to the surgical triage unit with constant right upper quadrant pain of 36 hours duration, nausea, and vomiting. Physical examination shows marked tenderness and involuntary guarding in the right hypochondrium with inspiratory arrest on deep palpation (positive Murphy's sign). Vital signs: temperature 38.6°C, pulse 108 bpm, blood pressure 118/74 mmHg, respiratory rate 20 breaths/min. Laboratory analysis reveals a leukocyte count of 19,200/mm³. Total bilirubin is 1.4 mg/dL, serum creatinine is 0.9 mg/dL, and platelet count is 240,000/mm³. Transabdominal ultrasound demonstrates gallstones, gallbladder wall thickness of 5.5 mm, and pericholecystic fluid without common bile duct dilation. According to the Tokyo Guidelines 2018 (TG18), what is the severity grade of this patient's acute cholecystitis?
A.Grade I (Mild) acute cholecystitis
B.Grade II (Moderate) acute cholecystitis
C.Grade III (Severe) acute cholecystitis
D.Recurrent uncomplicated biliary colic
Explanation: According to the Tokyo Guidelines 2018 (TG18), acute cholecystitis is classified into three severity grades. Grade II (Moderate) is defined by the presence of any one of the following criteria: elevated WBC count (>18,000/mm³), palpable tender mass in the right upper quadrant, disease duration >72 hours, or marked local inflammation (gangrenous cholecystitis, pericholecystic abscess, hepatic abscess, biliary peritonitis, emphysematous cholecystitis). Because her leukocyte count is 19,200/mm³ without organ dysfunction, she meets Grade II criteria. Grade III (Severe) requires systemic organ dysfunction (cardiovascular, neurological, respiratory, renal, hepatic, or hematological failure).
3A 44-year-old male is admitted with severe epigastric pain radiating to the back, accompanied by nausea and multiple episodes of vomiting. Serum lipase is 1,840 U/L (reference <60 U/L), and serum amylase is 920 U/L. Transabdominal ultrasound reveals multiple small gallstones with acoustic shadowing, no common bile duct dilation (CBD 4.5 mm), and a normal liver parenchyma. Vital signs are normal, and he exhibits no respiratory distress or renal impairment. Within 48 hours of fluid resuscitation and analgesia, his abdominal pain resolves, and he tolerates a low-fat oral diet without nausea. What is the optimal surgical timing for index cholecystectomy in this patient?
A.Elective cholecystectomy scheduled 6 to 8 weeks after discharge to allow tissue edema to subside
B.Cholecystectomy only if a repeat ultrasound at 30 days demonstrates persistent gallstones
C.Laparoscopic cholecystectomy during the same index hospital admission once clinical symptoms have resolved
D.Endoscopic retrograde cholangiopancreatography with sphincterotomy followed by outpatient observation
Explanation: In patients with mild acute biliary pancreatitis, index admission laparoscopic cholecystectomy (performed as soon as clinical abdominal pain has resolved and oral diet is tolerated) is the gold standard recommended by the International Association of Pancreatology (IAP), and the American Gastroenterological Association (AGA). In the randomized PONCHO trial, interval cholecystectomy was associated with readmission for recurrent gallstone-related complications (pancreatitis, cholecystitis, cholangitis or colic) in about 17% of patients during the wait, versus about 5% with same-admission surgery, without any reduction in operative difficulty.
4A 68-year-old woman presents to the surgical service with a 4-day history of left lower quadrant pain, constipation, and fever. Physical examination reveals tenderness and a palpable fullness in the left iliac fossa without generalized guarding. Vital signs: temperature 38.3°C, pulse 92 bpm, blood pressure 130/80 mmHg. Contrast-enhanced abdominal CT confirms acute sigmoid diverticulitis with a 5.0-cm walled-off pelvic fluid collection containing gas and rim enhancement, consistent with Hinchey Stage II disease. Which of the following is the most appropriate initial management strategy?
A.Emergency Hartmann procedure with sigmoidectomy and end colostomy
B.Elective open sigmoid resection with primary colorectal anastomosis after bowel prep
C.Laparoscopic peritoneal lavage and placement of pelvic suction drains alone
D.Intravenous broad-spectrum antibiotics combined with percutaneous catheter drainage
Explanation: Hinchey Stage II diverticulitis is characterized by a distant walled-off pelvic or retroperitoneal abscess. For diverticular abscesses measuring ≥3-4 cm in diameter without generalized peritonitis, current surgical guidelines (ASCRS, WSES) recommend intravenous broad-spectrum antimicrobial therapy combined with image-guided percutaneous catheter drainage. This approach controls sepsis, allows the acute inflammation to resolve, and avoids emergency stoma creation, permitting subsequent elective one-stage resection with primary anastomosis if indicated.
5A 58-year-old man who underwent an open appendectomy 15 years ago presents with bilious vomiting, obstipation, and crampy abdominal pain for 24 hours. Physical examination reveals abdominal distention and high-pitched bowel sounds, but the abdomen remains soft with no localized tenderness or rebound. An abdominal radiograph demonstrates dilated small bowel loops with multiple air-fluid levels and an absence of colonic gas. Vital signs: pulse 86 bpm, blood pressure 128/78 mmHg, temperature 36.9°C. Leukocyte count is 8,200/mm³ and serum lactate is 1.1 mmol/L. A nasogastric tube is placed with decompression. What is the most appropriate next step in evaluation and treatment?
A.Administration of water-soluble contrast (Gastrografin) with serial abdominal radiography
B.Immediate exploratory laparotomy for adhesiolysis within 6 hours of presentation
C.Emergency diagnostic laparoscopy to inspect bowel viability
D.Administration of stimulant laxatives and prokinetic agents via the nasogastric tube
Explanation: In an uncomplicated, hemodynamically stable patient with adhesive small bowel obstruction (SBO) and no clinical, laboratory, or radiological signs of strangulation, ischemia, or peritonitis, a trial of nonoperative management (NOM) with nasogastric decompression and intravenous fluid resuscitation is standard. The administration of 50-100 mL of water-soluble oral contrast (Gastrografin) is both diagnostic and therapeutic: if contrast reaches the colon within 24 hours on serial radiography, nonoperative resolution is predicted with high accuracy (sensitivity and specificity above 90% in meta-analyses), and the hyperosmolar contrast promotes luminal fluid shift and bowel transit, accelerating resolution.
6A 38-year-old man presents with sudden-onset, agonizing epigastric pain that began abruptly 3 hours ago while at work. On examination, he is lying completely still with shallow respirations. His abdomen is rigid and involuntary guarded throughout ('board-like' abdomen) with generalized peritoneal signs. An erect chest radiograph shows free subdiaphragmatic air (pneumoperitoneum) beneath both hemidiaphragms. After intravenous fluid resuscitation, analgesia, and broad-spectrum antibiotics, he undergoes urgent exploration. A 0.8-cm perforation is identified on the anterior wall of the first portion of the duodenum. What is the standard surgical repair technique?
A.Partial gastrectomy with Roux-en-Y gastrojejunostomy reconstruction
B.Primary closure reinforced with a pedicled vascularized omental flap (Graham patch)
C.Truncal vagotomy combined with pyloroplasty and duodenal wedge excision
D.Simple primary closure using nonabsorbable sutures without omental coverage
Explanation: For an acute perforated duodenal ulcer measuring <2 cm in a patient without underlying malignancy, the standard surgical procedure of choice is primary repair reinforced with a pedicled omental patch (the Graham patch, or modified Graham closure). The omental flap provides angiogenic factors, mechanical seal, and bacterial clearance, significantly lowering the risk of postoperative duodenal fistulization. Definitive acid-reducing procedures (such as vagotomy or gastrectomy) are no longer routinely indicated in the modern era of potent proton pump inhibitors and Helicobacter pylori eradication therapy.
7A 72-year-old male with a history of permanent atrial fibrillation and ischemic cardiomyopathy presents with sudden, catastrophic mid-abdominal pain for 4 hours. His pain is severe and unresponsive to morphine, but his initial physical examination reveals a soft abdomen with mild generalized discomfort and no peritoneal signs ('pain out of proportion to physical examination'). Vital signs: heart rate 116 bpm (irregularly irregular), blood pressure 138/84 mmHg, respiratory rate 22 breaths/min. An arterial blood gas shows pH 7.31, bicarbonate 16 mEq/L, and serum lactate 4.2 mmol/L. What is the most appropriate next diagnostic study to confirm the suspected diagnosis?
A.Plain abdominal radiographs in supine and erect projections
B.Transabdominal Doppler ultrasound of the mesenteric vasculature
C.Biphasic contrast-enhanced multidetector CT angiography of the abdomen
D.Upper and lower gastrointestinal endoscopy with mucosal biopsies
Explanation: The clinical scenario of acute, severe abdominal pain out of proportion to physical examination in an elderly patient with atrial fibrillation and elevated serum lactate is hallmark for acute mesenteric ischemia, most commonly caused by an acute superior mesenteric artery (SMA) embolism (accounting for ~50% of cases). Biphasic contrast-enhanced CT angiography (CTA) is the gold standard diagnostic modality, offering sensitivity and specificity exceeding 95%. It rapidly identifies the site of arterial occlusion, evaluates bowel wall enhancement, and assesses for signs of intestinal infarction (pneumatosis intestinalis, portomesenteric venous gas).
8An 81-year-old resident of a nursing home with chronic constipation and Parkinson's disease is evaluated for progressive massive abdominal distention, obstipation, and mild cramping pain over 3 days. Vital signs are stable: temperature 37.0°C, pulse 78 bpm, blood pressure 126/80 mmHg. On examination, the abdomen is tympanitic and non-tender without guarding or rebound. An abdominal radiograph demonstrates a hugely distended, inverted U-shaped loop of bowel without haustra projecting from the pelvis toward the right upper quadrant, showing the classic 'coffee-bean' sign. Leukocyte count and serum lactate are normal. What is the recommended initial management?
A.Immediate emergency Hartmann procedure with open sigmoid resection
B.Barium enema under fluoroscopy to achieve hydrostatic reduction
C.Oral administration of polyethylene glycol electrolyte lavage solution
D.Endoscopic detorsion and decompression via flexible sigmoidoscopy with rectal tube placement
Explanation: This patient presents with uncomplicated sigmoid volvulus, characterized by classic radiologic 'coffee-bean' appearance and stable clinical status without peritonitis or bowel ischemia. In the absence of clinical or endoscopic signs of bowel perforation or gangrene, rigid or flexible sigmoidoscopy for endoscopic detorsion and decompression is the primary treatment of choice, achieving success in 70-85% of cases. A soft rectal flatus tube is left in place for 24-48 hours. Because recurrence rates after nonoperative detorsion exceed 50-70%, semi-elective sigmoid resection during the same hospital stay is recommended once the patient is stabilized.
9A 48-year-old woman is admitted with right upper quadrant pain, mild jaundice, and dark urine. Transabdominal ultrasound reveals cholelithiasis, a dilated common bile duct measuring 11 mm, and a single 7-mm hyperechoic shadow in the distal common bile duct. Laboratory studies show total bilirubin 4.8 mg/dL, direct bilirubin 3.6 mg/dL, alkaline phosphatase 340 U/L, and AST 110 U/L. She is afebrile with normal vital signs, leukocyte count 7,400/mm³, and normal renal function. According to ASGE guidelines, this patient is in the 'high risk' category for choledocholithiasis. What is the most appropriate management plan?
A.Preoperative ERCP with sphincterotomy and stone extraction, followed by elective laparoscopic cholecystectomy
B.Immediate laparoscopic cholecystectomy without common bile duct evaluation or cholangiography
C.Percutaneous transhepatic biliary drainage followed by observation for 6 weeks
D.Intravenous antibiotic therapy alone with repeat ultrasound in 4 weeks
Explanation: The patient has confirmed choledocholithiasis on ultrasound with elevated bilirubin (>4 mg/dL) and dilated common bile duct, placing her in the high-risk (>50% probability) category according to ASGE guidelines. The standard management for high-risk patients in centers where two-stage management is practiced is preoperative endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy and stone clearance, followed by laparoscopic cholecystectomy during the same hospital stay. Alternatively, single-stage laparoscopic cholecystectomy with intraoperative laparoscopic CBD exploration is equally effective where advanced laparoscopic expertise is available.
10A 76-year-old male presents with right upper quadrant abdominal pain, shaking chills, and a fever of 39.4°C. On examination, he is clinically jaundiced, disoriented, and lethargic. Vital signs: blood pressure 82/50 mmHg, pulse 124 bpm, respiratory rate 26 breaths/min. Laboratory analysis shows WBC 24,000/mm³ with 18% bands, total bilirubin 8.5 mg/dL, and serum creatinine 2.4 mg/dL. He exhibits Reynolds' pentad of acute cholangitis. Following immediate fluid resuscitation, broad-spectrum intravenous antibiotics, and vasopressor support in the intensive care unit, what is the definitive emergency intervention?
A.Emergency open exploratory laparotomy and radical cholecystectomy
B.Urgent biliary decompression via endoscopic retrograde cholangiopancreatography (ERCP)
C.Continuous renal replacement therapy and delayed biliary stenting after 72 hours
D.Administration of high-dose intravenous corticosteroids and serial abdominal examinations
Explanation: The patient presents with severe (Grade III) acute cholangitis manifested by Reynolds' pentad (Charcot's triad of RUQ pain, fever, and jaundice, plus hypotension and altered mental status). According to Tokyo Guidelines 2018 (TG18), Grade III acute cholangitis represents a life-threatening surgical emergency requiring rapid medical stabilization in an ICU followed by urgent, emergency biliary decompression—most commonly performed via ERCP with biliary sphincterotomy and plastic stent placement or nasobiliary catheter drainage. If ERCP fails or is unavailable, percutaneous transhepatic biliary drainage (PTBD) or emergent surgical T-tube drainage is indicated.

About the Certificación en Cirugía General Exam

Independent practice resource developed by OpenExamPrep for general surgeons preparing for the theoretical phase (Certificación 1ª Fase) of the Consejo Mexicano de Cirugía General, A.C. (CMCG) certification. In Mexico, specialty certification is issued by specialty councils that hold idoneidad from the Comité Normativo Nacional de Consejos de Especialidades Médicas (CONACEM). The questions are built from the council's published 32-unit list of knowledge areas and current Mexican and international surgical guidelines. This bank is an independent English-language MCQ study adaptation, not an official translation or simulation of the Spanish-language exam; the written open-answer clinical phase is not simulated.

Exam sponsor: Consejo Mexicano de Cirugía General, A.C. (CMCG) under CONACEM idoneidad. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Two sequential phases, both taken online on two devices. Phase 1 is the theoretical examination (Certificación 1ª Fase); for the 2027 call it is offered on 9, 16, 23 and 30 January 2027. Candidates who pass it take Phase 2, the clinical examination, in March: written open-ended answers to clinical scenarios assessing medical knowledge, clinical judgment, critical thinking, professionalism and ethics, graded within 21 days by a panel of at least three CMCG-certified surgeons. Passing Phase 2 requires at least 8 points and a finding of academic sufficiency from every examiner. This practice bank covers the knowledge tested in Phase 1; the clinical phase is not simulated.

Time Limit

Not published

Passing Score

Theoretical phase: not published; clinical phase: ≥8 points plus sufficiency from every examiner

Exam / Certification Fees

MXN 4,500 (graduates of 2026 and earlier); MXN 3,500 (2027 graduates)

Exam sponsor website

Reported exam pass rate: not-published. 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.

Official knowledge area (weight not published)

Bases de la cirugía y el paciente quirúrgico

Response to surgical trauma, fluids and electrolytes (hypokalemia, hyperkalemia, hyponatremia), hemostasis and transfusion, wound healing and surgical wound classes, surgical site infection and antimicrobial prophylaxis, perioperative risk and ERAS, surgical nutrition and refeeding syndrome, and the professional competencies of the surgeon (units 1–8).

Official knowledge area (weight not published)

Trauma, piel y tejido subcutáneo

ATLS primary survey and surgical airway, thoracic trauma, hemorrhagic shock and massive transfusion, FAST, damage control surgery and abdominal compartment syndrome, solid-organ and retroperitoneal injuries, pelvic fractures, burns and escharotomy (units 9–10).

Official knowledge area (weight not published)

Abdomen agudo, pared abdominal y aparato digestivo

Appendicitis, biliary disease (Tokyo Guidelines 2018, choledocholithiasis, bile duct injury), acute pancreatitis (revised Atlanta, step-up approach), diverticulitis, bowel obstruction and volvulus, perforated and bleeding peptic ulcer, mesenteric ischemia, groin and ventral hernias, and colorectal and hepatobiliary surgery (units 12–20 and 22).

Official knowledge area (weight not published)

Cirugía oncológica, endocrina y de mama

Gastric, colorectal and hepatic oncologic surgery, hereditary cancer syndromes, breast imaging and breast cancer surgery, thyroid nodules and cancer, parathyroid disease, and thyroidectomy complications (units 11, 21 and 23).

Official knowledge area (weight not published)

Áreas quirúrgicas relacionadas

Vascular surgery (aortic aneurysm), bariatric surgery indications, pediatric surgery and the acute scrotum, and the other related areas listed in units 24–32.

Preparing for the Certificación en Cirugía General Exam

What You Need to Know

  • Passing score: Theoretical phase: not published; clinical phase: ≥8 points plus sufficiency from every examiner
  • Assessment: Two sequential phases, both taken online on two devices. Phase 1 is the theoretical examination (Certificación 1ª Fase); for the 2027 call it is offered on 9, 16, 23 and 30 January 2027. Candidates who pass it take Phase 2, the clinical examination, in March: written open-ended answers to clinical scenarios assessing medical knowledge, clinical judgment, critical thinking, professionalism and ethics, graded within 21 days by a panel of at least three CMCG-certified surgeons. Passing Phase 2 requires at least 8 points and a finding of academic sufficiency from every examiner. This practice bank covers the knowledge tested in Phase 1; the clinical phase is not simulated.
  • Time limit: Not published
  • Exam / certification fees: MXN 4,500 (graduates of 2026 and earlier); MXN 3,500 (2027 graduates) Official sources

Using Our Practice Resources

  • Work through all 104 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Certificación en Cirugía General: Suggested Study Strategy

1Master the Tokyo Guidelines 2018 (TG18) for acute cholecystitis and cholangitis: diagnostic criteria, severity grading (Grade I Mild, Grade II Moderate, Grade III Severe with organ dysfunction), and the timing of biliary drainage and cholecystectomy.
2Understand the revised Atlanta 2012 classification for acute pancreatitis: interstitial edematous versus necrotizing pancreatitis, collections before and after 4 weeks, and the step-up approach for infected necrosis.
3Review the Hinchey classification of acute diverticulitis and the indications for antibiotics, percutaneous drainage of abscesses of about 3–4 cm or more, and emergency resection.
4Know groin anatomy and repair: the myopectineal orifice, Hesselbach's triangle, the Lichtenstein technique, and the 'triangle of doom' and 'triangle of pain' in laparoscopic repair.
5Work through the 32 official knowledge units, including the less common ones (vascular, thoracic, transplant, pediatric and bariatric surgery), because the council's list covers them all.

Frequently Asked Questions

What is the Consejo Mexicano de Cirugía General certification?

The Consejo Mexicano de Cirugía General, A.C. (CMCG) is the specialty council that certifies general surgeons in Mexico under CONACEM idoneidad. It also runs separate certifications in bariatric surgery, renal transplant surgery and gastrointestinal endoscopy. Certification is valid for 5 years and is renewed by points or by examination.

How is the CMCG certification examination structured?

It has two online phases. The theoretical phase (Certificación 1ª Fase) is offered on 9, 16, 23 and 30 January 2027 for the 2027 call. Candidates who pass it take the clinical phase in March, writing open answers to clinical scenarios that a panel of at least three certified surgeons grades; passing requires at least 8 points and sufficiency from every examiner.

Does this practice resource simulate both phases?

No. This bank covers the knowledge tested in the theoretical phase. The clinical phase, in which candidates write their own answers to clinical scenarios, is not simulated by multiple-choice questions.

What does the CMCG publish about the exam's content?

The council publishes a list of 32 knowledge units (Áreas del conocimiento a evaluar en Cirugía General y SRS), from the systemic response to surgical trauma and fluids and electrolytes through trauma, oncology, the digestive tract, endocrine and breast surgery, to urology, vascular, thoracic, transplant and pediatric surgery, together with a suggested bibliography. It does not publish topic weights or an item count.

What is the fee and how do I register?

For the 2027 first-time certification call, registration opened on 3 August 2026 and closes on 20 November 2026 without extension. The fee is MXN 4,500 for graduates of 2026 and earlier and MXN 3,500 for 2027 graduates, paid online by card or by bank deposit or transfer referencing the assigned folio. Required documents include the medical degree and cédula, CURP, and the specialty diploma and university title (final-year residents submit a constancia from the course director).

Why is this practice bank written in English?

The official CMCG examination is in Spanish. This OpenExamPrep bank is an independent English-language MCQ study adaptation for residents, international medical graduates and bilingual trainees; it is not an official translation or exam simulation, and it keeps standard clinical classifications and Spanish names where helpful.