100+ Free WACS Primary Practice Questions

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West African College of Surgeons Membership Exam — Otorhinolaryngology

Practice Questions100 questions

2026 Statistics

Key Facts: WACS Primary Exam

2 hours

Exam Duration

WACS Guidelines

50%

Passing Score

WACS Portal

$150

Exam Fee (USD)

WACS Exam Advert

100 MCQs

Question Count

WACS Exam Format

35-45%

Pass Rate

Historical Candidate Reports

CBT

Delivery Mode

WACS Examination Portal

The West African College of Surgeons (WACS) Primary Fellowship Examination has a pass rate of approximately 35-45%. The exam is administered as a 2-hour CBT containing 100 multiple-choice questions. It tests basic medical sciences: Applied Anatomy, Applied Physiology, and General Pathology (including Microbiology and Pharmacology). A passing score of 50% is required to qualify for residency training in Nigeria, Ghana, and other member West African nations.

Sample WACS Primary Practice Questions

Try these sample questions to test your WACS Primary exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During thyroidectomy, ligation of which artery places the external branch of the superior laryngeal nerve at greatest risk?

A.Superior thyroid artery, close to the gland's superior pole

B.Superior thyroid artery, far from the gland's superior pole

C.Inferior thyroid artery, close to the gland's inferior pole

D.Inferior thyroid artery, far from the gland's inferior pole

Explanation: The external branch of the superior laryngeal nerve runs in close proximity to the superior thyroid artery near the superior pole of the thyroid gland. To avoid injuring it, the artery should be ligated as close to the gland as possible (distally), meaning ligation far from the pole (proximally) increases the risk.

2Which of the following forms the posterior wall of the inguinal canal?

A.Aponeurosis of the external oblique muscle

B.Internal oblique muscle and lacunar ligament

C.Fascia transversalis and conjoint tendon

D.Inguinal ligament and tractus iliopubicus

Explanation: The posterior wall of the inguinal canal is formed mainly by the fascia transversalis throughout, reinforced medially by the conjoint tendon (falx inguinalis), which is the joined aponeuroses of the internal oblique and transversus abdominis muscles.

3What are the anatomical boundaries of the femoral ring, which forms the entrance to the femoral canal?

A.Anteriorly: inguinal ligament; Posteriorly: pectineal ligament; Medially: lacunar ligament; Laterally: femoral vein

B.Anteriorly: inguinal ligament; Posteriorly: femoral vein; Medially: pectineal ligament; Laterally: lacunar ligament

C.Anteriorly: pectineal ligament; Posteriorly: inguinal ligament; Medially: femoral vein; Laterally: lacunar ligament

D.Anteriorly: transversalis fascia; Posteriorly: pectineus muscle; Medially: femoral artery; Laterally: femoral vein

Explanation: The boundaries of the femoral ring are crucial for understanding femoral hernias: anteriorly by the inguinal ligament (Poupart's ligament), posteriorly by the pectineal ligament (Cooper's ligament), medially by the lacunar ligament (Gimbernat's ligament), and laterally by the femoral vein.

4Which vessel is the primary source of the cystic artery in the majority of individuals, and where is it typically located?

A.Left hepatic artery, running anterior to the common hepatic duct

B.Right hepatic artery, running within the cystohepatic triangle of Calot

C.Gastroduodenal artery, running inferior to the duodenum

D.Common hepatic artery, running anterior to the portal vein

Explanation: In about 75-80% of individuals, the cystic artery arises from the right hepatic artery and crosses behind the common hepatic duct to enter the cystohepatic triangle of Calot, bounded by the cystic duct, common hepatic duct, and the liver margin.

5A surgeon performing a cholecystectomy identifies the borders of Calot's triangle. What are the boundaries of the cystohepatic triangle of Calot?

A.Cystic duct, common bile duct, and portal vein

B.Cystic duct, common hepatic duct, and inferior border of the liver

C.Cystic duct, common hepatic duct, and cystic artery

D.Gallbladder neck, cystic duct, and common hepatic artery

Explanation: The boundaries of the cystohepatic triangle of Calot are the cystic duct inferiorly, the common hepatic duct medially, and the inferior border of the liver (segment V) superiorly. The cystic artery and right hepatic artery typically traverse this triangle.

6Which anatomical structure lies directly posterior to the neck of the pancreas?

A.Inferior vena cava

B.Left renal vein

C.Formation of the portal vein

D.Abdominal aorta

Explanation: The portal vein is formed directly behind the neck of the pancreas by the junction of the superior mesenteric vein and the splenic vein. This relation is crucial during pancreaticoduodenectomy (Whipple's procedure).

7Which artery forms the critical anastomosis between the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA), supplying the colon?

A.Marginal artery of Drummond

B.Ileocolic artery

C.Middle colic artery

D.Right colic artery

Explanation: The marginal artery of Drummond is a continuous arterial arcade running along the inner border of the colon, formed by anastomoses between branches of the superior mesenteric artery (ileocolic, right colic, middle colic) and inferior mesenteric artery (left colic, sigmoid branches).

8What is the relationship of the ureter to the uterine artery as it courses through the female pelvis?

A.The ureter passes anterior to the uterine artery

B.The ureter passes posterior (under) to the uterine artery

C.The ureter runs parallel and lateral to the uterine artery

D.The ureter runs parallel and medial to the uterine artery

Explanation: The ureter runs posterior (under) to the uterine artery near the cervix in the female pelvis. This is famously summarized by the mnemonic 'water (urine in ureter) runs under the bridge (uterine artery)'. This relationship makes the ureter highly vulnerable to injury during hysterectomy.

9Where does the thoracic duct typically originate and where does it terminate in the venous system?

A.Originates from the cisterna chyli at T12/L1; terminates at the junction of the left internal jugular and subclavian veins

B.Originates from the mediastinum at T4; terminates at the right subclavian vein

C.Originates from the spleen; terminates at the portal vein

D.Originates from the hepatic lymph system; terminates at the inferior vena cava

Explanation: The thoracic duct begins in the abdomen as the cisterna chyli at the level of T12 or L1, ascends through the aortic hiatus of the diaphragm, and terminates at the junction of the left internal jugular and left subclavian veins (the left venous angle).

10Which of the following is a parietal branch of the anterior division of the internal iliac artery?

A.Superior vesical artery

B.Obturator artery

C.Internal pudendal artery

D.Superior gluteal artery

Explanation: The obturator artery is a parietal branch of the anterior division of the internal iliac artery, supplying the pelvic wall and medial thigh. The internal pudendal is also anterior but is classified as a visceral/parietal branch of the perineum, while the superior gluteal is the main branch of the posterior division.

About the WACS Primary Exam

The WACS Primary Fellowship Examination is a Computer-Based Test (CBT) assessing basic sciences (Anatomy, Physiology, and Pathology) relevant to surgical practice. It is a mandatory requirement for entering residency training in surgery and related specialties in West Africa.

Questions

100 scored questions

Time Limit

2 hours

Passing Score

50%

Exam Fee

$150 (West African College of Surgeons (WACS))

WACS Primary Exam Content Outline

35%

Applied Anatomy

Anatomy of the head, neck, thorax, abdomen, pelvis, limbs, and nervous system, with emphasis on surgical relations.

35%

Applied Physiology, Biochemistry & Pharmacology

Systemic physiology, biochemistry of metabolism, fluid/electrolyte regulation, and principles of surgical pharmacology.

30%

General Pathology, Microbiology & Parasitology

Pathology of cell injury, wound healing, inflammation, neoplasia, microbiology of common surgical pathogens, and sterile techniques.

How to Pass the WACS Primary Exam

What You Need to Know

Passing score: 50%
Exam length: 100 questions
Time limit: 2 hours
Exam fee: $150

Keys to Passing

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

WACS Primary Study Tips from Top Performers

1Focus heavily on clinically applied anatomy, especially relations, boundaries, fasciae, and nerve and vascular supplies of regions commonly operated on.

2Review the endocrine and metabolic response to injury, acid-base balance, and fluid/electrolyte physiology, as these are heavily tested.

3Understand the phases of wound healing, systemic response to burns, and classifications/treatments of shock in General Pathology.

4Use high-quality practice question banks to simulate the CBT interface and build timing strategy.

5Read standard postgraduate textbooks like Last's Anatomy, Ganong's Review of Medical Physiology, and Robbins Basic Pathology.

Frequently Asked Questions

What is the WACS Primary Fellowship Examination?

The WACS Primary Fellowship Examination is a screening exam for medical and dental graduates seeking admission into the residency training program of the West African College of Surgeons. It tests core knowledge in basic medical sciences (Anatomy, Physiology, and Pathology) as they apply to surgical specialties.

What is the format and duration of the WACS Primary Exam?

The exam is conducted as a Computer-Based Test (CBT) consisting of 100 multiple-choice questions (MCQs). Candidates are given 2 hours to complete the examination.

What score is required to pass the WACS Primary Exam?

Candidates must achieve a minimum score of 50% overall to pass the Primary Fellowship Examination.

What is the registration fee for the WACS Primary Exam?

The registration fee is typically $150 USD (or local currency equivalent in Nigerian Naira, Ghanaian Cedis, etc.), payable electronically through the WACS portal.

Who is eligible to take the WACS Primary Examination?

Medical and dental graduates (holding MBBS or BDS) who have completed their pre-registration housemanship/internship and have full registration with their country's medical council are eligible.