100+ Free FRCS Neurosurgery Practice Questions
Prepare for the Intercollegiate Specialty Fellowship Examination in Neurosurgery (FRCS SN) exam with instant access — no signup required.
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Sample FRCS Neurosurgery Practice Questions
Try these sample questions to test your FRCS Neurosurgery exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 58-year-old presents with a 6-week history of progressive headache and dysphasia. MRI shows a peripherally enhancing left temporal mass with central necrosis and surrounding T2/FLAIR signal. Histology confirms a WHO grade 4 IDH-wildtype astrocytic tumour. Which molecular marker most strongly predicts benefit from temozolomide and a better prognosis?
2According to the WHO 2021 classification of CNS tumours, which combination of molecular features defines a 1p/19q-codeleted oligodendroglioma?
3A 45-year-old has a well-circumscribed, dural-based, homogeneously enhancing extra-axial mass with a dural tail on MRI. At operation the lesion is firm and attached to the dura. Which is the single most appropriate grading system to apply to the resection achieved?
4A 35-year-old presents with progressive hearing loss, tinnitus and unsteadiness. MRI shows an enhancing mass in the left cerebellopontine angle extending into the internal auditory meatus, with an 'ice-cream cone' appearance. Which cranial nerve does this tumour most commonly arise from?
5A 30-year-old woman has secondary amenorrhoea and galactorrhoea. Serum prolactin is markedly elevated at 8,000 mU/L and MRI shows a 1.5 cm pituitary macroadenoma. There is no visual field defect. What is the most appropriate first-line management?
6A 52-year-old presents with bitemporal hemianopia. MRI demonstrates a sellar/suprasellar mass with elevation of the optic chiasm. Which structure is most directly responsible for the visual field defect?
7A 6-year-old presents with morning headache, vomiting and truncal ataxia. CT shows a midline posterior fossa mass arising from the cerebellar vermis with hydrocephalus. Histology shows small round blue cells with Homer Wright rosettes. What is the most likely diagnosis?
8A 60-year-old with known metastatic non-small cell lung cancer develops a single 3 cm enhancing cerebellar metastasis causing fourth ventricular effacement and early obstructive hydrocephalus, but is otherwise neurologically intact with good performance status. What is the most appropriate management of the lesion?
9A 28-year-old man with a family history of bilateral vestibular schwannomas is found to have multiple meningiomas and an ependymoma. Which gene is most likely mutated?
10During an awake craniotomy for a left frontal glioma, intraoperative direct cortical stimulation of an area immediately anterior to the inferior precentral gyrus causes speech arrest. Which functional region has most likely been identified?
About the FRCS Neurosurgery Exam
The FRCS (SN) is the exit examination in neurosurgery for UK and Ireland higher surgical trainees, delivered by the JCIE. It comprises Section 1 written papers (SBA and EMI delivered at Pearson VUE) and a Section 2 clinical and structured oral examination, both set at the standard of a day-one consultant.
Assessment
Section 1: two computer-based written papers (SBA and EMI) taken on the same day. Section 2: a two-day clinical examination (long case and short cases) plus structured oral stations.
Time Limit
Section 1 Paper 1 (SBA) approximately 2 hours and Paper 2 (EMI) approximately 2 hours 30 minutes; Section 2 spans two days of clinical and oral assessment.
Passing Score
Section 1 pass mark is set by criterion-referenced standard setting (no fixed percentage). Section 2 marking events are scored 4-8, with 6 as the pass standard, benchmarked to the day-one consultant level.
Exam Fee
From 1 January 2026 the total fee is GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420), as set by the JCIE. (Joint Committee on Intercollegiate Examinations (JCIE))
FRCS Neurosurgery Exam Content Outline
Neuro-oncology
Gliomas and WHO 2021 molecular markers, meningiomas, pituitary tumours, vestibular schwannomas, metastases and adjuvant therapy.
Vascular neurosurgery
Aneurysmal subarachnoid haemorrhage, AVMs and cavernomas, carotid disease, ischaemic stroke and intracerebral haemorrhage.
Spinal neurosurgery
Degenerative spine, cauda equina, cervical myelopathy, spinal trauma, cord compression and spinal infection.
Neurotrauma and neurocritical care
Head injury and GCS, intracranial and cerebral perfusion pressure, traumatic haematomas and decompressive surgery.
Functional neurosurgery
Trigeminal neuralgia, deep brain stimulation, epilepsy surgery, movement disorders and spasticity.
Paediatric neurosurgery
Hydrocephalus and shunts, neural tube defects, craniosynostosis, Chiari malformations and paediatric tumours.
Peripheral nerve
Entrapment neuropathies, traumatic and brachial plexus injuries, Seddon grading and nerve regeneration.
Applied neurosciences and anatomy
CSF physiology, cranial and vascular anatomy, neurophysiology, neuropharmacology and neuroradiology.
Neurosurgical practice and professionalism
Consent and capacity, surgical safety, perioperative care and the day-one consultant standard.
How to Pass the FRCS Neurosurgery Exam
What You Need to Know
- Passing score: Section 1 pass mark is set by criterion-referenced standard setting (no fixed percentage). Section 2 marking events are scored 4-8, with 6 as the pass standard, benchmarked to the day-one consultant level.
- Assessment: Section 1: two computer-based written papers (SBA and EMI) taken on the same day. Section 2: a two-day clinical examination (long case and short cases) plus structured oral stations.
- Time limit: Section 1 Paper 1 (SBA) approximately 2 hours and Paper 2 (EMI) approximately 2 hours 30 minutes; Section 2 spans two days of clinical and oral assessment.
- Exam fee: From 1 January 2026 the total fee is GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420), as set by the JCIE.
Keys to Passing
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
FRCS Neurosurgery Study Tips from Top Performers
Frequently Asked Questions
How is the FRCS Neurosurgery (FRCS SN) exam structured?
It has two parts. Section 1 is two computer-based written papers - a Single Best Answer paper and an Extended Matching Items paper - delivered at Pearson VUE. Section 2 is a two-day clinical examination with a long case, short cases and structured oral stations. Section 1 must be passed before attempting Section 2.
How much does the FRCS Neurosurgery exam cost in 2026?
From 1 January 2026 the total JCIE examination fee is GBP 2,000, split as GBP 580 for Section 1 and GBP 1,420 for Section 2. Fees are reviewed annually by the JCIE.
What standard is the FRCS Neurosurgery exam set at?
The examination is pitched at the level of a day-one consultant who is competent to practise safely and independently in the generality of neurosurgery. Section 1 uses criterion-referenced standard setting, and Section 2 marking events are scored 4-8 with 6 as the pass.
How many attempts are allowed at FRCS Neurosurgery?
Candidates have a maximum of four attempts at each section, with Section 1 to be completed within two years of the first attempt, and the whole examination completed within the JCIE-defined overall window.