100+ Free FRCS (OMFS) Section 1 SBA Practice Questions

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Sample FRCS (OMFS) Section 1 SBA Practice Questions

Try these sample questions to test your FRCS (OMFS) Section 1 SBA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient with bilateral midfacial mobility and a floating maxillary alveolus after blunt trauma most likely has which Le Fort pattern?

A.Le Fort I

B.Le Fort II

C.Le Fort III

D.Isolated zygomaticomaxillary complex fracture

Explanation: Le Fort I is a horizontal maxillary fracture separating the dentoalveolar segment (hard palate) from the midface, producing a mobile floating maxilla. Le Fort II is pyramidal through the infraorbital rim and nasal bridge; Le Fort III is craniofacial dissociation across the zygomatic arches and nasofrontal region.

2According to Champy's principles for mandibular angle fracture fixation with a single miniplate, where should the plate ideally be placed?

A.Along the inferior border of the mandible

B.Along the superior border / external oblique ridge (tension band)

C.Across the lingual cortex only

D.Through the mandibular canal to engage both cortices

Explanation: Champy's ideal lines of osteosynthesis place a tension-band miniplate along the superior border/external oblique ridge for many angle fractures, counteracting tensile forces during function. Inferior-border plating alone does not address the tension side in the same way for load-sharing miniplate osteosynthesis.

3Which clinical finding most strongly suggests an orbital floor blow-out fracture requiring urgent review for muscle entrapment in a child?

A.Periorbital ecchymosis alone

B.Isolated epistaxis

C.Vertical diplopia with restricted upgaze and nausea/bradycardia (oculocardiac reflex)

D.Numbness of the upper lip without diplopia

Explanation: Paediatric trapdoor orbital floor fractures can incarcerate inferior rectus/soft tissue, causing restricted upgaze, diplopia, and vagal oculocardiac reflex (nausea, bradycardia). This is a surgical urgency to prevent ischaemic muscle injury, unlike isolated ecchymosis or infraorbital paraesthesia alone.

4The Gillies temporal approach for zygomatic elevation accesses the zygoma by dissecting in which plane?

A.Between skin and temporoparietal fascia

B.Through the maxillary sinus (Caldwell-Luc)

C.Via a coronal scalp flap only

D.Deep to the deep temporal fascia and superficial to the temporalis muscle

Explanation: In the Gillies approach, a temporal hairline incision is deepened to the deep temporal fascia, which is incised to expose temporalis. An elevator is passed deep to the deep temporal fascia and superficial to temporalis, sliding on the muscle toward the zygomatic arch for elevation. Dissection superficial to the temporoparietal fascia endangers the frontal branch of the facial nerve.

5Which imaging modality is the first-line investigation for complex midfacial fractures when clinically stable?

A.Non-contrast CT of the facial bones with multiplanar reformats

B.Plain Waters view only

C.MRI of the face as first investigation

D.Ultrasound of the orbits alone

Explanation: Fine-cut CT with axial, coronal and sagittal reformats (and 3D when helpful) is the standard for mapping midface fracture patterns, orbital walls and surgical planning. Plain films miss many midface details; MRI is secondary for soft tissue when needed; ultrasound cannot delineate complex bony midface injury.

6In ATLS-based management of severe maxillofacial trauma, which priority comes first?

A.Definitive occlusal reduction

B.Airway assessment and protection with C-spine precautions

C.Immediate open reduction of all facial fractures

D.Routine tracheostomy before any assessment

Explanation: Life-threatening priorities follow ABC: secure the airway (blood, swelling, debris, unstable midface) while protecting the cervical spine before definitive fracture fixation. Occlusal reduction and ORIF follow once the patient is stabilised.

7A displaced fracture of the mandibular condylar neck with malocclusion in an adult is most appropriately managed initially by which principle?

A.Always leave untreated if mouth opening exceeds 20 mm

B.Mandatory immediate total joint replacement

C.Restore occlusion and function; closed treatment or ORIF according to displacement, height loss and function

D.Extraction of all molar teeth on the fractured side

Explanation: Adult condylar fractures are managed to restore occlusion, vertical height and TMJ function. Closed treatment with elastic guidance suits many minimally displaced fractures; ORIF is considered for significant displacement, loss of ramus height, or inability to restore occlusion closed. TJP and routine extractions are not first-line.

8Which feature best distinguishes a naso-orbito-ethmoid (NOE) fracture from an isolated nasal bone fracture?

A.Epistaxis alone

B.Isolated septal haematoma

C.Unilateral epistaxis without orbital findings

D.Telecanthus with medial canthal tendon disruption and flattened nasal bridge

Explanation: NOE fractures disrupt the medial canthal complex, producing telecanthus, loss of nasal projection and orbital wall involvement. Isolated nasal bone fractures lack medial canthal disruption and true telecanthus.

9For a displaced parasymphyseal mandibular fracture with a second contralateral angle fracture (bucket-handle pattern), which concern is most critical during fixation planning?

A.Maintaining chin projection, occlusion and recognising bilateral instability with risk of airway compromise from posterior tongue fall

B.Ignoring the second fracture once one side is plated

C.Placing only intermaxillary fixation without considering ORIF

D.Assuming the inferior alveolar nerve is never at risk

Explanation: Bilateral anterior mandibular fractures can allow the anterior segment to displace posteriorly, dropping the tongue base and threatening the airway. Stable fixation must restore occlusion and projection while recognising bilateral instability; the IAN can also be injured at fracture lines.

10Which statement about frontal sinus fractures is most accurate for OMFS decision-making?

A.All frontal sinus fractures require cranialisation

B.Management depends on anterior/posterior table involvement, displacement, nasofrontal outflow tract patency and CSF leak risk

C.Observation is never appropriate

D.Antibiotics alone always suffice

Explanation: Frontal sinus fracture care is stratified: isolated minimally displaced anterior table may be observed or cosmetically reduced; posterior table displacement, CSF leak, and nasofrontal duct obstruction drive obliteration/cranialisation or sinus-preserving strategies. Blanket cranialisation or antibiotics alone is incorrect.

About the FRCS (OMFS) Section 1 SBA Exam

The FRCS (OMFS) is the UK/Ireland Intercollegiate Specialty Fellowship Examination in Oral & Maxillofacial Surgery. Section 1 is a computer-based written assessment of two 120-question SBA papers covering the SAC/ISCP OMFS curriculum. Section 2 is a clinical and oral examination at the standard of a day-one consultant in the generality of the specialty.

Assessment

Section 1 is two computer-based Single Best Answer papers of 120 questions each (240 SBA total), sat on the same day at Pearson VUE. Candidates who meet the eligibility-to-proceed standard may sit Section 2 (clinical cases and structured orals covering craniofacial, dentoalveolar/implants, TMJ, surgical dermatology, head and neck oncology/reconstruction, salivary disease, oral medicine/pathology, cleft, orthognathic, infections, orofacial pain, trauma and aesthetic surgery).

Time Limit

Section 1: two papers of 2 hours 15 minutes each (4 hours 30 minutes total).

Passing Score

No fixed percentage. Trained examiners standard-set each diet to produce an eligibility-to-proceed mark for Section 2. No negative marking.

Exam Fee

Combined fee GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420) for examinations up to 31 December 2026; GBP 2,070 from 1 January 2027 (JCIE). (Joint Committee on Intercollegiate Examinations (JCIE))

FRCS (OMFS) Section 1 SBA Exam Content Outline

15%

Maxillofacial Trauma

Mandibular, midface, zygomatic, orbital, NOE, frontal and dentoalveolar fractures; airway and imaging priorities.

12%

Head and Neck Oncology

Oral cavity SCC staging, neck dissection, MDT pathways, adjuvant therapy and osteoradionecrosis.

10%

Head and Neck Reconstruction

Pedicled and free flaps, bone grafts, mandibular reconstruction and flap monitoring.

Orthognathic Surgery

BSSO, Le Fort I, genioplasty, occlusion planning, distraction and complications.

Salivary Gland Surgery and Pathology

Parotid, submandibular and sublingual disease, stones, tumours and Frey's syndrome.

Dentoalveolar Surgery and Implantology

Third molars, preprosthetic surgery, sinus lift, implants and dentoalveolar trauma.

TMJ Disorders

Internal derangement, Wilkes staging, ankylosis, dislocation and joint surgery.

Oral Medicine and Pathology

Mucosal disease, PMD, odontogenic cysts/tumours, MRONJ and biopsy principles.

Orofacial Infections and Emergency Surgery

Fascial space infections, Ludwig angina, deep neck sepsis and airway rescue.

Cleft Lip and Palate

Embryology, primary repair timing, VPI, alveolar bone graft and cleft orthognathic care.

Craniofacial Surgery

Craniosynostosis syndromes, skull-base access and craniofacial trauma principles.

Surgical Dermatology

Head and neck skin cancer margins, local flaps and melanoma principles for OMFS.

Orofacial Pain

Trigeminal neuralgia, atypical facial pain, TMD pain and neuropathic management.

Aesthetic Surgery

Rhinoplasty, blepharoplasty, facelift principles and aesthetic patient selection.

How to Pass the FRCS (OMFS) Section 1 SBA Exam

What You Need to Know

Passing score: No fixed percentage. Trained examiners standard-set each diet to produce an eligibility-to-proceed mark for Section 2. No negative marking.
Assessment: Section 1 is two computer-based Single Best Answer papers of 120 questions each (240 SBA total), sat on the same day at Pearson VUE. Candidates who meet the eligibility-to-proceed standard may sit Section 2 (clinical cases and structured orals covering craniofacial, dentoalveolar/implants, TMJ, surgical dermatology, head and neck oncology/reconstruction, salivary disease, oral medicine/pathology, cleft, orthognathic, infections, orofacial pain, trauma and aesthetic surgery).
Time limit: Section 1: two papers of 2 hours 15 minutes each (4 hours 30 minutes total).
Exam fee: Combined fee GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420) for examinations up to 31 December 2026; GBP 2,070 from 1 January 2027 (JCIE).

Keys to Passing

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

FRCS (OMFS) Section 1 SBA Study Tips from Top Performers

1Map revision to the JCIE OMFS Syllabus Blueprint 2023 and the Section 2 oral topic list so written SBA practice mirrors the full specialty scope, not only trauma and oncology.

2Practise timed SBA blocks (approximately 1 minute per question) under Pearson VUE conditions, answering every item because there is no negative marking.

3Drill high-yield applied decisions: Champy fixation lines, Le Fort patterns, fascial space airway risk, AJCC oral cancer T categories with depth of invasion, free-flap pedicles, and UK cleft pathway timing.

Frequently Asked Questions

How is FRCS (OMFS) Section 1 structured?

Section 1 is two computer-based Single Best Answer papers of 120 questions each (240 total), each lasting 2 hours 15 minutes, sat the same day at Pearson VUE test centres in the UK and Ireland. Meeting the eligibility-to-proceed standard allows progression to Section 2 clinical and oral examinations.

How much does the FRCS (OMFS) exam cost in 2026?

For examinations up to 31 December 2026 the combined fee is GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420). From 1 January 2027 the combined fee rises to GBP 2,070 (JCIE FAQs).

What is the pass mark for FRCS (OMFS) Section 1?

There is no fixed percentage pass mark. Trained examiners standard-set each diet to produce a sitting-specific eligibility-to-proceed mark. There is no negative marking.

What topics does FRCS (OMFS) Section 1 cover?

Section 1 covers curriculum content that can be assessed in writing. The JCIE OMFS Guide to Scope lists the examination domains used in Section 2 orals (trauma, oncology, reconstruction, salivary disease, orthognathic, cleft, TMJ, dentoalveolar/implants, oral medicine/pathology, infections, orofacial pain, craniofacial, surgical dermatology and aesthetic surgery), which also guide Section 1 preparation alongside the SAC/ISCP curriculum and Syllabus Blueprint 2023.