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100+ Free MRCS Part A Practice Questions

Pass your MRCS Part A (Intercollegiate Membership of the Royal College of Surgeons Part A) exam on the first try — instant access, no signup required.

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A patient with a long-standing groin lump has a biopsy showing a tumour composed of mature adipocytes. This benign tumour of fat is best termed a:

A
B
C
D
to track

Sample MRCS Part A Practice Questions

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

1A patient sustains a mid-shaft fracture of the humerus. Which nerve is most at risk of injury, leading to wrist drop and loss of extension at the wrist and fingers?
A.Axillary nerve
B.Radial nerve
C.Median nerve
D.Ulnar nerve
Explanation: The radial nerve runs in the spiral (radial) groove on the posterior humerus, closely applied to bone in the mid-shaft. A mid-shaft humeral fracture classically injures it, producing wrist drop because it supplies the wrist and finger extensors via the posterior interosseous branch.
2During an open inguinal hernia repair, the surgeon must protect the structures within the spermatic cord. Which of the following is NOT a normal content of the spermatic cord in the male?
A.Vas deferens
B.Pampiniform venous plexus
C.Genital branch of the genitofemoral nerve
D.Ilioinguinal nerve
Explanation: The ilioinguinal nerve runs on the outer surface of the spermatic cord within the inguinal canal but lies outside the coverings of the cord, not within it. It is at risk during hernia repair but is not a true content of the cord.
3A surgeon ligates a vessel close to the lower border of the first rib. Which structure marks the point where the subclavian artery becomes the axillary artery?
A.Lateral border of the first rib
B.Medial border of the first rib
C.Lateral border of pectoralis minor
D.Lower border of teres major
Explanation: The axillary artery begins at the lateral border of the first rib as a continuation of the subclavian artery. It then ends at the lower border of teres major, where it becomes the brachial artery.
4A thyroidectomy is complicated by injury to the external branch of the superior laryngeal nerve. What is the expected clinical consequence?
A.Complete loss of voice with bilateral cord paralysis
B.Inability to abduct the vocal cords
C.Loss of sensation above the vocal cords only
D.Weakness of the cricothyroid muscle causing voice fatigue and loss of high-pitched phonation
Explanation: The external branch of the superior laryngeal nerve supplies the cricothyroid muscle, which tenses the vocal cords. Injury causes a weak, easily fatigued voice and loss of high-pitched phonation. It runs near the superior thyroid artery and is at risk during ligation of that vessel.
5Which vertebral level corresponds to the transpyloric plane of Addison, an important surgical landmark for the pylorus, neck of pancreas and fundus of the gallbladder?
A.T12
B.L1
C.L3
D.L4
Explanation: The transpyloric plane lies at the level of the L1 vertebra, halfway between the jugular notch and the pubic symphysis. It passes through the pylorus, the neck of the pancreas, the origin of the superior mesenteric artery, the duodenojejunal flexure, the hila of the kidneys and the fundus of the gallbladder.
6A patient develops a deep neck space infection. The retropharyngeal space communicates inferiorly with which structure, allowing spread of infection?
A.Anterior cranial fossa
B.Carotid sheath only
C.Superior mediastinum
D.Peritoneal cavity
Explanation: The retropharyngeal space lies between the buccopharyngeal fascia and the prevertebral fascia and extends from the skull base down into the superior mediastinum. Infection here can therefore descend into the mediastinum, causing life-threatening mediastinitis.
7During a difficult laparoscopic cholecystectomy, which structure forms the anterior boundary of the epiploic foramen (foramen of Winslow)?
A.Free edge of the lesser omentum containing the portal triad
B.Inferior vena cava
C.First part of the duodenum
D.Caudate lobe of the liver
Explanation: The epiploic foramen connects the greater and lesser sacs. Its anterior boundary is the free edge of the lesser omentum (hepatoduodenal ligament), which contains the portal triad: the hepatic artery, bile duct and portal vein. The Pringle manoeuvre compresses this edge to control haemorrhage.
8A patient requires emergency cricothyroidotomy. The incision is made through the cricothyroid membrane, which lies between which two cartilages?
A.Thyroid cartilage and cricoid cartilage
B.Cricoid cartilage and first tracheal ring
C.Hyoid bone and thyroid cartilage
D.Two arytenoid cartilages
Explanation: The cricothyroid membrane spans between the lower border of the thyroid cartilage above and the upper border of the cricoid cartilage below. It is relatively avascular and superficial, making it the access point for an emergency surgical airway.
9A surgeon performing an appendicectomy notes the base of the appendix. The base of the appendix is reliably located at the convergence of which structures?
A.The three taeniae coli of the caecum
B.The hepatic and splenic flexures
C.The ileocaecal valve and the ascending colon
D.The mesoappendix and the terminal ileum
Explanation: The three taeniae coli of the caecum converge at the base of the appendix. Following the taeniae down to their convergence reliably leads the surgeon to the appendiceal base, even when the tip is in a variable (retrocaecal, pelvic, etc.) position.
10Which of the following arteries provides the dominant blood supply to the femoral head in the adult, and is therefore most threatened by an intracapsular neck of femur fracture?
A.Artery of the ligamentum teres
B.Obturator artery
C.First perforating branch of profunda femoris
D.Medial femoral circumflex artery
Explanation: In adults the medial femoral circumflex artery supplies the majority of the femoral head via the retinacular vessels ascending along the neck. An intracapsular fracture disrupts these vessels, risking avascular necrosis, which is why displaced intracapsular fractures are often treated with arthroplasty.

About the MRCS Part A Exam

MRCS Part A is the written, computer-based knowledge stage of the intercollegiate Membership of the Royal College of Surgeons examination, common to all four UK and Ireland surgical Royal Colleges. It consists of two single best answer MCQ papers totalling 300 questions, sat on one day, and tests applied basic science and principles of surgery to the standard expected two to three years after qualification.

Assessment

Two single best answer MCQ papers taken on the same day: Paper 1 Applied Basic Sciences (180 questions) and Paper 2 Principles of Surgery in General (120 questions).

Time Limit

Five hours: three-hour Applied Basic Sciences paper (AM) and two-hour Principles of Surgery in General paper (PM)

Passing Score

Set by standard setting each diet; the overall pass mark is typically around 70-72%, with a minimum standard required in both papers in combination

Exam Fee

Approximately GBP 650 for UK and international centres (additional local tax may apply, e.g. 18% for candidates sitting in India) (Intercollegiate Surgical Examinations (RCS England / RCS Edinburgh / RCPS Glasgow / RCSI))

MRCS Part A Exam Content Outline

25%

Applied Surgical Anatomy

Regional anatomy of thorax, abdomen, pelvis, limbs, spine and head and neck, with embryology, histology, surface and imaging anatomy.

13%

Applied Surgical Physiology

Cardiovascular, respiratory, renal, gastrointestinal and endocrine physiology, fluid and acid-base balance, shock and the surgical stress response.

10%

Applied Surgical Pathology

Inflammation, wound healing, cell injury, neoplasia, haematology, transfusion and transplantation immunology.

8%

Microbiology and Pharmacology

Surgical microbiology, antimicrobials and resistance, blood-borne viruses, and pharmacology for safe surgical prescribing.

2%

Imaging

Principles and appropriate selection of diagnostic and interventional imaging in surgical patients.

42%

Principles of Surgery in General

Perioperative care, common surgical conditions, trauma and critical care, basic surgical skills, transplantation, paediatric and palliative surgery, and professionalism.

How to Pass the MRCS Part A Exam

What You Need to Know

  • Passing score: Set by standard setting each diet; the overall pass mark is typically around 70-72%, with a minimum standard required in both papers in combination
  • Assessment: Two single best answer MCQ papers taken on the same day: Paper 1 Applied Basic Sciences (180 questions) and Paper 2 Principles of Surgery in General (120 questions).
  • Time limit: Five hours: three-hour Applied Basic Sciences paper (AM) and two-hour Principles of Surgery in General paper (PM)
  • Exam fee: Approximately GBP 650 for UK and international centres (additional local tax may apply, e.g. 18% for candidates sitting in India)

Keys to Passing

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

MRCS Part A Study Tips from Top Performers

1Weight your revision toward anatomy and the principles of surgery, which together carry the most marks; regional and applied anatomy alone account for roughly a quarter of Paper 1.
2Practise large volumes of single best answer questions under timed conditions, since the exam rewards rapid application of core knowledge rather than deep specialty detail.
3Use UK-standard references such as the official intercollegiate syllabus, NICE guidance and the BNF, and review feedback on weaker content areas to target subsequent study.

Frequently Asked Questions

How many questions are on the MRCS Part A exam?

MRCS Part A has 300 single best answer multiple choice questions in total: 180 in the three-hour Applied Basic Sciences paper and 120 in the two-hour Principles of Surgery in General paper, both taken on the same day.

What is the pass mark for MRCS Part A?

There is no fixed pass mark; it is set by standard setting for each diet and is typically around 70-72%. Candidates must demonstrate the required standard in both papers in combination, with marks combined for a total Part A score. There is no negative marking.

How much does MRCS Part A cost and who provides the exam?

The fee is approximately GBP 650 for UK and international candidates, with local taxes added in some countries (for example, 18% for candidates sitting in India). The exam is delivered at Pearson VUE computer-based testing centres on behalf of the four surgical Royal Colleges.

How many attempts are allowed at MRCS Part A?

Candidates are permitted a maximum of six attempts to pass the intercollegiate MRCS Part A examination.