100+ Free MRCS Part B OSCE Practice Questions

Pass your MRCS Part B OSCE (Intercollegiate MRCS Part B Objective Structured Clinical Examination) exam on the first try — instant access, no signup required.

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An anatomy station shows the course of the spinal cord. In an adult, at which vertebral level does the spinal cord typically terminate as the conus medullaris?

L1/L2

T12

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Sample MRCS Part B OSCE Practice Questions

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

1During a thyroidectomy you are dissecting near the inferior pole of the thyroid lobe. Which nerve is most at risk of injury here, producing a hoarse voice and an ineffective cough if damaged?

A.Recurrent laryngeal nerve

B.External branch of the superior laryngeal nerve

C.Glossopharyngeal nerve

D.Hypoglossal nerve

Explanation: The recurrent laryngeal nerve runs in or near the tracheo-oesophageal groove and is closely related to the inferior thyroid artery at the lower pole. Injury paralyses the ipsilateral vocal cord (all intrinsic laryngeal muscles except cricothyroid), causing hoarseness and a poor cough.

2An anatomy station shows the contents of the femoral triangle. From lateral to medial, what is the correct order of structures within the femoral sheath and adjacent to it?

A.Femoral vein, femoral artery, femoral nerve

B.Femoral nerve, femoral artery, femoral vein

C.Femoral artery, femoral vein, femoral nerve

D.Femoral nerve, femoral vein, femoral artery

Explanation: The mnemonic NAVY (lateral to medial: Nerve, Artery, Vein, Y-fronts/lymphatics) describes the femoral triangle. The femoral nerve lies outside the femoral sheath, while the artery and vein lie within it, with the femoral canal most medial.

3A patient sustains a mid-shaft humeral fracture. Which neurovascular structure is most likely injured, and what clinical sign would confirm it?

A.Axillary nerve - loss of sensation over the regimental badge area

B.Ulnar nerve - claw hand

C.Radial nerve - wrist drop

D.Median nerve - loss of thumb opposition

Explanation: The radial nerve runs in the spiral (radial) groove of the humerus and is at risk in mid-shaft fractures. Injury produces wrist drop (loss of wrist and finger extension) and loss of sensation over the dorsal first web space.

4In an anatomy station you are shown the boundaries of the inguinal canal. Which structure forms the floor of the inguinal canal?

A.External oblique aponeurosis

B.Conjoint tendon

C.Transversalis fascia

D.Inguinal ligament (and lacunar ligament medially)

Explanation: The floor of the inguinal canal is formed by the inguinal ligament, with the lacunar ligament contributing medially. The roof is formed by the arching fibres of internal oblique and transversus abdominis.

5A surgeon performing an open cholecystectomy must identify the boundaries of the hepatobiliary triangle (Calot's triangle) before clipping. Which structure runs within this triangle and is most commonly ligated here?

A.Cystic artery

B.Common bile duct

C.Right hepatic vein

D.Portal vein

Explanation: Calot's triangle is bounded by the cystic duct, the common hepatic duct, and the inferior surface of the liver. The cystic artery runs within it and is the key structure identified and ligated during cholecystectomy.

6An anatomy station presents a CT showing a structure passing through the foramen spinosum of the skull base. Which structure is this?

A.Maxillary nerve (V2)

B.Middle meningeal artery

C.Internal carotid artery

D.Mandibular nerve (V3)

Explanation: The middle meningeal artery (a branch of the maxillary artery) passes through the foramen spinosum to supply the dura. This is clinically relevant in extradural haematoma following pterion fracture.

7During an appendicectomy, the surgeon locates the base of the appendix. At which surface landmark does the base of the appendix most reliably lie?

A.Two-thirds of the way along a line from the umbilicus to the right anterior superior iliac spine

B.At McBurney's point, one-third of the way from the right anterior superior iliac spine to the umbilicus

C.At the convergence of the three taeniae coli on the caecum

D.At the midpoint of the inguinal ligament

Explanation: The position of the appendix tip is variable (retrocaecal, pelvic, etc.), but the BASE is constant where the three taeniae coli of the caecum converge. Following the taeniae down to the caecal pole reliably locates the appendiceal base intra-operatively.

8An anatomy specimen demonstrates the brachial plexus. The 'Erb's point' lesion (upper trunk, C5-C6) classically produces which posture?

A.Claw hand with loss of intrinsic hand muscles

B.Total flail arm with Horner's syndrome

C.Wrist drop with preserved hand sensation

D.Waiter's tip - arm adducted, internally rotated, forearm pronated

Explanation: An upper trunk (C5-C6) injury at Erb's point affects the suprascapular, axillary, and musculocutaneous nerves. The resulting 'waiter's tip' posture has the arm adducted and medially rotated, with the forearm pronated and the wrist flexed.

9A patient has a stab wound to the 'safe triangle' for chest drain insertion. What are the correct boundaries of this triangle of safety?

A.Anterior border of latissimus dorsi, lateral border of pectoralis major, line above the 5th intercostal space, apex below axilla

B.Sternal angle, mid-clavicular line, 2nd rib

C.Costal margin, xiphisternum, 12th rib

D.Anterior axillary line, posterior axillary line, 8th intercostal space

Explanation: The triangle of safety is bordered anteriorly by the lateral edge of pectoralis major, posteriorly by the anterior border of latissimus dorsi, inferiorly by a horizontal line at the level of the nipple (5th intercostal space), with the apex below the axilla. This avoids vital structures.

10When inserting a chest drain or performing intercostal nerve block, in which part of the intercostal space should the needle pass to avoid the neurovascular bundle?

A.Immediately below the rib above

B.Immediately above the rib below

C.In the middle of the intercostal space

D.Anywhere, as the bundle is in the centre

Explanation: The intercostal neurovascular bundle (vein, artery, nerve from superior to inferior - VAN) runs in the costal groove on the inferior border of each rib. To avoid it, the needle should pass just ABOVE the rib below, over the upper border of the lower rib.

About the MRCS Part B OSCE Exam

MRCS Part B is the Objective Structured Clinical Examination of the intercollegiate Membership of the Royal College of Surgeons, run jointly by the four UK and Ireland surgical Royal Colleges. It consists of 17 examined stations testing applied knowledge (anatomy, surgical pathology, applied surgical science, critical care) and applied skills (communication, history taking, clinical and procedural skills). Candidates must pass both the Knowledge and Skills components to pass.

Assessment

An OSCE of 17 examined stations (each 9 minutes), grouped into Applied Knowledge (8 stations) and Applied Skills (9 stations), with additional preparation and rest stations.

Time Limit

Approximately 9 minutes per examined station with 1 minute reading time, run as a half-day circuit.

Passing Score

No overall pass mark. Candidates must pass BOTH the Knowledge (mark out of 160) and Skills (mark out of 180) broad content areas at the same sitting; pass marks are set by borderline regression methodology.

Exam Fee

GBP 1,177 (2026 fee; consistent across RCS England, RCSEd, RCPSG, and RCSI). (Intercollegiate Surgical Examinations (RCS England / RCS Edinburgh / RCPS Glasgow / RCSI))

MRCS Part B OSCE Exam Content Outline

30%

Anatomy and surgical pathology

Surgical anatomy and pathology applied to clinical surgery, including head and neck, limbs, thorax, abdomen, and tumour pathology and staging.

18%

Applied surgical science and critical care

Physiology, the metabolic response to surgery, fluid and electrolyte management, acid-base, trauma, sepsis, and critical care, including data interpretation.

29%

Clinical and procedural skills

Clinical examination, procedural skills, aseptic technique, suturing and knot-tying, and generic practical surgical competencies.

23%

Communication skills

History taking, consent, breaking bad news, handover, candour, confidentiality, and professionalism mapped to GMC Good Medical Practice.

How to Pass the MRCS Part B OSCE Exam

What You Need to Know

Passing score: No overall pass mark. Candidates must pass BOTH the Knowledge (mark out of 160) and Skills (mark out of 180) broad content areas at the same sitting; pass marks are set by borderline regression methodology.
Assessment: An OSCE of 17 examined stations (each 9 minutes), grouped into Applied Knowledge (8 stations) and Applied Skills (9 stations), with additional preparation and rest stations.
Time limit: Approximately 9 minutes per examined station with 1 minute reading time, run as a half-day circuit.
Exam fee: GBP 1,177 (2026 fee; consistent across RCS England, RCSEd, RCPSG, and RCSI).

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 B OSCE Study Tips from Top Performers

1Practise applying basic science to clinical scenarios out loud, as the OSCE rewards reasoning and communication, not pure recall - rehearse anatomy and pathology with a study partner acting as examiner.

2Drill structured frameworks (SPIKES for breaking bad news, SBAR for handover, SOCRATES for pain, valid consent and Montgomery for risk disclosure) so your communication stations are slick and time-efficient.

3Build a station routine for procedural and examination skills (aseptic technique, catheterisation, suturing, abdominal and vascular examination) and verbalise each step, since you must pass both the Knowledge and Skills components separately.

Frequently Asked Questions

How many stations are there in the MRCS Part B OSCE?

The OSCE normally consists of 17 examined stations, each lasting 9 minutes, plus preparation and rest stations. The 17 stations are divided into 8 Applied Knowledge stations and 9 Applied Skills stations.

What is the pass mark for MRCS Part B?

There is no single overall pass mark. Candidates must pass both the Knowledge broad content area (out of 160 marks) and the Skills broad content area (out of 180 marks) at the same sitting. Station pass marks are determined using borderline regression methodology.

How much does the MRCS Part B OSCE cost in 2026?

The 2026 exam fee is GBP 1,177, and it is the same across the four surgical Royal Colleges (RCS England, RCS Edinburgh, RCPS Glasgow, and RCSI). Candidates must have passed MRCS Part A before applying for Part B.

What does the MRCS Part B OSCE test?

It tests applied knowledge (anatomy, surgical pathology, applied surgical science, and critical care) and applied skills (communication including history taking and giving information, plus clinical and procedural skills), mapped to the GMC's Good Medical Practice domains.