Sri G. Thrumurthy, Tania S. De Silva, Zia M. Moinuddin, Stuart Enoch pp.424 Oxford University Press 2013 ISBN: 978-0199645626
SBA for the MRCS Part A and EMQs for the MRCS Part A, a pair of books from Oxford University Press, aim to provide busy prospective surgeons with the opportunity to develop their ability to recall, apply and reinforce their scientific and clinical knowledge in a manner that closely resembles what they will face on exam day. In an increasingly populated and arguably web-dominated market, where does this offering fit in?
The MRCS examination is a two part process. Part A involves two multiple choice question papers followed by Part B which takes the form of an 18 station OSCE. Part A is broken in to: paper one covering Applied Basic Science; and one paper covering Principles of Surgery in General. Paper one comprises 135 Single Best Answer (SBA) questions and paper two comprises a mixture of SBAs and Extended Matching Questions (EMQs).
I concur with the statement in the introduction to these books: a thorough understanding of the essential principles of surgery needs to be obtained from core textbooks and clinical experience; but developing the ability to rapidly recall and apply this knowledge, as well as developing an exam strategy that works for the individual is vital to success in MRCS Part A. This is best achieved by sitting practice questions.
The books are divided into chapters that are essentially individual short practice exams, representative of the MRCS curriculum. The presentation is clear and succinct, with the area of the curriculum being covered displayed with each question. Each chapter is followed by a section with the answers and thorough explanations. At the end of each book is an index of topics linking to both questions and explanations.
The difficulty of the questions is appropriate and varied and the time it takes to go through the questions closely matches that of the real exam, with a mixture of some short and some longer stems, some harder questions and some easy. I would gauge the overall difficulty as a little harder than the actual MRCS papers. Across the books there was appropriate repetition that reinforced essential topics. The quality of the explanations in the answers sections was generally high, particularly in the EMQ book, which I found to be better than other revision tools I used in this area. The index, allowing one to go directly to questions on a particular topic, is a nice touch.
I thought there was an excessive number of negative “which of the following is not true” questions, and even some double-negative questions. This does force one to think through one’s understanding of the topic in question, however (fortunately) they are not present to the same degree in the exam. I found the explanations, as good as they were, to be quite word-heavy. Certain principles, particularly anatomical ones, would benefit from diagrams. There are some diagrams, but I would have appreciated more.
I would also have liked a short section addressing exam tips and techniques.
Many candidates now use online question banks to prepare for the exam, and, indeed, the number of questions available with the various offerings is impressive, they cover the curriculum well and work well for ‘casual’ revision. However the quality of the questions is variable, the explanations sometimes lacking, and sitting at a computer is distracting.
The layout of these books into individual ‘mini-practice exams’, each covering the main areas of the curriculum, is an excellent approach, and allows for focused, realistic, exam-circumstance preparation. The MRCS Part A is still a pencil-and-paper exam, and the benefit of sitting down and preparing in the same manner cannot be overstated. This, coupled with the high quality of the questions, and the explanations given, ensures that these books will be of great benefit to any MRCS candidate’s preparation.