ABS to MRCS at the RCS: philosophy, format and future

After considering the ABS and CSiG parts of the FRCS examination and the standard for the new MRCS examination, it became important that the MRCS evolved away from the template of multiple true-false questions. Formats other than true-false questions can be used to test mental processes that are not simple factual recall. Formal mathematical tests can be evolved to equate different parts of the examination so that raw marks can be more clearly related to grades. Dispensing with the arbitrary requirement for five items in an MCQ question will enable better questions to be asked. Finally, an examination must be valid in context. With the above advances the examination will be effective, but its goal can be assessed only if the vision of the MRCS learning course is attained. The course aims to prepare surgeons for higher surgical training with a good general knowledge of surgery and an in-depth knowledge of the basic principles of surgery. The surgical trainee who has attained the MRCS should be able to manage a sick patient who suffers from the complications associated with surgery by using the principles of surgical anatomy, physiology and pathology. The trainee should know what to do initially during the 'golden hour' of opportunity, whom to call for help, and when.