SET GENERIC SURGICAL SCIENCE EXAMINATION

AND SET CLINICAL EXAMINATION

CURRICULUM CONTEXT
SET 1 Surgical Science Curriculum
Knowledge of Anatomy, Pathology and Physiology is fundamental to safe and comprehensive
surgical practice. SET Trainees consolidate knowledge, understanding and application of
these basic sciences at the outset of their surgical training.

During SET1 Trainees gain an understanding of the basic sciences as they apply to the
principles of surgery and acquire skills in basic surgery, clinical assessment and the use of
diagnostic modalities.

Learning
SET 1 trainees gain knowledge and skills during clinical placements, by attending courses, by
utilising online resources and through text-based study. SET Trainees are also required to
participate in hospital resident training programs. The College provides a Recommended
Reading List, Case Studies other online learning resources and examples of practice Multiple
Choice Questions on the College website to assist trainees to learn the basic surgical
sciences.

Online Resources have been developed by the College to provide a context for trainees to
learn and apply the basic surgical sciences. Case studies, examples of practice multiple
choice questions and discussion forums are presented on the College website,
complementing trainees' in-depth reading and study of basic sciences. Trainees are
encouraged to use the College online resources as a flexible, self-directed learning resource
to be accessed in any order at convenient times.

The Case Studies also provide opportunities for trainees to practise applying different kinds of
knowledge to clinical situations – to use basic sciences, patient history and the results of
physical examination and investigation to build judgement, make diagnoses, make clinical
decisions and recommend treatment. Clinical scenarios are presented in a format that
encourages trainees to apply their knowledge as they progress sequentially through a number
of stages of unfolding information. Trainees are challenged at each stage with questions and
discussion points.

Trainees can practise answering multiple choice questions online. Practice questions include
answers and explanations, allowing trainees to self-correct their responses.

Surgical Science Assessment

SET trainees’ knowledge and skills are formally assessed by examination: the Generic SET
Surgical Science Examination (SSE), the Specialty-specific SET Surgical Science
Examinations and the Clinical Examination (which has elements of applied surgical science
as well as clinical skills). Other assessments are conducted in the workplace.

The SET Surgical Science Examinations relate to the College Competency of Medical
Expertise; these examinations test candidates’ knowledge, understanding and application of
Anatomy, Pathology and Physiology, in health and disease as they apply to generic and
specialty specific situations.

Every trainee must complete the Generic Surgical Science Examination, the Clinical
Examination. Specialty-specific Surgical Science Examinations must be completed in
accordance with each specialty’s requirements. The Specialty-specific Surgical Science
curricula are outlined by the nine surgical specialties and further information about these
examinations is available from specialty websites.
 The generic component of the SSE presents an equal number of questions in Anatomy,
Physiology and Pathology.
In the speciality specific SSE there is a variable balance between the three disciplines

Specialty-specific Surgical Science Examination

In 2008, General Surgery and Urology have a common ‘specialty-specific’ examination.
Trainees in these specialties will all undertake the same Surgical Science Examination.
Cardiothoracic Surgery, Neurosurgery, Otolaryngology Head and Neck Surgery, and
Vascular Surgery have separate specialty-specific Surgical Science Examinations.
Orthopaedic Surgery, Paediatric Surgery and Plastic & Reconstructive Surgery will
continue with their current examination processes.

Please refer to specialty websites for specialty training regulations.

SET Surgical Science Examination and Clinical Examination requirements

Generic Surgical Science 1 examination 2 days x 2 ½ hours written examination,

Examination MCQ format, 240 questions
Specialty-specific Surgical Science 1 examination 1 day x 2 ½ hours written examination,
Examination* MCQ format, 120 questions
Clinical Examination 1 examination 2 to 3 hour practical examination,
OSCE format
* See the notes above the table on the specialty specific Surgical Science Examination.

Pass requirements and timing of the SET Surgical Science Examinations

Once selected into a specialty training program a candidate may sit the Generic Surgical
Science Examination.
The generic and specialty specific components of the examination will be considered
separately
Candidates may carry forward a pass in one component of the SSE (generic or specialty
specific).
Each specialty has established time limits for the successful completion of the different
components of the examination (refer to individual specialty training regulations).

CURRICULUM TOPICS

The following tables describe Anatomy, Pathology and Physiology topics included in the Generic
Surgical Science Examination.

Trainees are advised to refer to specialty websites for Specialty-specific Surgical Science Examination
content.
CURRICULUM TOPICS

ANATOMY
TOPIC Text Content Exclude
Abdomen Last Gross anatomy of Anomalies of intra-abdominal anatomy
o Abdominal wall
o Retroperitoneum
o Abdominal organs
o Vessels
o Nerves
o Male and female external genitalia
Histology of intra-abdominal organs (visual)
Embryologic origin of abdominal organs
CNS Last Cerebral blood supply
o Venous sinuses
o Circle of Willis and major branches
Gross anatomy of brain including
o Ventricles
o named nuclei
o major traits
Gross anatomy of spinal cord including consequences of
injury
Major neural plexuses
o cervical
o brachial
o lumbar
Cranial nerves
Head and Last Gross anatomy of the skull and cervical vertebrae Anatomy of orbit, internal ear, nasal cavities, oral cavity, facial
neck Gross anatomy of the major structures of the neck and muscles
thoracic inlet
Histology Wheater General cellular histology, structure and function Bone and cartilage
Epithelia
ANATOMY (continued)
Text Content Exclude
Lower Last General features of Embryology
limb o Bones Foot
o Muscles
o Nerves
o Vessels of lower limbs and their actions
o Joint anatomy
Pelvis Last Gross anatomy of Detailed musculoskeletal anatomy of pelvis
o Abdominal wall Skeletal embryology
o Retroperitoneum Detailed anatomy of male and female
o Abdominal organs reproductive organs
o Vessels Joints
o Nerves
Functional anatomy and musculature of
o Organs
o Vessels
o Nerves
Bony anatomy of
o thoraco-lumbar spine
o pelvis – overview
Thorax Last Surface anatomy
Gross anatomy of the chest wall and major intrathoracic structures including
diaphragm and pleura
Nerve supply to chest wall and thoracic organs
Vascular anatomy, lymphatic drainage
Embryology
o Thoracic wall
o Diaphragm
Upper Last General features of Embryology
limb o Bones Joint anatomy
o Muscles
o Nerves
o Vessels of upper limbs and their actions
PATHOLOGY
TOPIC Text Content Exclude
Antibiotics Rang Cell wall active agents
Specific antibiotic activity profiles
Yung -
Infectious
Diseases, a
clinical
approach
Genetics and Robbins Mendelian Genetics Cloning
molecular Cyto genetics Rarer genetic-based diseases
biology Molecular biology Specialty specific content
Cell division
Immunology Immune response
Transplantation and immunogenetics
Antibodies structure and function
Hypersensitivity
HLA typing
Robbins Auto immune conditions
Major histo-compatibility complexity
Immunity to infection
Infection General bacteriology, virulence specific localised infections
Robbins Entecic infections, toxic shock
Infection (e.g. IVDUs, post splenectomy, post operative, tetanus)
Yung - Disinfection, sterilisation
Infectious Fungi, viruses, parasites
Diseases, a antibiotic resistance
clinical
approach
Neoplasia Robbins Neoplastic growth and spread
Carcinogenesis
Pathology of individual neoplasms
Common tumours
Hamartoma
PATHOLOGY (continued)
Text Content Exclude
General Robbins Cellular pathology
Pathological Antibodies – structure and function
Phenomena Radiation damage
Apoptosis, cell injury
Haemostasis, haemorrhage, thrombosis, oedema
Ischaemia
Infarction
Atheroma
Necrosis, degeneration
Apoptosis
Disorders of metabolism
Amyloid
Fibrinoid
Hyaline
Pathology Robbins Lymploma and myeloma
blood Chronic anaemia
Australian Red Disorders of platelets and haemostasis
Cross – Blood Intra vascular haemolysis
Transfusion and Transfusion
Component
Therapy
PATHOLOGY (continued)
Text Content Exclude
Pharmacology Rang Drug side effects and interactions
Pharmacokinetics and volume distribution
Opie – Liver disease and drug metabolism
Drugs and Prolonged suxamethonium side effects, including neuromuscular blockade
the Heart Local anaesthetics
Salicylate side effects
Specific Narcotics
designated
Mechanisms of thrombolytic and cardiovascular drugs (including digoxin and anti-
journal
arrhythmics),
references
o actions, side effects
Lipid lowering agents
Fluid therapy
Induction agents / reversal of anaesthesia
Insulin management / oral hypoglycaemics
Aspirin
Sedation
Anticoagulation
Vasopressor / vasodilators
Antibiotic - dosing, toxicity
Anticonvulsants
Analgesia
Statistics Listed text All relevant
Tissue Robbins Acute inflammation
response to Granulomatous inflammation
injury Chronic inflammation
Bacterial infection
Viral infection
Wound healing
Radiation and cytotoxic drugs
Temperature regulation
Growth factors and cytokines
Trauma and shock
Organ failure
Visual Robbins TB
Basic histological features including:
o Neoplasia
o Inflammation
o Recognition of pathogens and inflammatory cells on gram stain
PHYSIOLOGY
Text Content Exclude
Cardiovascular Ganong Cardiovascular physiology in health and disease with respect to:
o Cardiac function
o Control of peripheral blood flow
o Control of cerebral blood flow
o Gas exchange
o Lymphatic function
Principles of haemodynamics
Shock syndromes
Central and peripheral control of cardiovascular function
Foetal circulation and changes at birth
Pharmacologic control of cardiac rate and blood pressure
Endocrine Ganong Adrenal
Male/female hormones/pregnancy
Guyton Pancreas
GI hormones
Pituitary
Pineal
Thyroid
Renin/Angiotensin
Gastro Ganong GI hormones /enzymes Taste
Vagal activity and GI function
Gut motility
Absorptive function
Digestion
Water absorption
Metabolism and Ganong Nutritional requirements of humans in health and disease
Nutrition Nutritional management of surgical patients
Fluid and electrolyte balance
Acid base balance
Central and local control of digestion, absorption and metabolism
Metabolic consequences of nutritional imbalance
PHYSIOLOGY (continued)
Text Content Exclude
Neurophysiology Ganong Pain Vision
Neurotransmission Hearing
Guyton Neuromuscular transmission and muscle function Taste
Neuronal function Sleep
Homeostasis
CNS functions
o Brain stem, cerebellum, hypothalamus
Spinal cord traits
CSI dynamics
Sympathetic and parasympathetic functions
Respiratory Ganong Respiratory physiology in health and disease with respect to:
o Gas exchange
West o Acid base balance
o Cardiovascular responses
Cardiorespiratory developmental physiology
Effects of surgery on respiratory function
Central control of respiratory function
Urinary tract Ganong Detailed physiology of the kidneys and urinary system
Guyton Fluid and electrolyte balance
 GENERIC SURGICAL SCIENCE EXAMINATION
AND SET CLINICAL EXAMINATION
RECOMMENDED READING LISTS – Generic Examinable from October 2008

Candidates with questions regarding the Recommended Reading Lists are advised to contact the Division
of Education Development and Assessment. Examinable material is contained in the publications listed
below.

Prescribed Textbooks for the Basic Science Exam

Anatomy
Last's Anatomy, Regional and Applied, 9th Edition, 1998 (reprinted 2003) - McMinn R.M.H., Churchill
Livingstone
Wheater's Functional Histolog,y 5th Edition, 2006 - Young, B., Lowe, J. S., Stevens, A., and Heath, J.W.,
Churchill Livingstone
Langman’s Medical Embryology, 10th Edition, 2006 - Sadler T.W., Lippincott Williams and Wilkins

Pathology
Really Essential Medical Immunology, 2nd Edition, 2005 – Roitt, I., Rabson, A., Delves, P. Part 1-4.
Immunopathology, including Transplantation Immunology, is referenced from Robbins and Cotran
Pathologic Basis of Disease, 7th Edition,
Robbins and Cotran Pathologic Basis of Disease, 7th Edition, 2005 – Kumar, Abbas, AK; Fausto, N.,
Elsevier Saunders International, Chapters 1-9, 11, 13
Blood Transfusion and Component Therapy - National Blood Transfusion Committee, Australian Red
Cross, January 1994. Current information available at: http://www.transfusion.com.au/. Circular of
information
Infection Control in Surgery, July 1998 - Advisory Committee on Infection Control in Surgery, (Available on
request from RACS)
Infectious Diseases: A Clinical Approach 2nd Edition, - Yung A et al (eds). Melbourne: IP Communications,
2005. ISBN: 0-9578617-7-X Chapters: 1-4, 7, 11, 14-16, 18, 20, 22, 24, 28, 39, 42-44
Pharmacology 5th Edition, 2003 – Rang.HP; Dale MM; Ritter JM; and Moore PK Churchill Livingstone
Online Training: Resource Units (previously known as STEM Units)
Immunology/Transplant
Surgical Infections
General Principles of Pathology/Microbiology
Cellular and Molecular Biology
Pharmacology/Pharmocokinetics/Drugs and Therapeutics
Statistics
Neoplasia/Oncology/Cancer Genetics
Interpreting Statistics in Medical Literature: a Vade Mecum for Surgeons - Guller V and DeLong ER,
Journal of the American College of Surgeons, 2004 198:441 – 458
Dendritic Cells - Yao V, Platell C and Hall JC. ANZ Journal of Surgery. 2002: 72(7), 501-6
Pharmacology, 5th Edition, - Rang HP, Dale MM, Ritter JM, Moore PK. Churchill Livingston Edinburgh
2003
Drugs and the Heart 6th Edition, - Opie LH, Gersh BJ., Elsevier Saunders Philadelphia 2005

Pathology Journals
Rapid Sequence Induction Medications: An Update - Frakes MA. J Emerg Nurse 2003; 29:533-40
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#jen
Guidelines for Conscious Sedation and Monitoring During Gastrointestinal Endoscopy - American Society
for Gastrointestinal Endoscopy. Gastrointestinal Endoscopy 2003; 58:317-322 www.guideline.gov
Management of Sedation in Mechanically Ventilated Patients - Hogarth DK, Hall J. Curr Opin Crit Care
2004; 10:40-46
Sedation in Neurointensive Care: Advances in Understanding and Practice - Citerio G, Cormio M., Curr
Opin Crit Care 2003; 9:120-126
Principles of Office Anesthesia: Part 1 Infiltrative Anesthesia - Achar S, Kundu S. Am Fam Physician.
2002; 66:91-4 www.aafp.org/afp
Principles of Office Anesthesia: Part II Topical Anesthesia - Achar S, Kundu S. Am Fam Physician.
2002; 66:99-102 www.aafp.org/afp
Clinical Pharmacology of Local Anaesthetics - White JL, Durieux ME. Anesthesiology Clinics of North
America, Volume 23, Issue 1, March 2005, Pages 73-84
www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID
=853&ContentID=13946&DirectListComboInd=D
Future of Regional Anesthesia - Rosenberg PH. Acta Anaesthesiol Scand 2005; 49:913-918
Current Issues in Spinal Anesthesia - Liu SS, McDonald SB. Anesthesiology 2001; 94: 888-906 www.cja-
jca.org/cgi/reprint/49/suppl_1/R9.pdf
Local Anesthetics and Peripheral Nerve Blocks in the Emergency Department - Crystal CS, Blankenship
RB. Emerg Med Clin N Am 2005; 23:477-502
www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID
=853&ContentID=13946&DirectListComboInd=D
Non-Opoid Post-Operative Analgesia - Dahl V, Raeder JC. Acta Anaesthesiol Scand 2000; 44:1191-
1203
The Pharmacological Basis of Contemporary Pain Management - MacPherson RD. Pharmacology and
Therapeutics 2000; 88:163-85
Pain Control in Outpatient Surgery - Schecter WP, Bongard FS, Gainor BJ et al. J Am Coll Surg 2002;
195:95-104
www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID
=853&ContentID=13946&DirectListComboInd=D
Analgesia for Patients with Advanced Disease I - Hall EJ, Sykes NP. Postgrad Med J. 2004; 80:148-
154 http://pmj.bmj.com/cgi/reprint/80/941/148
Analgesia for Patients with Advanced Disease II - Hall EJ, Sykes NP. Postgrad Med J. 2004; 80:190-195
http://pmj.bmj.com/cgi/reprint/80/942/190
Pharmacological Principles of Antibiotic Prescription in the Critically ill - Pinder M, Bellomo R. Lipman
J. Anaesth Intensive Care 2002; 30:134-44
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#aic
Minimising Antibiotic Resistance., Livermore DM. Lancet Infect Dis 2005; 5:450-59
Optimizing Antimicrobial Dosing in the Critically ill Patient., Goldberg J, Owens RC. Curr Opin in Crit
Care 2002; 8: 435-440
Anesthetics, Sedatives and Paralytics. Understanding Their Use in the ICU., Aranda M, Hanson CW.
Surg Clin N Amer 2000; 80:933-
947 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&N
avMenuID=853&ContentID=18792&DirectListComboInd=D#scna
Nutritional Support of the Critically ill and Injured Patient, Slone DS., Crit Care Clin 2004; 20:135-157
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#ccc
Nutritional Support of the Chronically Critically ill Patient., Mechanick JI, Brett EM. Crit Care Clin 2002;
18: 597-618
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#ccc
Crystalloids and Colloids in Trauma Resuscitation: A Brief Overview of the Current Debate, Rizoli SB. J
Trauma 2003; 54:S82-88
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#jt
Perioperative Fluid Management and Clinical Outcomes in Adults, Grocott MPW, Mytheb MG, Gan TJ.
Anesth Anal 2005; 100:1093-106. http://www.anesthesia-analgesia.org/cgi/reprint/100/4/1093.pdf
Excessive Use of Normal Saline in Managing Traumatized Patients in Shock: A Preventable Contributor to
Acidosis., Ho AM-H, Karmakar MK, Contrardi LH, NG SSW, Hewson JR., J Trauma. 2001; 51:173-177
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM
enuID=853&ContentID=18792&DirectListComboInd=D#jt

Physiology
Respiratory Physiology: The Essentials, 7th Edition, 2005 - West, J.B., Lipincott, Williams and Wilkins
Review of Medical Physiology, 22nd Edition, 2005 - Ganong W.F., Lange.
http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&CFID=1031476&CFTOKEN=302179
40&jsessionid=f030c766ca2e$D4$AE$2#books
Textbook of Medical Physiology, 11th Edition - Guyton, A.C., Hall, J.E., Saunders 2005

Visual Questions
A proportion of questions used in each examination will refer to photographs, photomicrographs,
radiographs, C.T. scans, etc. These visual questions may include illustrations from:
Color Atlas of Anatomy, 5th Ed., - Rohen, J.W. & Lutjen-Drecoll, E., Williams & Wilkins
Colour Atlas of Anatomical Pathology, 2nd Ed., 1995 - Cooke R., Stewart B., Churchill Livingstone (the
illustrations from this publication are from the files of the Royal Brisbane Hospital.)
CD-ROM McMinn’s Interactive Clinical Anatomy - Mosby - Williams & Wilkins Pty. Ltd.
Wheater’s Basic Histopathology: A Colour Atlas and Text, 3rd Ed., 1996 – Burkitt HG: Stevens, A; Low JS,
and Young B. Churchill Livingston

Clinical Examination Reading List*

ATLS/EMST Course Manual 7th Ed. (2004)
CCrISP Course Manual 2nd Ed. 2003: Anderson, D.
RACS: Infection Control in Surgical Skills Course Handbook (1998)
Bailey and Love’s Short Practice of Surgery 24th Ed
Basic Surgical Skills Manual – Skinner, I., (2000) (reprinted 2005)
Australian and New Zealand Surgical Skills Education and Training (ASSET) Course Manual (2006)
All prescribed texts for the Basic Science Examination
Online Training: Resource Units (previously known as STEM Units)

* The recommended reading list for the Clinical Examination is not prescriptive or exhaustive, nor is it
guaranteed to cover every possible question. Candidates are expected to demonstrate competency in
history taking, examination of all systems, counselling and performing procedures commonly undertaken
during SET1.
 ROYAL AUSTRALASIAN COLLEGE OF SURGEONS
SPECIALTY SPECIFIC SURGICAL SCIENCE EXAMINATIONS
READING LISTS – specialty specific

Examinable from October 2008

Candidates with questions regarding the Recommended Reading Lists are advised to contact the specialty boards.

Specialty Anatomy Pathology Physiology

Cardiothoracic Robbins 7th Edition West
Surgery Chapters: Ganong
11 – Blood Vessels Guyton
12 – Heart
15 – Lung
17 – Oesophagus only
General Surgery West
Ganong
Guyton
Neurosurgery Robbins 7th Edition West
Chapters: Ganong
24 Guyton
27 – Peripheral Nerve
and Skeletal
Muscle
28 – Central Nervous
System
Orthopaedic West
Surgery Ganong
Guyton
Otolaryngology Robbins 7th Edition West
Head and Neck Chapters: Ganong
Surgery 16 – Head and Neck Guyton
17 – Oesophagus only Cummings:
24 – Thyroid, Otolaryngology: Head &
Pasathyroid and Neck Surgery, 4th ed.
Aspects of 2005 Mosby, Inc.
Multiple
Endocrine
Neoplasia only
25 – Skin - common
tumour only
Paediatric Surgery Last's Anatomy, Regional Surgery of Infants and none
and Applied, 9th Edition, Children: Scientific
1998 (reprinted 2003) - Principles and Practice
McMinn R.M.H., Churchill Oldham K et al, Lippincott
Livingstone Raven)

Plastic and West

Reconstructive Ganong
Surgery Guyton
Urology West
Ganong
Guyton
Vascular Surgery Robbins 7th Edition West
Chapters: Ganong
11 – Blood Vessels Guyton