Regulations for the award of Membership of the Surgical Royal

Colleges of the United Kingdom and in Ireland: MRCS (ENT) with

effect from March 2023

1. The Examinations

1.1 Part A MRCS - (MCQ)

1.1.1 Part A is a four hour MCQ examination consisting of two papers, each of two hours’
duration, taken on the same day. From 1st January 2017 the Part A will be a five hour
MCQ examination consisting of a three hour paper (Applied Basic Science) followed by
a two hour paper (Principles of Surgery in General), still taken on the same day.

1.1.2 The marks for both papers are combined to give a total mark for Part A.

1.1.3 The papers sat at each of the Colleges at any particular sitting are identical and are
held simultaneously.

1.1.4 The papers cover generic surgical sciences and applied knowledge, including the core
knowledge required in all nine specialties as follows:

Paper 1 - Applied Basic Sciences MCQ paper

Paper 2 - Principles of Surgery-in-General MCQ paper

1.1.5 To achieve a pass in Part A the candidate will be required to demonstrate a minimum
level of competence in each of the two papers in addition to achieving or exceeding the
pass mark set for the combined total mark for Part A.

1.1.6 With effect from April 2013 candidates will be entitled to a maximum of 6 attempts at
Part A.

1.2 Intercollegiate MRCS (ENT) OSCE

1.2.1 The MRCS (ENT) OSCE comprises of 20 written/online stations and 4 clinical bays
where candidates will be required to examine actors.

1.2.2 Each OSCE bay is normally of seven minutes’ duration.

1.2.3 To facilitate the assessment of non-verbal communication skills and interaction with the
examiner and patient (or actor in the role of the patient as the case may be), the
Colleges will require candidates for the OSCE component to remove any clothing and/or
other item which covers all, or part of, the candidate's face for the duration of the stations
in question.

1.2.4 With effect from February 2022, this examination will be known as the MRCS
(ENT) OSCE. Until this time, the exam was called the DO-HNS Part 2 OSCE.

1.3 All parts of the examination will be conducted in English.

2. Eligibility

To be eligible to obtain the Diploma of Membership in ENT under these Regulations applicants for
Membership must:

2.1 hold a primary medical qualification that is acceptable to the United Kingdom General Medical
Council for Full, or Provisional Registration or to the Medical Council in Ireland for Full or
Temporary Registration; overseas candidates must hold a primary medical qualification

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 acceptable to the Councils of the four Colleges; (prospective candidates who wish to check the
acceptability of their medical degree should check the World Directory of Medical Schools on
http://search.wdoms.org/. If the medical school does not appear on this list, candidates should
contact the examinations department/section at the College to which they wish to apply for the
examination;

2.2 Candidates who have been erased from the GMC register (or that of an equivalent international
body) for reasons related to fitness to practise are not permitted entry to any MRCS examination.

Candidates who are suspended from practice by the GMC (or equivalent international body)
and/or their employer are not permitted to apply for entry to any MRCS examination until the
suspension has been lifted.

Candidates who are subject to any warnings, interim orders, undertakings or conditions on their
practice from the GMC (or equivalent international body) and/or their employer must declare this
information to the relevant College upon applying to any MRCS examination. Candidates are also
required to disclose information as to why the condition or undertaking has been imposed. Any
information provided may be checked with GMC (or equivalent) and/or their employer. This will
be reviewed by the relevant College prior to the examination and will be taken into account in
deciding whether a candidate is permitted to sit the examination. The relevant College’s decision
on these matters is final.

Candidates should note that failure to declare conditions, warnings, or suspension as required:
• at the time of application
• prior to the examination date for which they have entered, or
• when applying for election to membership

will result in penalties being applied as defined in the Intercollegiate Code of Conduct and
Intercollegiate Misconduct regulations.

2.3 have passed Intercollegiate MRCS Part A (or MRCS Parts 1 and 2) and Intercollegiate DO-HNS
Part 2 (since February 2008) or the Intercollegiate MRCS (ENT) OSCE (since February 2022);
and

2.4 have met the timing/number of attempt requirements for passing the examinations (as detailed in
Section 5) and

2.5 have applied for Membership in ENT and been approved by the relevant College Council. Details
of the procedure for election to Membership may be obtained from individual Colleges.

2.6 Candidates will be eligible for election as Members of the College with which they successfully
complete MRCS (ENT) OSCE for the award of MRCS (ENT).

3. Entry to Examination

3.1 In order to enter the examination, all candidates must hold a primary medical qualification
acceptable to the Councils of the four Colleges. (See note under paragraph 2.1 above on
checking eligibility of primary medical qualifications.)

3.2 Candidates can enter any part of the examination through any College.

3.3 Applicants for entry to Part A of the Intercollegiate MRCS must comply with the Regulations for
that examination.

3.4 Candidates must pass MRCS Part A before applying for the Intercollegiate MRCS (ENT) OSCE
examination.

3.5 Candidates who already hold both parts of the DO-HNS (since it became intercollegiate in 2008)

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 and who wish to be eligible to receive MRCS (ENT) may apply to enter MRCS Part A, subject to
5.3 below.

NB: Candidates should be aware that, in all cases within any part of the MRCS and DO-HNS regulations,
application cannot be made to two examinations or sittings of the same examination at the same time.
An examination must be passed before moving to the next stage of the route.

Candidates are not permitted to apply for an MRCS (ENT) OSCE examination when the exam sitting
commencement date falls within six weeks of an examination date previously entered. This regulation
is applicable across all four Surgical Colleges. Candidates who enter for an examination, with any
College, within six weeks of a previous examination will forfeit their fee.

4. Administration

4.1 The OSCE is held at one host centre up to three times a year in the UK and Ireland. The host
centre will rotate between The Royal College of Surgeons of Edinburgh, The Royal College of
Surgeons of England, The Royal College of Physicians and Surgeons of Glasgow and The Royal
College of Surgeons in Ireland. (Please refer to the websites of the four surgical Royal Colleges
for calendar details).

4.2 The host centre will send out the OSCE programme to all candidates sitting in that diet.

4.3 The results will be issued by the College to which the candidate applied.

5. Timing/Attempts

Harmonisation of Regulations regarding number of attempts permitted

The regulations have been harmonised to reflect the two different routes to Membership following
completion of requirements:

• Candidates who have successfully completed Part A are permitted to enter either the MRCS
Part B (OSCE), or the MRCS (ENT) OSCE for the award of MRCS (ENT).

• Candidates are allowed up to four attempts at the MRCS Part B (OSCE).

• Candidates are allowed up to four attempts at the MRCS (ENT) OSCE for the award of
MRCS (ENT).

• One additional attempt may be granted under the Additional Attempt Policy.

• An attempt is defined as an occasion when a candidate commences, but does not

necessarily complete, the Part B (OSCE), or the MRCS (ENT) OSCE for the award of MRCS
(ENT) i.e. submission of an application form is not an attempt.

Accordingly:

5.1. Candidates are permitted four attempts in which to pass the MRCS (ENT) OSCE. If unsuccessful,
for the award of MRCS and NOT MRCS (ENT), candidates will still be entitled to four attempts at
MRCS Part B (OSCE)

5.2 The number of attempts for completion of the MRCS (ENT) OSCE for the award of MRCS (ENT)
cannot be increased.

5.3 Candidates who are “time-expired” in the Intercollegiate MRCS Examination of the Surgical Royal
Colleges of the United Kingdom and in Ireland or the Collegiate MRCS are not permitted to sit
Part A of the MRCS examination or the MRCS (ENT) OSCE for the award of MRCS (ENT) of the
Surgical Royal Colleges of the United Kingdom and in Ireland under these Regulations.

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5.4 Candidates who have passed any parts of the MRCS Examination will not be permitted to re-sit
the same component or part with any of the Colleges unless under the circumstances defined in
regulation 5.6 below.

5.5 Any candidate entering any part of the MRCS or MRCS (ENT) under these regulations is required
to pass the MRCS (ENT) OSCE within seven years of passing MRCS Part A.

5.6 Candidates who do not pass the MRCS (ENT) OSCE within seven years of passing the MRCS
Part A will be required to take and pass the MRCS Part A examination again. Candidates who re-
enter the MRCS Part A examination and pass will have a further seven years in which to pass the
MRCS (ENT) OSCE.

5.6.1 In this instance, candidates re-starting the MRCS (ENT) will not have the number of
attempts as defined in section 3.10 of the MRCS regulations and regulation 5.1 above re-
set. Instead, candidates will have the number of attempts remaining at each part or
component of the exam in which to complete each part or component. For example, if a
candidate had passed the MRCS Part A on their third attempt and had made two attempts
at the MRCS (ENT) OSCE before becoming time-expired under regulation 5.5 above, the
candidate will then have three attempts to pass the MRCS Part A and two attempts to pass
the MRCS (ENT) OSCE.

5.6.2 In the event that a candidate re-starting the MRCS (ENT) passed the MRCS Part A on their
sixth attempt, they would have a single further attempt in which to pass the MRCS Part A.

6. Recommendations and Advice

It is strongly recommended that candidates seek the advice of their trainer, programme director, or
equivalent, before deciding when to take any part of the examination, particularly before taking the
MRCS (ENT) OSCE, due to the limited number of attempts available in which to pass all components
of this examination.

7. Admission to the Examination

Candidates should consult individual College websites or contact the examinations

department/section of the relevant College for details of dates and venues for examinations.
Details of the examinations department/section of each of the four Colleges are to be found at
the end of these regulations.

7.1 Candidates can enter any part of the examination through any College, but may only enter
with one College at each sitting. Any candidate who has entered an examination with more
than one of the four Colleges at the same sitting will forfeit the fee for each additional application.

7.2 Application for entry to any part of the examination must:

7.2.1 be made on the appropriate (paper or electronic version) application form;

7.2.2 be accompanied by the specific examination fee, payment of which must be received
in full by the relevant College before a candidate may enter the examination; and

7.2.3 reach the examinations department/section of the appropriate College by the date
specified in the examinations calendar. Applications received after the closing date may
be returned.

7.3 If, exceptionally, a candidate is permitted to enter the examination without first having paid the
specified examination fee and fails thereafter to pay the fee, the candidate shall not be permitted
to take any further examinations with any Surgical Royal College without payment of the
outstanding fee or, if the unpaid fee relates to such a candidate’s Final part of the examination,
the relevant College reserves the right not to mark or assess that part of the examination or not

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 allow the candidate to proceed to Membership of the relevant College in accordance with these
Regulations.

8. Proof of Identity

8.1 Candidates must bring proof of identity to each examination. Proof of identity must be an official
document, such as a current passport or driving licence that includes their name, signature and
a photograph.

8.2 For the purposes of visual identification, any candidate sitting any examination will be required to
remove any clothing and/or other item which covers all, or part of the candidate’s face. The
Colleges will observe sensitivity and, in specific circumstances privacy in the visual identification
of candidates.

8.3 The Colleges reserve the right to make recordings of the examinations for the purposes of quality
assurance and training.

9. Withdrawal from the Examination

9.1 A candidate who withdraws, in writing, an application for admission to any part of the examination
may be refunded the fee paid (less an administrative fee of 20%) provided that notice of an
intention to withdraw is received by the examinations department/section before the closing date
by which applications are due, as shown in the examinations calendar. No refunds are normally
made to candidates who withdraw after the closing date.

9.2 Applications for consideration of a refund on medical grounds must be accompanied by a medical
certificate and must cover the date of the examination. The application must be submitted within
14 days of the commencement of the examination. Applications approved on these grounds will
be refunded 80% of the fee.

9.3 Applications for a refund on bereavement grounds must be accompanied by a death certificate
and must be submitted within 14 days of the commencement of the examination. Applications will
be considered for immediate family members only. Applications approved on these grounds will
be refunded 100% of the fee.

9.4 Applications for consideration of a refund on compassionate grounds should be supported by the
College or Clinical Tutor or the Assigned Educational Supervisor and the Head of the School of
Surgery. All such applications must be submitted to the examinations department/section of the
appropriate College within 14 days of the commencement of the examination and will be refunded
80% of the fee.

From August 2022 onwards, candidates who withdraw on the grounds of having tested positive
for Covid-19 and wish to apply for a refund (less an administrative fee of 20%) should provide
evidence in the form of a letter from their consultant/trainer to confirm that they had been too ill to
work at the time of the examination.

9.5 The Colleges reserve the right, regardless of eligibility to take the examination, to review
applications on an individual basis in exceptional circumstances. For information on pregnancy
and deferral see paragraph 14.

9.6 Candidates with special needs should advise the appropriate College at the time of application of
the nature of their needs and any assistance that they require. Requests should be supported by
medical evidence (an educational psychologist’s report is required for requests for extra time
because of dyslexia). If appropriate, details of extra time or other allowances made by other
examining bodies should be given, although the Colleges are not bound to follow these.

9.7 Candidates should note that the four Royal Surgical Colleges operate a ‘Fit to Sit’ policy; if a
candidate attends and takes an examination, they are declaring themselves fit to sit the

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 examination and they will not be able to subsequently claim that their performance was affected
by mitigating circumstances. Candidates will therefore need to take responsibility for deciding in
advance whether they are unwell or facing other significant mitigating circumstances.

10. Results

10.1 Results will be posted on the website and sent out in the post and/or email by the examinations
department/section of the College through which the candidate entered.

10.2 The MRCS (ENT) Diploma will be issued by the College to which the candidate applied for the
MRCS (ENT) OSCE examination that they passed.

10.3 Anonymised result data will be analysed for the purposes of standard setting, and anonymised
result data may also be used for research purposes.

10.4 Result outcome data for UK trainees will be passed to HEE, on behalf of the four statutory
education bodies, for recruitment purposes.

11. Feedback

All candidates will receive a breakdown of their result. No further feedback is available.

12. Appeals Mechanism

Details of the appeals process and fees charged may be obtained from the appropriate College.

13. Improper Conduct by Examination Candidates

In the case of improper conduct of an examination candidate as defined below, the four Colleges acting
jointly may impose a penalty relating to the candidate’s eligibility for the relevant or future examinations.
Improper conduct is defined as:

13.1 Dishonestly obtaining or attempting to obtain entry to the examination by making false claims
about eligibility for the examination or falsifying any aspects of the entry documentation.

13.2 Obtaining or seeking to obtain unfair advantage during an examination, or inciting other
candidates to do the same.

Examples of unfair advantage are: having on the person any material that would give advantage
in an examination once the examination has commenced (this includes electronic communication
devices), communicating or attempting to communicate with another candidate once the
examination has commenced, refusing to follow the instructions given by examiners or
examinations staff concerning the conduct of and procedure for the examination. This list is not
exhaustive.

13.3 Removing or attempting to remove from the examination any confidential material relating to the
examination.

13.4 Obtaining or attempting to obtain confidential information concerning the examination from an
examiner or examination official.

13.5 Passing confidential information on the content of the examination to a third party.

The list given above is not exhaustive.

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13.6 If a candidate is found to have acted improperly his/her name may be reported to the relevant
national authority. The Colleges may also on an individual basis decide that a candidate should
not be allowed to proceed further with the examination or, having passed the examination, may
not be admitted to Membership, according to their own statutes and regulations, in cases where
serious misconduct not related to the examination is judged to make the person unfit to become
a Member of the College.

14. Notification of Pregnancy and Deferral

14.1 A deferral may be permitted to candidates supplying an appropriate medical report which satisfies
the relevant College indicating that:

14.1.1 the candidate has any pregnancy related problems or illness; and/or

14.1.2 the candidate’s confinement is due shortly before or around the date of the examination;
and/or

14.1.3 the candidate has sufficient discomfort for her to consider that it will have a detrimental
effect on her performance.

14.2 In such circumstances, a deferral will be permitted and no further fee will be required.

14.3 Any candidate who does not inform the College of her pregnancy and is consequently unable to
sit for that examination will not normally be allowed to defer this examination without submission
of another fee.

NOTE: These Regulations are under continual review. It is recommended that candidates keep
in regular contact with their College to ensure that they have the most up-to-date information.
Any changes will be announced on the College website. Regular announcements are also made
on the Intercollegiate MRCS website: http://www.intercollegiatemrcsexams.org.uk/

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College Details

The Royal College of Surgeons of Edinburgh

Examinations Section
Nicolson Street
Edinburgh
EH8 9DW
Tel: 0131 527 1600
Email: [email protected]
Web: www.rcsed.ac.uk

The Royal College of Surgeons of England

38-43 Lincoln’s Inn Fields
London
WC2A 3PE
Tel: 020 7405 3474
Email: [email protected]
Web: www.rcseng.ac.uk

The Royal College of Physicians and Surgeons of Glasgow

232-242 Vincent Street
Glasgow
G2 5RJ
Tel: 0141 221 6072
Email: [email protected]
Web: www.rcpsg.ac.uk

The Royal College of Surgeons in Ireland

123 St Stephen’s Green
Dublin 2
Ireland
Tel: 00353 1402 2221
Email: [email protected]
Web: www.rcsi.ie

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