MRCS Part B Revision · Anatomy
Hand 1 — MRCS Part B Anatomy
By Dr Richard Miller, MBChB FRCS · Reviewed
Hand 1 is a surgical anatomy station. Three of the seventeen examined stations in the MRCS Part B OSCE are surgical anatomy. The anatomy stations put a prosected specimen, a model or an image in front of you and ask you to identify structures and say what they do, what they relate to and what happens when they are injured.
What you need to know for the Hand 1 station
The Hand (1)
The Hand
the carpal bones can be classified as belonging to two transverse rows or three longitudinal columns.
The pair of rows together form an arch which is convex proximally and concave distally. On the palmar side, the carpus is concave, forming the carpal tunnel which is covered by the flexor retinaculum. Because the proximal row is simultaneously related to the articular surfaces of the radius and the distal row, it adapts constantly to these mobile surfaces. The bones of this row - scaphoid, lunate, and triquetrum - have their individual movements. The scaphoid contributes to the stability of the midcarpus as it articulates distally with the trapezium and the trapezoid. The distal row is more rigid as its transverse arch moves with the metacarpals.
The Scaphoid
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union.
Delays may compromise healing. Failure of the fracture to heal ("non-union") will lead to post-traumatic osteoarthritis of the carpus. One reason for this is because of the "tenuous" blood supply to the proximal segment. Even rapidly immobilized fractures may require surgical treatment, including use of a headless compression screw such as the Herbert screw to bind the two halves together.
Images from this station
What are you asked at the Hand 1 station?
The station runs to 18 questions over nine minutes. These are the questions as they are put to you; the model answers are in the question bank.
- Identify the specimen
- Identify structures 1-4
- Identify structures 5-8
- Identify structures 9 and 10
- Identify areas 11-13 on structure 1
- Identify structure 14 on bone 8
- What muscle attaches at 15?
- Identify the muscles attaching at 16 and 17
- Identify the muscles attaching at 18 and 19
- Identify the muscles attaching at 20 and 21
- Identify the muscles attaching at 22 and 24
- What is the normal alignment of the wrist?
And 6 more at this station.
How is the anatomy station marked in MRCS Part B?
An anatomy station is marked out of 20, and all 20 marks go to clinical knowledge and its application. No communication, technical-skill or professionalism marks are available in an anatomy bay, which is unusual: in most other stations more than half the marks sit outside your factual knowledge.
FAQ
What does the Hand 1 station ask?
It opens with "Identify the specimen" and runs to 18 questions over nine minutes. An anatomy station is marked out of 20, and all 20 marks go to clinical knowledge and its application. No communication, technical-skill or professionalism marks are available in an anatomy bay, which is unusual: in most other stations more than half the marks sit outside your factual knowledge.
How many anatomy stations are there in MRCS Part B?
Three of the seventeen examined stations are surgical anatomy, and two more are surgical pathology. Together they make up the five Anatomy and surgical pathology stations of the Applied Knowledge component.
How are the anatomy stations marked?
Each station is marked out of 20 and all 20 marks are awarded for clinical knowledge and its application. You also receive a separate global rating of pass, borderline or fail for the station.
Are the specimens real?
Yes. Anatomy bays use prosected cadaveric specimens, models and images. Candidates report being shown photographs of specimens as well as the specimens themselves, so practise on real dissection photography rather than diagrams alone.
What happens if I get an early question wrong?
The intercollegiate guidance says that if a wrong answer would affect your performance on later questions at the same station, the examiner gives you the correct answer before moving on. One mistake does not have to cost you the whole bay.
How many stations are in the MRCS Part B OSCE?
Seventeen examined stations of nine minutes each, with a minute to read the task before each one. Two preparation stations and at least one rest station bring the circuit to about twenty, and the exam takes about three and a half hours.
What is the pass mark for MRCS Part B?
There is no published pass mark. The cut score is set separately for Applied Knowledge and Applied Skills, for each circuit, by borderline regression. Published pass rates across the 2024/25 diets ranged from 51% to 66%.
Can I fail a station and still pass?
Yes. There is no rule about how many stations you may fail: the cut score applies to your total mark in each component, so a weak station costs the marks you lost on it and strong stations elsewhere can make them back. Applied Knowledge and Applied Skills are passed separately and must both be passed at the same sitting, so a strong anatomy performance cannot rescue a weak communication one.
Dr Richard Miller, MBChB FRCS
Station summaries are reviewed against the current intercollegiate MRCS syllabus and the published marking blueprint. Guidance changes between diets: check the royal colleges' own pages before relying on a date, a fee or a threshold.
Practise this station
The question bank carries the model answer to every question above, with the rest of the anatomy stations.
More anatomy stations