MRCS Part B Revision · Procedural and technical skills
Catheterisation — MRCS Part B Procedural and technical skills
By Dr Richard Miller, MBChB FRCS · Reviewed
Catheterisation is a procedural station. Two of the seventeen examined stations in the MRCS Part B OSCE are procedural. The procedural stations ask you to perform a practical task, usually on a model, while explaining what you are doing and why.
What you need to know for the Catheterisation station
Catheterisation
- Wash your hands, introduce yourself, check the patient's identity, explain the procedure to the patient and obtain their consent.
- Collect all of your equipment and lay it out onto your (clean) portable trolley.
- Open the catheter pack, making sure you avoid contaminating it (the contents are sterile). Make sure the patient's trousers and underwear are lowered and you have your trolley in the correct position by the side of the bed.
- Put on the first pair of sterile gloves. Get your assistant to open the water and fill your syringe for the catheter balloon and get your assistant to pour the cleaning solution into one of the trays in your pack.
- Grasp the penis gently but firmly with a swab held in your non-dominant hand. Clean the penis with single sweeps of the solution-soaked gauze, moving away from the meatus towards the perineum. Repeat 2-3 times.
- Place the drape over the penis
- Holding the penis upright, gently insert the nozzle of the anaesthetic gel (Instillagel) syringe into the meatus and squeeze the contents of the syringe into the penis. Wait for several minutes to allow the anaesthetic gel to take effect before proceeding.
- Change/remove outer gloves
- Remove the catheter tip from it's bag, but ensure that the rest of it remains within the bag so that you maximise the sterility of the procedure. Insert it gently into the meatus and feed it steadily inwards (if it gets stuck, you can try to pull the penis downwards gently, which straightens the urethra). Hold the penis at 90o initially, until you feel some resistance. This will occur as you enter the membranous urethra. At this point, lower the penis again.
- As you approach the end of the catheter place your kidney dish under the free drainage end of the catheter.
- When urine flows out, it is safe to inflate the balloon with the specified amount of sterile water.
- Attach the catheter to the collection bag
- Remove your drapes and all other equipment from the bed.
- Ensure that the foreskin (if present) is pulled down over the glans. If you forget to do this, then there is a risk of paraphimosis, which is very painful.
- Clear away your rubbish. Thank the patient, and ensure that they are comfortable and re-dressed. Document the procedure in the notes (if on the ward) and make sure that the instructions for urine output measurement (eg. frequency, etc) are known to the ward staff.
Press on the gentleman's abdomen to put pressure on the bladder
Flush the catheter to ensure that it is not blocked with gel
Monitor the urine output for a short period of time
Check the bladder using a bladder scanner
Re-position the catheter
What are you asked at the Catheterisation station?
The station runs to 6 questions over nine minutes. These are the questions as they are put to you; the model answers are in the question bank.
- What kit would you like the ward staff to lay out for you?
- Describe how you would catheterise a male patient. You may like to practise in your local skills lab
- Describe how you would catheterise a female patient. You may like to practise in your local skills lab
- The catheter is in but there is no urine coming out. What would you do?
- If you had trouble passing the catheter what options do you have?
- What are your differential diagnoses for anuria post-op with a catheter in-situ?
How is the procedural and technical skills station marked in MRCS Part B?
The two procedural stations are marked differently from each other. Procedural skills with a patient carries 8 marks for clinical and technical skill and 4 each for knowledge, communication and professionalism. Procedural skills, technical, performed on a model rather than a person, carries 12 for skill and 8 for knowledge, with no communication or professionalism marks available.
FAQ
What does the Catheterisation station ask?
It opens with "What kit would you like the ward staff to lay out for you?" and runs to 6 questions over nine minutes. The two procedural stations are marked differently from each other. Procedural skills with a patient carries 8 marks for clinical and technical skill and 4 each for knowledge, communication and professionalism. Procedural skills, technical, performed on a model rather than a person, carries 12 for skill and 8 for knowledge, with no communication or professionalism marks available.
What procedural skills are tested in MRCS Part B?
Two of the seventeen examined stations are procedural: one with a patient and one purely technical. Candidates most often report suturing, abscess incision and drainage, catheterisation and chest drain insertion.
How is a procedural station marked?
The station with a patient carries 8 of its 20 marks for clinical and technical skill and 4 each for knowledge, communication and professionalism. The technical station carries 12 for skill and 8 for knowledge, with no communication marks.
Should I talk while I perform the procedure?
At the station with a patient, yes: a third of the marks there are for communication and professionalism, and they are gone if you work in silence. At the purely technical station those marks do not exist, so the technique itself is what counts.
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 procedural and technical skills stations.
More procedural and technical skills stations