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MRCS Part B Questions

MRCS Part B Revision · Procedural and technical skills

LA — MRCS Part B Procedural and technical skills

By Dr Richard Miller, MBChB FRCS · Reviewed

LA 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 LA station

Wash Your Hands
Ensure that you are seen by the examiners to wash your hands using alcohol gel provided.

Introduce, Explain and perform safety checks of patient and consent form
Start by introducing yourself and explaining the procedure. Then perform the essential safety checks of the patient and the consent form

Prepare equipment and Check local anaesthetic
Check that you have all your equipment available and check the strength and expiry date of the local anaesthetic

Draw up and administer local anaesthetic
Draw up with a 21G needle and administer with a 25G needle. Always withdraw the syringe before starting to administer the local anaesthetic

Check efficacy
Offer to wait 5 minutes before testing efficacy

Top Tips
• The administration of local anaesthetic is relatively simple. The key is that you show all the safety aspects including checking the consent form, expiry date of local anaesthetic and withdrawing the syringe prior to infiltrating the local anaesthetic

• It is essential that you know the maximum safe doses of both lidocaine and bupivacaine and the symptoms of toxicity

What are you asked at the LA 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.

  1. Describe what you would do prior to infiltrating the anaesthetic
  2. What equipment will you need?
  3. Describe how you will perform the procedure
  4. How would you complete the procedure
  5. 5. What category of local anaesthetic lidocaine? What other types of local anaesthetic do you know?
  6. What is the onset of action of lidocaine and bupivacaine

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 LA station ask?

It opens with "Describe what you would do prior to infiltrating the anaesthetic" 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