MRCS Part B Revision · Procedural and technical skills
Venepuncture — MRCS Part B Procedural and technical skills
By Dr Richard Miller, MBChB FRCS · Reviewed
Venepuncture 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 Venepuncture station
Venepuncture
• As the patient is high risk for a transmissible blood disease it is important to ensure you follow universal precautions when taking blood
• Ensure you have kit including tourniquet, green needle, syringe or vacutainer, blood culture bottles, alcohol wipe, cotton wool and tape, sharps bin
• Wash your hands
• Wear an apron, eye protection and gloves
• Firmly tie the tourniquet around the arm (if a mannequin stating this may suffice)
• Palpate the antecubital fossa or given area for a vein
• Clean the area with an alcohol wipe and allow time to dry
• Insert the needle or vacutainer into the vein watching for flash back
• Take off 10ml of blood
• Release the tourniquet
• Carefully withdraw the needle and apply cotton wool/swab with pressure
• Fill the anaerobic bottle first with 5ml and then the anaerobic bottle
• Dispose of the shape and syringe
• Apply tape or plaster
• Thank patient
• Dispose of protective clothing in orange bag
• Wash hands
• Offer to label the blood cultures
• Ensure you have kit including tourniquet, green needle, syringe or vacutainer, blood culture bottles, alcohol wipe, cotton wool and tape, sharps bin
• Wash your hands
• Wear an apron, eye protection and gloves
• Firmly tie the tourniquet around the arm (if a mannequin stating this may suffice)
• Palpate the antecubital fossa or given area for a vein
• Clean the area with an alcohol wipe and allow time to dry
• Insert the needle or vacutainer into the vein watching for flash back
• Take off 10ml of blood
• Release the tourniquet
• Carefully withdraw the needle and apply cotton wool/swab with pressure
• Fill the anaerobic bottle first with 5ml and then the anaerobic bottle
• Dispose of the shape and syringe
• Apply tape or plaster
• Thank patient
• Dispose of protective clothing in orange bag
• Wash hands
• Offer to label the blood cultures
What are you asked at the Venepuncture station?
The station runs to 7 questions over nine minutes. These are the questions as they are put to you; the model answers are in the question bank.
- When the station begins please ask appropriate questions and then proceed to take blood cultures from the patient. Surgical Skills: Venepuncture
- What questions would you like to ask the patient?
- On questioning the patient reveals that she is an ex-IVDU and might have 'hep something'. Please take blood cultures from her
- What extra information would you put on the blood culture microbiology form
- On reviewing her notes you notice that she is under investigation for possible endocarditis. How would this change how you take blood cultures?
- What is the most likely causative organism for endocarditis in this patient?
- If the patient is penicillin allergic what is the most appropriate antibiotic to start?
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 Venepuncture station ask?
It opens with "When the station begins please ask appropriate questions and then proceed to take blood cultures from the patient. Surgical Skills: Venepuncture" and runs to 7 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