The Joint Committee on Intercollegiate Examinations (JCIE), is responsible for organising surgical specialty exit examinations. Each surgical specialty FRCS examination has a Board Chair, and they report to the overall JCIE Board. The Hospital Trust chosen to deliver the clinical exam must formally agree to host this complex ask. Some years ago, I led a FRCS (T&O) clinical and viva voce examination at the Royal Blackburn Hospital, and I would like to write about my experience. This examination had 135 candidates, 72 examiners and 60 patients, a task not to be undertaken lightly.
The FRCS (T&O) consists of the Part 1 (the written assessment) and Part 2 (the clinical and viva voce examination). The Part 1 and examiner logistics are organised by the JCIE without involvement of the local organiser (host). The host liaises with the JCIE T&O administrative lead in delivering the clinical part of the examination. The viva voce part of the exam is usually undertaken in a suitable local hotel. I chose the Trust outpatient and physiotherapy departments for the clinical examination, as adequate space and isolation from noisy areas was vital. The clinical examination was on the Sunday, as this is the quietest working day for the Trust.
Hospital Trusts may be helpful in supplying administrative and nursing support, but this is not always the case. Do not expect your NHS secretary to provide the extra administrative support. You must be organised, lead and be prepared to undertake much of the mundane work. I took six days annual leave to plan and to organise the event. It is a huge responsibility; as future surgical careers may depend on successful delivery of the exam. The JCIE administrative support was very professional and helpful. Involve your surgical colleagues early, as you shall need them to recruit volunteer patients from the different T & O sub-specialties. The clinical exam requires nursing and other volunteer support to run smoothly.
Planning and recruitment of clinical cases must start many months prior to the exam. Consent, patient details, contact details, a summary of the condition (history and examination findings), investigations, imaging and treatment all require to be recorded accurately. Many more cases than are first thought will be necessary as unexpected events may occur. The night before my exam it snowed (the only time that it snowed all that year) and I lost 30% of my clinical cases. Luckily, I had a reserve of about 35%, though this needed a rapid reorganisation of the case mix for intermediate and short cases, which was rather stressful. Most of the patients enjoyed the day, with many asking when the next exam would be, as they would like to volunteer again.
Volunteering to host an exam is not to everyone’s taste, but I found it to be a very rewarding experience and of course it is vital for maintaining future surgical standards, as passing the exam is an intrinsic part of obtaining a CCT. I also received a signed certificate from the T&O Board Chair commemorating the event!