Table Of ContentCracking the
Intercollegiate
General Surgery
FRCS Viva
A Revision Guide
Cracking the
Intercollegiate
General Surgery
FRCS Viva
A Revision Guide
Edited by
Elizabeth Ball MBChB PhD FRCS
Consultant Oncoplastic Breast Surgeon
Ipswich Hospital NHS Trust, Ipswich, UK
Stewart Walsh MSc MCh FRCS
Associate Professor of Surgery and Consultant Vascular Surgeon
University Hospital Limerick, Limerick, Ireland
Tjun Tang MA(Hons) MD FRCS
Consultant Vascular Surgeon
Changi General Hospital, Singapore
Boca Raton London New York
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Version Date: 20130710
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This book is dedicated to my nearest and dearest,
for their love, support and understanding.
Elizabeth Ball
For Serena, who put up with it all from the beginning.
Stewart Walsh
This book is gratefully dedicated to my wife and children: Nicole
the most supportive, loving and understanding person I know and
Eleanor and Leo, who give me the greatest joy in life. Thank you.
Tjun Tang
Contents
Foreword ...................................................................................................................ix
The Editors ................................................................................................................xi
The Contributors ....................................................................................................xiii
Introduction ............................................................................................................xvii
Abbreviations ..........................................................................................................xxi
Chapter 1 Academic Viva .....................................................................................1
Elizabeth Ball, Tjun Tang and Stewart Walsh
Chapter 2 Critical Care .......................................................................................25
Jithesh Appukutty, Elizabeth Ball, John Davidson, Vinodkumar
Singh, Nicole Keong, Tjun Tang and Stewart Walsh
Chapter 3 Emergency Surgery ............................................................................85
Elizabeth Ball, Nicole Keong, Dermot O’Riordan, C J Shukla,
Tjun Tang, Colin Walsh and Stewart Walsh
Chapter 4 General Surgery ...............................................................................153
Elizabeth Ball, Pankaj Mishra, Dermot O’Riordan, C J Shukla,
Tjun Tang, Thomas Tsang, Colin Walsh and Stewart Walsh
Chapter 5 Breast Surgery ..................................................................................229
Elizabeth Ball, Amy E E Burger and Sue K Down
Chapter 6 Colorectal Surgery ...........................................................................257
Edward Courtney, Gillian Tierney and Samson Tou
Chapter 7 Endocrine Surgery ............................................................................277
Elizabeth Ball and Ashish Lal
Chapter 8 HPB Surgery ....................................................................................293
Saurabh Jamdar, Jeffrey Lordan, Dermot O’Riordan and
Manel Riera
vii
viii Contents
Chapter 9 Transplant Surgery .......................................................................303
Zia Moinuddin, Rajesh Sivaprakasam and David van Dellen
Chapter 10 Upper GI Surgery ..........................................................................319
Naheed Farooq, Dermot O’Riordan, Dimitri Pournaras,
Manel Riera and Andy Tsang
Chapter 11 Vascular Surgery ...........................................................................335
Tjun Tang, Janice Tsui, Stewart Walsh and Michael Wu
Bibliography .....................................................................................................355
Index ..................................................................................................................359
Foreword
This is no question a high hurdle. But it’s not something that cannot be done.
Lou Lamoriello
This observation was made about hockey but could equally be applied to the FRCS
examination. ‘The exit exam’ sits in the mind of every surgeon throughout his or her
final years of training. It is the last hurdle, the ultimate professional examination on
the road to independent practice as a consultant surgeon. It is the surgical profes-
sion’s final opportunity to ensure that the trainees reach the standards and calibre
expected of consultant surgeons in the United Kingdom and Ireland. It was never
meant to be straightforward.
For many exit FRCS candidates, it is often a number of years since they have
been in an examination situation. Undergraduate and postgraduate medical educa-
tion has changed radically over the last decade. Increasingly, FRCS candidates may
have little or no experience of the ‘viva voce’ that forms a major component of the
exit exam and which was the bread and butter of exams in my day. These examina-
tions seek not only to evaluate the candidate’s knowledge of various surgical topics
but also to test the candidate’s reasoning and decision-making skills through the use
of multiple clinical scenarios. Patients are no longer passive recipients of our knowl-
edge and wisdom and come prepared to their consultation armed with information
gleaned from the Internet and prepared to interrogate the unwary practitioner. The
‘viva voce’ not only is an integral part of the examination, but also serves to prepare
candidates for life as independent consultant surgeons.
The contributors to this book have all taken and passed the Intercollegiate FRCS
in General Surgery in the last 5 years. They have not produced a textbook but instead
have sought to provide a guide to approaching the viva for those yet to take the
examination. By the time of the exit exam, candidates have many competing pres-
sures compared to the MRCS earlier in training. Families, mortgages and ‘getting
that job’ all add to the stress for candidates. Hopefully, by providing some advice on
how to tackle the myriad of topics that may come up in the vivas, this book will go
some way toward reducing the stress.
Dr Stansfield, an anatomist at the Royal College of Surgeons, sent my generation
of surgeons off to their exams with the rejoinder, ‘I don’t wish you luck, I wish you
justice’; reading this book will ensure justice is delivered.
The Lord Ribeiro Kt, CBE, FRCS
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