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Following the format change to include single best answer questions (SBAs), this book equips candidates with a full range of testing examples to develop familiarity with the format and prepare for success in their FRCS (Tr&Orth) examination. Containing over 1,000 level 2 SBA questions, detailed explanations ensure candidates understand the reasoning and evidence-based decision-making behind each answer. Covering the breadth of the orthopaedic syllabus, including more difficult subject areas such as biomechanics, prosthetics/orthotics, anatomy and statistics, this is a crucial resource for all candidates. Encouraging the integration of clinical information with problem solving, this question format helps candidates learn and retain the answers more efficiently than with simple factual recall. Written by highly experienced clinicians and examiners, these example questions are essential for preparing for the real examination.
Section 2 of the basic science (Tr & Orth) syllabus is a large topic, difficult to grasp at face value as it appears quite removed from the average orthopaedic surgeon’s practice. However, it pervades many aspects of clinical practice and therefore must be understood.
It contains large sections of A-list topics that just need to be learnt as well as possible, otherwise marks will be thrown away.
A recent shift in emphasis with basic science from the ICB is to try and link a topic into a clinical problem to make the subject more clinically relevant and less dry. A classic example is the clinical photograph of an explanted worn PE cup leading on to a discussion of wear.
A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing solution for each individual patient.
Wear is an A-list topic with similar competency questions in the first part of a viva but unexpected or esoteric higher-order thinking questions in the second part. This is a method to keep the topic fresh with each diet of exams.
The stress–strain curve is a triple A-list subject. It always seems to be asked in viva examinations and is a definite top 10 core basic science question. In recent years this topic has been reinvented as it was becoming too predictable. We make no apologies for including the question in all of its various guises.
Fracture biomechanics can be tough-going for most candidates and yet it is definitely an A-list topic. Textbook chapters can be too complicated and detailed to understand whilst short note sections may appear incomplete as biomechanical assumptions have not been fully explained or the brevity of the notes makes them difficult to fully understand, never mind encouraging any higher-order thinking.
We hope this chapter uncomplicates a difficult area of the syllabus that a lot of candidates find offputting.
The average orthopaedic trainee about to sit the FRCS (Tr & Orth) exam requires a basic knowledge of genetics.
This doesn’t need to be encyclopaedic, but candidates will need to have a sound grasp of disease inheritance and genetic disorders. Trainees should be able to draw a family pedigree of single gene inheritance and know the gene mutations of the more common orthopaedic conditions.
By comparison, mention genetic viva questions to any examiner and you get a slightly puzzled look back. Safe to say, it is not a major A-list topic for the vivas and probably doesn’t even make the B-list. However, the subject does intermittently appear in the vivas and therefore it is definitely worthwhile knowing how the questions will run in order to uncomplicate a potentially complicated topic.
There has been a change in emphasis in the oral questions in the last 2 years to higher-order thinking and judgement. Exam revision should be less book reading and more being practical and adept at managing complex clinical conditions. Examiners would argue if you have been well trained in the basics it isn’t too difficult to apply these basic principles to various clinical situations that you may be tested on in the oral exam. If you haven’t managed periprosthetic joint infection (PJI) then it’s going to be doubly difficult to answer the real-life practical questions that are related to managing a patient with this condition.
We have aimed the candidates’ answers for a 7–8 score, so they are significantly more detailed than what would be required for a bare pass. Aiming for the minimum to pass will generally be unsuccessful and is not recommended.