2016 – Written Experience – RW

Written Examination

Not many people have discussed their preparations for the written examination. A lot of the advice that I was given was “you will be fine” without a lot of structure behind it. I think that there are many ways to approach this examination and I will give my thoughts and also tell you the books and websites that I used.

GET BASIC SCIENCES DONE. Early. At least once. So much of this is not revision but new learning. You need it for the written and especially for the Clinicals. Every viva station I had had some sort of basic science question in it somewhere. Read the Ramachandran basic sciences book, cover to cover, making notes if that is what you do. Do this one year before you hit the written exam and spend a month or two on it. Then, you can revise it a couple of times before each examination. The Ramachandran book covers pretty much everything. You can then do some additional reading in the basic sciences chapter of Miller and also the section on basic sciences towards the back of the Banaszkiewicz main book (I will list all of these at the bottom of this). The other good reference was Joideep Phadnis’s revision notes. These seem to be in pretty wide circulation now amongst various email chains and are essentially one registrar’s synopsis of the entire syllabus, from all of the major textbooks, in 1800 pages of pdf. Amazing (give me a shout if you want a copy).

Early on, register on Orthobullets. Start doing questions. Do them in blocks of 50 initially and go through the testmaster link so that you can save your results and watch your scores getting better and better. I did all of the free questions on Orthobullets twice before the exam (>5000 questions). The first time round this was over about a year. At the end of that I was at the low 70s overall. In the month or two up to the exam I did it a second time round. If you select the option to make tests out of unanswered questions then you won’t be seeing the same questions time and time again. Gradually build up the number of questions you are doing in one go. At first, my scores when doing 100 questions were a lot lower than 50 questions as I was losing focus. Gradually I got better and better at doing more. This is good for the exam as it is a bit of a slog. By the end of the second go through I was comfortably in the mid-80s. Orthobullets is, however, the easiest of all of the practice materials. You also learn a surprising amount of basic sciences just by doing the questions. I also spent a bit of time trying to analyse my guesses. I very quickly realised that my first guess was my best by a long way and that became my strategy for the exam itself. If I overthought things then I invariably got it wrong.

As the date got nearer I did all of the other practice books. There are a few out there and you will hear about the Sri-Ram book (hard), Mr Khanduja’s (hard), the one by Ben Olivere and Ian McNamara (hardish), the Black Book (old and therefore very hard in parts) and one from the Oxford lot (hardish). These are all harder than the exam and do not worry about scores in the 60s even running up to the exam. The main thing is that they all have good explanatory paragraphs after each section and you can learn a lot by doing them.

Finally, I saved all of the past UKITEs that I could get my hands on until the last few weeks. These are definitely the most similar to the exam itself, both in style and format – especially the more recent. I think they equate to a lower score than the exam because they do not have any filter to remove the crap questions (up to 10% of the questions from the exam are scrapped in the final reckoning because no one gets them right). I think if you are getting in the mid-60s and over in these then you will be fine. I was mid to high 70s by the end and got 80% in the exam.  These papers are flying around in various email chains. If you have any friends in the northern deaneries then they seem to have most of them. I had 2007 to 2012. I had to modify them all to make them true test papers as a lot were screenshots with the answers lit up.

Finally, book the examination as early as possible. The earlier that you book the written examination, the higher up on the list you are to get your preferred clinical examination (i.e. as soon as possible). Just get it all out of the way as soon as possible. It dominates a year of your life and the thought of that dragging on is unpleasant.

List of books and websites

This is not exhaustive and is just the ones I used. Also includes the ones I used for the clinicals.


Essential for written. Also very good discussion on all topics that some like using for the clinicals well. US website.


Australian website. Excellent topic based teaching. Became more and more useful as I approached the written examination. Has a useful section on examinations.

Miller’s Review of Orthopaedics 7e

Essential (?) text. Some people really don’t get on with the format. I found some chapters very useful. Most of the diagrams are from Netter and are very clear. Adult recon chapter I thought was particularly useful.

Basic Orthopaedic Sciences: The Stanmore Guide – Manoj Ramachandran     

If you choose not to read this, the examiner will have so you are taking a bit of a risk. Just learn it.                

Postgraduate Orthopaedics: The Candidate’s Guide to the FRCS (Tr and Orth) Examination – Paul Banaszkiewicz

Seen by many as the one textbook you need for the clinicals. I really did not like it. No depth to it. The companion book I found much more useful (see below).

Postgraduate Orthopaedics: Viva Guide for the FRCS (Tr & Orth) Examination – Paul Banaszkiewicz

Good for viva prep. Key topics covered well. Literature to quote in abundance

Postgraduate Orthopaedics: Mcqs And Emqs For The Frcs (Tr & Ortho) – Kesavan Sri-Ram

Written questions. Definitely harder than the real test.

FRCS Trauma and Orthopaedics Viva (Oxford Higher Specialty Training Higher Revision – Nev Davies et al. Oxford.

The oxford viva book. I think there is one for the MCQs/EMQs as well. Both pretty good.

Orthopaedic Basic and Clinical Science for the Postgraduate Examination: Viva Practice & Diagrams – Dawson Bowlng, Olivere and McNamara

This one is pretty good for the viva. Some of the diagrams are really useful. Some are useless. Joideep’s notes cannot be beaten for diagrams.  I think there is a very similar book for the written in this series by same authors.

FRCS(Tr & Orth): MCQs and Clinical Cases – Vika Khanduja

Mr Khanduja’s book. Just a re-print of all of the cases that he does for the JBJS. If you are a subscriber then it is easier to look through your old copies.

Netter’s Concise Orthopaedic Anatomy, Updated Edition, 2e (Netter Basic Science)

This is the hidden gem in the bunch. I thought it would just be a few Netter slides that the examiners might show me so I ought to have a look… I was wrong. It is the whole of orthopaedics in a pocket sized A5 masterpiece. Check it out. If you knew this, you would breeze through the clinicals. All stations.

Examination Techniques in Orthopaedics – Nick Harris

It still amazes me that they got away with this… The birds are arguably fitter in the earlier editions. The tops are definitely more see-through (so D’Jon tells me). Half naked models aside, it is a decent text.

Review Questions in Orthopaedics – Craig et al

THIS IS THE BLACK BOOK! For years I would ask people, what is this black book? Nobody could really tell me. Then someone emailed me a grainy copy as a pdf. Then I found it in Addenbrookes library. Scarily difficult and outdated in parts but a lot is still relevant and the explanations are good.