5d • Clinical question
How I Failed MRCS Part A
When I decided to sit MRCS Part A, I knew it would be difficult.
What I did not realise was how different it would be from every exam I had taken before.
I was not a surgical trainee.
I was not spending every day in theatre.
I was not discussing anatomy on ward rounds or revising physiology after work.
Like many international candidates, I was balancing work, life, and study while trying to prepare for one of the broadest examinations in medicine.
At first, I underestimated the exam.
I looked at the syllabus and thought:
"I studied anatomy in medical school."
"I know pathology."
"I learned physiology years ago."
The problem was that "learning it once" and "being able to answer MRCS questions" are completely different things.
The first few weeks of revision felt comfortable.
Then reality arrived.
I opened an anatomy question bank.
I couldn't remember nerve roots.
I couldn't remember embryological derivatives.
I confused foramina, blood supply, and anatomical relations.
Physiology was even worse.
Acid-base balance.
Renal physiology.
Endocrine feedback loops.
Respiratory mechanics.
I realised that knowledge I once knew had slowly disappeared over the years.
Instead of accepting this, I made another mistake.
I avoided my weak areas.
I revised topics I enjoyed.
I spent time reading surgical notes.
I watched videos.
I highlighted textbooks.
It felt productive.
But I wasn't improving.
The examination doesn't reward what you already know.
It exposes what you don't know.
As the exam approached, I became more anxious.
Every revision session reminded me of another topic I had forgotten.
Every question bank revealed another weakness.
I started jumping between resources, searching for the perfect notes.
I convinced myself that if I found the right book, the right course, or the right question bank, everything would suddenly become easier.
It never did.
Exam day arrived.
Paper 1 started.
For the first twenty questions, I felt reasonably confident.
Then came anatomy.
Then embryology.
Then physiology.
Then pathology.
Then questions that seemed to combine all four subjects into a single scenario.
The more difficult the questions became, the harder I tried.
The harder I tried, the more I second-guessed myself.
Simple questions became difficult.
Difficult questions became impossible.
I left the examination centre exhausted.
For weeks afterwards, I replayed questions in my head.
Some I knew I had answered correctly.
Others haunted me.
When the result arrived, it confirmed what I already suspected.
Failed.
I was disappointed.
Not because I had failed.
But because I knew why.
I had spent months studying.
Yet much of that time had not been effective.
I was reading instead of recalling.
Highlighting instead of learning.
Recognising instead of understanding.
The failure forced me to change everything.
I stopped chasing resources.
I chose a small number of trusted materials.
I started answering questions every day.
I revised anatomy repeatedly.
I focused on understanding concepts instead of memorising isolated facts.
Most importantly, I accepted that MRCS Part A is not testing whether you are currently working in surgery.
It is testing whether you possess the scientific foundation expected of a future surgeon.
The second time I prepared differently.
Slowly, the subjects that once seemed impossible began to connect.
Anatomy explained clinical signs.
Physiology explained pathology.
Pathology explained surgical disease.
The syllabus stopped feeling like hundreds of separate topics and started feeling like one integrated system.
When I sat the examination again, I was still nervous.
Everyone is.
But this time I recognised the patterns.
I understood what the examiners were asking.
And this time, I passed.
Looking back, failing MRCS Part A was not the end of my journey.
It was the moment I realised that success in MRCS does not come from being naturally clever, working in surgery, or owning every textbook.
It comes from consistency, active learning, and respecting the examination.
The day I stopped studying to finish the syllabus and started studying to understand it was the day everything changed.
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How I Failed MRCS Part A
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