What happens in the FRCS exam

Section 2 of the FRCS (Cardiothoracic Surgery) is the clinical part of the exam, taken after passing the written Section 1. It has four clinical sessions: a 45-minute cardiac and a 45-minute thoracic intermediate case session, in each of which three volunteer patients are seen, and a 30-minute cardiac and a 30-minute thoracic session in which six scenarios on instruments and on imaging or investigations are discussed. There are also three 30-minute orals: one on cardiac and one on thoracic critical conditions, ICU and trauma, and one in the sub-specialty, cardiac or thoracic surgery, chosen at application. Examiners mark against the JCIE's marking descriptors on a scale of 4 to 8, and the pass standard is set at the level of a day one consultant in the generality of the specialty.

Checked against the official sources on 27 September 2026.

The parts, in order

How it is marked

Examiners use the JCIE marking descriptors, a rating scale from 4 to 8 covering basic knowledge, higher order processing, clinical skills and professionalism. A 4 describes poor basic knowledge and a lack of understanding to a level of concern; a 6 describes competent knowledge, no major errors and safe practice; an 8 describes excellent basic knowledge and knowing the breadth and depth of the topic.

Passing

The JCIE states that the pass mark is set at the level of a day one consultant in the generality of the specialty. It does not publish a numerical pass mark for Section 2 or how the marks are combined.

Worth knowing

• Candidates must reach the required standard in Section 1 (two written papers of 120 single best answer questions) before they can sit Section 2.
• Section 2 is held at pre-selected host centres in the UK and Ireland, and candidates have a maximum of four attempts at it.
• The JCIE's published sample oral questions for cardiothoracic surgery each set a clinical scenario, such as extensive calcification of the ascending aorta in a man needing coronary surgery, then ask an introductory question followed by two further questions (for example on management, then on complications of management).
• The JCIE's guidance for oral question writers asks for open, higher order questions that follow a logical progression, increasing in complexity and mimicking the tasks expected of a day one consultant, rather than simple recall.
• Section 2 results are available within two weeks of the exam, and the result letter includes a breakdown of your performance.

Sources

• JCIE Policy SR4 v8.0: Regulations relating to the Intercollegiate Specialty Examination in Cardiothoracic Surgery (last reviewed Aug 2025)
• JCIE: Cardiothoracic Surgery (specialty page)
• JCIE: Cardiothoracic Surgery Oral Questions (published samples)
• JCIE Policy G1 v10.0: Guidance Notes for Applicants (last reviewed July 2025)
• JCIE Policy G38 v3.0: Marking Descriptors (last reviewed 9 Feb 2024)
• JCIE: JCIE information page (links the Section 2 marking descriptors)
• JCIE Policy G35 v1.1: Structured oral question writing guidelines
• JCIE: Oral Question Development (specialty coding sheets, templates and samples)
• JCIE: Frequently Asked Questions