What happens in the FRCS ORL-HNS exam

Section 2 of the FRCS (Otolaryngology) is the clinical part of the exam, taken after passing the written Section 1. It has three 20-minute clinical sessions: history taking and communication skills with actors, and two sessions of short cases with volunteer patients, one in otology including neuro-otology and head and neck surgery, the other in paediatric otolaryngology and rhinology and facial plastics. There are also four 30-minute orals, one in each of those four areas. 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.
• The regulations say that, for these four areas, candidates should know the basic sciences, the clinical presentation and progression of disease, investigations, the management policy of disease processes, and operative techniques, including reconstruction.
• 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 otolaryngology each set a clinical scenario, such as bleeding two hours after a tonsillectomy, 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 SR8 v8.0: Regulations relating to the Intercollegiate Specialty Examination in Otolaryngology (last reviewed Aug 2025)
• JCIE: Otolaryngology (specialty page)
• JCIE: Otolaryngology oral question samples (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