# Practising for Otolaryngology (FRCS ORL-HNS oral) with MedMock

Canonical page: https://medmock.com/exams/otolaryngology-frcs-orl-hns-oral

## What is the FRCS ORL-HNS viva, and how do you practise for it?

JCIE FRCS ORL-HNS Section 2 — one actor-led history-taking and communication station plus four examiner-led vivas covering otology / neuro-otology, head & neck surgery, paediatric otolaryngology and rhinology & facial plastics. Each viva probes basic sciences, clinical presentation and progression, investigations, management policy, and operative techniques (including reconstruction). The full exam also holds two 20-minute clinical short-case sessions with real volunteer patients; those require examining a patient, so they are not simulated here. MedMock lets you practise it out loud against an AI examiner, with examiner-style feedback on any question you finish.

## What happens in the real FRCS ORL-HNS (checked against the official source on 2026-09-27)

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.

- **Clinical: History Taking & Communication Skills** (20 minutes): One 20-minute session with actors present, assessing history taking and communication skills.
- **Clinical short cases: Otology including Neuro-Otology, and Head & Neck Surgery** (20 minutes): A 20-minute session of short cases with volunteers, who are past or present patients relevant to the specialty, recruited by the host examiner.
- **Clinical short cases: Paediatric Otolaryngology, and Rhinology & Facial Plastics** (20 minutes): A 20-minute session of short cases with volunteers.
- **Oral: Otology including Neuro-Otology** (30 minutes): A 30-minute oral on otology, including neuro-otology.
- **Oral: Head & Neck Surgery** (30 minutes): A 30-minute oral on head and neck surgery.
- **Oral: Paediatric Otolaryngology** (30 minutes): A 30-minute oral on paediatric otolaryngology.
- **Oral: Rhinology & Facial Plastics** (30 minutes): A 30-minute oral on rhinology and facial plastics. Facial plastics covers otoplasty, rhinoplasty, flap reconstruction, excision of facial lesions, suturing techniques, tissue handling and the assessment of patients having cosmetic procedures.

Marking: 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.

Sources: https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=70ce2bf4-9877-465d-ac7b-692883c59a3c https://www.jcie.org.uk/content/content.aspx?ID=17 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=4263333e-9e08-4726-bc6d-ed58fb54cb02 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=386bbc69-2612-4727-8ed5-a0d8808ba9e7 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=58EA3EC7-DE60-4160-9D15-D8757F511D14 https://www.jcie.org.uk/content/content.aspx?ID=4 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=52bb7306-cbbd-4bd9-ba1e-f3d597feeb03 https://www.jcie.org.uk/content/content.aspx?ID=6 https://www.jcie.org.uk/content/content.aspx?ID=10
Full format page: https://medmock.com/exams/otolaryngology-frcs-orl-hns-oral/format

Upcoming sittings: from 25 November 2026 (Glasgow); from 21 April 2027 (Dundee); from 24 November 2027 (Newcastle upon Tyne) (source: JCIE (the four surgical Royal Colleges), checked 2026-09-23).
All FRCS ORL-HNS dates: https://medmock.com/exams/otolaryngology-frcs-orl-hns-oral#dates

## Stations you can practise

- **History Taking & Communication Skills** — 20-min actor-led OSCE-style history-taking and communication encounter on a focused ENT presentation (hoarse voice / unilateral neck lump / suspected head & neck cancer / hearing loss). NICE NG12 two-week-wait pathway, BAHNO MDT framing, ICE-driven counselling and explicit safety-netting.
- **Otology including Neuro‐Otology** — 30-min examiner-led oral on otology and neuro-otology — applied temporal-bone anatomy, audiological and vestibular assessment, NICE NG98 hearing-loss pathway, BCIG/BACIA cochlear-implant candidacy, vestibular schwannoma surveillance and management (British Skull Base Society / Koos grading), middle-ear and skull-base operative principles.
- **Head & Neck Surgery** — 30-min examiner-led oral on head & neck surgical oncology and salivary / thyroid pathology — NICE NG12 / NG36 / CSG6 head-and-neck cancer pathway, TNM-8 HPV-stratified staging, BAHNO MDT structure, Robbins neck-level anatomy, selective and modified-radical neck dissection principles, free-flap reconstruction.
- **Paediatric Otolaryngology** — 30-min examiner-led oral on paediatric ENT — applied airway and middle-ear anatomy, Cotton-Myer subglottic stenosis grading, airway emergencies, paediatric OSA / adenotonsillar pathway, hearing screening (NHSP), cleft and craniofacial principles, NICE / RCPCH safeguarding awareness.
- **Rhinology & Facial Plastics** — 30-min examiner-led oral on rhinology and facial plastics — applied nasal and sinus anatomy, EPOS 2020 / NICE NG79 rhinosinusitis, endoscopic sinus and skull-base surgery, ENT UK / INTEGRATE epistaxis and BCSH / BSH anticoagulant-management pathway, septorhinoplasty principles (internal nasal valve, preservation rhinoplasty, dorsal hump reduction), and facial-flap reconstruction.

## Sample FRCS ORL-HNS questions

- *Head & Neck Surgery:* A 55-year-old with nasopharyngeal carcinoma. Discuss management.
- *Paediatric Otolaryngology:* A 6-year-old with chronic adenotonsillar hypertrophy and sleep apnoea. Discuss surgery.

## Example scenarios

- *History Taking & Communication Skills:* Take a focused history from Mr Doyle, a 58-year-old 30-pack-year smoker with 6 weeks of hoarseness and right-sided referred otalgia. He is anxious about cancer and wants to know what happens next.
- *Otology including Neuro‐Otology:* A 38-year-old woman with 14 months of progressive right-sided SNHL and intermittent imbalance has an MRI showing a 1.8 cm right CPA lesion. Walk me through the CPA anatomy, Koos grading, and your decision between surveillance, radiosurgery and microsurgery.
- *Head & Neck Surgery:* A 62-year-old man with a 4-week right level II neck node 2.5 cm, FNAC poorly-differentiated SCC. Walk me through your unknown-primary workup, the Robbins anatomy of level II, the principles of selective neck dissection and adjuvant decisions.
- *Paediatric Otolaryngology:* A 3-year-old boy with biphasic stridor since 18 months and two prior croup admissions. MLB shows Cotton-Myer III subglottic stenosis. Talk me through the developmental anatomy, grading, and your decision between endoscopic intervention, LTR and cricotracheal resection.
- *Rhinology & Facial Plastics:* A 56-year-old man on warfarin (INR 3.2) with intractable left posterior epistaxis after 90 minutes of bedside packing. Walk me through nasal vascular anatomy, warfarin reversal, the operative steps of endoscopic sphenopalatine artery ligation and briefly the principles of dorsal hump reduction.

## How a practice session works

1. **Choose a question** — Pick from the FRCS ORL-HNS questions — all 5 that MedMock runs, or let MedMock surprise you the way exam day will.
2. **Have the conversation** — Speak naturally, out loud. The AI examiner listens, follows up and probes further, exactly like the viva.
3. **Get instant feedback** — The moment you finish, you get specific, examiner-style feedback and a score — what you did well, what cost you marks, and precisely what to fix before the next attempt.

## Price

Start with a one-off £5 taster: 30 credits (30 minutes of speaking practice), not a subscription. After that, or instead, £119 per month for 600 credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Cancel at any time. Full details: https://medmock.com/pricing

## Frequently asked questions

### How does the feedback work?

When you finish a question you can have it marked, and the scorecard comes back in seconds — what you did well, what cost you marks, and exactly what to work on next. Scorecards, mark schemes and model answers are included at no extra credit cost.

### Can I practise specific FRCS ORL-HNS questions?

Yes. You can pick any of the 5 questions to drill a weak area, or run a mixed set to simulate the real exam.

### How much does it cost?

You can start with a one-off £5 taster: 30 credits, which is 30 minutes of speaking practice, with no subscription. After that, or at any time, you can choose a monthly plan, which includes a monthly credit allowance. Current prices are on the pricing page.

## About MedMock

MedMock is a web app for practising the spoken parts of UK medical and dental exams and interviews out loud. The candidate talks; an AI patient, examiner or interview panel answers in real time by voice; and when the station ends MedMock marks the performance against that exam's assessment domains and shows the model answer.

It covers 104 spoken exams and interviews — OSCEs, vivas, structured oral exams, simulated consultations, and specialty-training and consultant interviews. It does not cover written or multiple-choice papers, and it is not a question bank.

It was founded by Mr Sam Nahas, MBBS BSc MEd FRCS (Tr & Orth), a practising consultant orthopaedic surgeon in the UK, with co-founder and CTO Arjan Jandu. It is operated by VirtualPatients Ltd (company no. 16303492).

Pricing: a one-off £5 taster of 30 credits to try it (not a subscription, one per account), and a monthly subscription from £20 to £129 depending on the exam (student exams cost least, fellowship exit exams and consultant interviews most), or £199 to £275 for the Intensive plans, which carry more credits. One credit is one minute of spoken practice, or two typed exchanges, and where the examiner or patient speaks first, that opening line is free. Examiner scorecards, mark schemes and model answers for finished sessions are included at no extra credit cost. Subscriptions can be cancelled at any time.

It runs in a web browser on a laptop or phone; spoken practice needs a microphone. There is no public demo: practice needs an account with credits, usually from the taster or a monthly plan.

MedMock is for adults aged 18 or over. Sign-up asks every new account to confirm it.

MedMock is a revision tool. The patients, examiners and cases are fictional and AI-generated; it is not clinical guidance and is not affiliated with or endorsed by any Royal College, the GMC, the GDC or any examining body.

Start with the £5 taster: https://medmock.com/auth/signup