# Practising for Trauma & Orthopaedic (FRCS T&O oral) with MedMock

Canonical page: https://medmock.com/exams/trauma-and-orthopaedic-frcs-t-and-o-oral

## What is the FRCS T&O viva, and how do you practise for it?

The JCIE publishes the FRCS T&O Section 2 format in one place — policy SR11 v8.0, “Examination format (from August 2022)”. It is four 30-minute orals (adult elective orthopaedics including spine; trauma including spine; children's orthopaedics / hand and upper limb; applied basic sciences) and four 15-minute clinical stations: “Clinical Intermediate Cases (2 x 15 minutes)” and “Clinical Short Cases (1 x 15 minutes Upper Limb / 1 x 15 minutes Lower Limb)”. SR11 also says which of them uses a real person: “Volunteers are used for Intermediate Cases. Clinical scenarios are used for Short Cases.” MedMock runs all eight by voice. Two things here are MedMock's own and are labelled as such wherever they appear. First, the intermediate cases run WITHOUT hands-on examination — you take the history and the examiner supplies the findings — so they practise history, interpretation and discussion, not examination technique, and the JCIE's published “Clinical examination skills” domain cannot be assessed on this platform. Second, the way a 30-minute oral is divided inside the half hour is MedMock's practice structure: examiner pairs are official (GMC-approved T&O curriculum 5.3.6, “independently marked by examiners working in pairs”), but the JCIE publishes no handover time and no topic count, and its own oral question template shows one theme taken through three progressively harder questions. The JCIE publishes no aggregation rule, pass mark or domain weighting for Section 2, so MedMock reports a practice score and never a predicted result. MedMock lets you practise it out loud against an AI examiner, with examiner-style feedback on any question you finish.

A complete example station — full transcript and the scorecard MedMock produced — is at https://medmock.com/exams/trauma-and-orthopaedic-frcs-t-and-o-oral/example

## What happens in the real FRCS T&O (checked against the official source on 2026-09-24)

Section 2 of the FRCS (Trauma & Orthopaedic Surgery) is the clinical part of the exam, taken after passing the written Section 1. It has four 15-minute clinical cases (two intermediate cases with volunteer patients, and two short cases based on clinical scenarios, one upper limb and one lower limb) and four 30-minute orals. 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: intermediate cases (two)** (15 minutes): Two cases of 15 minutes each with volunteers, who are past or present patients relevant to the specialty, recruited by the host examiner.
- **Clinical: short case, upper limb** (15 minutes): A 15-minute upper limb case based on a clinical scenario rather than a volunteer.
- **Clinical: short case, lower limb** (15 minutes): A 15-minute lower limb case based on a clinical scenario rather than a volunteer.
- **Oral: adult elective orthopaedics including spine** (30 minutes): A 30-minute oral on adult elective orthopaedics, including the spine.
- **Oral: trauma including spine** (30 minutes): A 30-minute oral on trauma, including the spine.
- **Oral: children's orthopaedics / hand and upper limb** (30 minutes): A 30-minute oral on children's orthopaedics and on the hand and upper limb.
- **Oral: applied basic sciences** (30 minutes): A 30-minute oral on applied basic sciences related to orthopaedics, including anatomy and surgical approaches, pathology, biomechanics, audit, methodology and outcome-based medicine.

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 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=c23a99ef-a323-44de-a0a5-a89ee5230295 https://www.jcie.org.uk/content/content.aspx?ID=20 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=8 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=52bb7306-cbbd-4bd9-ba1e-f3d597feeb03 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=65e490a2-287b-4386-9b35-d6b06126f81e
Full format page: https://medmock.com/exams/trauma-and-orthopaedic-frcs-t-and-o-oral/format

## How to prepare for the FRCS T&O (facts checked against official sources on 2026-09-27)

Section 2 of the FRCS (Trauma & Orthopaedic Surgery) is four 15-minute clinical cases and four 30-minute orals, marked on the JCIE's 4 to 8 descriptors at the standard of a day-one consultant in the generality of the specialty. Prepare by revising the whole T&O curriculum and syllabus blueprint, examining patients with a consultant watching, and rehearsing oral answers that start from an image, justify each decision and handle complications without needing prompts.

1. **Know your attempts and your window** — You reach Section 2 by meeting the Section 1 standard. You then have a maximum of four attempts, with no re-entry, and the whole examination process must be completed within seven years. Places can be limited and are allocated in order of your Section 1 application date.
2. **Revise the generality of the specialty** — The pass standard is a day-one consultant across all of T&O, and the JCIE directs you to the curriculum for the scope of the exam. Its syllabus blueprint maps the syllabus to Section 2, and the regulations include visceral, neurosurgical and skin trauma, and statistics relevant to orthopaedic practice.
3. **Be ready for the critical conditions** — The T&O curriculum lists critical conditions where misdiagnosis or mismanagement can have devastating consequences for life or limb, among them compartment syndrome, cauda equina syndrome, necrotising fasciitis, metastatic spinal compression and the acute painful hip in a child. Make sure you can talk through recognising and managing each one.
4. **Learn what earns a 7 or 8** — In the JCIE's marking descriptors a 6 is competent knowledge, no major errors and safe practice. Higher marks go to good or excellent responses without prompting and to supporting evidence, while a 5 includes poor responses that needed significant prompting. Practise answering fully and citing the evidence behind your decisions.
5. **Rehearse orals that build from a scenario** — The JCIE's sample oral questions open with a scenario, often an image such as a radiograph, followed by an introductory question and two more on management and complications. Question writers are told to avoid simple recall and to make you apply knowledge and justify decisions, so practise with colleagues who show you an image and keep asking why.
6. **Examine patients with a consultant watching** — The intermediate cases use volunteers who are past or present patients; the short cases, one upper limb and one lower limb, use clinical scenarios. The descriptors cover history taking, examination, diagnostic skills and how you treat volunteers, so practise concise, courteous examinations in clinic and present your findings clearly.
7. **Cover applied basic science and research** — The basic science oral covers anatomy and surgical approaches, pathology, biomechanics, audit, methodology and outcome-based medicine. The JCIE's samples include drawing on request and weighing the current evidence behind a colleague's practice, so practise drawing key diagrams and critiquing the evidence out loud.

Official resources:

- JCIE: Trauma & Orthopaedic Surgery (https://www.jcie.org.uk/content/content.aspx?ID=20): The specialty page with the regulations, the syllabus blueprint and sample written (Section 1) questions.
- JCIE Policy SR11: Regulations for the Intercollegiate Specialty Examination in Trauma & Orthopaedic Surgery (https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=c23a99ef-a323-44de-a0a5-a89ee5230295): The official Section 2 format, the scope of the exam and the attempt limits.
- Trauma & Orthopaedic Surgery Syllabus Blueprint 2023 (https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=a00f232c-4cee-4d28-94f8-466f24372472): How each syllabus item maps to Section 2 and the other assessments; use it to check you have covered the breadth.
- JCIE Marking Descriptors (https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=58EA3EC7-DE60-4160-9D15-D8757F511D14): The 4 to 8 rating scale Section 2 examiners use for knowledge, higher-order thinking, clinical skills and professionalism.
- JCIE: Oral Question Development (https://www.jcie.org.uk/content/content.aspx?ID=6): The JCIE's oral question-writing guidelines and a set of sample T&O oral questions with the key points examiners look for.
- JCIE: Information for all candidates (https://www.jcie.org.uk/content/content.aspx?ID=12): The JCIE's 12-minute video on what to expect before, during and after Section 2.
- Trauma & Orthopaedic Surgery Curriculum: appendices (ISCP) (https://www.iscp.ac.uk/iscp/curriculum/trauma-orthopaedic-surgery-curriculum/appendices/): The T&O syllabus and the list of critical conditions and key topics.

Sources: https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=c23a99ef-a323-44de-a0a5-a89ee5230295 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=52bb7306-cbbd-4bd9-ba1e-f3d597feeb03 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=a00f232c-4cee-4d28-94f8-466f24372472 https://www.iscp.ac.uk/media/1530/appendix-3-critical-conditions-and-key-topics-aug-26.pdf https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=58EA3EC7-DE60-4160-9D15-D8757F511D14 https://www.jcie.org.uk/Utils/DocumentGenerator.aspx?Type=CMS&docID=65e490a2-287b-4386-9b35-d6b06126f81e https://www.jcie.org.uk/content/content.aspx?ID=20 https://www.jcie.org.uk/content/content.aspx?ID=6 https://www.jcie.org.uk/content/content.aspx?ID=7 https://www.jcie.org.uk/content/content.aspx?ID=12 https://www.iscp.ac.uk/iscp/curriculum/trauma-orthopaedic-surgery-curriculum/appendices/ https://www.iscp.ac.uk/iscp/curriculum/trauma-orthopaedic-surgery-curriculum/5-programme-of-assessment/ https://www.jcie.org.uk/content/content.aspx?ID=10
Full guide: https://medmock.com/exams/trauma-and-orthopaedic-frcs-t-and-o-oral/prepare

Upcoming sittings: from 7 February 2027 (Edinburgh); from 25 April 2027 (Cork); from 7 November 2027 (Oswestry) (source: JCIE (the four surgical Royal Colleges), checked 2026-09-23).
All FRCS T&O dates: https://medmock.com/exams/trauma-and-orthopaedic-frcs-t-and-o-oral#dates

## Stations you can practise

- **Adult elective orthopaedics including spine** — 30-minute JCIE oral table on adult elective orthopaedics including spine. Each topic opens with a clinical scenario, often with imaging, and is taken through clinic approach, management and complications before the examiner moves on. Examiner pairs are official; the six topics of roughly five minutes and the handover halfway are MedMock's practice structure, not a published JCIE format.
- **Trauma including spine** — 30-minute JCIE oral table on trauma including spine. Each topic opens with a case, often with imaging, and is taken through classification and biomechanics, treatment strategy, and soft-tissue / complication management. Examiner pairs are official; the six topics of roughly five minutes and the handover halfway are MedMock's practice structure, not a published JCIE format.
- **Children’s orthopaedics / Hand and upper limb** — 30-minute JCIE oral table on children's orthopaedics and hand / upper limb. Each topic is taken through presentation anatomy and diagnosis, management, and complications or procedural approach. Examiner pairs are official; the six topics of roughly five minutes and the handover halfway are MedMock's practice structure, not a published JCIE format.
- **Applied basic sciences related to orthopaedics, including anatomy and surgical approaches, pathology, biomechanics, audit, methodology & outcome based medicine** — 30-minute JCIE oral table on applied basic sciences — surgical anatomy and approaches, pathology, biomechanics and biomaterials, and audit / methodology / outcome-based medicine, each often opened from a stimulus such as a departmental guideline or a radiograph. Examiner pairs are official; the six topics of roughly five minutes and the handover halfway are MedMock's practice structure, not a published JCIE format.
- **Intermediate case 1 — history & discussion** — 15-minute Clinical Intermediate Case. In the real exam a volunteer — a past or present patient — is in the room and you examine them. MedMock has no patient to examine, so this station is a platform adaptation: you take a focused orthopaedic history, then the examiner supplies the examination findings verbally with relevant imaging and leads the discussion — interpretation, differential, investigations, management and complications. It practises history, interpretation and discussion, not examination technique, and the JCIE's “Clinical examination skills” domain cannot be assessed here. The JCIE publishes no anatomical split and no internal timing for the intermediate cases; drawing this one from the upper limb and spine, and the five-minute history, are MedMock's own choices.
- **Intermediate case 2 — history & discussion** — 15-minute Clinical Intermediate Case. In the real exam a volunteer — a past or present patient — is in the room and you examine them. MedMock has no patient to examine, so this station is a platform adaptation: you take a focused orthopaedic history, then the examiner supplies the examination findings verbally with relevant imaging and leads the discussion — interpretation, differential, investigations, management and complications. It practises history, interpretation and discussion, not examination technique, and the JCIE's “Clinical examination skills” domain cannot be assessed here. The JCIE publishes no anatomical split and no internal timing for the intermediate cases; drawing this one from the lower limb, and the five-minute history, are MedMock's own choices.
- **Short cases — upper limb** — 15-minute Clinical Short Case station, upper limb. The JCIE runs these on clinical scenarios rather than on a volunteer patient, so MedMock runs this station the way the exam runs it: the examiner opens each case on a scenario, often a clinical photograph or radiograph, and takes you through what you see, how you would examine for it and what you would expect to find, the named clinical tests and what a positive result means, then diagnosis and management. The JCIE does not publish how many short cases sit inside the 15 minutes; MedMock runs three of about five minutes, which is MedMock's structure.
- **Short cases — lower limb** — 15-minute Clinical Short Case station, lower limb. The JCIE runs these on clinical scenarios rather than on a volunteer patient, so MedMock runs this station the way the exam runs it: the examiner opens each case on a scenario, often a clinical photograph or radiograph, and takes you through what you see, how you would examine for it and what you would expect to find, the named clinical tests and what a positive result means, then diagnosis and management. The JCIE does not publish how many short cases sit inside the 15 minutes; MedMock runs three of about five minutes, which is MedMock's structure.
- **5 Minute Drill** — One topic from a real oral, not a whole station. MedMock runs the 30-minute JCIE orals as six topics of about five minutes each — that shape is MedMock's practice structure, not a published JCIE format — and this is a single one of those topics, examined the same way, for drilling a weak area between full mocks. Pick any topic across the syllabus, or take a random one.

## Sample FRCS T&O questions

- *Adult elective orthopaedics including spine:* Why does acute haematogenous osteomyelitis begin in the metaphysis, and how does the local anatomy dictate where the pus goes and how you drain it? Include the joints where the anatomy converts osteomyelitis into septic arthritis.
- *Adult elective orthopaedics including spine:* A 65-year-old woman with adhesive capsulitis. Discuss management.

## Example scenarios

- *Trauma including spine:* A 25-year-old polytrauma patient with a Gustilo IIIb open tibial fracture, 5 cm segmental bone loss, and absent distal pulses after splinting. Talk through your damage-control strategy, the orthoplastic plan under BOAST 4, and limb-salvage vs amputation decision-making.
- *Adult elective orthopaedics including spine:* A 68-year-old with painful knee osteoarthritis despite non-operative care. Discuss your assessment, suitability for knee replacement, and management of complications.
- *Children’s orthopaedics / Hand and upper limb:* A 5-year-old with a displaced Gartland III supracondylar humeral fracture post-fall, AIN palsy, hand pink and pulseless. Discuss assessment, classification, management and consent the parents.
- *Applied basic sciences related to orthopaedics, including anatomy and surgical approaches, pathology, biomechanics, audit, methodology & outcome based medicine:* Describe the deltopectoral approach to the shoulder and the structures at risk, discuss the biomechanics of glenoid component wear in modern reverse arthroplasty design, and outline an audit cycle around 30-day readmission after primary shoulder arthroplasty.
- *Intermediate case 1 — history & discussion:* A 58-year-old right-hand-dominant electrician with six months of night pain and weakness in the right shoulder. Take a focused history; the examiner will then give you the examination findings and imaging, and discuss diagnosis, investigations and management with you.
- *Intermediate case 2 — history & discussion:* A 68-year-old with groin pain on walking, now limiting them to 400 yards, ten years after a right total hip replacement. Take a focused history; the examiner will then give you the examination findings and radiographs, and discuss the differential for the painful THR and your management plan.
- *Short cases — upper limb:* Look at this photograph of a 54-year-old's hand. Describe what you see. How would you examine this patient, what would you expect to find, and which clinical tests would you use? Then take me through your diagnosis and management.
- *Short cases — lower limb:* This 62-year-old walks in with the gait you can see here. Describe it. How would you examine the hip and knee for this, what would you expect to find, and what would you do next?

## How a practice session works

1. **Choose a question** — Pick from the FRCS T&O questions — all 9 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 T&O questions?

Yes. You can pick any of the 9 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