How to prepare for the FRCS T&O
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.
Step by step
- 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
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
The official Section 2 format, the scope of the exam and the attempt limits.
- Trauma & Orthopaedic Surgery Syllabus Blueprint 2023
How each syllabus item maps to Section 2 and the other assessments; use it to check you have covered the breadth.
- JCIE Marking Descriptors
The 4 to 8 rating scale Section 2 examiners use for knowledge, higher-order thinking, clinical skills and professionalism.
- JCIE: Oral Question Development
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
The JCIE's 12-minute video on what to expect before, during and after Section 2.
- Trauma & Orthopaedic Surgery Curriculum: appendices (ISCP)
The T&O syllabus and the list of critical conditions and key topics.
Practise with MedMock
MedMock runs all eight Section 2 stations by voice: the four 30-minute orals, the two short-case stations on clinical scenarios, and the two intermediate cases as history and discussion, with the examiner supplying the examination findings. With no patient to examine it cannot assess examination technique; the six topics per oral are MedMock's practice format, not a JCIE one, and scores are practice scores, not predicted results. A five-minute drill lets you practise a single topic, as in the worked example.
Questions candidates ask
How many attempts do I get at Section 2?
Four, with no re-entry, and the whole process must be finished within seven years. Attempts at the Joint Surgical Colleges Fellowship Examination count towards the same total.
Is there a published pass mark?
No numerical pass mark is published; the standard is a day-one consultant in the generality of the specialty. If you are unsuccessful, your Final Performance Report shows each station's pass mark and the mark you achieved.
Who examines me?
Examiners work in pairs and mark independently, with reference to the marking descriptors and a standard agreed at a calibration meeting before each diet.
When is my Section 2 date set?
You give a preferred Section 2 option, which you can change free of charge by emailing the JCIE before your confirmed Section 1 exam date; after that, penalties apply. Your Section 2 date is confirmed when you are told you are eligible to proceed, and your preferred option cannot be guaranteed.
How long should I prepare?
The JCIE does not set a preparation period. Because your Section 2 date follows directly from your Section 1 result, it helps to start clinical and oral practice while you are still revising for Section 1.
Sources
- JCIE Policy SR11 v8.0: Regulations relating to the Intercollegiate Specialty Examination in Trauma & Orthopaedic Surgery (last reviewed Aug 2025)
- JCIE Policy G35 v1.1: Structured oral question writing guidelines
- JCIE Policy G1 v10.0: Guidance Notes for Applicants
- JCIE: Trauma & Orthopaedic Surgery Syllabus Blueprint 2023 (v2.0, reviewed Jul 2023)
- Trauma & Orthopaedic Surgery Curriculum, Appendix 3: Critical Conditions and Key Topics (ISCP, Aug 2026)
- JCIE Policy G38 v3.0: Marking Descriptors (last reviewed 9 Feb 2024)
- JCIE: Trauma & Orthopaedic sample oral questions
- JCIE: Trauma & Orthopaedic Surgery (specialty page)
- JCIE: Oral Question Development
- JCIE: News (May 2026 update)
- JCIE: Specialty information - information for all candidates
- Trauma & Orthopaedic Surgery Curriculum: appendices (ISCP)
- Trauma & Orthopaedic Surgery Curriculum: 5 Programme of assessment (ISCP)
- JCIE: Frequently Asked Questions
Checked on 27 September 2026.
Exams and their regulations change. MedMock is not affiliated with any examining body; always check the current guidance on the official site before you book.