Two hurdles, not one total.

The rule that matters most

That makes the two sections independent hurdles, and it has a direct consequence for revision: strength in one section does not compensate for weakness in the other. Marks are not pooled.

How the pass mark is set

Each station is assessed twice over: a mark for each domain using structured descriptors, and an overall judgement of the performance as a whole — pass, borderline or fail. So every station yields both a mark out of 20 and a global rating.

Those two together drive borderline regression: the station’s pass mark is derived from the relationship between the marks awarded and the global ratings, rather than being fixed in advance. A circuit’s pass mark is then compiled from the pass marks of its individual scenarios, and 0.84 SEM is added to each of Knowledge and Skills to hold the standard.

• Scenario-level calculations draw on every UK sitting back to February 2013, capped at the most recent 500 uses of that scenario.
• Only scenarios not significantly altered in that period are included.
• Each circuit gets its own pass mark. Circuits differ slightly in difficulty, so the pass mark differs slightly between them — it is not a fixed percentage.
• A circuit is identical across all UK and Ireland centres running on a given day, and may repeat on a later day in the same diet.

ICBSE notes that because both sections must be passed together, the effective SEM for the exam as a whole exceeds the 1.0 generally treated as a desirable minimum.

What actually happens on the day

• Stations run 9 minutes each. You get one minute outside to read the instructions, which stay available inside the bay.
• In physical examination and history-taking stations a signal comes at 6 minutes: present your findings from that point.
• Two examined stations are preceded by a 9-minute preparation station. With rest stations, the circuit totals about 20 stations.
• The stations are split into two circuits with an interval of roughly 15 to 20 minutes between them.
• Total duration is approximately 3 hours 30 minutes.
• One station may be pre-tested and does not count towards your mark. You are not told which.
• Photographic ID is required; phones and electronic devices are handed in before the circuit; a dress code applies for infection control.
• At the end there is a debrief, a feedback form, and an informal discussion with the Supervising Examiner.

Attempts

Part A must be passed before applying for Part B. Candidates are allowed up to six attempts at Part A and four attempts at Part B, irrespective of the interval between them; one further attempt may be granted under the Additional Attempt Policy. Part B must be passed within seven years of passing Part A — otherwise Part A has to be taken and passed again. That seven-year limit is an ICBSE regulation, not a GMC rule.

What the exam demands, in numbers

From ICBSE’s most recent published annual report, covering 1 August 2023 to 31 July 2024:

Roughly two candidates in five do not pass at a given sitting. The pass mark moves between circuits by up to about a dozen marks, which is the borderline regression working as described rather than a fixed bar.

Candidates receive feedback showing their mark in each broad content area, Knowledge and Skills, as well as for the OSCE overall.

What this changes about revision

• Balance across the two sections, not across the whole exam. Marks do not pool, so a strong Knowledge section cannot rescue a weak Skills section. The study plan in this pack sequences within each section for that reason.
• The global rating is a second judgement, not a summary of the marks. A performance can accumulate marks and still read as borderline overall; the two are recorded separately.
• There is no fixed percentage to aim at. The pass mark is generated per circuit, so the useful target is the standard described in the descriptors, not a number.
• The 6-minute signal is a structural fact, not a suggestion. In examination and history stations, everything you have not elicited by then has to be presented as unfinished.

Sources

• ICBSE, Standard Setting in the MRCS Part B (OSCE) — borderline regression, the two-section rule, 0.84 SEM, circuit-specific pass marks.
• ICBSE, MRCS Part B OSCE: candidate instructions and guidance notes, August 2021 — timings, preparation and rest stations, section mark totals, conduct on the day.
• ICBSE, Regulations for the Intercollegiate MRCS Examination, January 2025 — attempt limits (3.10) and the seven-year limit on passing Part B after Part A (4.2–4.3).
• ICBSE, Guide to the intercollegiate MRCS examination, August 2021 — blueprint and the domain mark allocations.
• ICBSE, Annual Report 2023/24 — candidate numbers, pass rates, pass-mark ranges, reliability.

The MRCS is set by ICBSE on behalf of the four surgical Royal Colleges. This page summarises their published material; it is not theirs and is not endorsed by them. Where a figure was ambiguous in the source, it is reproduced as published rather than interpreted.