Surgical Sciences Examination

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Overview
Structure of the examination

Changes to the Urology and Cardiothoracic Surgery Specialty Specific Examinations
Application Forms

Dates and locations
Examples of questions

Scoring and answering system
Item analysis
Preparation for the Surgical Science Examinations (online resources)
Syllabus
Recommended Reading
Frequently asked questions
Examination security
Contact

Overview

All Surgical and Education Training (SET) Trainees will undertake:

Your specialty determines the Specialty Specific examination you will undertake:

Structure of the examination

As of February 2012, the Generic SSE will consist of

  • a 20 question Generic Spot Test Anatomy based question paper
  • an 80 question Generic multiple choice question (MCQ) Anatomy based question paper
  • a 120 question Generic MCQ Pathology/Physiology based question paper

The Anatomy Spot Test question paper consists of 20 image-based questions. Each question will have up to four parts to be answered. Each answer must be no longer than 8 words.

The Anatomy Spot Test Questions and MCQ paper will be conducted over two and a half hours on the first day of the Generic Examination; the Pathology/Physiology MCQ paper will be conducted over two and a half hours on the second day.

A minimum standard is required in each of the anatomy, physiology and pathology sections of the examination, at the same sitting, before a candidate can be deemed to have passed the generic examination.

The Specialty Specific SSE will consist of

  • a 120 question Specialty-Specific MCQ paper

Changes to the Urology and Cardiothoracic Surgery Specialty Specific Examinations

For trainees commencing SET in Urology and Cardiothoracic Surgery in 2012, the timing of the specialty specific examinations has changed.

The Urology and Cardiothoracic Surgery specialty specific examinations will now be undertaken from SET 3 onwards.

Any trainee who was accepted and commenced training in these specialties prior to 2012 and has not as yet completed the Specialty Specific Examination will be required to successfully complete this examination prior to the end of SET 2 to avoid dismissal from their respective specialty.

Please refer to the tables outlining the eligibility requirements for presenting for the surgical science examinations for SET 1 trainees commencing in Cardiothoracic Surgery and Urology in 2012:

Cardiothoracic eligibility requirements

  SET1 SET2 SET3 SET4
  2012 2012 2014 2015
Generic Examination X X    
Cardiothoracic Specialty     X X
Clinical Examination X X  

 

Urology eligibility requirements

  SET1 SET2 SET3 SET4
  2012 2012 2014 2015
Generic Examination X X    
Cardiothoracic Specialty       X
Clinical Examination X X    

The format of the Urology specialty specific examination will remain unchanged as an MCQ (Multiple Choice Question) examination. The Cardiothoracic Surgery specialty specific examination will consist of an MCQ and Anatomy viva examination.

A syllabus for both examinations will be available in early 2012.

Question types and allocated weighting (February 2012)

  DISCIPLINE NUMBER OF ALLOCATED QUESTIONS QUESTION TYPES PERCENTAGE
PAPER 1 Anatomy 80 60 type X & 20 type A/B 50%
20 SPOTS
PAPER 2 Pathology 60 44 type X and 16 type A/B 25%
Physiology 60 43 type x and17 type A/B 25%
    220    

Candidates are still required to achieve the pass standard in each discipline to be successful at this examination.

The suggested time allocation for the Anatomy paper is:

- 100 minutes for the 80 MCQ's

- 50 minutes for the 20 SPOT test questions

Application Forms

APPLICATIONS RECEIVED AFTER THE CLOSING DATE (5PM AEST) WILL NOT BE ACCEPTED

 

Please be advised examination application documents will not be accepted as faxed copies, under any circumstances. All examination application documents are to be either scanned and emailed, or posted to the College by the published closing dates (see below). .

Dates and locations

The Surgical Sciences Examination is conducted twice per year:

  • February-March
  • June-July

The Surgical Sciences Examination is offered in the following centres:

  • Australia: Adelaide, Brisbane, Canberra, Hobart, Melbourne, Perth, Sydney
  • New Zealand: Auckland, Christchurch, Dunedin, Wellington

Timetable

February-March 2013

Closing date - Monday 3 December 2012
SET Surgical Science (Generic) - 13 and 14 February 2013
SET Surgical Science (Specialty specific) - 15 February 2013

Examination session times (daylight saving times in Melbourne, Sydney, Hobart, Adelaide, Canberra and New Zealand):

Melbourne, Sydney, Hobart and Canberra - 10am to 12.30pm
Brisbane - 9am to 11.30am
Adelaide - 9.30am to 12pm
Perth - 8am to 10.30am
New Zealand - 12pm to 2.30pm

June-July 2013

Closing Date - Thursday 11 April 2013
SET Surgical Science (Generic) - 5 and 6 June 2013
SET Surgical Science (Specialty specific) - 7 June 2013

Examination session times:

Melbourne, Sydney, Brisbane, Hobart and Canberra - 10am to 12.30pm
Adelaide - 9.30am to 12pm
Perth - 8am to 10.30am
New Zealand - 12pm to 2.30pm

  • The venue at which you choose to present for the examination must be recorded on the application form and cannot be altered after the closing date.
  • The underlying regulations apply to candidates withdrawing from the Surgical Sciences Examination and/or Clinical Examination or when transferring to a future Surgical Sciences Examination and/or Clinical Examination.

Withdrawals from examinations

Applicants who:

  • withdraw from the examination prior to the examination closing date will be refunded 100% of the examination fee
  • withdraw from the examination more than 10 working days prior to the first scheduled day of the examination will be refunded 50% of the examination fee
  • withdraw from the examination 10 working days or less, of the first scheduled day of the examination will be refunded 25% of the examination fee.

Special circumstances and disability

Trainees and IMGs may apply for Special Circumstances if they believe that their examination performance or preparation has been hampered by illness, disability or other causes to such a substantial degree that it is likely to adversely affect the outcome of an examination. Read more about special circumstances and disability.

 

Examples of questions

Anatomy Spot Test Questions - example paper

Anatomy MCQ - example paper

 

Each of the MCQ papers contain 3 sections, with different types of questions.

The 3 types are:

  1. type A single response questions (Type A, Hubbard and Clemans, 1961), each of which calls for a single best response
  2. type B relationship analysis questions (Type E, Hubbard and Clemans, 1961), which test factual knowledge as well as cause-effect relationships
  3. type X multiple true-false questions (Type X, Hubbard and Clemans, 1961), where each question has 4 statements to each of which candidates respond.

The 3 types of questions are used with the intention of testing different cognitive abilities:

  • Type A - attempts to test judgmental ability.
  • Type B - ability to understand relationships.
  • Type X - factual knowledge and its application.

Visual questions - A proportion of questions used in an MCQ examination will refer to photographs, photomicrographs, radiographs, computed tomography scans, etc. Candidates are required to respond to questions based on visual trigger materials, such as histology micrographs, photographs of gross specimens and radiographs. These questions test recognition of structures, as well as recall of information.

Examination papers may include illustrations from:

  • Color Atlas of Anatomy, 5th edition, - Rohen, J.W. & Lutjen-Drecoll, E., Williams & Wilkins
  • Colour Atlas of Anatomical Pathology, 2nd edition, 1995 - Cooke R., Stewart B., Churchill Livingstone - The illustrations from this publication are from the files of the Royal Brisbane Hospital.
  • CD-ROM McMinn's Interactive Clinical Anatomy - Mosby - Williams & Wilkins Pty. Ltd.

Type A: Single-response questions (Hubbard & Clemans Type A)

Each of these questions has only one correct response. The question consists of a stem, which is an incomplete statement or a question, followed by a series of 5 alternative completions or answers to the stem. The candidate is instructed to select the 1 completion or answer to the stem that is considered most appropriate.

Example 1 - The most important factor increasing blood flow through an active muscle is:

A) adrenaline release during exercise
B) activation of sympathetic dilator fibres
C) reduced constrictor tone in the arterioles of the muscle
D) local action of metabolites on vessels in the muscle
E) the "muscle pump" action

Of the 5 alternatives, D is clearly the best, as local mechanisms are the most important in maintaining the high blood flow in skeletal muscle during exercise.
B is an incorrect statement.
A, C and E are incorrect responses as each, though increasing blood flow, does not do so as significantly as D.
Thus the correct response is D.


Type B: Relationship-analysis questions (Hubbard & Clemans Type E)

Each of these questions has a statement or assertion (S) and a reason (R), each of which may be true or false. It is first necessary to determine if each of S and R is true or false. If, and only if, both S and R are true, a further decision has to be made in determining if R explains S. The candidate then marks the answer sheet according to the following key:

A - if S is true, R is true and is a valid explanation of S.
B - if S is true, R is true but is not a valid explanation of S.
C - if S is true and R is false.
D - if S is false and R is true.
E - if both S and R are false.

Example 2
S - Vitamin C is necessary for normal wound healing
because
R - Vitamin C is necessary for the hydroxylation of proline during collagen formation

In this question, both S and R are true statements, and R is the reason for vitamin C being necessary for normal wound healing. Thus the correct response is A.

Example 2
S - After developing Cushing's disease patients can show a decrease in height
because
R - Abnormalities in muscle function are common in patients with Cushing's disease

In this question both S and R are true as decrease in height and proximal muscle weakness are clinical features of Cushing's syndrome. The decrease in height is, however, due to osteoporosis and pathological fractures of the spine and not to abnormalities in muscle function. Thus the correct response is B.


Type X: Multiple true-false questions (Hubbard & Clemens Type K)

In each of these questions, an incomplete statement or question, which forms the stem, is followed by 4 suggested completions or answers, each of which is either true or false. The examinee has to identify each alternative as being either true or false.

Example 3 - The facial nerve:
A) contains taste fibres from the anterior two-thirds of the tongue
B) arises from the pontomedullary junction medial to the vestibulo-cochlear nerve
C) has a sensory root which is larger than the motor root
D) supplies the buccinator muscle

In this question, each of the completions A, B and C is false, because the facial nerve contains taste fibres from the anterior two-thirds of the tongue, arises medial to the vestibulo-cochlear nerve and has a sensory root lateral to the motor root. Only D is true.

 

Scoring and answering system

Before decisions are made at the meeting of the Surgical Science and Clinical Examination Committee, discipline subcommittees study question performance data provided by the computer centre, and identify questions which may have been keyed incorrectly for one reason or another. Such questions are usually very few in a given examination. When detected, these questions are omitted from the scoring and further analysis of the data. Reliability estimates of the board's examinations have been consistently high (Kuder-Richardson reliability more than +0.90), with correspondingly small standard errors of measurement. Each candidate whose score falls within one standard error below the pass mark is carefully studied before a decision is made on his/her fate.

A certain proportion of the questions in each examination has been used in previous examinations and performance data are therefore available on them. These questions serve as "marker questions", which enable the board to determine the relative difficulty of a given examination in relation to previous examinations. The pass mark for each examination can thus be adjusted to allow for slight fluctuations in examination difficulty. The board's experience is that such fluctuation is small, but not negligible, and borderline candidates may be affected by it.

Many factors are taken into consideration before a decision is taken on the fate of a borderline candidate. These include how close the score is to the pass mark (for example, within one standard error), performance of the candidate in previous attempts, if any, and whether other extenuating circumstances may have disadvantaged the candidate.

A minimum pass mark, which is somewhat lower than the aggregate pass mark, is set for each of the components in the examination: anatomy, physiology and pathology. A candidate whose aggregate mark is above the pass mark, but whose mark in one or more components is below the pass mark in that component, fails the examination. Candidates are advised to refrain from neglecting any discipline in preparing for the examination.


Neurosurgery Specialty Specific Examination

Since 2011 the Board in Neurosurgery has adopted a modified version of the standard setting procedure to that applied by General Surgery, Urology, Otolaryngology Head and Neck Surgery, Cardiothoracic Surgery and Vascular Surgery for the Specialty Specific Examination.

At a workshop prior to the examinations for the coming year, consultants in Neurosurgery will determine the pass mark for the examinations by undertaking a modified Angoff method of standard setting. This panel will collaborate to make a judgement of the expected performance of a borderline candidate at each question that will be included in the examination. By undertaking this prior to the examinations, it will allow the Board in Neurosurgery the ability to ensure the pass mark remains consistent.

This is not a change in the current methodology of determining the pass mark or the standard applied. Rather it is a reversal of the procedure so that the pass mark determines the selection of questions for each examination as opposed to the selection of questions determining the pass mark. The pass mark must be variable if the Angoff method is undertaken after the examination to ensure the standard of the examination remains consistent. The Board in Neurosurgery has recommended that the pass mark will be up to 75%. A review of the questions used in the examination will be undertaken to ensure the examination was valid; however, there will be less consideration required of the performance of borderline candidates as the pass mark was determined prior to the examination.

Also view: Neurosurgery SSE - Recommended reading list and advice


Answering system - Answer sheets for the Surgical Science Examination are read by an optical scanner. Therefore, candidates must:

  • use lead pencil
  • blacken the circle corresponding to selected response.

Note: A wrong answer may be erased but, unless the eraser is complete, the optical scanner may read 2 marked responses to a question, and register an incorrect response. Candidates are advised to quip themselves with a spare lead pencil and an eraser.

Item analysis

The difficulty and discriminating indices of each question are determined by computer analysis after each examination. The former is a misnomer and should really be called the easiness or facility index as it represents the percentage of candidates who answered that question correctly. This index is spread throughout the percentage range, showing that questions are of varying difficulty, though the majority are in the 20% to 80% range.

The discriminating index of a question (which is also known as the biserial-r correlation coefficient) is an estimate of the extent to which candidates' scores on that question correlate with their scores on the whole examination. Theoretically, this value could range from -1.00 to +1.00, though for the majority of the questions it is positive, as is to be expected. If for a given question this value is below +0.20, and especially if it is negative, the question is reviewed carefully to determine whether any flaws in construction or in keying exist.

Intermittent workshops are held for examiners on the construction of multiple choice questions and on the use of performance data. Particular attention is paid to the avoidance of ambiguity of wording, clues and other common construction errors. In all questions, standard international units are used. Where this may be confusing the more common alternative is given in parentheses, for example 10 kPa (75mm of mercury).

Standard symbols include:

  • metre = m
  • millimetre = mm
  • kilogram = kg
  • gram = g
  • litre = l
  • millilitre = ml
  • mole = mol
  • millimole, milliosmole = mmol
  • degree celsius = °C
  • second = s
  • millisecond = ms
  • Ampere = A
  • Hertz = Hz.

Abbreviations or acronyms when used to save repetition are initially included in parentheses after the full term. For example, endoscopic retrograde cholangiopancreatogram (ERCP) and intravenous pyelogram (IVP).

Preparation for the Surgical Science Examinations (online resources)

These online resources are for members only (login required):

Syllabus

View detailed features of each area of the Generic SSE

Recommended reading

Frequently asked questions

View the frequently asked questions about the Generic Surgical Science Examination and the Specialty Specific Surgical Science Examination.

Examination security

The College takes great care to ensure absolute security in the examination system:

  • Candidate credentials and particulars are carefully checked.
  • All examination material is prepared at the College in Melbourne and sent under seal to examination sites where it is opened under supervision.
  • The examination is held simultaneously in all centres. Each copy of the examination paper is collected at the end of each examination.
  • Used and unused papers are packed, sealed and returned to the College for checking.
  • Visual material is included with the Surgical Sciences Examination papers.

As a result of these precautions any missing examination material can be traced.

Contact

Examinations Department
Royal Australasian College of Surgeons
College of Surgeons' Gardens
250-290 Spring Street
East Melbourne VIC 3002 Australia

Telephone: +61 3 9249 1244
Fax: +61 3 9249 1298
Email: examinations@surgeons.org