The College Surgeons Exam in Hong Kong is a challenging and essential path to becoming a recognized surgical specialist within the Hong Kong SAR, China. Managed by the College of Surgeons of Hong Kong (CSHK) and the Hong Kong Intercollegiate Board of Surgical Colleges (HKICBSC), this comprehensive evaluation determines if a medical practitioner possesses the critical knowledge, clinical acumen, and technical skills necessary for independent surgical practice. This guide focuses on preparation for the key examination points within the Basic and Higher Surgical Training programs, which are prerequisites for achieving Fellowship of the CSHK and nomination to the Hong Kong Academy of Medicine. It is designed for doctors who have completed their initial medical degree and are committed to a career in surgery.

What the Course Entails and Exam Details

This examination is not a single test but a series of major assessment milestones embedded within a rigorous, multi-year training program. The ultimate "course" entails achieving a master-level understanding of surgical principles, specialty knowledge, and practical skills. The major exam details you must prepare for include:

• Hong Kong Intercollegiate Board of Surgical Colleges Membership (MHKICBSC) Examination:
• Part 1: Applied Basic Sciences. This covers the fundamentals of Anatomy, Physiology, and Pathology tailored to surgical practice.
• Part 2: Clinical Problem Solving. This component tests your ability to apply basic science and clinical knowledge to solve real-world patient problems.
• Part 3: Objective Structured Clinical Examination (OSCE). This is a critical practical assessment.
• Joint Specialty Fellowship Examination (Exit Exam):
• Conducted jointly with the Royal College of Surgeons of Edinburgh (RCSEd) in various specialties, including General Surgery, Cardiothoracic Surgery, Neurosurgery, Paediatric Surgery, Urology, and Plastic Surgery.
• This is the final hurdle before becoming a fellow and a specialist.
• Continuous Assessment: Throughout your training, you will be evaluated on your professional development through in-training assessments, including:
• Logbook Maintenance: A prospective record of all practical and academic activities.
• Mini-Clinical Evaluation Exercise (Mini-CEX): Observation and feedback on patient interactions.
• Direct Observation of Procedural Skills in Surgery (Surgical DOPS) and Endoscopy (Endoscopic DOPS): Structured assessment of technical skills.
• Case-based Discussion (CBD): A discussion of an actual clinical case to assess clinical reasoning.

 What to Expect in the Final Exam

While "final" can refer to the end of each stage, we will detail the expectation for the highest-level tests: the Membership Part 3 (OSCE) and the Joint Specialty Fellowship Examination (Exit Exam).

Membership Part 3 (OSCE)

• Format: A multi-station objective structured clinical examination. You will move through approximately 16 stations.
• Core Areas: Stations are divided into basic and applied science, communication skills, and clinical skills.
• Time Limit: Each station is timed, typically lasting a few minutes. The entire exam takes several hours.
• Passing Requirements: You must pass each content area to achieve an overall pass.

Joint Specialty Fellowship Examination (Exit Exam)

This exam consists of two main sections. Candidates must pass Section I before proceeding to Section II. A pass in Section I remains valid for a limited period, during which Section II can be attempted multiple times.

Section I: Written Examination

• Format: Two Multiple Choice Question papers (Single Best Answer).
• Content: Questions focus on advanced specialty knowledge.
• Time Limit: Typically 2 hours and 30 minutes per paper.

Section II: Viva and Clinical Examination

• Oral Examinations (Viva): Three separate sessions, each approximately 30 minutes long, covering:
• A. Emergency Surgery/Trauma/Critical Care.
• B. General Surgery & Principles of Surgery (or specialty equivalent).
• C. Academic Oral & Surgical Anatomy. This includes a 30-minute reading period for a scientific paper before a 15-minute viva on it, followed by a 15-minute viva on anatomy.
• Clinical Examination: Two sessions, each approximately 30 minutes long, including:
• A. Medium-length Case: 15 minutes of history taking and physical examination, followed by a 15-minute viva on findings and management.
• B. Short Cases: Examination on at least three distinct clinical cases.

The passing standard for the exit exam is set at the level of a newly qualified specialist surgeon.

How to Study and Exam Centers

Preparation for these exams must be integrated into your daily clinical work from the very start of training. A passive study method is insufficient; active participation in a surgical ecosystem is paramount.

Study Strategies:

• Master the Syllabus: Obtain the most current regulations and syllabus from the CSHK website. Every topic listed is fair game.
• Utilize Official Preparatory Courses: CSHK organizes dedicated annual prep courses, particularly for the Exit Examination, which often include mock exams, bedside teaching, and tips from external and local tutors. Invest in these courses.
• Form Study Groups: Collaborating with colleagues is essential. You can practice viva techniques, drill one another on anatomy, and review scientific papers together.
• Participate Actively in Continuous Assessment: Treat your Mini-CEX, DOPS, and CBDs as opportunities for formative feedback, not just bureaucratic check-boxes. They are designed to improve the very skills you will be tested on.
• Practice with Past Papers and Question Banks: For the written sections, familiarize yourself with the SBA/EMQ format using available resources and question banks from HKICBSC, CSHK, and affiliated colleges like the RCSEd.
• Sharpen Clinical Skills Daily: Use every patient encounter to refine your history-taking and examination techniques. Seek opportunities for supervised operative experience and document it in your logbook.

Exam Centers:

• MHKICBSC Part 1 and 2 (Written): These are typically held at the CSHK secretariat, designated hospital venues, or large examination halls in Hong Kong.
• MHKICBSC Part 3 (OSCE) and Fellowship Exit Exam (Viva/Clinical): These components require clinical settings and real patients, so they are held at various accredited hospitals in Hong Kong, such as Queen Mary Hospital, Pamela Youde Nethersole Eastern Hospital, or others designated by the CSHK. The specific locations and dates are announced on the CSHK website and communicated directly to registered candidates.

 Job Opportunities from the Course

Successfully navigating these exams is the only pathway to becoming a specialist surgeon in Hong Kong. This opens a wide range of career opportunities:

• Basic Surgical Trainee (BST): Entry-level post.
• Higher Surgical Trainee (HST): Advanced post in a specific surgical specialty.
• Member of the College of Surgeons of Hong Kong (MHKICBSC): A major career milestone.
• Fellow of the College of Surgeons of Hong Kong (FCSHK): Specialist designation.
• Specialist in General Surgery (or other subspecialties): Recognized on the Medical Council of Hong Kong's Specialist Register.
• Consultant Surgeon: Senior position within the Hospital Authority (public sector).
• Specialist Surgeon in Private Practice: A widely chosen and respected career path in Hong Kong.
• Academic Surgeon: Opportunities for teaching and research at medical schools, such as the University of Hong Kong or the Chinese University of Hong Kong.
• Hospital and Healthcare Management: Surgical experience is valuable for leadership roles.
• Medico-legal Expert: Providing expert opinion in surgical cases.

This is a long journey, but each exam passed is a testament to your growing expertise and commitment. Good luck with your preparation!