Ace the Exam was created in response to the paucity of resources available to junior doctors preparing for the Generic Surgical Sciences Exam (GSSE). Ace the Exam provides accurate simulated questions to replicate the exam as closely as possible, with focused explanations to aid recall and direct further study.

How to use this resource

There is no substitute for practice questions when preparing for a multiple-choice question exam. It is impossible to focus the mind adequately to fully memorise all the required material, particularly that not encountered or utilised on a daily basis in clinical practice.

The Royal Australasian College of Surgeons (RACS) states the exam is designed to ensure trainees have acquired a minimum standard of knowledge in Anatomy, Physiology and Pathology. The exam is mandatory for entry into any of the surgical specialties overseen by RACS, with around 1000 candidates sitting per year. Over one-third of these will fail. Not infrequently, it takes multiple sittings to pass.

The breadth of material to learn is what makes the GSSE challenging – though sometimes questions come up which require relatively detailed knowledge of a very niche topic. These are impossible to predict, and invariably no amount of trawling through the recommended textbooks is going to help you remember these specific facts. This is where practice questions come in.

Practice questions force you to focus your mind on a particular topic. They test your knowledge of the subject, but there is also an intrinsic technique to answering multiple-choice questions. After dedicated practice you will recognise patterns and understand what the question is looking for. Moreover, you may remember niche facts that are sufficient to answer a question correctly, even if recall of the topic overall is limited. Ultimately this exam, like all others, involves an element of game-playing. Focused preparation will always usurp broad, unfocused reading around a topic.

Exam textbooks and sections

The GSSE is written almost entirely from three key texts, stated clearly in the syllabus. These are Last’s Anatomy, Regional and Applied, 9th edition; Ganong’s Review of Medical Physiology, 25th Edition; and Robbins and Cotran’s Pathological Basis of Disease, 9th edition. Other texts and papers are mentioned in the syllabus, but the vast majority of questions you will encounter in the exam are taken from these three texts. In many cases, the questions are taken almost verbatim from the texts.

Note that these editions are far from the most recent editions of these textbooks. We would encourage candidates to stick to the recommended editions, as the exam tests knowledge of the material in the books more than it does up to date practices. Each question in Ace The Exam has a page reference to the relevant textbook, so that the candidate can confirm the correct answer, reinforce their memorisation of the particular topic and read around the topic to strengthen their knowledge.

The GSSE is split up into two papers: Anatomy, and Pathology and Physiology. Currently the Anatomy paper is 100 questions, whereas the Pathology and Physiology paper is 120. The Anatomy paper includes 20 “spotter” questions, asking candidates to identify and answer questions about an anatomical image. Each paper lasts 2 and-a-half hours (150 minutes), meaning that you have 75 – 90 seconds per question. This is not a lot of time.

Question types

There are four question designs encountered in the GSSE: Anatomy spotter questions, Type X, Type A and Type B.

Type X are the most common. There 61 type X questions in the anatomy paper, 44 in the pathology and 43 in the physiology. These feature a stem and then four true-or-false options below it. Each of these true-or-false options is worth 1 mark.

Type A are the commonly-encountered “best of five” questions. A question stem is presented, followed by a choice of answers labeled A to E. Each question is worth one mark.

Type B are a more unusual question design, aiming to test your knowledge of relationships between topics. The questions proceed as follows:

The candidate has to determine whether both S and R are true and, if so, whether they are related. The hardest decision is, when both S and R are true, whether they are truly related or not.

The anatomy paper has around 19 type A and B questions, pathology 16 and physiology 17.

In addition, the anatomy paper has spotter questions. These feature an anatomical image, with two to four follow-on questions. The answers for these are free text, and assessed after the exam. Each question is worth 8 marks overall.

Maximising your revision

Ultimately you will not be able to answer many questions correctly without having done some pre-reading and we direct candidates primarily to comprehensive study of the reference texts mentioned earlier. That said, we endorse early and consistent use of practice questions alongside reading the texts, to cement learning and focus the mind. Practice questions engage the mind effectively and can make an otherwise arduous process somewhat more enjoyable.

We make no apology for covering the same topic or area multiple times in the questions. Repetition breeds learning, but complacency (“I’ve seen this before, the answer is definitely A”) is punished by variations between individual questions. With rigorous exam practice, questions can be answered confidently, accurately and quickly. Time is a premium in the GSSE and the ability to synthesise the information in the question stem and produce an accurate answer in a short space of time is invaluable.

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