FRACS Orthopaedic Surgery Fellowship Examination Format Explained
Overall structure
Seven segments: two written papers plus five clinical/viva segments, marked on the Expanded Close Marking System.
Components and structure
The FRACS Orthopaedic Surgery Fellowship Examination is assessed across the following components:
- Paper 1 (mixed-format) — 75 questions, 130 min. X-Type (True/False) MCQs, no negative marking; pass mark relative to cohort mean.
- Paper 2 (mixed-format) — 150 min. 2 essays, 2 generic surgical competency SAQs, 10 ISAWEs (image-based).
- CC1 (computer-based clinical scenarios) (viva) — 35 min. 4 scenarios.
- CC2 (live patients) (viva) — 3 stations, 35 min. 3 live patients.
- Clinical Investigation & Management viva (viva) — 30 min. 5 scenarios.
- Operative Surgery vivas 1 & 2 (viva) — 2 stations, 30 min. computer-based, 5 scenarios each.
Marked with the Expanded Close Marking System (ECMS, grades 1-4). Written delivered electronically.
Exam format glossary
Key assessment formats used in the FRACS Orthopaedic Surgery Fellowship Examination, defined. Each definition is general and applies across colleges.
- Multiple Choice Question (MCQ)
- A written item that presents a clinical or factual stem with several answer options, of which one or more are correct, marked automatically against a key.
- Short Answer Question (SAQ)
- A written question that requires a structured free-text response, marked by examiners against a model answer or rubric rather than by machine.
- Viva voce
- A structured oral examination in which examiners question the candidate in real time, assessing reasoning, justification and depth of understanding under pressure.
What the format means for your preparation
The single most common preparation mistake is studying as if the examination only had an MCQ component. Format-aware preparation looks like this:
- MCQ components reward high question volume and pattern recognition. Read explanations, not just answers, and revisit weak domains with spaced repetition.
- Short answer / SAQ components reward a prioritised, structured response under time pressure. Practise writing complete answers in the available time, not just outlining points.
- Viva or OSCE components reward verbalised structured reasoning. Practise aloud, ideally with feedback, rather than rehearsing silently.
- Practical or image-based components reward repeated exposure under time pressure. Build a routine that includes timed slide or image interpretation.
What separates pass from fail under this format
Across multiple sittings, these failure modes recur:
- Viva station anxiety: structured communication of orthopaedic management is a learned skill that requires repeated practice.
- Basic science underprepared - biomechanics and musculoskeletal science remain examinable even at Fellowship level.
- Subspecialty gaps: spine surgery, hand surgery, and sports medicine require dedicated preparation.
- Insufficient written practice; structured SAQ-style answers differ from clinical documentation habits.
How PRIMEX maps to the format
- SAQ practice with AI feedback calibrated to FRACS Orthopaedic examination standards.
- Viva simulation for structured presentation of orthopaedic clinical reasoning.
- Curriculum-mapped study resources across all orthopaedic subspecialties.
Start your 7-day free PRIMEX trial for the FRACS Orthopaedic Surgery Fellowship Examination and practise in the format you will actually sit.
Start free trialFrequently asked questions
What is the format of the FRACS Orthopaedic Surgery Fellowship Examination?
Seven segments: two written papers plus five clinical/viva segments, marked on the Expanded Close Marking System.
How many components does the FRACS Orthopaedic Surgery Fellowship Examination have?
The examination has 6 assessed components, examined and weighted as the examining body specifies. The structured breakdown above reflects the official examination materials.
Which component is hardest?
Difficulty varies by candidate. Most fail-tier outcomes trace back to underprepared structured-answer technique or insufficient question practice volume rather than to one specific component.
How should the format change how I prepare?
Match your practice mode to the format. SAQ paper means write structured timed answers; viva or OSCE means rehearse speaking aloud under time pressure; MCQ means build pattern recognition through high-volume practice.
Does PRIMEX cover every component?
PRIMEX covers each component of the FRACS Orthopaedic Surgery Fellowship Examination with format-specific practice: MCQ banks, AI-graded SAQ practice, and viva or OSCE simulation as the format requires.