Orthopaedic Exam Day: What to Expect and How to Prepare

Orthopaedic exam day is long, tightly timetabled and run by people who do this every year. Most of what goes wrong on the day is avoidable: wrong venue, missing ID, a night of cramming, a bad station carried into the next one. This guide sets out what actually happens on the day at the FRCS (Tr & Orth) Section 2, the FRACS Orthopaedic Surgery Fellowship Examination, ABOS Part II and the EBOT oral, using each board's published rules, then how to use the final week and the last 24 hours. For the psychology of nerves and stamina, read the companion article on managing exam nerves and performance anxiety.

What happens on the day: exam by exam

Each board sends joining instructions, and those override anything written here. What follows is what the boards publish.

FRCS (Tr & Orth) Section 2

Section 2 is the clinical component of the Intercollegiate Specialty Examination run by the Joint Committee on Intercollegiate Examinations (JCIE) (opens in a new tab). Since August 2022 it has consisted of:

• Clinical: two 15-minute intermediate cases with volunteers, plus one 15-minute upper limb and one 15-minute lower limb short case built on clinical scenarios.
• Orals: four 30-minute vivas covering adult elective orthopaedics including spine; trauma including spine; children's orthopaedics with hand and upper limb; and applied basic sciences.

The volunteers are past or present patients recruited by the host examiner, and the exam is held in pre-selected host centres in the UK and Ireland. JCIE confirms your Section 2 date by email once you are eligible. The pass standard is set at "the level of a day one consultant in the generality of the specialty" (JCIE Guidance Notes for Applicants (opens in a new tab)). The JCIE marking descriptors run from 4 to 8, and a 6 describes "competent knowledge", "no major errors" and "safe practice" (JCIE marking descriptors (opens in a new tab)).

Three JCIE rules matter on the day:

• Lateness. "No allowance will be made for a candidate who is late for an examination or who is absent from an examination as a result of misreading the instructions or timetable." It does not count as an attempt, but you normally lose the fee and must re-apply.
• Illness. If you become ill during the exam, report it immediately, and send a medical certificate dated that day to the Specialty Manager within five working days. Withdrawing during the exam for any other reason counts as an attempt.
• Unauthorised items. JCIE's malpractice policy lists notes, textbooks, mobile phones and smartwatches among material that must not enter the exam room (JCIE policies (opens in a new tab)).

The Section 2 guide covers how to prepare for each station.

FRACS Orthopaedic Surgery

The RACS Fellowship Examination in Orthopaedic Surgery has seven segments: two written papers, then five clinical/viva segments about a month later (RACS Notes to Candidates 2026 (opens in a new tab)).

• Written day. Paper 1 is 75 X-type MCQs in 130 minutes; paper 2 is 150 minutes of essays, short-answer and illustrated short-answer (ISAWE) questions, delivered electronically at Cliftons centres in Australian and New Zealand cities. RACS says the only thing you need to bring is photo identification, and phones, watches and other devices are handed in at registration (RACS writtens on the day (opens in a new tab)).
• Clinical/viva weekend. For orthopaedics, the five segments run over a Saturday and Sunday at a single venue chosen by the Court of Examiners: Clinical Cases 1 (four video scenarios, 36 minutes), Clinical Cases 2 (three live patients, 36 minutes), a 30-minute investigation and management viva, and two 30-minute operative surgery vivas.

The clinicals/vivas page (opens in a new tab) sets out the logistics. Provisional venues come about eight weeks before; your timetable and venue maps arrive four to six weeks before. Arrive at least 15 minutes before each segment, use public transport or a taxi because parking is not guaranteed, and contact the Examinations Department if you are running late, because late candidates may not be accommodated. Bring photo ID to every segment; you receive a candidate number badge at the first segment and bring it to each one after. Marshals store all watches, phones and tablets. Depending on your rotation, you may be held in quarantine until the last group has started. No catering is provided, so bring your own food; tea, coffee, water and biscuits are available, but there are no rooms for candidates at hospital venues between same-day segments.

Inside, a pair of examiners introduces themselves, addresses you by candidate number rather than name and introduces any observer, who is there to observe the examiners. Each segment is marked separately. The FRACS exam guide covers preparation.

ABOS Part II

The ABOS Part II oral examination is held each July at the Palmer House in Chicago, with roughly 800 candidates a year (ABOS Part II (opens in a new tab)). By exam day the content is fixed: you will have uploaded and finalised the images, records and case summaries for your 12 selected cases in June, and those are the only materials you may use (ABOS 2026 upload information packet (opens in a new tab)).

• Before the day. Your date and time appear on your ABOS Dashboard in late May, and your booth assignment in July.
• Arrival. You report to the candidate briefing at the time on your Dashboard "with only your photo ID. Nothing else will be permitted in the Examination Booth." ABOS asks candidates to dress in professional attire.
• Format. Four 30-minute sessions with a five-minute break between each. In each session, two examiners question you on three of your cases, about eight minutes per case. Everything you uploaded is on the examination computer; you may not bring documents or images.
• Scoring. Each examiner scores each case on nine facets, from 3 (above expected level) to 0 (unacceptable). Examiners do not make pass or fail decisions.

Results are posted on the Dashboard in early September (ABOS Part II calendar (opens in a new tab)). The ABOS certification guide covers the case list and preparation.

EBOT Part 2 oral

The EBOT oral consists of five 30-minute sessions, rotating through upper limb, lower limb, spine, children's orthopaedics and trauma, and basic sciences (EBOT oral exam (opens in a new tab)). The 2026 oral was held in Madrid in September (EFORT (opens in a new tab)). The EBOT and EFORT pages we checked do not set out arrival or ID rules for the oral, so rely on the instructions EBOT sends. Withdrawal is costly late: within 30 working days of the exam, no refund is made except in exceptional circumstances. The EBOT/FEBOT guide has the full format.

At a glance

The final week: rehearse, do not learn

By the last week the knowledge you take into the exam is largely set. What the week can still change is delivery.

• Stop adding new topics. New material learned this late is fragile, and finding new gaps erodes confidence. Consolidate what is mostly solid.
• Switch from input to output. Run timed mock vivas out loud, ideally with someone playing examiner, and do timed questions if you still have a written component. Rehearse the opening of your answers until it is automatic; passing the orthopaedic viva sets out the structures worth rehearsing.
• Rehearse at the right time and length. Sit at least one full-length mock at the times of the real exam. The guide to mock exams covers how to get the most from them.
• Protect sleep. In a meta-analysis of short-term sleep deprivation, the largest effect was on simple attention and the smallest on reasoning accuracy (Lim and Dinges 2010 (opens in a new tab)). A long day of stations depends on sustained attention.
• Make the logistics boring. Reread your joining instructions. Confirm the venue, the route, the travel time and the arrival time for each session. For FRACS, check whether your segments are at more than one venue on the same day. Book accommodation close to the venue if you are travelling.
• Check what to bring. Valid photo ID, your candidate details and food if your board does not provide catering. If you are not sure whether to bring clinical equipment for patient stations, ask the exam office rather than guessing.

The last 24 hours

Stop revising by the afternoon. The urge to review one more classification comes from anxiety, not need. A late session costs sleep and tends to surface gaps you cannot fix.

Pack the night before. Lay out ID, clothes, joining instructions and a printed map. Dress as you would for a consultant clinic; ABOS asks for professional attire, and clothes you can examine in matter for patient stations.

Eat something familiar. This is not the evening to try a new restaurant near the venue. Drink water through the evening, tapering before bed.

Skip alcohol. In a review of studies in healthy volunteers, alcohol at every dose delayed the first REM sleep period and increased sleep disruption in the second half of the night; at moderate and high doses, most studies also found less total REM sleep (Ebrahim 2013 (opens in a new tab)).

A warm shower or bath may help you fall asleep. A meta-analysis found that a warm shower or bath at 40–42.5 °C, taken one to two hours before bed for as little as ten minutes, shortened the time taken to fall asleep. The authors note the research is limited (Haghayegh 2019 (opens in a new tab)).

Do not experiment. No new sleeping tablets, no new supplements, no change to your usual caffeine pattern.

Accept a poor night. Many candidates sleep badly before a viva. One short night is not total sleep deprivation, and the sleep you protected through the final week counts for more.

The morning

Eat a familiar breakfast even if you are not hungry, have your usual coffee and leave with a time buffer that covers a delayed train. Speaking out loud while you get ready, for example talking through a standard surgical approach, warms up the voice you will use for the next few hours.

At the venue, avoid the groups of candidates quizzing each other on rare conditions; it raises anxiety and changes nothing you know. Find a quiet corner. In a Science study, students who did a brief writing exercise about their worries immediately before an important test scored higher, especially those who were habitually anxious (Ramirez and Beilock 2011 (opens in a new tab)); bin the page before you go in. The anxiety article covers that and the breathing evidence in detail.

In the room

Clinical stations. Introduce yourself, ask for consent, ask about pain before you touch, expose appropriately and compare with the other side. Examiners watch your hands and your communication as well as your diagnosis. A common condition diagnosed efficiently with a sensible plan scores better than an esoteric guess.

Vivas. When an image is put in front of you, state the modality and view, then describe what you see before naming a diagnosis. For trauma, start with resuscitation. Thinking aloud in a structure gives examiners something to mark even when the final answer is wrong.

Being moved on. RACS states that examiners "may move the candidate along to the next portion of the viva" if the candidate has "clearly exhausted their knowledge in an area, or they have satisfied the examiners requirements" (RACS Notes to Candidates 2026 (opens in a new tab)). A change of topic is not a verdict. RACS also tells candidates to ask for clarification when stuck, to follow an examiner's prompt to reconsider, and to say so if they have never done the operation being discussed, then describe how they would manage it from reading.

Between stations. Leave the last station behind. Do not compare answers with other candidates in quarantine or the corridor.

After the exam

ABOS posts results on the Dashboard in early September. At FRACS, unsuccessful candidates receive a composite written report from the Senior Examiner within two weeks and should arrange an interview with their Board Chair and Supervisor within four weeks of the exam (RACS Notes to Candidates 2026 (opens in a new tab)). If the result goes against you, retaking an orthopaedic fellowship exam covers what to change; if it goes your way, see what to do after passing.

For how the four exams compare in format and preparation, see the global orthopaedic board exam atlas.