A 14-Week FRCS (Tr & Orth) Revision Plan

Who this is for

Registrars with a Section 1 sitting three to four months away who are working a full rota. It assumes you have several years of trauma and orthopaedics behind you and need to turn clinical experience into exam-ready judgement across the whole specialty, including the subspecialties you have not rotated through recently.

Principles

Question-first revision

Answer a timed block on a topic before you read about it. The questions you get wrong, or right for the wrong reason, define what you read. That is faster than reading a chapter end to end, and closer to what the paper asks of you.

Time in proportion to breadth

The JCIE publishes no question weightings, so no plan can match the paper exactly. This one gives each domain time in proportion to its breadth in our map of the syllabus: trauma and applied basic science are the two largest areas and take five weeks between them; paediatrics is next; hip, knee, shoulder and elbow, and hand and wrist take about a week each; foot and ankle, spine and oncology are smaller. If your own experience is thin in one area, move time towards it.

Spaced repetition

Return to every area at widening intervals: a few days, then a week or two, then a month. A topic covered once in week 2 and never again will have faded by the exam, so each week below includes a review block of questions from earlier weeks.

Confidence rating

Rate your confidence before each answer. A wrong guess is a gap. A wrong answer you were sure of is a dangerous misconception: a belief you would act on in the exam and in clinic. Review those first, every week.

Timed practice

Each paper allows a little over a minute per question. Pace is a skill learned only against the clock, so do timed blocks from week 1 and full papers from week 8.

Revising around a rota

Plan for the weeks that go wrong. A short daily habit — ten questions on the commute, or the five-question Daily Five between cases — survives nights and on-calls, and frees rest days for longer blocks and mocks.

The plan at a glance

Weeks 1–5: basic science and trauma

These two domains are the broadest, and they underpin the rest: an arthroplasty question is often really about tribology, and a paediatric fracture question about the physis. Secure them first and keep them warm with review blocks for the rest of the plan.

• Week 1: bone structure, remodelling and fracture healing; cartilage, meniscus, tendon, ligament, muscle, nerve and disc; calcium homeostasis and metabolic bone disease; inflammatory and crystal arthropathy; genetics and skeletal dysplasia. Start with fracture healing and strain theory.
• Week 2: the stress–strain curve, viscoelasticity and fatigue; plates, nails and working length; metals, polyethylene, ceramics and cement; lubrication, wear and osteolysis; free body diagrams of the hip and the gait cycle. Read the stress–strain curve.
• Week 3: damage control and resuscitation; open fractures and the BOAST timings; compartment syndrome and vascular injury; non-union and fracture-related infection; shoulder girdle, humerus, elbow, forearm, distal radius, carpus and hand.
• Week 4: pelvic ring and acetabulum; hip fracture and the NICE guidance; femoral shaft, distal femur and periprosthetic fractures; tibial plateau, shaft and pilon; ankle; talus, calcaneus and Lisfranc injuries.
• Week 5: cervical and thoracolumbar injuries, cord syndromes and clearance; then surgical approaches and nerves at risk, bone and joint infection, thromboprophylaxis, imaging and neurophysiology, statistics, study design, consent and ethics.

Weeks 6–9: the adult regions

• Week 6: hip. Templating, fixation and bearing choice; dislocation, infection and periprosthetic fracture; bone loss and revision; impingement, dysplasia and avascular necrosis.
• Week 7: knee. Alignment, bone cuts and gap balancing; unicompartmental replacement and osteotomy; the stiff, unstable or infected replacement; cruciate, collateral and posterolateral corner injuries; meniscus, cartilage and the patellofemoral joint.
• Week 8: shoulder and elbow. Cuff disease and its tests; instability and bone loss; anatomic and reverse arthroplasty; frozen shoulder and the acromioclavicular joint; elbow instability, stiffness, arthritis, distal biceps and nerve compression. Sit a timed 120-question paper at the end of the week.
• Week 9: hand and wrist. Compression neuropathy and nerve injury; osteoarthritis and the rheumatoid hand; Dupuytren’s disease, tendon disorders and infection; carpal instability, scaphoid non-union, the distal radioulnar joint and Kienböck’s disease; brachial plexus and tendon transfers.

Weeks 10–12: paediatrics and the smaller domains

• Week 10: paediatric orthopaedics, the third-largest domain and for many candidates the least familiar. Developmental dysplasia, Perthes disease and slipped upper femoral epiphysis; clubfoot and foot deformity; rotational and angular deformity and limb length; cerebral palsy; physeal injuries, supracondylar fractures and non-accidental injury; infection, dysplasias and syndromes. Give it a full, heavy week.
• Week 11: foot and ankle — hallux valgus and rigidus, lesser toes, the diabetic foot and Charcot, ankle and hindfoot arthritis, flatfoot, cavus and instability — then musculoskeletal oncology: staging and biopsy, the benign and malignant bone tumours, soft-tissue sarcoma, metastases and myeloma.
• Week 12: spine — cervical radiculopathy and myelopathy, lumbar disc disease, stenosis and spondylolisthesis, cauda equina syndrome, infection and tumour, scoliosis and kyphosis, the inflammatory spine. Use the rest of the week on your weakest domain so far, and sit a second timed 120-question paper.

Weeks 13–14: mocks and repair

Sit the first full two-paper mock exam early in week 13, on a rest day, under exam conditions: both papers, 2 hours 15 minutes each, with a break between them. Then spend longer reviewing it than you spent sitting it.

• Sort every wrong answer into gap (did not know), misread (knew, but missed a detail in the stem) or misconception (confidently wrong). Each needs a different fix.
• Rework your three weakest domains with targeted blocks, not with re-reading.
• Sit the second full mock early in week 14, so there are days left to act on it.
• In the last few days, revise the numbers that discriminate — guideline timings, classification thresholds, angles — and then rest. Fatigue costs more marks than a missed topic.

Shorter and longer variants

Eight weeks

Pair the weeks: basic science in one week, trauma in two, hip with knee, shoulder and elbow with hand and wrist, paediatrics on its own, the three smaller domains together, and one week of mocks. Keep the daily habit and both full mocks; cut reading, not questions.

Six months

Give each week of the plan two weeks, at about half the weekly question count. Use the extra time for a second pass through the bank in mixed, timed blocks from month four, and for a third full mock.