Updated intercollegiate statement on the recent MRCS Part A exam question

15 Sep 2022

A spokesperson for The Intercollegiate Committee for Basic Surgical Examinations (ICBSE) of the Surgical Royal Colleges of the United Kingdom and Ireland said:

We have urgently reviewed how this question was included in the exam. 

This summer a panel representing the four surgical colleges of the UK and Ireland undertook a large-scale re-write of the Membership Examination of the Surgical Royal Colleges of Great Britain and Ireland (the MRCS) exam questions, in order to keep them updated.

There was previously a question designed to test surgeons’ understanding of the relative risks of different blood borne viruses.  Tasked with writing a question to test this, the panel drafted a question that asked candidates:

  • While taking a blood sample from a 27-year-old homosexual man, a junior doctor has a problem with the safety feature on the needle and sustains a needle stick injury. What is the most likely infection transmitted in this situation? 
    A. Hepatitis B
    B. Hepatitis C
    C. HIV
    D. Human T cell virus
    E. Malaria

The correct answer to this question is Hepatitis B, which is highly infectious, not HIV, because well-controlled HIV presents a very low risk to clinical staff in the event of needle stick injury. 

This question was designed to test candidates’ knowledge of the risks. HIV, if present, treated or untreated, represents a lower risk than Hep B in this situation.  With Hep B being the correct answer, any candidate who answered HIV would not receive a mark.  That being the case, the question was not designed to reinforce outdated perceptions of HIV, indeed quite the contrary.  The question rewarded those who know that HIV carries less risk than Hepatitis B and controlled HIV carries very little risk.

Nevertheless, we understand the question was poorly worded and has caused offence. We will not be using it again.