FCPS Part 2 Surgery Exam 2027: Format, Eligibility & Fee
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FCPS Part 2 Surgery Quick Summary
FCPS Part II in Surgery is the final exit exam of the College of Physicians and Surgeons Pakistan (CPSP). It has two computer-based theory papers of 100 single best answer MCQs each, then a TOACS and clinical cases held only in Pakistan. The fee is Rs 15,050, and the next theory dates are 16 February and 17 August 2027. You need four years of completed training, the IMM, an approved synopsis and a published article.
Passing FCPS Part II in Surgery gives you the FCPS fellowship and the specialist title in Pakistan. This guide covers who can apply, the research rule that now catches many candidates out, how the theory and clinical parts are marked, what to study and how to plan the last few months, with sample questions from our QBank.
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Who can sit FCPS Part 2 Surgery
FCPS Part II in Surgery is open to trainees who have completed four years of supervised training in General Surgery at a CPSP accredited unit. Before you apply you need:
- FCPS Part I passed in the relevant subject group, or a CPSP exemption.
- The Intermediate Module (IMM) passed.
- All four years of training and every required rotation completed. CPSP does not relax this for the major subjects.
- A training completion certificate from your supervisor, and your e-logbook entries up to date.
- An approved synopsis and a published article (see the next section).
Training done partly abroad must be in a unit CPSP accredits for that period. If you are not sure whether a rotation counts, ask the CPSP Department of Postgraduate Medical Education before the closing date, not after.
Research and the published article rule
Research is now a hard requirement, not something you can finish later. Under CPSP notifications issued in July and September 2025:
- Your synopsis must be approved by the CPSP Research Evaluation Unit (REU).
- You must complete the Research Methodology, Biostatistics and Academic Writing (RMB&AW) workshop before writing the synopsis.
- You need one original article based on that synopsis, with you as first author, published in an indexed journal with an impact factor or in an HEC W or X category journal.
- The article must be uploaded to your CPSP e-portal at least three months before the exam.
Journal review and publication can take six months or more, so start the synopsis early in your third year.
How to apply, step by step
CPSP publishes the exam notice with closing dates on its website. Read the eligibility section for your subject.
Make sure training records, e-logbook, IMM result, workshops and the published article are all on your CPSP e-portal account.
Apply through the e-portal and choose your theory centre in Pakistan, or one of the CPSP centres abroad that holds Part II theory.
Pay Rs 15,050 before the closing date to avoid the late fee.
Your exact date, shift and centre appear on the admit card in your e-portal account.
Theory papers
| Paper | Questions | Time |
|---|---|---|
| Paper I | 100 single best answer MCQs | 2.5 hours |
| Paper II | 100 single best answer MCQs | 2.5 hours |
Both papers are computer-based and are taken on the same day in two shifts. Questions are clinical scenarios at the level of a consultant in training: expect management decisions, interpretation of investigations and complications rather than plain recall. Only candidates who pass the theory are called for the clinical exam.
TOACS and clinical exam
The clinical exam for Surgery follows the CPSP guideline for the major subjects: a TOACS on day one, then a long case and short cases with a pair of examiners. Each part is marked out of 10 and you need 6 in each, with an overall 60%.
| Component | Format | Marks (pass) |
|---|---|---|
| TOACS | 15 to 18 stations of 4 to 8 minutes each | 10 (6) |
| Long case | 60 minutes: 30 with the patient taking a history and examining, 30 of discussion with the examiners | 10 (6) |
| Short cases | Four short cases in 40 minutes | 10 (6) |
| Total | Aggregate of all three parts | 30 (18, which is 60%) |
TOACS results are announced on the same day. A score of 55% or more lets you take the cases in that exam only; 60% or more carries forward to the next exam, so you can skip the TOACS while your theory pass is still valid.
What to study for FCPS Part 2 Surgery
CPSP does not publish a weighting for each topic. The bars below are our guide to how much time each area deserves, based on how the theory papers usually look:
A 16-week study plan
Most candidates prepare during the final months of training, so plan for about two hours on working days and more at weekends:
| Weeks | Focus | Daily target |
|---|---|---|
| 1 to 4 | Read the core text for the highest weighted areas and make short notes | 40 MCQs plus reading |
| 5 to 8 | Remaining areas, with recent guidelines for common conditions | 50 MCQs |
| 9 to 12 | Timed blocks of 100 questions, review every wrong answer | 100 MCQs on alternate days |
| 13 to 14 | Two full mock papers and weak area revision | Mock papers |
| 15 to 16 | Clinical practice: present long cases to a senior, rehearse TOACS stations | Two cases a day |
Recommended books for FCPS Part 2 Surgery
Read one core text well and use the others for reference, alongside a question bank.
| Book | Why it helps |
|---|---|
| Bailey and Love's Short Practice of Surgery | The standard text for the theory papers and the long case discussion. |
| Sabiston Textbook of Surgery | Deeper reading on management and recent evidence. |
| Schwartz's Principles of Surgery | An alternative to Sabiston for difficult topics. |
| ATLS Student Course Manual | Trauma algorithms that appear in both MCQs and TOACS stations. |
| Clinical Surgery by Das (or a similar clinical methods book) | Examination steps and case presentation for the short cases. |
Sample FCPS Part 2 Surgery MCQs
These five questions come from the free trial of our FCPS Part 2 Surgery QBank, covering general surgical topics. Tap a question to see the answer and explanation.
A 46-year-old man has symptomatic, reducible inguinal hernias on both sides, each about 3 cm. He has had no previous abdominal or pelvic surgery and is fit for general anaesthesia (ASA I). He works as a driver and wants to return to work quickly. The unit has surgeons experienced in all techniques. Which repair is preferred?A. Bilateral Lichtenstein repair at the same sittingB. Staged Lichtenstein repairs 3 months apartC. Bilateral Shouldice repairD. Laparo-endoscopic (TEP or TAPP) bilateral repairE. Bilateral Bassini repair
Answer: D. Laparo-endoscopic (TEP or TAPP) bilateral repair
Explanation: HerniaSurge recommends a laparo-endoscopic repair (TEP or TAPP) for bilateral inguinal hernias when expertise is available. Through the same three ports both myopectineal orifices are covered with mesh in the preperitoneal space. Compared with open repair it gives less early and chronic pain, faster return to work and similar recurrence rates.
A 70-year-old woman has a 1.5 cm by 1.2 cm full-thickness skin defect on her right lower eyelid after excision of a nodular basal cell carcinoma with clear margins. The tarsal plate and conjunctiva are intact, and the defect is too large for direct closure without pulling the lid down. What is the best option for reconstruction?A. Split-thickness skin graft from the thighB. Full-thickness skin graft from the post-auricular areaC. Healing by secondary intentionD. Full-thickness skin graft from the groinE. Free radial forearm flap
Answer: B. Full-thickness skin graft from the post-auricular area
Explanation: A full-thickness skin graft (FTSG) contains the epidermis and the whole dermis. It shows more primary contraction (immediate recoil when harvested) but much less secondary contraction (wound contraction during healing) than a split-thickness graft (STSG), which contains only part of the dermis. On the lower eyelid, secondary contraction would pull the lid down and cause ectropion, so an FTSG is preferred.
A 74-year-old man on long-term prednisolone 20 mg daily for interstitial lung disease presents with generalised peritonitis. Blood pressure is 82/48 mmHg despite 2 L of crystalloid, and he needs noradrenaline. Lactate is 5.2 mmol/L. At laparotomy there is gross faecal contamination from a perforated sigmoid diverticulum. What is the most appropriate operation?A. Sigmoid colectomy with primary anastomosis and no stomaB. Laparoscopic lavage and drainageC. Hartmann's procedureD. Oversewing of the perforation and drainageE. Total proctocolectomy with end ileostomy
Answer: C. Hartmann's procedure
Explanation: Hinchey IV means generalised faecal peritonitis. This patient also has septic shock (vasopressor need, lactate >2 mmol/L) and immunosuppression from steroids. These factors make an anastomosis unsafe because of a high leak risk and poor physiological reserve.
A 49-year-old man is admitted with epigastric pain radiating to the back and a lipase of 2,400 U/L. Ultrasound shows multiple gallstones and a 5 mm common bile duct. He has no organ failure at any point, no local complications on imaging and he is afebrile with normal bilirubin. By day 3 he is pain-free and eating a low-fat diet. When should he have cholecystectomy?A. Laparoscopic cholecystectomy during this admissionB. Laparoscopic cholecystectomy 6 to 8 weeks after dischargeC. No cholecystectomy unless he has a second attackD. ERCP with sphincterotomy instead of cholecystectomyE. Cholecystectomy only after a CT shows resolution of pancreatitis
Answer: A. Laparoscopic cholecystectomy during this admission
Explanation: This is mild gallstone pancreatitis (revised Atlanta: no organ failure, no local or systemic complications). The Dutch PONCHO trial (2015) showed that same-admission cholecystectomy cut readmission for recurrent gallstone-related complications (recurrent pancreatitis, cholangitis, colic) from 17% to 5% compared with interval surgery at about 4 weeks, with no increase in operative difficulty. IAP/APA, BSG and AGA guidelines therefore recommend LC during the index admission once the attack has settled.
A 27-year-old woman at 22 weeks of gestation presents with 18 hours of periumbilical pain that has moved to the right flank. Temperature 37.9°C, pulse 104/min. She is tender in the right mid-abdomen. White cell count 15.2 ×109/L. Graded-compression ultrasound does not visualise the appendix and shows a normal fetus and normal ovaries. What is the most appropriate next investigation?A. CT of the abdomen with intravenous contrastB. MRI of the abdomen and pelvis without gadoliniumC. Repeat ultrasound in 24 hoursD. Diagnostic laparoscopy without further imagingE. Plain abdominal X-ray with pelvic shielding
Answer: B. MRI of the abdomen and pelvis without gadolinium
Explanation: Ultrasound is first line in pregnancy, but the appendix is often not visualised after the first trimester because the gravid uterus displaces it upwards and laterally (hence flank pain). When ultrasound is non-diagnostic, non-contrast MRI is the next step: sensitivity and specificity are above 90%, there is no ionising radiation, and it also shows other causes (ovarian torsion, degenerating fibroid, hydronephrosis). Gadolinium is avoided because it crosses the placenta.
Want to try more FCPS Part 2 Surgery questions?
Start with 30 free questions from the same QBank, each with a full explanation, then unlock the full bank when you are ready.
Fee and 2027 dates
| Item | Details |
|---|---|
| Exam fee | Rs 15,000 plus Rs 50 handling charges (Rs 15,050) |
| Late fee | Charged after the normal closing date; see the CPSP notice |
| Withdrawal | 75% of the fee is refunded if you withdraw by the deadline |
| Theory dates 2027 | 16 February and 17 August 2027 |
| Theory centres in Pakistan | Karachi, Hyderabad, Larkana, Quetta, Multan, Lahore, Faisalabad, Islamabad, Peshawar and Abbottabad |
| Theory centres abroad | Riyadh, Kathmandu and Birmingham (Solihull) |
| Clinical exam | Pakistan only; venue announced after the theory result |
Fees and dates are those CPSP has announced for the current cycle. Always confirm them in the latest notice before paying.
Results and attempts
After you pass the theory, you can appear in three of the next four consecutive clinical exams, counting any you miss, and the first clinical attempt is mandatory. If you do not pass within these chances, you need to pass the theory again.
Once you pass, CPSP awards the FCPS fellowship. Many fellows go on to work in the Gulf, where each country has its own licensing exam; see our guides to the DHA Dubai exam, the QCHP Qatar exam and the Saudi licensing exam.
Frequently asked questions
How many MCQs are in the FCPS Part 2 Surgery exam?
The theory has two computer-based papers, each with 100 single best answer MCQs, so 200 questions in total. Each paper lasts two and a half hours.
What is the fee for FCPS Part 2 Surgery?
Rs 15,000 plus Rs 50 handling charges, so Rs 15,050. A late fee applies after the closing date.
When is the next FCPS Part 2 exam?
For Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology and Ophthalmology, the 2027 theory exams are on 16 February and 17 August 2027.
Is a published article required for FCPS Part 2?
Yes. CPSP requires one original article based on your approved synopsis, with you as first author, in an indexed journal with an impact factor or an HEC W or X category journal. It must be on the e-portal at least three months before the exam.
How many attempts do I get at the clinical exam?
After you pass the theory, you can sit three of the next four consecutive clinical exams, counting any you miss, and you must take the first one.
What happens if I pass the TOACS but fail the cases?
A TOACS score of 60% or more carries forward, so you can go straight to the long and short cases next time while your theory pass is valid. A score of 55% to 59% lets you sit the cases only in the current exam.
Which book is best for FCPS Part 2 Surgery?
Bailey and Love is the core text for most candidates, with Sabiston or Schwartz for depth, the ATLS manual for trauma and a clinical methods book for the long and short cases.
Further reading
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