FCPS Part 1 Paper 2 for Surgery & Allied: what to study
Paper 2 for the surgery group takes Paper 1 science and applies it to surgical patients: regional anatomy, fluids, wound healing, surgical pathology, oncology and the drugs surgeons use.
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How Paper 2 differs from Paper 1
Paper 1 is common to every candidate and tests the basic sciences. Paper 2 is where the groups separate. For Surgery & Allied, the same basic sciences come back, but each question now has a surgical patient in it.
A Paper 1 question might ask which nerve supplies deltoid. A Paper 2 question asks what a patient cannot do after a surgical neck fracture of the humerus, and why.
So Paper 2 rewards applied knowledge: knowing the science well enough to use it at the bedside and in theatre.
The areas that matter most
Applied regional anatomy
- Head and neck: thyroid relations, recurrent laryngeal nerve, parotid and facial nerve, neck triangles, airway procedures.
- Thorax: chest drain site, diaphragm openings, mediastinum, breast lymphatics.
- Abdomen: inguinal canal and hernias, peritoneum, blood supply of the gut, portal system.
- Pelvis and perineum: pelvic floor, prostate, rectum and anal canal.
- Limbs: nerve injuries by fracture site, compartments, vascular access.
Applied physiology
- Fluids and electrolytes: maintenance needs, losses from vomiting and fistulas, potassium and sodium correction.
- The metabolic response to injury: ebb and flow phases, hormonal changes.
- Shock: classes of haemorrhage, compensation.
- Blood: haemostasis, transfusion and its complications.
- GI physiology: swallowing, gastric emptying, absorption after resections.
Surgical pathology
- Inflammation, repair and wound healing: phases, factors that delay healing, keloid.
- Surgical infection: wound classes, organisms, sepsis, necrotising fasciitis.
- Common surgical conditions: gallstones, pancreatitis, obstruction, appendicitis, GI bleeding, hernias.
- Vascular disease: atherosclerosis, aneurysms, DVT, varicose veins, leg ulcers.
- Specimen handling: biopsy types, frozen section, fixation.
Surgical oncology
Each major cancer has a predictable set of questions: risk factors, spread, tumour markers, the key investigation and the operation.
- Head and neck, thyroid and brain tumours
- Lung, oesophagus and stomach
- Liver, pancreas and biliary tree
- Colorectal cancer and polyp syndromes
- Kidney, bladder, prostate and testis
- Breast
- Bone, soft tissue and skin
Drugs in surgical practice
Antibiotic prophylaxis, analgesics, anaesthetic agents, muscle relaxants, IV fluids and nutrition, inotropes, antithyroid drugs, antiseptics, and anticoagulants with their reversal.
A suggested order
- Finish Paper 1 anatomy and pathology first. Paper 2 builds directly on them.
- Fluids, shock and the metabolic response. These underpin many applied questions.
- Wound healing, infection and sepsis.
- Regional anatomy, one region a week, alongside the common surgical conditions of that region.
- Oncology, one system at a time.
- Surgical pharmacology last, as it ties the other topics together.
How to use questions
Paper 2 questions are longer and often clinical. Two habits help:
- Read the last line first. Know what is being asked before you read the story.
- Name the topic behind the question. A question about a patient vomiting after pyloric stenosis is really a question about metabolic alkalosis.
After each wrong answer, read the full topic, not only the explanation. One applied topic, such as the inguinal canal, usually holds four or five future questions.
Common mistakes
- Studying Paper 2 as clinical surgery from a ward handbook. The paper asks about the science behind surgical practice.
- Leaving oncology until the end. It is large, and each cancer has its own markers and operations.
- Ignoring pharmacology because "surgeons do not prescribe much". Prophylaxis, analgesia, anaesthesia and anticoagulation come up regularly.
Where FCPS-1 Prep fits
The FCPS-1 Prep question bank has a dedicated Surgery & Allied Paper 2 set alongside the shared Paper 1. Every question explains each option and links to a full topic review, so you can move from a missed question to the whole topic in one click.
Read next: Medicine vs surgery group · Anatomy high-yield · Study plan
Frequently asked questions
Is Paper 2 harder than Paper 1?
It is different rather than harder. The science is the same, but questions are more clinical and assume you can apply it.
Should I start Paper 2 before finishing Paper 1?
Finish the core of Paper 1 anatomy and pathology first. Paper 2 makes much more sense once those are in place.
Do I need surgical textbooks for Paper 2?
A standard surgery textbook helps for oncology and surgical conditions, but keep the focus on mechanisms, anatomy and pathology rather than operative detail.